Category: Coping

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One Mindfully

  • A simple, but transformative skill: learning how to be fully and wholly present in just one moment at a time.
  • Learning “one mindfully” (as we call it in the DBT world) can reduce anxiety, improve concentration, increase our ability to handle a crisis, increase our ability to connect to our authentic selves, and increase our efficiency.
  • The opposite of this concept is “mindlessness” (not fully being present with any activity – i.e. “going on autopilot”) or multi-tasking (attempting to do two activities at the same time).
  • The most common way many of us “multi-task” is something most of us would not identify as multi-tasking: Thinking about one thing while doing another.
  • Like the time you were in a meeting but actually preoccupied by the conflict you had the night before. Or, when you were writing an email while thinking about how to prepare for something later in the day.
  • When we use one-mindfully we work to be present with our whole selves, which means paying attention to the content of the moment while also paying attention to internal cues about our experience of that moment. 
  • We set an intention for what we will focus our attention and energy on, and we work to keep ourselves focused on that intention despite urges to split our attention, or give in to distraction.
  • This does not mean that we cannot choose to change where spend our energy and attention or that we have to completely finish before shifting our attention; it means that when we change what we are doing (and where we are focusing) we do so with intention and awareness, even if we are right in the middle of something.
  • This also does not mean we cannot transition quickly between tasks (think about cooking: you are chopping the carrots, then stopping to stir the onions). We can be wholly present with one activity while another in the background does not have our attention. 
  • This skill centers us, and requires that we recommit again and again to what we will spend our energy on in the face of distractions. It also requires that we reassess as time goes on to determine if we want to continue recommitting to that moment, or to changing where our focus will be.

Most of us struggle fairly significantly with “doing” one thing at a time. This is because many of us are “doing” one thing, but thinking about another. In this way, we’ve become accustomed to leaving the present moment for one in the past, one in the future, or one that may never happen. When we do this we reduce our ability to concentrate by dividing our attention. We also decrease the likelihood we will pick up on important cues from the environment around us; when we are distracted we are not able to be as perceptive.

In simple terms this skill is “doing” one thing at a time, but more complexly it is devoting your attention and energy to only one “thing” at a time. As Marsha Linehan says, this means, “When you are thinking, think. When you are worrying, worry. When you are planning, plan. When you are remembering, remember. Do each thing with all of your attention”. Dialectical Behavior Therapy, and Marsha Linehan, would encourage all of us to spend as much time as possible being wholly present with whatever moment we are engaged in.

Many of us are spending large chunks of our time distracted, and not present in both mind and body in whatever moment we are in. To be wholly and fully present means paying attention to your outer world (i.e. the conversation you are in) and your inner world (your internal reactions to that conversation in your thinking, feeling, and sensing). Although it sounds simple enough, it is actually a lot of input to pay attention to at any given point in time and takes some practice straddling both your inner and outer worlds simultaneously.

One-Mindfully can be a powerful grounding and centering tool because it focuses us simply on the moment we are in. A common treatment for trauma, anxiety, and depression is learning how to be in and stay in the present. Like any new skill, I encourage folks to try this first in “low stress” situations (i.e. ones that are not likely to incite a lot of activation in your inner world) before high stress situations (i.e. ones where you expect to have a lot of thoughts, intense feelings, or intense sensations).

See comments for more on this skill including ideas for how to implement it today.

Comments:

  1. Often, I see this struggle to be “one mindful” in the way many of us manage our relationships with our computers during the workday. Does this sound familiar: “You’re writing an email and you get a pop-up notification that you’ve gotten a calendar invite. Without even thinking you stop writing the email, review / accept the calendar invite, and then try to return to your email. But wait, now you lost where you were and so you re-read your last sentence, get back in the mindset of the the response and boom, an instant message comes in asking you if you saw the most recent email from so-and-so about this-thing or that-thing. So you scroll to the top of your inbox and read the email, respond to the instant message but wait now you can’t find that email you just had opened. Ok, you found it. But wait what were you saying, and ok now there is only 5 minutes left before the next thing on your calendar and somehow you haven’t gotten to that response yet. Now you feel this anxious pressure to get it out, but you are also aware this isn’t the quality response you wanted to send out so now you have to decide if it’s more important to get it out quickly or thoughtfully…etc”. Multiply that experience throughout your day and your day ends with you feeling frazzled, unproductive, behind, like you’ve missed a bunch of things and like you’ve been ping-ponging around all day. And that’s because you have! All those notifications are very stimulating and they are prime ways in which we forget to insert that intentionality into our decision about where we spend our time and attention when we are with our devices. One low-stress way to start trying to introduce this skill into your life is by bringing thoughtfulness to what notifications you need on, and how you respond to those notifications when they are on. As Marsha Linehan might say, “When you are writing an email, write the email.” If you find you are tempted to be distracted by your phone turn it over or put it on silence. If you are expecting to hear from someone important while you write, work to make yourself accessible in a way that will not distract you (i.e. ask them to call you, or silence texts from other people except that one person). Setting up a routine that enables a mindful perspective can take some work, but it should help improve concentration and productivity and leave you feeling better at the end of the day. 
  2. Back when therapy was always in an office you were forced to take a one-mindful perspective with your session. You didn’t have a screen, or your phone handy and the temptations to engage with something outside the content of the session were much less accessible. If you are doing remote based therapy try and re-create the in-office experience as much as possible by eliminating the possibility of something outside of the session distracting you away from being fully in the session.
  3. If you are someone who commonly multi-tasks or operates in a “mindless” manner, it will take time time and deliberate practice to bring a more “one-mindful” stance to how you spend your time. For tips on how to bring this concept to your life at a pace that works for you, see my post on how to sustainably make long-term changes.
  4. This concept / skill is kind of like living your life in real time meditation, albeit a meditation where you are responsive to your environment. Like our meditative practice, your mission throughout is to regularly bringing your attention back to your chosen focal point. For an introduction to meditation, and this concept of returning to a chosen focal point, see my introduction to meditation post (which has more direct parallels to today’s post), and my post on general meditation.
  5. Sometimes we find that we can’t control our attention. That’s ok. No one is perfect at this. Sometimes we are coping best by accepting what is not within our control, and often times what is out of our control is content of our inner worlds. (If you struggle with this concept this post on acceptance might help). This can mean the thought, feeling, sensation, or external circumstance arising is too distracting or powerful to redirect yourself from (i.e. you just got news of something upsetting and of course you can’t focus on your previous intention). At that time, it can be helpful to view that as a cue that you need to switch your attention over for a period of time, even if you don’t want to.  A powerful way in which you can stop ruminating (when you can’t stop thinking about something) is to set a timer for ten minutes, and just be with the worry. After ten minutes, when the timer goes off, you may find it’s easier to redirect your attention back to a different focal point. After ten minutes of really fully devoting yourself to it (instead of having it simmer in the back of your thoughts for hours at a time where you ping pong between thinking about that and all the other things in your day) you may have found a solution, or exhausted all the different ways you can think or worry about something, but either way it’s more likely to feel less pressing. There are other skills to combat intrusive worries for another day.
  6. Regarding the idea of perfection – it is not realistic (or even the goal) to exclusively live in a “one mindfully” stance. Sometimes we do want or need to split our attention and that’s OK. The key is to selectively and with awareness choose to do so, and to use one mindfully with more important tasks.
  7. A little more on identifying and understanding multi-tasking. There are three ways of multi-tasking: attempting to do one activity while you think about another activity (sitting in your meeting and thinking about that conversation you had last night), attempting to think about two things at the same time (going through the grocery list while you try and plan out that email to your boss), or attempting to do two things at the same time (talking to your friend and scrolling on your phone). A one-mindful perspective would encourage you to limit each as much as possible. 
  8. If you find yourself regularly tempted to split your attention or “zone out” start trying to pay attention and get curious about it. Sometimes there is a lot we can learn about what we are trying to distance ourselves from when we pull our full attention away in these ways.
  9. Marsha Linehan’s skills, including one-mindfully, are outlined in full in her skills training manual and associated skills training workbooks.

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What is an Emotion?

  • If you want to manage and cope with your emotions, a helpful starting point is understanding what they are, how they work, and how (beyond feeling them) they effect us.
  • What emotions we feel, and how intensely we feel them, is simply a combination of chemical processes in our brain and sensations in our body working as a feedback loop in response to signals from one another and our environment.
  • An example: You feel scared. Your brain sends that fear signal to your body. Your heart may start racing, you you may start sweating, you may instinctively raise your shoulders up by your ears. You may think to yourself, “this isn’t safe, I’m in danger”.  Your brain then detects all that activity which continues prompting the emotion of fear.
  • Feeling emotions for extended periods of time is simply this feedback loop restarting again and again as we experience the emotion, thoughts, and associated body changes.
  • Each emotion has a series of specific body changes and sensations associated with it. Those body sensations are unique to each person, but there is often overlap between people in how they feel each particular emotion.
  • The more we can learn to notice and observe our emotions and their impact on us, the less controlled we are by them. An entry point to this (and there are others) is noticing and identifying what is happening in your body as you are feeling your emotions.
  • It can be a helpful exercise to think of something that made you feel a particular emotion, reconnect with that feeling, and then do a scan throughout your body to notice how the emotion effects you. 
  • You can build up a personal catalog of identifiers for each emotion (i.e. anger makes me feel heat in my chest and tension in my jaw, guilt makes me feel a pit in my stomach and a knot in my throat etc).
  • There will be more to come on this topic, including why we have emotions and tips and skills for managing them.
  • See today’s post for a further explanation of why we need to pay attention to our bodies if we want to better manage our minds

If you’ve studied philosophy you know there is an age old question about the differences between mind and body. In this day an age, those of us familiar with neuroscience know that mind and body are actually part of the same intricate system of circuitry, feedback loops, and signals. Emotions are a complex part of this system, but simply put they consist of (neurochemical) changes in the brain that go on to have an effect on our bodies, thoughts, behavior, and even our interpretations of the environment around us.


Understanding how to manage our emotions becomes easier once we understand that they exist in a feedback loop with our bodies. We can enter that loop and begin the process of taming, settling, regulating, and managing our emotions by becoming familiar with how each emotion effects our body.  


Try and bring curiosity to your body when you realize you are feeling an emotion. What do you notice? Pay attention to temperature, tension, pressure, tightness, etc. You may need to scan around to different parts of your body to gather all the information about what’s happening. As a bonus, the process of stepping back and observing yourself will likely help lower the intensity of the emotion you are experiencing. 


If you’re not used to directing your attention to your body you may be surprised at how much is happening in it. If you find you feel numb and can’t feel your body that’s a cue you’re out of your window of tolerance and need to ground (see comments). You may also find you don’t feel some emotions even though you know they exist. Try accessing a lower intensity version of those emotions, for example if you are someone that can’t connect with feelings of anger, try connecting with frustration, or irritability – and notice how that effects your body.


Over time, that increased awareness of our body can help us detect emotions before they get too big (increasing our odds of wrangling them back in), and offers us the opportunity to intervene in the feedback loop with strategies to manage our emotions. More on those strategies in a future post, but for now work paying attention to your personal feedback loop and its effect on your body.  

Comments:

  1. This post contains a fusion of information from (1) Marsha Linehan’s Skills training manual for DBT, and her theory of emotions (pages 87, 88, and 137 of the manual), (2) Bessel Van Der Kolk’s “The body keeps the score”, (3) Daniel Siegel’s “Mindsight” and (4) David Wallin’s “Attachment in Psychotherapy”.
  2. As David Wallin explains, “Asking our patients to label what they feel…invites them to observe that experience rather than simply identify with it and feel overwhelmed. Enhanced bodily awareness and the growing sense that feelings can be painful without being intolerable sets the stage” for healing. This quote is from page 81 of David Wallin’s Attachment and Psychotherapy, a book meant for therapists but readable for not-therapists who are interested in learning more. Full citation: Wallin, D. J. (2007). Attachment in psychotherapy. New York: Guilford Press. 
  3. Scientists rely on this fact, that our emotions are neural processes, to make advances in medicine and to better understand human behavior and functioning. They’ll use scans /testing devices in research studies to help them determine what emotion a person is feeling based on which part of the brain shows the most activity. “In the early 1990s novel brain-imaging techniques opened up undreamed-of capacities to gain a sophisticated understanding about the way the brain processes information…PET and later… fMRI scans enabled scientists to visualize how different parts of the brain are activated when people are engaged in certain tasks or when they remember events from the past. For the first time we could watch the brain as it processed memories, sensations , and emotions and begin to map the circuits of mind and consciousness” – Page 39 of Bessel Van Der Kolk’s “The Body Keeps the Score”. Full citation: van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.4
  4. Want to know more about the connections between how your brain, your emotions, and your thoughts work? See my previous post Your Brain as an Association Machine for more information. 
  5. I mention the feedback loop between our brains and our body in this post. Did you know most emotions last only a few seconds to minutes? If you’re feeling something for an extended period of time the feedback loop is restarting, which means there is an opportunity for you to intervene. Learn more about the brevity of emotions here.
  6. Not sure you buy into the idea that you want to feel all your emotions? Or maybe you only want to feel some of them? Check out this post that explains the value in negative emotions.
  7. Think you’re not someone who is effected by your emotions? Think again – we’ve all got them, and they can effect us even when we push them away or don’t feel them.
  8. I mention Grounding and The Window of Tolerance in this post. If you find you need to ground a lot while trying to be in your body it’s a cue that you would benefit from therapy. It will help you widen your window of tolerance.

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Displacement

  • Our feelings are harder to access in environments where they are not welcome. This can be with certain people who we feel shut us down, and it can also be with our internal world if we believe certain feelings are bad, unproductive, or unacceptable.
  • When we can’t access and process through our feelings directly we may find ourselves prone to using displacement. When we “displace” we focus our energy, attention, and conversation around something other than the core issue at hand.
  • Displacement can be an indirect way of addressing an emotionally charged / intense topic or a topic we can’t find an accessible entry point into discussing or feeling our way through.
  • Example: you’ve had a bad day at work and take out your anger on your family once you’re home. Perhaps you’re feeling angry about work, and simultaneously feeling like you can’t change that environment / express yourself there and maintain professionalism (i.e. you can’t find an accessible entry point at work to handle your concerns in a direct way).
  • Although you don’t want to be irritable at home, you may (consciously or unconsciously) rationalize to yourself that your family is “stuck with you” and so you release your frustrations at home. In this scenario the person has displaced their anger at work onto their family members and in an environment where they feel their negative emotions are more tolerated.
  • Sometimes displacement of this nature can happen even when we don’t consciously *feel* angry. So yes, this means you can have a feeling, not register that you are having it, and then direct a release of it toward some other topic or person in your life. 
  • The trouble with displacement is we focus our attention, energy, and conversation around the focal point, at times without acknowledgement or awareness of the underlying issue(s) at hand. 
  • Unfortunately, even if we can “resolve” the displaced issue (in this example the conflict with our family), we haven’t resolved the core issue (work) and the recipient(s) of our displacement often leave the interaction(s) feeling like the other has been unreasonable.
  • If we are regularly displacing in our lives we run the risk of resentment in relationships, having the same fight repeatedly, believing our internal world is unreasonable, and feeling confused by or untrustworthy of our reactions. 
  • More in today’s post and comments about how displacement can creep into relationships and decrease our ability to solve problems in our lives. Also, tips for how to find displacement and what to do about it.

When we “displace” we focus our thoughts, communications and/or reactions to a “stand-in” person / object / situation as opposed to the actual person / situation we are having a reaction to. When someone says they feel treated like a punching bag, often they are describing being the recipient of someone else’s displaced feelings. 


Displacement can happen in lots of ways, imagine you and your spouse are in a fight about how the dishes are loaded in the dishwasher. More often then not those types of fights are a displacement of a different, larger, and more emotionally overwhelming topic. Instead of facing that topic head on, we can displace onto something more accessible and concrete, like how the dishes are loaded. In this scenario the intense emotions about a larger dynamic (could be anything, perhaps how heard one party feels) are displaced onto a smaller dynamic (how the dishes are loaded) that comes to represent the larger one.

Sometimes we can displace as a way of protecting ourselves from feelings we don’t want to have or believe we shouldn’t be having. At those times we can be fully wedded the the notion that we are having reactions to “the dishes” rather than some larger problem we don’t want to be true of our relationship or in our lives.


Other times when we displace, we may feel aware that the strength of our reaction doesn’t totally make sense. A helpful way to get to core of an issue when you suspect displacement is at play in yourself or others is to ask (in a collaborative, non-judgmental, and accepting manner):

  1. Can you articulate why there is so much emotion or heat around this topic?
  2. Does it feel like this type of thing happens in other ways we may not be discussing?
  3. What else happened today or recently that this reminds me of that I might also be having a reaction to? 
  4. Does it feel like we might really be talking about something or someone else here?

Until we can get to the core of the issues we face we are at risk of having the same underlying concern or conflict around “stand-in” topics. With curiosity and introspection we can work to understand and know ourselves better to catch displacement in the act, and get to addressing core underlying concerns.

Notes

  1. One of the reasons that therapy is effective is that a skilled therapist provides a space for someone to feel their feelings without judgment. The relationship becomes a safe place to release your emotions, and it’s not uncommon for patients to find themselves surprised by what comes out in a session. If this has happened to you in treatment this is often a great sign that you feel safe in your relationship with your therapist and they are helping you access, process through, and release what is already there and needs room to come out.
  2. Once we’ve gotten good at recognizing the signs of displacement in ourselves and can recognize when we’re displacing from one topic to another the displaced topic itself can become a helpful entry point into conversation. For example, “I’m noticing myself feeling angry about the dishes but as I think about it, I’m realizing it’s not just the dishes, it’s more that the dishes are one example of how I feel like I ask you to do something and it doesn’t happen. I think we really need to talk about this because I can tell I’m getting resentful”. 
  3. Affairs in relationships can happen for many reasons, but one avenue for thinking about them (and there are many others) is through the notion of displacement. If you are having an affair one of many questions you can ask to build introspection and awareness is what need aren’t you getting met from your partner or your life that you have displaced into this other relationship? 
  4. I mention in the post that sometimes we can feel like our reactions don’t totally make sense for the situation we are in. Sometimes this is because we are displacing, but all feelings are valid even if they are about numerous situations at the same time. See this post on the cumulative nature of emotions as well as this post on how our brains make associations for a deeper dive into that topic.
  5. I mention in the post that our feelings are harder to access in environments where they are not welcome including our internal world if we believe certain feelings are bad, unproductive, or unacceptable. See more here for how to approach your internal world in a way that won’t shut it down .
  6. I mention in the post that we can have an emotion and not register we are having it. It’s true. For more about how this works see this post on emotional blocking.
  7. Alcoholics Anonymous groups talk about displacement too, though they use the phrase “Coming out Sideways” to discuss how emotions or reactions can come out “sideways” to a focal point other than the core issue, problem, concern, or person. 
  8. Our insight into our use of displacement can vary even if we are otherwise self-aware and reflective. We can be very self-aware in some categories of our life and in some relationships, as less so in others. Further, we can displace more around certain types of issues than others. Our insight can vary based on a variety of factors including whether we’re in our window of tolerance, or when we’re operating outside of our limits.
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Primary and Secondary Emotions

  • Our emotions, when they are heightened, can feel like a freight train, plowing through and interrupting everything in their tracks.
  • Often this is because, like cars on a freight train, emotions and thoughts are pouring in rapid fire one after another with no end in sight. 
  • An example: you feel angry for a moment, but then, perhaps you feel guilty for feeling angry (or expressing it). Perhaps that can lead to frustration that you feel guilty. So on and so forth.
  • Some of us have a hard time identifying what our feelings are, or labeling them into categories like “anger”, “guilt”, or “frustration”. Instead we just feel revved up or activated or (at the other end of the spectrum) numb or flat.
  • In the DBT world Marsha Linehan describes primary and secondary emotions to help us begin to make sense of our inner world. Primary emotions are responses to our external world (like events around you or the actions of others). Secondary emotions are responses to our internal world (i.e. emotions in response to our emotions or thoughts).  
  • For most of us, secondary emotions are the ones that cause the most upheaval and distress.
  • That’s because we can have many secondary emotions and they often come in quickly and more powerfully than the primary emotion that preceded it. 
  • Secondary emotions often have a judgment built into them (i.e. I noticed I’m angry, but I feel like I shouldn’t be angry, so now I feel ashamed about my anger).
  • This can leave us in a trap where our emotions are loud, overwhelming, hard to distinguish from one another, and subsequently hard to resolve – even if we’re really trying. Instead we can feel out of control spinning and cycling, often in ways that interfere with our ability to be present in our lives. 

For us to manage our emotional world we need to know what we are feeling and how to take care of ourselves in response to that feeling. An essential skill to help us regulate (balance) our emotional world is learning how to feel and process through emotions in a way resolves them.


There are many tools for managing your emotions, but one way to help you through them is to learn how to identify them. Once we’ve identified them, we often feel better because our internal world feels organized and less chaotic by our awareness of what’s happening within it. This is similar to strategic problem solving, usually the first step in a problem solving strategy is identifying what the issue is so you can address what needs resolution. The concept of Primary and Secondary emotions from Dialectical Behavior Therapy gives us a helpful starting point to do this in our emotional world.


Primary emotions are reactions to events in your external environment (being angry at someone for criticizing, feeling happy that a loved one is coming to visit etc). Secondary emotions are are reactions to your internal world (i.e. your thoughts and feelings). For example: feeling  guilty when you feel angry or feeling pride in your ability to be happy for someone else.


Secondary emotions tend to cause the most distress for a few reasons:


1. They can be set off in a long overwhelming string (which I call emotional chaining), with numerous thoughts and feelings coming from and leading to one another.  


2. They can dilute, overwhelm, and drown out the primary emotion making it difficult to identify and resolve whatever set that off. This overpowering often leaves us confused, potentially upset with ourselves, and overwhelmed. 


3. If we have judged ourselves for experiencing our primary emotion (i.e. I got angry, but feel like I shouldn’t have gotten angry), we will both be stuck with our feeling and our belief that we shouldn’t have it; a complete trap to effective resolution of what’s happening. 


To increase your ability to manage your emotions, start working to identify “primary” and “secondary” emotions.  Look out for the three traps listed above and see notes for more resources.

Notes:

  1. This post references material from Marsha Linehan’s emotion regulation module in her Dialectical Behavior Therapy treatment manual, specifically pages 86 and 89 of the manual. Full Citation: Linehan, M. (1993). Skills training manual for treating borderline personality disorder. New York: Guilford Press.
  2. If you struggle with secondary emotion trap number 1 (emotional chaining) and number 2 (secondary emotions overwhelming primary emotions) you want to work to help slow down your internal world so it doesn’t move quite as rapid fire. Working on staying in the present hugely helps here. There will be additional posts to come on this, but see this post on meditation for something you can start today. 
  3. If you struggle with secondary emotion trap number 3, (judgments), see these prior posts for help with tools and concepts to decrease the power of judgments; and this series on identifying, understanding, and challenging judgments.
  4. Knowing how to manage emotions is a complex skill, sometimes we need to let ourselves ride them out, sometimes we need to pull away from them, sometimes we need to actively manage them. There will be many more posts to come on this topic but these previous posts on controlling our attention and knowing which types of coping skills to use when have helpful content.
  5. Today’s post assumes you buy in that all feelings are worth having. Perhaps you don’t. This post covers some of the many reasons we want to keep both our positive and our negative emotions around.
  6. Sometimes our emotions are too big or feel too far away for us to tolerate feeling through them. This happens when we are outside our window of tolerance. If this is the case you want to work towards grounding to help turn the dial down on the intensity (or the numbness) before working on feeling through.
  7. This is similar, but not to be confused with behavioral chaining, a DBT technique in which you look back at each moment that lead up to a particular behavior to identify the feeling or experience that started the behavior.

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The Myth of Exposure Therapy

  • Many of us wrongly believe that “exposure therapy” is repeatedly putting ourselves in a feared situation in the hopes it will decrease our anxiety in that situation.
  • I.e. “If I get on the plane enough times my fear of flying will go away”.
  • While low-level anxiety often dissipates with repeated exposure, higher level anxiety is made worse or stays the same with this tactic.
  • That’s because what makes exposure therapy effective is that the therapist exposes someone to a feared situation AND helps them have a different set of internal responses
  • It is that repeated experience of being in a situation and having a DIFFERENT internal experience that can shift our relationship with the situation.
  • An exposure therapist would NOT advocate for white knuckling your way through
    Exposure therapy isn’t the only way to deal with fears of this nature, but the key for any and every individual to be aware of is that exposure therapy is not simply putting yourself in the situation time and time again and “pushing” through it.
  • If you want to work on a feared situation I’d encourage you to work to increase your awareness of where that line is between “high” and “low” anxiety situations
  • In low-anxiety situations – sure – expose yourself. You may just need to get the hang of it. 
  • You can address high anxiety situations in a variety of ways including formal exposure therapy, standard therapy, working to build insight into what’s under the anxiety in an effort to help it dissipate, and increasing your mindfulness and grounding skills (info on those two in the comments).

I can’t tell you how many times a client has walked into my office talking about a struggle in a particular situation; a fear of flying, anxiety with public speaking, difficulties with crowds. Often, they tell me about how they have “white-knuckled” their way through this situation time and again in an attempt at “exposure therapy”. More often than not, they find it doesn’t work.


This is when I tell them that’s not how exposure therapy works. When a therapist is helping a client with an exposure the therapist is both EXPOSING the client to the situation they struggle with AND helping them have a DIFFERENT internal experience while doing so. It is that repeated experience of being in the situation and having a DIFFERENT internal experience that can shift our relationship with the situation. 


For most of us, if we knew how to have a different internal experience while in the situation we would have done that long ago. What may feel intuitive to us in those moments (and perhaps not in our control)  is to have the reaction we’ve always had. 


Getting on the plane 35 times in an effort to expose yourself to a feared situation in the hopes it will neutralize (or numb) you to it can work with situations where you feel anxiety in a low intensity manner (i.e. think about performance anxiety where we are jittery the first few times, but with repeated experience we get more and more comfortable). With higher intensity anxiety you may actually be reinforcing (i.e. strengthening or making worse) the anxious response by exposing yourself to it without having built up coping strategies or skills for how to manage your internal world while you are exposed to the situation. 


What I can do with my clients, and what you can do too, is work know ourselves well enough to know where that line is between the “low(er)” anxiety situations and the “high(er)” anxiety situations. When our anxiety is lower we often just need to stick with it and get the hang of it. You should notice yourself feeling less and less anxious over time. When anxiety is higher, the anxiety doesn’t change or get worse with repeated exposure. That’s a cue not to keep going without a different set of internal responses.

Notes:

  1. How much anxiety we feel in a certain situation can vary based on a variety of factors. I.e. one day a situation might be “low intensity” and the next day the same situation might be “high intensity”.  The key here is to work to pay attention to knowing your own anxious cues and responding to what they tell you.
  2. I am not a specialist in exposure therapy, and in fact when I have clients in need of this type of treatment I will send them to a specialist for a series of sessions to work with someone in the situation they are struggling with to come up with strategies specific to their situation and their needs. This is often short-term work and it can be done alongside a longer therapy.
  3. One tactic you can try if you want to try building that different set of internal responses is strengthening your grounding based skills (those help combat anxiety by keeping you in the present) and mindfulness skills (those both keep you in the present and help you increase your ability to control your attention. Both Mindfulness and Grounding will help you “tame” your anxiety in those moments, though there are many more skills and techniques that an exposure specialist could work with you on (sometimes in as little as 4-6 sessions) if you’re really stuck with something. 
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No One Creates All the Problems in Their Life…

  • If something affects you, bothers you, or creates problems for you, it’s yours to participate in fixing, even if you didn’t create it or it’s not “your” fault. 
  • Some of us are given the tremendous advantage of having the majority of our physical, social, emotional, and financial needs met from an early age. Most of us are not. 
  • When we don’t have those needs met it can effect our ability to trust, connect, hold boundaries, be vulnerable with others, and be in touch with our inner world in a productive way. 
  • Regardless, the accountability and responsibility lies within each of us to do what is in our power to move towards creating the life we want to have. 
  • For many of us that can mean “cleaning up” after early formative experiences you didn’t have control over, but that have shaped you into being a person who has developed dynamics or patterns that create problems in your life moving forward.
  • Those dynamics and patterns become our responsibility to manage and deal with as we go through our lives, even if they were formed because of experiences we didn’t create
  • Many of us can get stuck in the in-between of “it affected me” but “I didn’t cause it”, leaving us in a passive or helpless place wishing for someone else to “clean up”, “deal with”, or tolerate some dynamic within us. 
  • While, there is validity in the feelings of fear, anger, loss, and sadness that are tied to how unfair a situation may be, those feelings are your responsibility to work through so they don’t interfere with your ability to move towards creating the life you want to lead
  • No one creates all of the problems in their life; regardless each of us is responsible for dealing with them anyways.
  • With this mindset we can be the victim of something, but not a casualty of it

According to Dialectal Behavior Therapy we are ultimately the ones responsible for participating in our lives in a way that brings us meaning, joy, and satisfaction. Our ability to connect, relate, trust, share, hold boundaries, be vulnerable, and be productively connected to our thoughts and feelings is hugely shaped by our early relationships, relationships we have at a time when we don’t get to choose who we are around. For some of us, those relationships and that environment provide a ripe and fertile ground for healthy and safe development. Most of us, however, hit some “snags” along the way and struggle on some level with the dynamics just listed.


Those “snags” are our responsibility, even if we didn’t participate in creating them. For example, your difficulty with vulnerability becomes your responsibility, even if you were the victim of earlier experiences that made being vulnerable inaccessible. 


DBT encourages each of us to hold our end goals, values, and priorities in mind, and to do what we need to – and can do (there will be limits here) to get ourselves in the life we want to lead. This does not mean “what happens” in your life is your sole responsibility. There are far too many external forces at play for that to be possible. What it does mean is the roadblocks you hit are yours to work through, regardless of how they got there.


For some of us we run into a thought traps around a fairness or a “who caused it” mindset. We can come to believe because a “mess” or “problem” in our life wasn’t created or initiated by us it isn’t our responsibility to participate in dealing with. We can get so focused on “who created it” or “how it got there” that we become distracted, helpless,  and more focused on what is outside of our control (the choices someone else made) than what could be within our control (how we cope, manage, or can grow as a result of an experience).


There is validity in the unfairness or the bitterness felt around cleaning up a problem you didn’t create. Own, accept, process and work through those feelings rather than let them stop you from focusing on your growth and your goals.

Notes:

  1. This perspective would most certainly acknowledge that some of us have more work to do than others because of factors totally outside of our control. That’s unfair. But it’s reality, and for us to be able to have the life we want its our work to do. 
  2. This does not mean there is no point to working to make the world and our society / culture a more fair place. What it does mean is that we don’t want the unfairness of something to create passivity in us that stops us in our tracks and strips us from working towards what is meaningful and important to us as individuals. What this principle says is that it may be unfair, but you are ultimately the one that suffers if you let that stop you or hold you back.
  3. This perspective would also not say that “if we are unhappy it is our fault”, however it would say if we are unhappy we want to be on the lookout for ways in which we may also be struggling with passivity or helplessness in certain areas that may be interfering with our ability to improve our circumstances. For some, a lot more energy is focused on “who started it”. While is helpless to bring insight and awareness into how something developed, if we stop there we are at a stalemate of helplessness.  
  4. I can appreciate some may be reading this and thinking about it through the lens of community or systemic factors that have a huge impact on wellbeing (think gangs, gun violence, etc). This principle is much more about helping an individual challenge patterns of helplessness or passivity that may be keeping them stuck than it is about how to effect change on a much larger system (like a community). It is worth noting that the systems we are in have a huge impact on our wellbeing, happiness, and health and the more privilege we have the more able we are to minimize the impact of those systemic forces. If you read the post thinking more about larger systemic forces I’d encourage you to go back and re-read it through the lens of the individual.
  5. Unsure why you’d want to be in touch with your inner world? See this post on Emotional Blocking, and this post on how our emotions are like traffic signals.
  6. Helplessness and passivity are often NATURAL and HEALTHY reactions to environments where we don’t have control. If you struggle with these dynamics know that you may be applying a tactic that used to work in one life scenario in a way that no longer serves you. See Your Brain as An Association Machine for more information on how this can happen.
  7. Elements of this post may be confusing for someone that identifies as “co-dependent”, given the lack of clear boundaries I am describing. If this is you, think about this through the lens of how you can “fix” by focusing on what is within your internal world or scope of control rather than how you can “fix” by working to change another person.
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Building Mastery

  • There are concrete steps you can take to improve your self esteem, confidence, and sense of worth / value.
  • To feel good about ourselves we need to be doing something routinely that we feel proud of.
  • For us to feel proud of something it needs to be hard enough that it is a challenge, but not too hard that it’s overwhelming.
  • If it’s too easy we won’t really feel proud of it, and if it’s too difficult we’ll feel overwhelmed or defeated.
  • A common area of struggle in this arena is that many of us don’t actually hold realistic expectations for what’s “too difficult”.
  • This is one of the reasons many new years resolutions fall apart – many of us don’t accurately assess where that sweet spot is between “a challenge” and “unrealistically challenging”.
  • To be successful at setting and achieving realistic goals many of us have to wrestle with our “shoulds”.
  • We can feel like “I should already be____”, so when we set a goal we are inadvertently trying to make up for lost time.
  • This often backfires. When we try a challenge and it’s too far out of reach it actually DECREASES self-esteem, and can leave us feeling lazy, out of control, inadequate and generally unmotivated.
  • Accept where you are now, pick a goal to work towards that it just beyond that, and gradually work to get to the final milestone.

Marsha Linehan outlines in her Dialectical Behavior Therapy Treatment Manual exactly how to increase your sense of self esteem and confidence, and it’s through a process she calls “Building Mastery”.

Taking on appropriately challenging activities, goals, and tasks is a tool we can use to help us boost our sense of worth, confidence, and self esteem. If you’d like to try building #mastery you want to pick a #goal to work towards that feels challenging, but is realistic with how you live your life. For that sense of mastery and #accomplishment to be built the goal needs to be just out of current reach, but still accessible with effort.

If you find you are often someone who doesn’t meet the goals you set for yourself, your ambition might be blinding you from what is realistic and sustainable in your life. For many of us, we set goals that require we make changes that are too far out of reach, we then can’t meet the goal, and wind up feeling defeated, lazy, and incapable. This puts us at risk of giving up, and over time, this can erode at our sense of worth, ambition, and ability.

If you find yourself in a position where you set goals and routinely don’t meet them it’s not a signal that you are failure, you “can’t do it”, or that there is no hope – it’s often a signal that you have selected a goal too challenging for where you are at this juncture in your life. And yes, something can be too challenging even if you think it “should” be simple.

When you find yourself at the crossroads of wanting to make a change, wanting to learn a new skill, or wanting to boost your self esteem remember the key concepts behind building mastery, which includes setting an appropriately challenging goal and building on it over time. If you cannot achieve it, find a way to make the goal a little less challenging. Maybe it’s too much to exercise 5 times a week, but maybe 4 times or 3 times is more accessible (at first). You can always keep setting end goals that are a challenge beyond what you’ve mastered, but the key is doing so in a way that maximizes sweet spot between not enough of a challenge and too much of one.

Notes:

1 . It’s not uncommon for people to hold beliefs like, “exercising is good for me, so I should be able to do it regularly” or “I want to be a person who________’s every day, so I’m going to start that now”. The challenge is, we start with the end goal in mind, feel overwhelmed by how much it actually requires of us, and often give up and feel defeated. We come to believe “I’m not a person who can _____, because I tried and it didn’t work”. And yes, we did try, but we didn’t try in a way that was within that window of “challenging enough”. Instead, we may have unknowingly picked a goal that was too challenging without recognizing it in that way because we believed it “should” be within our reach. Unfortunately, this approach actually diminishes our sense of self-esteem because we are unable to stick with a goal we set. Read here for more on how “shoulds” can show up in disguise and throw us off track.

2. For more information on how to set realistic goals for yourself, and how to make gradual changes see this post.

3. Been trying to make a change for ages and it just won’t stick? In addition to exploring the reasonableness of your goals, it may also be time to consider “Secondary Gains”.

4. Do you have a hard time letting go of the “shoulds”? This is not uncommon. Really. It holds many of us back. This post may help.

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Foundations of Meditation

  • A step-by-step guide to the Foundational Meditation for Mental Health
    • 1.  Make sure you are comfortable enough to not move for the duration of the exercise 
    • 2.  Pick a “Focal Point” using one of your five sense. I recommend starting with touch and waiting to use sight until you are more advanced.
      • Ideas:
        • Try pressing your finger tips together or
        • Put a beverage in your mouth and don’t swallow it
    • 3.  Set a timer for 30 seconds.
    • 4. Close your eyes and work to notice “what comes up”. (I.e. what thoughts enter your mind, what sensations you feel in your body, and what emotional feelings you notice internally). Once you notice something return to the focal point you’ve selected. 
    • 5. You stop when the timer stops.
    • Do this once a day for a month. After a month you can gradually increase to up to two minutes (or longer), though I have found 30 seconds a day can be enough for someone to see significant gains.
    • The only time we’d want you breaking the meditation is if you are in danger (i.e. a fire alarm goes off etc), otherwise, it is your job to notice whatever urges arise without acting on them, including urges to move your body, end the meditation, think through something – etc.
    • You will drift away many times; this is the whole point of the exercise.  You are working on increasing your ability to notice when you drift away and come back to your chosen focal point
    • This is not meant to be relaxing, it is a very active process of observing your mind body. What you are doing with this exercise is strengthening your ability to have an internal experience that you don’t react to
    • It’s ok if you get irritated, want to stop, find yourself feeling tempted to move, wonder if you’re doing it “right”. These are all just thoughts, feelings, senses, and urges and it is your job to notice them without acting on them.

Regardless of whether or not you have a meditation practice already, I always encourage my clients to start with this foundational exercise. When we meditate in this way we strengthen our ability to cope by working on being present with our thoughts, feelings, and bodily sensations.  We are noticing them, but not letting them dictate our actions or behavior.


When I introduce this skill to my clients I introduce it to empower someone to strengthen their ability to improve their concentration and to be less controlled by their emotional states. I also use it to help them increase their ability to control their attention, which makes them less susceptible to triggers.


The goal is to work on being present with what comes up, to notice it, and then to let it go and be present for the next “thing” (be it a thought, sensation, or feeling). 


Many of my clients get stuck in one of two places, so be on the lookout for these traps:

  1. They start “Chaining”, meaning they have a thought and then they react to that thought with another thought, or maybe a feeling, and so on and so forth so the meditation exercise becomes more like a stream of consciousness. This is normally how our minds work, so it will probably start to happen during the exercise. It’s ok, you’re going to get better at catching that and then redirecting yourself. Instead work towards noticing a thought, and then letting it float away while waiting for the next one. 
  2. The other common trap is: “Blocking”. This is when you try and “clear your mind” so that you have quiet or stillness. While that can be a great centering or relaxation exercise, it is not the type of meditative exercise we are trying to work towards. We want thoughts, feelings, and sensations to float into awareness so you can strengthen your ability to notice them and then re-direct your attention.

The skill with meditation is not in preventing your mind from wandering, it is in noticing when it wanders and then bringing it back to your chosen focal point. 


 You should find, after a month, you are less “reactive” and more able to notice your thoughts and feelings without having the urgency to respond to them. 

Notes:

  1. The focal point can be anything that uses one of your five sense. I personally find touch is the most accessible, but here are examples from all five senses. The key with any of these is to use it as an anchor, something you return to in-between the internal thoughts, feelings, and sensations you notice throughout the exercise.
    1. Taste: Put a candy in your mouth and notice the taste of it. Resist the temptation to move it around / crunch on it.
    2. Sound: Just listen to the sounds around you – this works best if you’re not in a completely quiet space, though if it is “quiet” you may find there were more sounds than you had been aware of when you quietly listen.
    3. Sight: Watch trees in the wind, watch snow or rain fall.
    4. Smell: Sit over a coffee or tea, spray a perfume or cologne.
  2. With step one, I encourage you to sit in a way in which you are comfortable, BUT as you get more and more advanced you might want to try sitting in a way this is slightly uncomfortable. This will give you an opportunity to work on sitting with your physical discomfort and tolerating the sensation of it.
  3. There will be a second post to come covering how to move away from having a focal point. As you get more and more advanced your focal point can get less specific, but phase one meditation is about working on noticing the drift and re-centering back to the established focal point. Eventually just “you” can be your focal point. 
  4. If “nothing” happens (i.e. you try this exercise every day for a week and you just have a blank mind) you can try scanning around your body to see what you notice or prompting yourself with questions about what’s happening in different areas of your body).
  5. If this is highly activating (which it might be if you struggle with anxiety, intense feelings, or you have a history of trauma) start with grounding and try decreasing the time to 15 or 20 seconds. Once you get really good at grounding you are likely to feel safer and more able to tolerate the exercise.
  6. Want to learn more about who may benefit from meditation? The post “Why Meditation” covers more details on how meditation can increase our ability to cope. The post “Controlling our Attention” covers how meditation can increase out ability to accept what we cannot control. Meditation can help us increase our ability to release our emotions, as covered in the post “Emotions are Brief“.
  7. I was trained on this in graduate school, and I remember we would start off every class with a two minute exercise. Inevitably someone would arrive late and shuffle around the room, drop a bag, pull out a chair, etc. I remember feeling and thinking “ugh! They’ve disrupted the peace! It’s interfering with the exercise”. Initially, I was not able to step back and recognize that my irritation at being “interrupted” and my thoughts about that were actually just another thought and feeling to notice. The exercise can’t be interrupted, because the whole purpose of it is to notice what comes up (internally or externally), and then come back to your chosen focal point. That noticing can include noticing your own irritability, like in my case, as well as noticing your own experience of distraction. The better we get at noticing and returning our attention to our chosen focal point in the exercise, the better we get with this skill in our day to day lives. 
  8. Over time, this exercise will teach you to be more mindful of your internal world and less reactive to it, which means (eventually) you may not need to do it on an ongoing basis. Instead, may find you are more and more used to being connected with your internal world, and this awareness without reactivity will happen more organically and naturally throughout your day.
  9. You may notice there is a focus on “not reacting” or “acting” in this exercise. That’s because we are working to introduce intention to when you act on internal experiences. The goal in life is, of course, to act and respond as is indicated for any given situation, and meditation of this nature helps introduce a pause so that you can increase your ability to notice your internal experiences before reacting to them. In life you won’t always just sit and notice, but that’s exactly what we do when we meditate – we strengthen our ability to resist the urge to act. There will, in life, be times where acting intuitively / quickly  makes sense (think about emergency situations), so we are not eliminating the ability or need (at times) for a quick reaction – but we are working to introduce intentionality so we can be more in control of when we act quickly.
  10. Chelsea Handler’s book, “Life will be the death of me” covers how meditation fundamentally changed her life.
  11. Jon Kabat-Zinn’s “Wherever you go there you are” is an excellent instructional book on meditation.
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Long Term Vs Short Term Self-Care

  • Care of the long-term self is just as important as care of the short-term self
  • When we care for our long-term self we make an investment in the future or prioritize what feels sustainable to us with regard to our energy, our commitments, our values, and our limits. We trade off what might feel comfortable or bring joy in this moment for something that will help life be more full at a later time.
  • When we care for our short-term self we do something that helps us feel good, relaxed, or at peace in the moment. Often we have fun, are in the present, and aren’t as focused on “what’s coming up”.
  • You will be at risk for cycles of depression and burnout if you don’t pay enough attention to caring for the long-term self OR the short-term self.
  • Taking care of your short-term self is essential to happiness and well-being. We can’t be happy in our lives if we’re not experiencing positive emotions on a regular basis.
  • If we over-invest in our short-term self we are avoiding addressing our future, which can leave us feeling anxious and uneasy as we know, deep down, we are “kicking the can down the road” and not addressing our long-term needs and well being.
  • If we over-invest in our long-term self we can be cheap, grumpy, or unhappy in our day to day lives. We can miss out on important experiences and opportunities.
  • We can stretch ourselves too thin when we over-prioritize either self. With over-prioritizing of the long term self we can live life without enough regard for the present, and we can miss out on positive experiences feeling like we’re always reaching never arriving. With over-prioritizing the short-term self we can over-commit, over-schedule and not set ourselves up sustainably leading to cycles of overwhelm and burnout.
  • Each of us has a different “balance point” between these parts of ourselves, and that balance point changes at different stages in our lives (meaning this is a consideration to revisit again and again).
  • Takeaway: when you’re trying to engage in “self-care” remember both your long-term and short-term self. If you’re noticing cycles of burnout think about how much you are considering either self in the decisions you make about how you spend your time, money, and energy.

For many, “self-care” routines can feel like a cycle of burnout, rest and repeat. We hear suggestions when we’re at the end of our rope like “get a massage”, “take a day off”, “try a yoga class”, and yes – all of those are absolutely self-care. I would classify them as “self-care of the short-term self”.

Having a special / positive experiences can make a day better, but ultimately if our version of “self-care” only cares for our short-term self we can neglect the needs of our long-term self. If we don’t care for both aspects of ourselves we will struggle with satisfaction, happiness, and leading a sustainable life.

Caring for the long-term self is about taking control (where you can) to set life up with regard to what feels sustainable, manageable, and not overwhelming to you. It’s also about making some decisions with respect to your future and prioritizing the experience of your future self. Caring for the short-term self is much more about what will be fun or feel good in the moment.

When we have a history of trauma, or when we are in survival mode we are more inclined to not consider the long-term self, as it can take a sense of safety in the world around you to believe that you can invest in yourself and your future; the more safety we feel in our lives the more able we are to consider both our long-term and short-term selves.

Many of us are inclined to lean towards caring for the short-term self or the long term self, and for each of us we need to find the right place of balance. Places to look for clues as to where you fall on this spectrum are how you spend your free time, spare money, and extra energy. How much of each do you allow yourself to “save” or “spend”?

While the popular and common notions of self-care do take care of (and are important) for the short-term self, we need to remember the long-term self. If you are in a cycle of burnout at work or with family or friends, short-term self-care may help you feel better in the moment, but what’s needed is long-term self-care to interrupt a cycle that’s got you stretched too thin and out of balance.

Notes:

  1. This post covers topics similar to those covered in my post on wants versus shoulds.
  2. Marsha Linehan’s Dialectal Behavior Therapy treatment covers the need for regular positive experiences and it is her treatment protocol that prescribes it as essential for a happy life. Per the treatment plan, without regular positive experiences no one, regardless of their privilege or circumstances, can be happy and satisfied with their lives.
  3. Sometimes this concept is best understood if you think about how it applies to money. If you spend all your money on a goal for the future and very little money on experiences that make you happy or comfortable in the moment you are likely to be putting a premium on your long-term self at the expense of your short-term self. Alternately, if you spend all your money on the here and now, (things that bring you temporary joy like vacations, nice food, or items that won’t appreciate in value in the long-term) you are taking care of your short-term self at the expense of your long-term self. There is such a thing as not preparing enough for the future, BUT there is also a thing as preparing too much and missing out on present-day experiences, living too cheaply or in a way that leaves you stressed out and frazzled.
  4. The more privilege we have the more control we have over factors like how much we work, how much vacation we take, how much money we have to save or spend and how much we time we can spend on leisure vs work. This concept can be applied relatively, and regardless of your level of privilege you can work towards caring for yourself by working towards considering what will help you feel good now, what will help you feel good later, and trying to find a balance between the two.
  5. What about vacations? Vacations are an incredibly important tool to reset, have new experiences, relax, learn, spend time as a family, and (temporarily) reduce burnout. However, there has been research that shows that the effects of a vacation wear off very rapidly after a return to work and those effects diminish even faster with a more demanding workload. Vacations are great, but you are more likely to find happiness by paying attention to your day to day experience and finding ways to improve that then relying on vacations to “reset” you.
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Thought Management Tool

  • Anxiety can be a runaway train. The following six step thought management tool helps you slow it down and regain control.
  • Step One: identify the raw worry thought. Just get it out there. It doesn’t matter if once you write it down it seems ridiculous.
    • Example:
      • I’m going to fail at giving this presentation
  • Step Two: Rephrase the worry thought so there is descriptive (rather than judgmental) language.  This will enable you to get to the “core” of the worry.
    • Example:
      • “I’m going to fail at giving this presentation” BECOMES
        • I’m going to freeze up and not be able to remember all the points I want to present
        • People won’t think I’m smart  / capable 
  • Step Three: List out all the reasons why you believe this worry could come true. 
    • Example:
      • People can be judgmental
      • people that don’t know me well may draw conclusions about how capable they think I am from this presentation
      • I have frozen up during presentations before.
  • Step Four: List out all the reasons why you believe this worry won’t come true.
    • Example:
      • People that know me are likely to use this presentation as only one instance in their sense of me and who I am
      • People that don’t know me will hopefully trust that I was assigned this presentation because others believe I can do this
      • I don’t know that people will be as quick to jump to conclusions as I fear
      • There will hopefully be opportunities to gain respect (even if I lose it) in the future
      • I haven’t always frozen up at presentations. Sometimes they go ok.
  • Step Five: Now identify your priorities, goals, and what really matters to you about the situation you are in.
    • Example:
      • I want to build my reputation at this company as someone that is reliable, capable, and a valuable member of the team
      • I want to be given more opportunities like this in the future
      • I want to build my confidence so I’m not always so anxious before presentations
      • I want the presentation to go well (i.e. I, my boss, and the client are satisfied with it).
      • I want to get better at giving presentations
  • Step six: Identify what you can do to address the worries you hold (with respect to the priorities you’ve established), how you can troubleshoot for the things you know are likely to “go wrong”, and how you can help yourself feel more comfortable.
    • Example:
      • I want to ask someone who has presented in front of these people before how “tough” an audience it is so I can be prepared for what to expect
      • I can remind myself that if people judge my intellect or my capacity based on one presentation then that’s not in my control and it’s short sighted on their part
      • I can practice before hand to feel more confident
      • I can remember to pause and collect my thoughts for a moment if I need to
      • I can bring bullet points with me so I remember the key points and one of my bullet points can be the remember to pause and collect my thoughts when I need to

One of the challenges with anxiety is that it can accelerate our thinking. We can get overwhelmed quickly –  to a point where we can’t identify what we are thinking or feeling, we just feel anxious, out of control, and (often) helpless to stop it.


Therapists work to help their clients slow down the speed of anxious thoughts and come to understand them. The tool in today’s post helps you slow down worries, understand key concerns, reduce helplessness, and feel more in control (which is often one of the reasons anxiety gets so severe). This tool gets you focused back on what matters to you and what you CAN control.


I recommend starting with writing this down or typing it out. In time, this may become automatic enough that you can do it in your head.


Step One. Raw Worry thought(s). You may have many, that’s ok, run through the exercise with each of them. The point of this column is to try and put words to the internal chaos so you know what you’re working with. Sometimes just clarifying the worry can help reduce anxiety.


Step Two. Rephrase the worry thought so there is descriptive (rather than judgmental) language. Judgments are often short-cuts that stop us in our tracks and leave us stuck in developing a plan of action. Substitute words like good, bad, right, wrong, should, shouldn’t, fail, succeed, hard, and easy with more descriptive language. See posts from 4/11-4/15 for detailed instructions on how to do this.


Steps three and four help challenge the likelihood of the worry coming true by forcing you to really think through the possibilities of what could happen.


Step Five: Pause and think through priorities. Look out for judgmental language here (i.e. instead of I want to do a “good” job, define what a “good” job means). The priorities for the situation don’t have to link up to the prior steps. This is a centering step to help you get to the heart of what matters to you and in this situation.


Step six: This gives you actionable steps, reduces helplessness, empowers you, and helps you gain control where control can be had. 


After completing the exercise you are likely to feel centered and able to take steps to move towards meeting your goal(s)

Sample completed tool below for anxiety about giving a presentation:

Notes:

  1. Deconstructing judgments is a key step and one that may require more detailed instruction. If you’re getting stuck on this step read this post to help you identify a judgment, this post to learn more about how judgments limit us, and this post to learn more about how to deconstruct a judgment.
  2. I developed this tool, but it contains concepts merged from DBT and CBT
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