Blog - Page 2 of 7 - Kate Gegg, AM, LCSW

March 16, 2023March 29, 2023

Pessimism

Pessimism is a coping strategy that protects us against the vulnerability of having hope.
Feeling hopeful leaves us open to potential disappointment or rejection. If we are fearful or avoidant of these experiences we are more inclined to rely on pessimism to protect us from experiencing them.
Our pessimism can blind us; it can limit our sense of the possibilities for ourselves and our future.
Many of us get stuck in a pessimistic stance without realizing it. To work towards recognizing pessimism in yourself, look out for rigidity; if it feels like you can’t imagine something would work, or something could change, or if it doesn’t feel worth trying, you may be approaching with pessimism.
While it’s okay to “start” with pessimism (if we are so inclined), it’s not recommended to end there. Instead, work towards integrating the counterbalance to pessimism, which is being realistic.
When we work towards being realistic we can see the possibility that the pessimistic outlook has some merit to it, but we can also hold hope and awareness that other outcomes are possible.
You’ll notice I’m not naming “optimism” as the counterbalance to pessimism. Optimism too is a strategy, one that can keep us hopeful, but can also limit our ability to see realistic barriers that might encroach on any given situation.
In its extreme, optimism can be a form of denial, while pessimism can be a state of hopelessness. It is helpful to try and step into you “optimistic” self to think through a scenario, as well as your “pessimistic” self. This can counter-balance rigidity and help pull you closer to a realistic stance.
It’s helpful to identify if a pessimistic stance comes intuitively to you as a first line response to an idea or potential pursuit so you can work on making use of it, and then counterbalancing it with a more realistic approach.
Ultimately, having a more realistic approach will not shield you from the vulnerability that comes with feeling hopeful or taking a chance, but it will enable you to make choices about when you are willing to enter a situation that involves risks (including the emotional risks of feeling rejected or disappointed).

For many of us, we have a pessimistic outlook as a way of insulating ourselves from the vulnerability we’d to feel if we allowed ourselves to hope. This is a tempting strategy to employ if we’ve been hurt, rejected, or disappointed in the past, and we can come to lean on our pessimism as a protective barrier between us and (potentially) feeling those feelings again.

Pessimism can be helpful because it enables us to think to through barriers to achieving a desired goal or outcome. It limits us when it interferes with our ability to assess an individual scenario based around its unique likelihood of coming to fruition. Pessimism also creates problems when it interferes with our ability to identify how valuable (and risk worthy) a pursuit is to us as individuals. When we rely on pessimism, our priority is often to shut down an idea or pursuit, often because we want to avoid a negative outcome (including feeling negative feelings).

An overly pessimistic stance can lead to feeling helpless and un-empowered. Pessimism can stop us in our tracks before we get started, and it can interfere with our ability to see genuine possibilities for ourselves and our future. It’s hard to act on your dreams (even ones that may be possible) if you’re a pessimist.

The antidote to pessimism is holding a realistic stance, one that holds awareness of why a situation might not work out *and* that there are other possible outcomes. When we’re realistic we can weigh the likelihood of success against our personal priorities and risk thresholds. To be clear, you can have a negative outlook on a situation and not be taking a pessimistic stance. Sometimes a situation is a long shot, or won’t work out, and you are realistically assessing the factors at play when you decide not to pursue it.

If you inclined towards pessimism, use it as a starting point and allow yourself to get in touch with the reasons why something may not work. Then, work to explore the potential for alternate possibilities and outcomes. At that point you can decide, based on your own personal thresholds, whether it’s worth it to you to take the emotional, social, financial, relational (etc) risk.

Comments:

If you are someone who relates to the notion that you want to protect yourself from negative emotions, I’d encourage you to read my prior posts on how all emotions (including negative ones) are useful and essential. The first covers how negative feelings are actually incredibly important tools to help us find long term happiness, and the second helps us better understand (and accept the need for) our anger.
The idea that pessimism serves a purpose is very linked to the concept of secondary gains, which are the positive aspects of something that is otherwise problematic in our lives.

November 9, 2022March 27, 2023

“It’s easier for everyone else”

This kind of of thinking, that life is easier for others and more difficult for us, is tempting at a time when we are hopeless or struggling to manage. The thought is often unhelpful, un-motivating, and channels our inner sense of helplessness. Here are a few counter-thoughts to hold onto that may help you approach these moments differently:
(1) Often times when we think “it’s easier” for others what we actually mean is “it’s intuitive” for others. Intuition develops with practice, modeling, and training (over time). Seen through this lens, over time and with practice, something new (and perhaps more helpful) could become intuitive to you too.
(2) Just because someone knows how to take care of themselves doesn’t mean they’ve had an “easy” journey to that point. Instead, it simply means they’ve found what works for them. Often times people who have the ability to cope have taken a path of learning and growth from prior struggles.
- This learning often means reflecting on whether or not our chosen (or perhaps automatic) coping methods truly help us, and holding a willingness to try new ways that may not be intuitive or comfortable to us (until we practice them again and again). The more we can learn and accept what serves us (and avoid what doesn’t) the “easier” coping becomes
(3) Sometimes when we get stuck on “it’s easier for them” what we’re really stuck on is a struggle with fairness; it isn’t that they are “coping better” its that they’ve got less to cope with. When we get preoccupied with “fairness” we are often fixated on factors outside of us, and we cannot resolve our personal pain from that orientation.
- Though we can always work to make to world more fair, we have to take care of ourselves in the interim. When we can take our experiences with unfairness head on, and can focus on what a lack of fairness has meant for us on a personal level (including our losses and pain) we can work to resolve pain around “unfairness” and its impact on us.
(4) Not everyone has the same triggers and sensitivities. What floors one person may feel manageable (i.e. “easy to cope with”) to another. Remember that what we struggle with is often a reflection of our prior experiences, with unresolved experiences tending to cause more pain than ones we have been able to work through and come to terms with.
(5) We don’t all feel our feelings with the same range and intensity. Some of us have much stronger and more intense experiences of all our emotions based on how our bodies process them. This means some of us may find ourselves in deeper emotional states than those around us; this is a more intense experience in life with positives and drawbacks.
(6) We can only see what people show us. Even if we’re highly skilled at reading people, we still can’t see it all. It may look “easier” because someone is invested in it “looking” easier, which doesn’t mean it is.

Regardless of how “easy” or “hard” life is, the truth is, coping comes more intuitively to some of us than others, and life does not evenly distribute objectively difficult times. Put simply, when we think about how “hard” or “easy” life is for us (or others), we are thinking in judgmental terms (i.e. we are using statements to evaluate rather than describe what we notice and observe). I have a whole series on how judgments limit us (see comments for how to find those prior posts), but big picture, today’s post illustrates just how much information we lose about what’s actually effecting us on a personal level when we rely on judgments instead of working towards describing, owning, and understanding a topic at hand.

In today’s post I offer six different ways to challenge how we can think more descriptively through how “hard” or “easy” our lives feel, and there are infinite other ways to deconstruct the judgment of “it’s easier for others”. The less we rely on judgmental statements (which often include easy, hard, right, wrong, good, bad, should, shouldn’t) the closer we can get to understanding, working through, and addressing what’s really upsetting for us.

If you found today’s deconstructions didn’t quite fit for you, think about how else you might say “they have it easier” without using the evaluative statements listed above. Once you can get to the heart of what you’re *really* upset about, you can then address whatever that is.

Next, your job becomes to resist to the temptation to rely on that familiar stance of “it’s easier for them” at a moment when you are struggling. This means challenging ourselves to be present in a different way and pointing your thoughts and energy in the direction that helps you deconstruct the judgment rather than burrow into it.

What may be tempting (or intuitive) to you, is to stay in the familiar “it’s easier for them” mindset, but we have to be responsible for turning our focus and attention elsewhere if we want to build new ways of coping. Eventually, pulling away from the judgement and going into our experiences may become intuitive, but it takes work, practice, intentionality, and time.

Comments:

Are you realizing you might lean on judgmental thinking? Learn more about how to recognize judgmental thoughts, dive deeper into understanding how they limit us, and get guidance on deconstructing a judgment from these linked prior posts.
One of the hangups I list (about fairness) is actually a different kind of hangup all on it’s own, called a “cognitive distortion” that will someday have its own post. If you related strongly to struggling around issues of “fairness” you may find it helpful to review this article that explains what a cognitive distortion is, and how to recognize and challenge it. You may also benefit from working to challenge “shoulds” (Like it should be just as easy for me as it is for her, life should be more fair etc). Big picture, issues of fairness are incredibly complex, and, if fairness is a value we hold, we are often best served to make our decisions through the lens of that value rather than to expect the world to abide by fairness as a “rule” or “law”. This relates somewhat to another post I have on how “fairness” can effect us, which may also be helpful to dive into.
Today’s post, in addition to include the “non-judgmentally” mindfulness still, also includes applications of the “effectively” mindfulness skill and the “willing” and “Turning the Mind” distress tolerance skill from Marsha Linehans DBT Skill’s training manual (Full Citation: Linehan, M. M. (2014). DBT (R) skills training handouts and worksheets, second edition (2nd ed.). Guilford Publications.).

October 26, 2022March 27, 2023

Distraction

Many of us know of the concept of distraction, not all of us know how to do it properly. Distraction, (when used carefully, judiciously and intentionally) is an essential coping skill in times of duress.
Many of us feel uneasy about distraction, because we aren’t solving “the problem”, when we use it. Instead, when we distract, we are giving our brains another focal point, for a period of time, that will enable us to take a break from the intensity of whatever we are distracting from.
If we can truly distract, i.e. truly sink in with our whole thinking and feeling world to something aside from what is distressing us, we often come back to that same thing at a later point (even hours later) feeling more refreshed and able to handle it.
Think about how you feel when you wake up after you’ve been upset. Often times you feel more distance, or are able to to have “new” thoughts or feelings about the same topic, even though you haven’t “done anything” directly to solve the problem.
We want distraction to be intentional: really sink in with your whole self, if, in the corners of your mind you’re still thinking about “it” (whatever you’re trying to distract from), you’re not distracted.
Properly distracting often includes refocusing yourself (again and again) on your distraction, or (if that doesn’t work) accepting your distraction is not stimulating enough and finding a higher intensity distraction to keep your mind off an activating topic.
To stay distracted: “leave” the situation. You may have to do this repeatedly. This can be done physically (literally leave an activating location), cognitively (when you notice yourself drifting into thoughts about “it” re-direct your attention), and through imagery (imagine the topic separate from you – in a box, on the other side of a wall etc).
We want distraction to be judicious: Use it only for brief periods of time (hours, maybe days depending on the urgency of the situation at hand). If we stay distracted from our problems we have actually shifted into avoiding them.
We have to police ourselves when we distract, only we know if we’ve drifted back and only we can refocus our attention. A major key to using distraction effectively is remaining invested in the need for distraction when we’ve chosen to use it as our coping skill.
Distraction can be anything as long as it (1) engages your whole self in a direction different than the topic you are distracting from and (2) doesn’t become a covert way of keeping yourself in the experience you are trying to distract from. More in today’s post about how to effectively distract.

Distraction is one of the key Distress Tolerance skills Marsha Linehan lays out in her Dialectical Behavior Therapy (DBT) Training manual. There are many ways to distract:

Activities: i.e. “doing” something else. Ideas: watch TV or a movie (be careful on the topic so it meets the criteria above), talk to a friend about something other than the topic at hand, read a book (it may be too hard to focus for some, if so, try something more stimulating), go out for a walk or run (but don’t think about the topic).

Emotions: Create different emotional experiences for yourself beyond the one that you are distracting from. To do this, you need to first identify how you are feeling and then dive into a different emotional state (perhaps through TV, conversation with others, music, books etc).

Thoughts : Try something that challenges your brain, like a crossword, mystery, or puzzle.

Contributing and Comparisons: The idea with these two is to extend our focus to people and situations beyond us and the issue troubling us at the moment. With contributing, you do an activity that is nice for someone outside of you, to help you feel like you’ve made a positive impact on another person or situation.

With comparisons, we are reminding ourselves of the full spectrum of human experience as a way to help ground ourselves in our awareness of where we fall on that spectrum. The key with comparisons is to leave the comparison with an awareness that that things have been different for us, and could be worse (which doesn’t mean they aren’t bad now). This means you can think about others coping worse than you in that moment, others in worse situations, or compare how you feel now to a time when you felt different (to remind yourself that you too will feel different some day). We need to resist the temptation to compare to someone in an enviable situation, that will not help.

When we use comparisons properly we often find we feel more grateful for our lives, communities, resources and strengths. We have to be very careful not to go to a shaming, judgmental or envious place, otherwise we can invalidate ourselves (it’s worse for him, that means I shouldn’t be so upset).

Think like A Therapist

“How do you do it?” i.e. “How do therapists spend all day listening to the emotional duress of others?”. Our training includes tools and perspectives that enable us to listen with a buffer. Read more if you too want to learn more about not taking other’s struggles home with you.
One (but not the only) reason folks often struggle to tolerate painful emotions is because it triggers a “fix-it mode” in us that leaves us wanting to take action in a way that makes the situation better. The trouble is, we can’t “fix” all situations in life and emotions are not light switches that can be turned on and off.
So, we need perspective one: You cannot stop someone (yourself included) from feeling their feelings. Take that pressure off of yourself and the situation. We can distract or ground at times of emotional intensity, but big picture what alleviates negative feelings is learning how to tolerate, work through, release, and ride them out.
Learning how to have a sustainable relationship with our emotions can take time (and therapy), though we can channel our desires to “fix-it” into efforts to connect, which can help someone struggling feel better even if a problem remains. This means offering the person in duress (you included) genuine empathy, compassion, validation, and support.
To offer that softness we need perspective two: Trust that the emotions are valid, even if we don’t fully understand them. Fighting or denying negative emotions often interferes with the process of releasing them in ourselves, and spurs disconnection and the experience invalidation (which creates a whole other host of problems) in others.
Big picture: release the idea that negative feelings are “bad”, “avoidable”, “problematic” etc. For us to be happy and satisfied we need to accept that negative feelings are a part of life, and it is our job to learn to sustainably live with both our negative and positive feelings.
Holding these perspectives when we (or others) are struggling means our “job” becomes less about “doing” (i.e. fixing or problem solving) and more about “being” (i.e. trusting, connecting and listening). This takes pressure off the situation and often makes listening and tolerating easier and less stressful for all parties.
Therapists are also comforted by their trust in the therapeutic process and see pain (and safely working through it) as a necessary part of the journey to a happier and more fulfilled life. This helps anchor us in those difficult moments; we know your pain and working through it is a necessary step along the way to feeling better.
If you too can try and develop that trust that you (or others) will make it though, you might find you feel safer, less frantic, and more comforted at difficult times. You may need to actively remind yourself or others that you can and will feel better some day – and that you have felt better in the past, even when it felt inaccessible at the time.
Lastly, we therapists know that the more we work through pain points in our lives, the less other people’s pain points trigger us. This is called widening our window of tolerance, and it means we can, over time (and often with therapy) learn how to be with intense feelings in a manner that doesn’t overwhelm us.

I get asked all the time, “How do you do it? How do you sit with people’s emotional pain as your job?” “Doesn’t it exhaust you, doesn’t it burn you out?”. Today, I am attempting to answer that question, and share some of the tools us therapists use to manage our work of sitting with painful topics. While this isn’t training on how to be a therapist, if you can adopt the perspectives in this post you may find yourself more at peace with your negative feelings, and more able to stay present, supportive, and connected to others when they are struggling.

When our relationship with our emotions is working well, emotions come and go. When we struggle with our emotions it’s usually because we have some hangup in the process of finding, feeling, accepting, and releasing our emotions. Big picture, our job, as your therapist, is to help you learn how to process through your thoughts and feelings so you can eventually do that work outside of therapy (without us). For that reason, us therapists are often looking for opportunities to accompany you alongside your painful emotions so you can experience, with support, your emotions in a manner that helps you productively work through them, learn from them, and make use of them.

For this reason, your therapist is not afraid of your emotions or the intense feelings and reactions you have to your life. In fact, it’s the opposite; your therapist is actually actively looking for those “pain points” and is working to help you process through (rather than avoid them or linger over them). It’s ok to need help in this process, that’s why we therapists exist. Not everyone has the intuition, models (or both) for how to have a constructive relationship with our feelings.

If you struggle with others painful emotions, try and be curious with yourself about what may be happening, and explore whether or not you truly buy into the perspectives in this post. More often than not, our struggles tolerating others pain comes from our own difficulties with accepting that negative emotions, and learning to be at peace with their existence, is a necessary fact of life.

Comments:

Today’s topic is complicated. While we aren’t “therapists” for our friends and family members, to have close relationships we do need to be able to hear people’s struggles in a manner that is sustainable for us, and that doesn’t put the burden of their problem on us. At times, in relationships, folks look to others to solve their problems for them or to take accountability they themselves don’t take. This helplessness can be a problem, quite separate from any discomfort we may hold listening to the struggle of another person. Today’s post is simply meant to help offer a handful of perspectives that might help you be more at ease when someone is sharing their struggles with you.
There are other ways us therapists manage the emotional intensity of our work too (things like only seeing a certain number of clients a day, or a week, etc). When we struggle, we often seek out consultation to make sure we’re offering what our clients need from us. There are many other ways we take care of ourselves in our job. Don’t expect that holding these perspectives is all that a person would need to tolerate an emotionally difficult topic, just know that holding these perspectives helps.
Remember to trust your intuition, if you are listening to someone and really feeling like they are struggling too much, or are in a major crisis – this is a time to reach out to professionals for help. We therapists don’t exclusively rely on “trust in the process”, we also call in for extra help and supports (like medications, hospitalizations, outside consultation for us to get a second opinion on our work with a client) when needed.
In your own therapy (if you’re in it) be curious about temptations you have to withhold from your therapist due to concerns with “burdening” your therapist with too much. One of the points of the therapeutic relationship is to have a safe place where you feel unrestricted in your ability to share whatever pain or hardship you are enduring. If you find yourself withholding, talk to your therapist about your fears that what you’re experiencing may be “too much”. There is probably a lot of fertile ground and opportunities for healing for you to explore what “too much” is, how you know if you’re “too much” and how you perceive in others cues that you’re “too much” for them. For more on this, I have a whole post on the things we don’t say in therapy, and how that effects from treatment .
I talk about the importance of going through stages of processing with your emotions. For more about how emotions “work” when they are “working well” see my posts explaining emotions and their brevity.
Unclear what I mean when I say we need to learn from our feelings? See post about how emotions are like traffic signals.
I mention the window of tolerance in this post, a foundational framework for understanding what a constructive relationship with our inner wold looks like.
Brene Brown has a great little video on the power of connecting through empathy, and how we can help alleviate emotional struggles by being empathic with one another. In addition, if find you have a difficult time accepting the pain of others I have another post that may help you dig deeper into what’s happening as you try and tolerate another’s trauma.
I talk about the connecting nature of offering validation in this post. I have another post on why validation is important.
I mention that sometimes emotions are too intense to be present with, and we need tools like grounding and distraction. There are a host of distress tolerance skills that can help at times of emotions intensity. More to come in future posts.

April 29, 2022March 27, 2023

Insight and Reflection

Usually people start therapy (or struggle) because there is some ongoing dynamic they can’t solve or change. Things like: “I can’t find a partner”, “I don’t have great relationships with my friends”, “I’m angry all the time” etc.
The journey then begins to try and uncover the mystery of what may be happening. The starting block of this understanding is reflecting – i.e. getting in touch with thoughts and feelings (and perhaps putting some patterns together that can help you better understand what has happened and why).
But for many, developing insight, which is awareness into how our way of being effects those around us (and subsequently our relationships), is desperately needed to inform a sense of direction, yet is inaccessible to discover (or accept) – perhaps because it requires a level of vulnerability from us.
To develop insight there needs to be a willingness to see ourselves outside of our rationalizations, explanations, and justifications for why we behave the way we do. It requires a willingness to see parts of yourself you like and don’t like and to examine how those parts of you effect others and your relationships.
Very often, a reflective stance (where we get in touch with thoughts and feelings) is confused with an insightful stance (where we understand our impact on others). Having the capacity to reflect can lead to insight, but we can spend a lot of time reflecting and still not seeing how we are participating in creating outcomes in our lives.
An example: Imagine it’s hard for me to open up because I fear rejection. When I am reflective I’m aware of my fear of rejection and being hurt. I might explore the current impact of prior experiences of rejection. When I’m insightful I’m aware my guarded nature creates a wall between me and others making it difficult for others to get close to me.
When we can see how we effect others, we can start to see how we may inadvertently get in our own way. We can use the knowledge we gain from our newfound insight into our impact on others to help us experiment with making changes that will enable us to relate to those around us in ways that are more likely to lead to the outcomes we want.
In our example, I might need to take a leap of faith and work towards being more vulnerable with others in spite of my fears. This path might not otherwise cross my mind given my fears of rejection if not for my insight that the ways in which I withhold from others creates a barrier to having the close relationships I want.
We can “hold on” (internally) to our insight about what changes are needed as a guiding path at those times when we realize there is a disconnect between what we want in our relationships with others and how we participate in them. That insight can anchor us to help us muster up the bravery to try something new.
More in today’s post about how to build insight and the differences (and links between) reflection and insight.

People come to therapy with a lot of beliefs and assumptions about “what it’s supposed to be like”. For many people that includes some version of getting in touch with and processing their thoughts and feelings, revisiting and processing formative moments in their lives, and making connections about what’s happening now and what has happened in the past.

All of these are excellent uses of therapy and can be the building blocks of developing insight. Folks can get stuck, however, in therapy (and in life) when they struggle to more directly work towards taking that next step, which is building insight and awareness into how they effect others, the environment around them, and how they participate in the outcomes they have experienced in their lives.

When we are busy justifying, defending, or rationalizing we often too wrapped up in ourselves to notice how we may be effecting others and the outcomes we experience. To be insightful we need look at the facts of how we treat others from a perspective that isn’t informed by all the awareness we hold about how or why we are justified in doing or saying what we do or say. Empathy can be a component of self-awareness: imagine yourself in the shoes of the other party and think about how you might react toward you if you were on the receiving end of your own words or actions (without the internal information you hold that informs your decisions to treat others or behave the way you do).

To try and build more insight get invested in the idea that you are likely effecting and contributing to the outcomes in your life, even if you don’t want that to be the case. Ask yourself, “how have I participated in this?” What might I be communicating with my action / inaction, tone, body language, or responsiveness?”. Pay attention to dynamics like reciprocity. Ask yourself how much trust or suspicion informs your stance in a relationship. Although others can’t read our minds, they can pick up on cues from us that inform the dynamic between us.

Reflection and self-awareness are different from one another, but both important in understanding yourself, making changes in your life, and improving your relationships.

Comments:

Insight and self-awareness are used interchangeably in this post, and some would call “insight” holding an awareness of your thoughts and feelings. I’m using the term reflection to refer to having awareness of your inner world, and insight to have the awareness of your impact on others as a way to highlight the different nature of these two components of emotional and relational awareness.
What I hope we can avoid here is too much confusion around semantics. I’m less concerned that you pin point when you are reflecting versus demonstrating insight, and am more interested in having you be invested in both, seeing the value in both, and recognizing an opportunity to incorporate both into your life (and – if applicable – your therapy). I’m also not communicating that reflecting is “inferior” to insight. Reflecting is important because it helps us find patterns, make connections, and get in touch with our inner world; it’s valuable in and of itself.
One thing that’s a bit tricky about building insight is we aren’t often told (directly) by others how we are impacting them or the community around us – people don’t usually say “you’re not getting that promotion because you can’t collaborate well and take in others ideas and so others around you see you as controlling and domineering” it’s often more like “we’re looking to see you continue to grow and work as a teammate with your colleagues, try and work on delegating”. So we have to do a bit of intuiting and piecing together based on patterns we observe and feedback we do get. This can run right into predispositions we hold to make assumptions or read situations based on our histories, so sometimes our attempts to build insight can be thwarted because we are trying to understand how we may be effecting others without necessarily having all the information. A tip here: Ask a safe, nonjudgmental person in your life for their honest feedback if you have a theory about how your way of being might effect them (or others). Another tip: Take a look at how you act/behave and what you say, and then work to observe how others around you handle similar situations (and how folks respond to them). You can learn a lot from watching what works (and doesn’t work) for others. I personally had a very transformative experience once when I went into a store and silently watched how a friend handled a return (in a way that was foreign and un-intuitive to me, but effective). There can be small teaching moments for us to tap into in our lives if we are looking to make use of them.
A potential blockage to self-awareness / insight?: Anxiety or Depression. In our efforts to cope with our emotional state we may start to ask for things like reassurance, only be comfortable interacting under certain conditions, have difficulties tolerating conversations where others don’t agree with us etc. Ultimately, all of that effects our relationships with others AND simultaneously feels necessary for us to cope with our emotional state. This is where learning new coping skills can come in very handy (once we have a sense of how our response to our symptoms is effecting others and our relationships).
You can think of “coping by distancing” as an example of a time when our thoughts, beliefs, and coping mechanisms may effect those around us in an unintended manner. Another example of us coping in a manner that might negatively effect our relationships is displacement.
This post encourages you to make changes. This post is full of tips on making changes in a sustainable manner.
For more on how we can inadvertently participate in creating outcomes in our life see my post on cyclical psychodynamics.
Looking to try and build more awareness into how your thinking informs how you approach others and problem solving? See my post on Internalizing and Externalizing.

April 15, 2022March 27, 2023

Why We Need Coping Skills

It’s not uncommon for many people, mental health professionals included, to think of coping skills as “a crutch”.
Many folks get stuck because they hold beliefs that they (or their patients) “should be able to feel their feelings as they are”, rather than accept that people may need to learn how to tolerate their emotional world through the use of moderators (like coping skills) that make emotions tolerable enough for us to be present with and then make use of.
We all have varying levels of skill at interfacing with our emotional world constructively. Those of us that didn’t have strong models for accepting, managing, and constructively expressing emotions are more likely to need to learn coping skills. Those of us that had them modeled for us are likely to find the tactics and concepts intuitive.
When we are not as skilled at naturally accessing our emotions in a constructive manner we may feel overwhelmed by them or numb and unable to be in touch with them. This is where the intentional use of coping skills tailored to you and your individual strengths and needs come in.
Those that struggle with flooding / emotional overwhelm may need distraction and present centered coping mechanisms (like grounding or meditation). Those that struggle with finding and feeling their emotions may need embodiment based coping skills like body scans, or deep breathing which help you connect more sustainably to yourself.
Even if you have strong emotional regulation skills (whether they were learned or came to you intuitively) there are also conceptual coping skills that are useful for everyone to learn and practice that help improve relationships with others, your relationship with yourself, and your communication.
There are many conceptual coping skills (see comments for ones I have covered in this account). An example: approaching a situation from a nonjudgmental stance. Instead we work to be descriptive and in doing so reduce the likelihood that judgments get in the way of our ability to get to the core of our reactions, preferences, values, and needs.
Other conceptual coping skills include acceptance, (where we work to acknowledge the limits of our control, and the reality – as it really is – in front of us) and willingness (which means openness and readiness to interface with your situation in in a manner that has your short and long term goals in mind).
Many of us get stuck because our life long way of doing things, feeling our feelings, problem solving, and addressing conflict feel like a core part of us – just who we are and how we are. But, if we can be open to expanding our approach, and integrating coping skills we can change lifelong patterns that haven’t served us.

One of the things I encourage in my practice, as well as in this account, is being able to live in harmony with your inner world, which does require an ability to tolerate your feelings and respond to them in a constructive manner. However, many of us get stuck because we don’t know how to feel our feelings without ruminating (I.e. keeping them activated in a cyclical manner without working though them); or some version of numbness (where we can’t feel our feelings and experience ourselves as cut off from them).

When we struggle to have a harmonious relationship with our feelings we can get pushed out of our window of tolerance to a place where our thinking world and our emotional world cannot work together. At those times, it is difficult to step back and get to a reflective place where we can notice, make sense of, feel AND think through what may be happening in an integrated manner.

A lot of therapists and self-help books encourage you to “feel your feelings”, which yes! We need to do. But we need to do so constructively and in a manner that helps of make use of them. Our emotional worlds can be chaotic and overwhelming; coping skills are tools that help us manage, navigate, and make use of our emotions in a constructive manner so they don’t overpower us.

There are in the moment coping skills like deep breathing or body scans that help to alleviate the intensity of emotion, or help us get in touch with our emotions. There are also conceptual coping skills that are windows through which we are work to see our lives, relationships, responsibilities and goals. When we use conceptual coping skills we are shifting our mindset so we can respond to the moment with what the moment needs, and what we need to bring about long and short-term success.

Often, once we’ve developed a regular practice with coping skills we actually have an increased tolerance for our capacity to feel our emotions at depth; this is because we know and trust we can feel deeply without being overrun. Our therapies, relationships, capacity for vulnerability and communication are all positively effected because we can fully feel our feelings, think and reflect in an integrated manner.

Comments:

*For the mental health professionals out there*: you may recognize this post as talking about the division we so often see between the cognitive / behaviorally oriented treatments and psychodynamically / relationally oriented treatments. I hear time and again how there is this divide in the field, often with skepticism about the validity of the treatment the other party offers. From my perspective, folks who are seeing limited progress from the relationally or psychodynamically based approaches may need some of the coping skills I describe in this account that fall into the behavioral or cognitive category. The coping skills provided by those interventions can create internal safety for our clients, which eventually enable them to lean more fully in to the psychodynamically and relationally oriented treatments which often require a level of collaboration and openness that may not be accessible without having some core distress tolerance, emotional regulation, and cognitive challenging skills. Similarly, clients who have solely done skill building work may eventually benefit from the insight oriented and relationally based work of a more psychodynamic and relational oriented therapy; having the tools to tolerate their inner world may enable them to not just use skills, but to work to begin to relate and connect to others (and them selves) in new and more effective patterns. It is not uncommon for me to work with psychodynamically oriented clinicians and see their “stuck” patients for skill building. Similarly, for my clients who I work with from a more relational or psychodynamic perspective, sometimes our work needs to shift into skill building to tolerate the depth of the insight oriented work. It doesn’t need to be either/or!
*For folks in therapy that feel stuck*: Talk to your therapist about the style of therapy they are doing with you! Do you feel like you can’t think / feel / reflect at the same time? You might need something more concrete from your therapist to get you adequate coping skills to handle what arises in your life. Alternately, do you feel you have great coping skills, but haven’t seen the kind of pattern change you would like? Talk to your therapist about looking at patterns and doing insight oriented work to help break old patterns that are no longer serving you.
I briefly mention “non-judgmentally” in this post. I have three extensive posts on this. If you (and most of us do) struggle with judgments please read further on how to take a nonjudgmental stance, how to deconstruct judgments, and the problems judgements create for us .
More here on a conceptual coping skill on finding balance in relationships, and effectively considering ourselves and others (at the same time).
For Communication coping skills to reduce conflict see this post on taking a pause from conflict; this post on patterns to avoid in your relationship and in conflict.
For help with the conceptual coping skill of acceptance see, more here.
For help with tolerating very difficult times see a collection of coping skills under the acronym IMPROVE.
For help with learning how to be in the present (which is useful if you are prone to flooding or disconnecting) see posts on being one-minded; meditation, and for newbies to meditation I’d encourage you to start with introductory meditation for mental health.
This post contains a fusion of perspectives from attachment theory (which prioritizes finding safety), DBT (which emphasizes the role of therapist as both supporter and teacher), and mindfulness based therapy. For more reading on any of these topics see Daniel Siegel’s mindsight (which goes into more depth on the impact of leaving the window of tolerance), Marsha Linehan’s textbook on DBT (this book is VERY dense and is a textbook used in graduate level classes), and David Wallin’s Attachment in Psychotherapy which is meant for clinicians but is more accessible to a non-clinician audience than the Linehan book.

March 24, 2022March 27, 2023

The Dangers of an Embedded Stance

There is “what is happening” and then there is how we perceive “what is happening”. Knowing how to tell the difference between the two has a huge impact on our functioning, relationships, and wellbeing.
When we are approaching a moment from an embedded stance we are not aware of how our perception is effecting our understanding of the moment. Instead, we equate what we feel, intuit, and believe to be an objective reflection of and reaction to reality. We don’t see ourselves as having a “perspective” we see ourselves as having the facts.
An embedded stance has its benefits; we can get lost in a moment of love, creativity, or act intuitively on danger. The challenge with an embedded stance is that we are not connected to how our own personal filters impact how objectively we can perceive what is happening around us.
When we are embedded, we are at risk of our internal world being more persuasive to us about “what is happening” than what the external world presents. This leaves us vulnerable to misunderstandings in relationships, making assumptions, and incorrectly “reading” interpersonal situations.
When we are embedded what we believe to be happening “is” happening. “Everyone hates me”, “It won’t get any better”, “I can never come back from this”, “there is no point” are thoughts that are much more dangerous when experienced by a person in an embedded stance, because they are believed to be truths.
For most of us our biggest challenge with an embedded stance is coming to recognize the signs of when we fall into it. Some of us are there much of the time, for others of us we can fall into it only at certain times, or only around certain topics.
The most important cue to look out for that will help you identify when you or others are embedded: We are convinced we are “right” AND we are unable to take a collaborative stance (meaning feedback, ideas, or the perspectives on what is happening from others does not inform / change / influence how you see a situation).
The more we can work to observe our inner worlds, the better we can get at catching when we’re in this embedded stance and shifting to a reflective or collaborative stance where we can recognize we have a (valid) perspective, but not the only perspective and often not all the facts.
We want to try and hold, at all times, that any perspective is informed by our thoughts, feelings, prior experiences, AND what we think of as reality (aka what is happening in the environment around us). None of us are ever completely without our filters, but we can work to see them and understand how they influence our perception of “what happens”
The path out of embededness is flexibility, openness, curiosity, self-inquiry, and an acceptance that we hold a perspective that is informed by both current and prior experience. The more we can accept the impact of perspective, the more we can sort out and eventually cope with “what is happening”.

Our thoughts and feelings are incredibly powerful influencers over our actions. While we want to live a life where we can honor, listen to, and respect our inner world, we also need to become monitors of when our inner world may be overly informing how we understand a situation.

When we are embedded we are no longer treating our feelings like traffic signals, but instead they have become truth detectors about what “is” happening inside and outside of us. As David Wallin says, “When embedded in experience…whatever we sense, feel, and believe at any given moment we simply take at face value” (P. 135).

This might mean if I notice I’m angry “because you didn’t do the dishes” I take that anger at face value and am more limited in my ability to step back, reflect, and recognize that what I’m actually angry about is a feeling of inequity in our household responsibilities; or, perhaps I’m angry and associating it with the dishes, but really it’s about the fact that I am hungry, or had a bad day at work. Perhaps my anger is also about my own relationship with responsibility; I would never give myself permission to rest before the responsibilities are done, and I am angry that you allow yourself to do so. My anger is important for me to listen to, reflect on, and perhaps act on and make changes around, but my ability to use my anger constructively is highly limited when I’m in an embedded stance, “I’m angry about the dishes because you didn’t and don’t do the dishes” is as far as I’ll ever get.

To really address and solve problems in our lives, we need to be able to see and understand “what is happening”. To do this effectively we have to look at what is happening both inside and outside of us. When we can access a reflective stance we can sit with, interpret, and make sense of our feelings and cues from our inner world. When embedded, we cannot access this reflective place.

Openness, flexibility, curiosity, self-inquiry, and a desire to slow down and look at all internal and external aspects of a situation will help us shift out of an embedded stance and into a reflective stance. Examples, further explanation, and further resources in today’s comments.

Comments:

The quote from page 135 is in reference to David Wallin’s Attachment in Psychotherapy. Full citation: Wallin, D. J. (2007). Attachment in psychotherapy. New York: Guilford Press.
If you are in an embedded stance a lot of the time, please take this as a cue that you need professional help. An embedded stance can be hurtful to relationships, jobs, and ones ability to make progress in treatment. It can even lead to harming ones self or others when we are “certain” things are a particular way that concerns or upsets us. If you are having those kinds of thoughts right now, reach out for help.
Embededness can exist on a spectrum; some of us experience it most of the time around many topics, others of us can fall in or out of it based on the topic and hand or current stressors in our lives. While many of us are not operating from an embedded stance most of the time, we want to hold awareness that we can all get there and we are more prone to doing so the less safe we feel, and the more stress our bodies have to endure (whether from sleep deprivation, illness, hunger, or ongoing environmental stressors – like conflict, lack of safety in relationships and in your community, etc). We also want to remember that embededness is not all or nothing, we may experience it only around certain topics and we may be able to access openness, flexibility, and curiosity around other topics or at other times.
One key thing to remember, sometimes are are “right”, i.e. seeing the facts of a situation in an objective, collaborative way with awareness of our subjectivity. Being aware and building insight into when we are operating from an embedded stance means that there are times when we are aware we are less open to and prone to reflection, but it doesn’t mean that there aren’t other times we can’t have an understanding of what’s happening in a productive and useful way. The key is to work towards knowing when you’re embedded and missing out on your subjectivity.
Other potential indicators that you are in an embedded stance:
1. We may find our focus narrowing on a singular “cause” and “effect” narrative about what’s happening to create the current dynamic and situation. When this happens we may start internalizing or externalizing (i.e. assigning responsibility entirely to someone else or ourselves for the outcome of a situation).
2. Often we are feeling one or more feelings intensely. I.E. we are flooded. If you are flooded you want to work to ground.
1. We may be out of our window of tolerance.
2. As David Wallin points out, we may not see any need or purpose for reflecting or considering a topic further (because we already think we “know all the facts”).
So what’s the difference between being “embedded” or “stubborn” or “a know-it-all”? When we are embedded we not only think we are right, we cannot take in another perspective as being valid or possible. The embedded stance applies to both our external relationships (like how we talk to or treat others), and most critically our internal world (how we think through things ourselves). When we are embedded we can’t entertain the idea that we hold a perspective, rather than the “facts”. If this is how you think of stubborn or a know it all – then ok! There is no difference, but if this feels slightly more nuanced, than I hope this explanation helps.
Embedness is a path to inadvertently creating self-fulfilling prophecies for ourselves and our relationships. As David Wallin says in Attachment and Psychotherapy when we are embedded we are “Unable to reflect on the difference between feelings and facts, we remain blind to the ways in which we habitually construct as well as construe the ‘reality’ of our own experience” (Wallin 158). For more on how this happens see my post on cyclical psychodynamics.
A lot of what I am writing about in terms of the way out of an embedded stance translates into Marsha Linehan of DBTs concept of “Dialectical”. As she says, “There is always more than one side to anything that exists. Look for both sides…what am I missing? Where is the kernel of truth in the other side”? Quote is from Page 151 of the 2nd edition of her DBT workbook manual, full citation: Linehan, M. M. (2015). DBT® skills training handouts and worksheets (2nd ed.). Guilford Press.
A further example of how an embedded stance can impact our perspective and hurt us in relationships: “When feeling frightened, for example, the circumstances that seem to have evoked our fear are regarded – unquestioningly – as realistically dangerous…our internal world trumps external reality, regardless of the facts of the case” (Wallin, 135). In some situations (like a fire) there isn’t too much interpretation needed; in relationships, however an embedded stance can very quickly create problems. I may feel it’s a huge warning sign if someone doesn’t arrive on time because of all the associations I have about feeling unimportant or blown off by prior relationships. In an embedded state I will take this to be true, because I feel blown off, I must be unimportant to this person. When embedded I fail to recognize the impact of my personal sensitivities, or perhaps the context of their situation. When embedded “there is only a single perspective on experience, a single view, as if there were no interpretations but only perceptions, no beliefs that are not also facts” (Wallin, p. 135). More here on how and why our brains can create associations and pathways to beliefs.
I talk about constructive uses of anger in the post. If this is a foreign idea to you, read more in my post about how to make use of anger, and why we need it.
How to handle a conversation when someone else seems to be coming at the dialogue from an embedded stance? You can feel shut out, unimportant, angry, and unheard. Try saying something like: “Hm. I’m feeling like I can’t really get through to you right now. Like everything I’m saying doesn’t seem to shift your perspective. I’d like to ask that you think about your willingness to be open to new ideas or a new perspective on this topic, I’m hopeful we can have a productive conversation if we can both come at this with an open mind”.

March 10, 2022March 27, 2023

Anger

We may not like it, but we need anger, and we have the capacity to experience it for a reason.
For so many of us our anger has created problems for us; we can’t connect to it because we don’t trust it, or when we feel it we do so in ways that we (or others) experience as out of control.
Anger is a signal that something (internally, externally, or both) isn’t working for us and needs to change. It can motivate us and help us protect ourselves from being harmed by situations, experiences, or people.
When we are not accepting of our anger we are at risk of repeatedly falling into situations that are hurtful to us; we need our anger as a cue to us that something isn’t working.
The key to having a productive relationship with our anger is noticing and responding to it in a way that doesn’t create problems for us or our relationships.
Part of having a harmonious relationship with your anger is learning to sit with it, be curious about it, and identify what it is signaling to you about your needs, limits, expectations, environment, and relationships.
When you feel anger, it becomes your job to identify what isn’t working about a situation, and address that situation in a manner that holds respect for you; your values, limits, and well being; and the emotional (and physical) well being of those around you.
We can be quick to confuse our “trigger” (what set off the anger) with the cause (which might actually be about an expectation, our limits, our needs, etc). The fact that we feel anger means something isn’t working, BUT that something isn’t always the “thing” we get angry at.
Because anger narrows our focus and intensifies our drive to act it can be counterintuitive to zoom out and sit with the big picture, but often that’s exactly what we need to do.
The more we can embrace the need for anger, and accept that it serves a functional purpose, the less we fight it when it arises, and the the more able we are to tame it, and express it in ways that protect us and our relationships.

Many of us have an uncomfortable relationship with our anger. It feels threatening, overwhelming, and potentially damaging to relationships. If you’ve followed this account for sometime you know that I am an advocate of building a harmonious relationship with your inner world, which includes all of your feelings – even anger.

In moments of an immediate threat our anger can help us protect what is ours; we can get physically aggressive or we can yell and intimidate. When we want to maintain positive relationships with others, however, our relationship with our anger needs to shift; we still want to feel it to receive cues about our needs and limits, but we need to be careful about how we express it. This does not mean that we “don’t want to feel angry”, what it means is we need to have our anger AND be thoughtful about what we do from there.

Anger, like all emotions, serves a functional purpose about the intersection of our needs and our environment. When we feel anger we are receiving a cue about feeling exploited, threatened, unsafe, or wronged. It can help to think of your anger as a signal that a limit has been passed, that a boundary is needed, that something needs to change, or that we feel unsafe.

To have a productive relationship with our anger we need to learn to sit with it, be curious about what’s causing it, and then address that cause in a manner that’s consistent with our long term goals and values. Anger has a heat and an energy about it that can make us want to act quickly. It can be intense, but we need to work towards learning to slow down, unpack it, and act on it with care.

This is where the thoughtful reflection and awareness about the function of anger is essential. Your anger has arisen to try and keep you safe. Trust that, then ask yourself what feels threatening and why; what expectation has been violated and how universal is that expectation; what is your anger telling you about the gap between what you need what you are getting; what is making you feel unsafe, exploited, or unseen and how can you address it? Try and be open to both internal and external causes of your anger

Comments:

Like all emotions, our ability to feel and manage our anger is informed by prior experiences. Emotions that were welcomed when we developed will be easier for us to access, tolerate, and regulate (i.e. turn the volume down on). Emotions that were not welcome may get twisted and we may have to work to learn how to feel them, or they may only come out in big ways, or jumbled up with other feelings. If anger wasn’t tolerated in your development, or if it only erupted in ways that were hurtful to relationships, chances are you too have internalized that “anger is bad” or “problematic” or “to be avoided” etc. It’s not uncommon for someone to tell me they don’t feel anger, or they perceive it as bad. In my experience, this generally means anger exists within this person’s inner world, and they need help learning how to feel and tolerate it. Without that tolerance, the anger can shift into guilt, shame, anxiety, or depression. For more on how our development shapes our ability to access and tolerate certain thoughts and feelings see my post on how our brains work as an association machine.
I mention that anger has a heat about it in the post, it most certainly does, and if we don’t have adequate emotion regulation skills or distress tolerance skills one of the only ways we know how to cope with it is to push it down (i.e. pretend it’s not there) or let it build up and erupt. For more on how emotions effect us even when “we don’t feel them” see my post on emotional blocking and its impact. For more on distress tolerance skills see this post on in the moment coping mechanisms, and this one too , and this post on why we need distress tolerance skills. There will be more emotion regulation and distress tolerance skills to come, but one huge way to improve your tolerance of your emotions (and decrease your impulsivity to release them in a burst) is to take up a meditation practice. And of course, any very intense emotion can be quickly tamed with grounding skills (though they work best when you practice them in low intensity situations first).
For those of us that have a history of not feeling heard in relationships, we are more prone to express our anger in a way that is “larger”, as an attempt to control situations through intimidation, or as an attempt to be taken seriously and heard. Part of grappling with changing how you express anger, may be grappling with the secondary gains you experience about the ways your expression of anger helps you feel heard, empowered, and in control. Read more more here on secondary gains and how to work through them.
Anger and conflict is inevitable in relationships. For tips on how to manage moments of anger in relationships in a constructive manner see posts on problematic dynamics to avoid, the importance of taking time in conflict, and this post on fair fighting.
I mention in the post that all of our feelings are signals about the intersection of our needs and our environment. It’s true. For more on how we can learn from our emotions see this post on emotions as traffic signals.
Moments of anger can push us out of our window of tolerance (and leave us vulnerable to overly internalizing or externalizing. Read here for more on how to recognize when we (or others) are internalizing or externalizing .
Do you have a hard time with your anger? Perhaps it feels unjustified or not ok. See my post on acceptance for help working to trust it.
I talk in the post about how our “short term” selves often want to release our anger, at the expense of our “long term selves”. For more on this concept and how to grapple with these different priorities see my post on our long and short term selves.

February 23, 2022March 27, 2023

Acceptance vs Hopelessness

What if it’s hopelessness, rather than acceptance, when we tell ourselves or others “this is just how I am”?
One of the biggest precipitants to disengaging too early from treatment, to not starting treatment at all, or to not really being “in” treatment even when you’re in it are beliefs we hold about what is fixed within ourselves, what cannot be changed, and what is possible for us.
A core tenant of finding satisfaction in life centers around acceptance; acceptance of what we cannot change, acceptance of how our development shaped us and informs how we are predisposed to interpreting the world, and acceptance of what we can and cannot control.
But how do we know when we’ve accepted something that might actually be more malleable than we realize? And what about those times when our acceptance is actually just us giving up because we’ve tried but been unable to shift something?
The short answer to that question is, of course, there is no way to “know” for certain, but if something doesn’t work for you, creates problems for you, or creates problems in your relationships let that be enough of an indicator that you (and others) are probably “tolerating” rather than “accepting”.
This is because we and others will carry anger, resentment, shame, guilt, frustration, fear and all sorts of other cues that there is a problem that needs to be addressed when something disrupts us, our responsibilities, and our relationships in this manner.
So now we are in a bind, where something within us seems as though it cannot change, and yet it causes problems in such a way that we need it to change for us to find satisfaction or peace in ourselves and our relationships.
“This is just how I am”, is usually also, “this is how I have been up until now, living life as I know it, with the beliefs that I hold about how change happens and what is possible for me”.
I often find when folks are in this spot they have previously tried to make a change, sometimes putting themselves through intense scrutiny or demands (I’m going to read every book on this, try these 300 different tactics, completely turn my schedule upside down…etc).
When those tactics don’t work, or don’t work sustainably / in the long run, take that as a cue you may be substituting discipline or control for what’s actually needed; trying differently, rather than trying harder. See more in today’s post.

Many of us go into treatment (and through our lives) with a lot of unquestioned notions about what is possible for us and our well being. “I’ve always been this way”, ‘I’ve tried and never been able to change it”, and “my family is this way too”, are just a few of the thoughts that can inform our sense of what is possible for us.

Holding on to those notions also influences what we see as “on the table” for working on in ourselves or in our treatment; if we’ve made up our minds it won’t change, we’re less inclined to talk about it as actively as something that we do hold more hope around. Some of the most important moments in my work come when my client and I realize I hold a belief that something within them can change that they themselves had given up on.

When we’ve given up on the possibility that some dynamic can change within us, we are usually asking others and ourselves to live with something that isn’t working; a temper, a drinking problem, a spending problem, an intimacy problem – etc.

Giving up on the belief that something could be different for us usually follows extensive effort on our part to elicit change in the ways we know how to. If you find yourself trying to put more and more control, discipline, or strategy into it, if you’re living your life jumping through hoops for this, or, if you’ve just outright given up even though the issue remains, I’d encourage you to take your emphasis off of how “hard” you are trying and focus more on trying differently.

Unfortunately there is not one single answer to what it means to “try differently”, but it usually starts with broadening your scope of looking at the issue. This could mean accepting secondary gains you experience from the “problematic” dynamic; identifying when you are relying too heavily on pulling away from or stuffing down emotions rather than using them as guide posts to learn from; challenging difficulties with trust or boundaries; or trying to be more open to something that might actually be helpful that you don’t want to need or rely on (i.e. coping skills, medication, limits, meditation, etc).

Everyone can learn, grow, and change. Don’t give up. More in today’s comments.

Comments:

One very important key fact here: while we can change how we behave, relate, process, and make decisions we cannot change what thoughts or feelings arise in us. We can learn to tolerate them, take care of them, honor them, distract from them, and a whole host of other practices – but the content of our thoughts and feelings cannot be controlled and is ours to learn to tolerate and live alongside.
I mention the idea of “broadening” the scope of how you conceptualize the problem at hand in this post. I heard another therapist use this metaphor once and it has always stayed with me. Think about a leak in your ceiling. Where you see the wet spot doesn’t necessarily tell you where the issue is. You often have to open up more of your house than you would have guessed to take care of the leak. Our internal worlds are like that home. If we focus our energy exclusively on the target “part” of us we want to change (or leaky spot) we often miss the big picture of what’s happening, and we are at risk of it continuing to happen without getting at what the larger system (i.e. whole person – i.e YOU) needs to function well, and function consistently. Often times folks that are trying to manage a systemic issue with discipline or control are missing out on addressing the root cause of the “leak”. This would be the equivalent of painting over the wet spot, or constantly using a hair dryer on it; labor intensive tactics that don’t get to the core problem at hand.
There’s a great joke that I reference all the time in therapy – “How many therapists does it take to change a light bulb?” the answer “One, but the light bulb has to really really really really really want to change”. Now of course, it’s not that simple, motivation is hugely informed by hope and trust, which we can all lose access to based on our prior experiences (so sometimes we have to start first with building hope and trust before motivation can arise – and this can take years, especially if you have a history of relational trauma ). BUT, the key take away from the joke, which I try and help my clients with, is that the desire to change, and a willingness to have the accountability for that change come back to you (rather than others or outside forces) is one of the most important influencers of change and success in treatment. This joke also holds another important point in it about boundaries; it doesn’t matter how dark the room is, or how much change is needed/urged/requested/desired from outside forces, the desire for change still has to come from within. While we can influence others with our expressions of how they effect us, our concern for them, or our perspective on how their life could be better, we cannot (even by forcing someone to go to therapy) make people want to change without there being some desire from within them for their life to be different or better in some way.
An area where I see this attempt for control often is around food and dieting. “If I could just stop eating these bad foods I would be able to keep the weight off”, so now I don’t eat chocolate, or I only eat it on weekends, and I have to count out every nut, and fruit is bad because it has sugar – etc”. While I am not a dietician (and I have to be careful here not to speak outside of the scope of my training), I have referred many of my clients who have struggled with eating / weight problems to dietitians and spoken to those dietitians along the way about their treatment recommendations and notion of healthy eating. Without fail, I have been told that “controlled” eating is usually on the disordered spectrum, which includes any kind of restrictive diet or rule based relationship with food that classifies some foods and “good” and others as “bad”. It’s not uncommon to have to unlearn the habit of trying to eat in an intellectual manner (i.e. counting calories, only eating “good” foods, restricting “bad” foods etc) and to have to learn how to listen to cues from your body about when, what, and how much to eat. I would call this an example of trying differently; your intuition may be to double down on your discipline and efforts to control, the path out may actually be controlling less and learning to listen to you body more. If this sounds like you please listen to the actual dietitians out there: Christy Harrison (a registered dietician) has a great podcast called “Food Psych” that covers many topics related to binge eating, restricting food, dieting, the link between anxiety/depression and eating; I’ve also encouraged clients to read books like “Mindful Eating: A Guide to Rediscovering a Healthy and Joyful Relationship with Food” by Jan Chozen Bays; or “Intuitive Eating “by Evelyn Triobole and Elyse Resch.
I mention how overly relying on pushing away emotions can get us into trouble. More on understanding our triggers here.
I talk about how difficulties with communication can be a common dynamic people tolerate between one another. For tips on effective communication see my posts on fair fighting and on the benefits of taking space in conflict.
One of the places we can go when we’ve given up hope on the possibility of being different is classifying ourselves or others as “lazy”. More here on how to deconstruct laziness .
Sometimes we have a lot of trouble being open to something that might really help us because we don’t think we SHOULD need it or we don’t want to need it. If that sounds like you, read this post on acceptance.
I talk more about the notion of holding accountability towards one self for the life you want to have in this prior post.
What I am writing about in this post is drawn somewhat from Marsha Linehan’s conceptual skill, “Willingness”, which she defines in her manual as, “Accepting what is, together with responding to what is, in an effective and appropriate way. It is doing what works. It is doing just what is needed in the current situation or moment”, rather than imposing your will or your sense of what is “right” when it conflicts with what is actually needed to meet your goals for the situation.

February 13, 2022April 26, 2023

IMPROVE

It does not make you inferior if a situation is more than you can handle; it makes you a person who knows your limits.
Sometimes, it is absolutely appropriate and necessary to temporarily bury feelings, hide them, or push them away. When we do this we are getting through the moment, and taking on only as much as we have capacity for.
We use distress tolerance skills as short term tools to help us manage when the intensity of our emotions is at a 9 or 10 out of 10. At those times we are at risk of coping in a manner that eases our duress for the moment, but creates problems for us down the road.
Think: substance use to numb ourselves, lashing out (verbally or physically) at others to release emotions, having an internal experience of our emotions that is so intense we can’t process what’s happening around us effectively, self-harm, or causing harm to others out of our own duress.
If you’ve ever looked back and thought, “I wasn’t in my right mind when I made that decision” chances are you could have used a distress tolerance skill to help you through.
Distress tolerance skills are not for the weak or people who “can’t handle it”, they are for any and all of us when a situation pushes us to our edge.
Remember, with distress tolerance skills we are not changing the moment, we are helping you get through the moment in a manner that will not create further problems for you once this moment has passed.
Distress tolerance skills have the added bonus of helping you “reset” so you can cope and come back online with you faculties intact, enabling you to manage the stressors ahead of you.
Using distress tolerance skills is often about getting out of black and white (all or nothing) thinking; “if I can’t make the problem go away, there is nothing I can do” is not constructive. You can improve your experience and increase your capacity to handle what is coming if you give yourself permission to use distress tolerance skills.
There is no right amount of time needed for you to be in a mode where distress tolerance skills are necessary, but generally speaking if you’re in a distress tolerance mode for more than 24 hours you may be navigating into the territory of avoidance, which creates a whole host of other problems in your life.
In today’s post I cover the skill “IMPROVE” from Marsha Linehan’s Dialectical Behavior Therapy textbook. Not every part of this will work for every person, consider this skill (and others I offer) as a buffet for you to pick and choose from for you to cope with your specific situation or stressors.

I – Imagery. If you can’t leave the situation in real life, you can temporarily use fantasy to create a new environment to be in. This skill can help us escape internal or external duress (i.e. imagining a more pleasant scenario), or, if it feels accessible, you can use it as a way of boosting yourself up (i.e. imagining yourself coping well).

M – Meaning. Terrible things happen. One way in which we can survive them is by making meaning out of them. This is often too big a task to do in the present, but what you can do is have faith in your ability to find meaning eventually. This can look like, “I don’t know how this will ever make sense to me, but I believe that I will find a way to learn, grow, and be a better person because of this”.

P – Prayer. If you are religious than this probably already makes sense. If not, think of prayer less literally as “asking god”, and more figuratively as a surrendering yourself to forces outside of your control. Prayer usually includes accepting what is happening and our limited ability to change it all while asking for help from some yet to be determined place (like from others, a future version of ourselves, our community etc).

R – Relaxing. Remember, our brains and bodies are connected in a giant feedback loop. If you are stressed, anxious, and upset your body is likely carrying that tension physically which signals to your brain the need to be on high alert (which can further heighten tension). You can interrupt the feedback loop by relaxing your body which will decrease your experience of the stress.

O – One thing in the moment. This is reviewed extensively here. This skill centers us and can reduce our experience of chaos.

V – Vacation (temporarily) from responsibilities. Also known as, a break, denial, avoidance, or time to regroup. For this to work you really have to clear your mind of the problem and focus on something else.

E – Encouragement. Our internal world can be brutal. Try shifting your internal voice to approach yourself like you would a friend or a child (with encouragement, kindness, a focus on capacity and strength, and without all the harshness that may be present for you at a difficult time).

Comments:

I write a lot in this account about the benefits of being present with your whole self throughout your day, which includes your body, emotions, thoughts, feelings, values, priorities, and the environment around you. While I absolutely stand by that recommendation, like nearly everything I’ve written about, this is not an all or nothing recommendation and the helpfulness of being present in this manner exists on a spectrum; there are times in all of our lives when we need to recognize our limits and our inability to be truly present in the moment. This post will help you identify where your limits are and, hint, often they are not where you want them to be. This post explains the rationale for distress tolerance skills. In it I cover the importance of having “distress tolerance skills” (as Marsha Linehan of DBT calls them) in your coping tool belt. I also cover how our brains respond to intense negative emotions in the comments.
Some of us may not identify with having our emotions at a 9 or 10 out of 10, but we do identify with repeatedly having those moments where we wish we hadn’t handled something in some way, or with feeling the opposite of intense emotions – nothing at all. The IMPROVE skills may be helpful for you too in those times, as well as grounding, another version of a “reset” for our brains that helps bring us back to the present and improve impulse control. Grounding skills are a version of vacation from responsibilities combined with one thing in the moment.
Another way to think about when to use distress tolerance skills is when you are outside of your window of tolerance.
When we force ourselves through a moment that is more intense than we know how to handle, without taking care of our emotional needs we are not only not using distress tolerance skills, we are at risk for experiencing the situation as traumatic. Read here for more on what makes something “traumatic”.
Your ability to use these skills heightens with a mindfulness practice, which helps us increase our ability to control what we place our attention on. See my prior posts on the rationale for mindfulness skills, for an introduction to meditation and its purpose, for sensory based meditation and for free form meditation.
Struggling with feeling like you shouldn’t “need” to do this or use these skills? See my post on Acceptance for help with this.
Are the concepts in IMPROVE new to you? That’s ok. The best way to help them become habits is to have realistic expectations for how to incorporate them into your life. See my post on how to make long term sustainable change.
A note on prayer. There are different types of prayer, why me prayers, asking for help prayers, acceptance prayers. In my experience “why me” prayers further our experience of helplessness where as acceptance and asking for help prayers are often more helpful in coping with an unfair or difficult moment.
Understanding how emotions work will help you better understand the “R” – Relax – skill. See post from November 1st, 2021 for more details on how our emotions work. As Marsha Linehan says of relaxing, “Often people tense their bodies as if by keeping them tense, they can actually make the situation change. They try to control the situation by controlling their bodies. The goal here is to accept reality with the body” by relaxing it. The quote is from page 99 of Linehan’s Skills Training Manual for Treating Borderline personality disorder, 1st edition. Full Citation: Linehan, M. M. (1993). Skills training manual for treating borderline personality disorder. Guilford Press.
Further insight into the benefits of “one thing in the moment” “O” skill, from Marsha Linehan’s manual: “Focusing on one thing in the moment can be very helpful in the middle of a crisis; it can provide time to settle down. The secret of this skill is to remember the the only pain one has to survive is ‘just this moment’. We all often suffer much more than is required by calling to mind past suffering and ruminating about future suffering we may have to endure” The quote is from page 100 of Linehan’s Skills Training Manual for Treating Borderline Personality Disorder, 1st edition. Full Citation: Linehan, M. M. (1993). Skills training manual for treating borderline personality disorder. Guilford Press.