ASSERTIVENESS

Assertiveness is the ability to express one’s feelings and assert

one’s right while respecting the feeling and rights of others.

Assertive communication is direct, open and honest and clarifies

one’s needs to other person. Assertiveness comes naturally to
some, but it is a skill that can be learned. People who have
mastered assertiveness are able to greatly reduce the of
interpersonal conflict in their lives, thereby reducing a major
source of stress.

BEHAVIOUR THERAPY

Behaviour therapy may be defined as attempt to alter

beneficially human behaviour and emotions by the application of
laws of modern learning behaviour.

ASSERTIVENESS TRAINING

It is a behaviour therapy technique in which the patient is given

the training to bring about change in emotional and behavioural
patterns by asserting himself. In other words one is encouraged
not to be afraid of showing an appropriate response, negative or
positive to an idea or suggestion. Many people hold back their
feelings. The assertive behaviour training is given by the
therapist, first by role playing and then by practice in real life
situation. Attention is focused on more interpersonal skills

IMPORTANCE OF ASSERTIVE TRAINING

Assertiveness affects many areas of life. Assertive people tend to

have fewer conflicts in their dealings with others, which
translates into much less stress in their lives. Having stronger,
more supportive relationship virtually guarantees that they have
people to count on, which also helps in stress management, and
leads to healthier life.

Contrasting with this, aggressiveness tends to alienate others

and create unnecessary stress. People who are aggressive have
failed relationship.

ASSERTIVE COMMUNICATION

Assertive behaviour helps to feel good about ourself and increases

our self esteem. It helps us to feel good about other people. Honesty
is basic to assertive behaviour. Assertive honesty is not an out
spoken declaration of everything that is in one’s mind.

Direct communication is stating what one wants with clarity.

Communication must occur in appropriate context to be
considered assertive. The location, timing and manner in which
the communication is presented must be correct for the situation.

BASIC HUMAN RIGHTS

There are 10 basic assertive rights;

1. Right to be treated with respect.

2. Right to express feelings, opinions and belief.
3. Right to say NO without feeling guilty
4. Right to make mistakes and accept the responsibility for them.
5. Right to be listened and to be taken seriously.
6. Right to change your mind.
7. Right to ask what you want.
8. Right to yourself first, sometimes.
9. Right to set your own priorities.
10. Right to refuse justification for your feeling or behaviour.

ADVANTAGES OF ASSERTIVE BEHAVIOUR

1. It helps us feel good about ourselves and others.
2. It leads to the development of mutual respect with others.
3. It increases our self esteem.
4. It helps us achieve goals.
5. It minimizes hurting and alienating other people.
6. It reduces anxiety.
7. It protects us from being taken advantage off by others.
8. It enables us to make decisions and free choices in life.
9. It enables us to express both verbally and non verbally, a
wide range of feelings both positive and negative.
10. Helps manage stress.
11. Freedom from internal conflicts.

DISADVANTAGES OF ASSERTIVE BEHAVIOUR

1. At times if not properly conveyed, then one considers it to be

rude.
2. It can also reflect over confidence.
3. One may appear to be arrogant.

RESPONSE PATTERNS

Individuals develop patterns of responding to others. There are

four response patterns;
1. Non-assertive
2. Assertive
3. Aggressive
4. Passive aggressive

NON-ASSERTIVE BEHAVIOUR

Individuals who are non assertive seek to please others at the

expense of denying their own basic rights. They come across of
being very apologetic and tend to be self deprecating. Their
voices are hesitant, weak and expressed in a mono tone. Their
eyes are usually downcast, all they want is to be pleased and
liked by others. Their behaviour helps them avoid unpleasant
situations and confrontations.

ASSERTIVE BEHAVIOUR

Assertive individuals stand up for their own rights while

protecting the right of others. Feelings are expressed honestly
and openly. They assume responsibility for their own choices
and allow others to choice for themselves. They maintain self
respect and respect for others. Their voices are warm and
expressive, and eye contact is intermittent but direct.

AGGRESSIVE BEHAVIOUR

Individuals who are aggressive defend their own basic rights by

violating the basic right of others. Feelings are often expressed
dishonestly an inappropriately. Aggressive individuals devalue
the self worth of others on whom they impose their choices.
 They express an air of superiority; their voices are
often loud, demanding, angry or cold without emotion.
Aggressive behaviour hinders inter personal relationships.

PASSIVE AGGRESSIVE BEHAVIOUR

Passive aggressive individuals defend their own rights by

resistance to social and occupational demands. These individual
are manipulative and sly and they undermine others with
behaviour that expresses opposite of what they are feeling.
They are highly critical and sarcasting. They allow others to
make choices for them, then resist by using passive behaviour
such as procrastination, dawdling, stubbornness and
forgetfulness.

They use actions instead of words to convey messages. The

goal is domination through retaliation. Their behaviour offers a
feeling of control and power. They possess extremely low self
confidence.

ALBERTI AND EMMONS (1980) defines assertive behaviour as

“Behaviour that enables individuals to act in their own best

interest, to stand up for themselves without undue anxiety, to
express their honest feelings comfortably, or to exercise their
own rights without denying the right of others.”

BEHAVIORAL COMPONENTS OF ASSERTIVE

BEHAVIOUR

ALBERTI and EMMONS have identified several defining

characteristics of assertive behaviour.
1. Eye contact- eye contact is considered appropriate when it is
intermittent. Individuals feel uncomfortable when someone
stares at them continuously and intently.
2. Body posture- sitting and leaning slightly towards the other
person in a conversation suggest an active interest in what is
being said.
3. Distance/physical contact- the distance between two
individuals in an interaction or physical contact between
them has a strong cultural influence.
4. Gestures- non verbal gestures may be culturally related.
Gestures can add emphasis, warmth, depth or power to the
spoken word.
5. Facial expression- various facial expressions convey
different messages (frown, smile, surprise, anger etc).
6. Voice-the voice conveys the message by its loudness, softness,
degree and placement of emphasis and evidence of emotional
tone.
7. Fluency- being able to discuss a subject with ease and with
obvious knowledge conveys assertiveness and self confidence.
8. Timing- assertive responses are more effective when they are
spontaneous and immediate.
9. Listening- assertive listening means giving the other
individual full attention by making eye contact.
10. Thoughts – cognitive processes affects one’s assertive
behaviour. two such processes are;
1. An individual’s attitude about the appropriateness of
assertive behaviour in general.
2. The appropriateness of assertive behaviour for himself or
herself specifically.
TECHNIQUES THAT PROMOTE ASSERTIVE
BEHAVIOUR
The following techniques are effective in responding to criticism
and avoiding manipulation by others.
1. Standing up for ones basic human rights.
Eg. “I have the right to express my opinion”
2. Assuming responsibility for ones own statements.
Eg. “ I don’t want to go out with you tonight”. Instead of it
“I cant go out with you tonight”. The latter implies a lack of
power or ability.
3. Responding as a broken record. Persistently repeating in a
calm voice what is wanted.
E.g. Telephone sales person “I want to help you save money by
changing long distance services”
Assertive response “I don’t want to change my long distance
services.”
4. Agreeing assertively –assertively agreeing negative aspects
about one’s self, admitting when an error has been made.
E.g. Mr. Jones “you sure let that meeting get out of hand.
What a waste of time”
Mr. Smith “yes, I didn’t do a very good job of conducting a
meeting today.”
5. Inquiring assertively – seeking additional information about
critical statements.
E.g. Male board member- “you made a real fool of yourself at
the board of meeting last night.”
Female board member –“oh really! Just tell what about my
behaviour offended you”
Male board member “you were so damn pushy”
 Female board member “were you offended that I spoke up for
my beliefs, or was it because that my beliefs are in direct
opposition to yours.”
6. Shifting from content to process – changing the focus of
communication from discussing the topic at hand to analyze
what is actually going on in the interaction.
Eg. Wife “would you please call me if you will be late for
dinner”
Husband “why don’t you just get off my back!”
“I always have to account for every minute of my time with
you”
Wife “sounds to me like we need to discuss some other things
here. What are you really angry about?”
7. Clouding/ fogging – concurring with the critics argument with
out becoming defensive and with out agreeing to change.
Eg nurse 1 “ you never come to the nurses association
meetings. I don’t know why you even belong.”
Nurse 2 “you’re right. I haven’t attended the very many
meeting”
8. Defusing – putting off further discussion with an angry
individual until he/she is calmer.
E.g. “You are very upset right now. I don’t want to discuss this
matter with while you are so upset. I will discuss it with you
in my office at 3 o’clock this afternoon.
9. Delaying assertively – putting off further discussion with
another individual.
E.g. “That’s a very challenging position you have taken, mr
brown. I’ll need time to give it some thought. I ll call you later
this afternoon.”
10. Responding assertively with irony –
E.g. man “I bet you are one of them so called women’s libbers,
aren’t you.”
Woman “why, yes thank you for noticing.”

OTHER TECHNIQUES OF ASSERTTVE TRAINING

1. Behavioral rehearsal – which is literally practicing how

you want look and sound. It is very useful technique when you
first want to use I statement.
2. Repeated assertion – this technique allows you to feel
comfortable by ignoring manipulative verbal side tapes.
Eg “I would like to show you some of our products.”
“No thank you, I am not interested.”
“I really have a great range to offer you”
“That may be true, but I am not interested at the moment.”
“Is there someone else who would be interested?”
“I don’t want any of these products”
“Okay, would you take this brochure and think about it.”
Yes, I will take the brochure.”
“Thank you.”
“You’re welcome”.
3. Negative enquiry- this technique seeks out criticism about
yourself in close relationship by prompting the expression
of honest negative feelings to improve communication.
E.g. “so you think that I am not interested”.
4. Negative assertion – this technique lets you look more
comfortably at negatives in your own behaviour. You
should accept your errors or faults, but not apologize.
 Eg “yes you’re right I don’t always listen to what you want
to say.”
5. Workable compromise- when you feel that you’re self
respect is not in question; consider a workable compromise
with the other person.
Eg. “I understand that you have a need to talk and I need
to finish what I am doing. So what about meeting in half
an hour.”

THOUGHT STOPPING TECHNIQUES

Assertive thinking is sometimes inhibited by repetitive negative

thoughts of which the mind refuses o let go. Individuals with low
self worth may be obsessed with thoughts such as, “I know he
never wants to go out with me. I am too ugly.”

This type of thinking fosters the belief that one’s

individual rights do not deserve the same consideration as those
of others, and it reflects non assertive communication and
behavioral response patterns.

Thought stopping techniques, developed by

psychiatrist Joseph Wolpe (1991) and are intended to eliminate
intrusive and unwanted thoughts.

METHOD

In a practice setting, with eyes closed, the individual

concentrates on an unwanted thought. Once the thought is
clearly established in the mind, he/she shouts aloud: STOP. This
action will interrupt the thought and is actually removed from
the awareness. The individual then immediately shifts one’s
thought to one which is more pleasant and desirable.

It is possible that the unwanted thought may soon reoccur. But

with practice the unwanted thought will be no longer intrusive.

ROLE OF NURSE

It is important for nurses to become aware of and recognizing

their own behavioral responses. Nurses who understand and use
assertiveness skills can in turn assist clients who wish to change
behaviour to increase their self confidence, and improve inter
personal relationship.

CONCLUSION

Assertiveness is very essential in our daily lives. We can’t get

things done if we are non assertive; of course we must ensure
that we are not aggressive. Whatever has to be said has to be
stated in clear and matter of fact terms and not in an abusive
manner.
 TOPIC – ASSERTIVE TRAINING

SUBJECT – MENTAL HEALTH NURSING

SUMITTED TO:
MR. ABHISHEK JACOB
SENIOR LECTURER
HOD PSYCHIATRIC NURSING
S.C.O.N SUBMITTED BY:
TINA C ABRAHAM
MSC NURSING 1ST YEAR
PSYCHIATRIC NURSING
S.C.O.N