Greetings! I have decided to start a blog, to get some tools out there that many of my clients have found helpful. In this way I intend to provide some help for a few more people, as I am running up against the limit of how many people I can see and impact through individual therapy and psychopharmacology. I plan to put some of these blogs in video form as well, for those who tend to process information better in the audio/visual format. In these blogs, I’ll address the most common therapy problems I’ve seen in my experience as a therapist, and share the ideas that I’ve learned work very well for my clients.
I’ll start this out with the most common problem I see as a therapist, and that is human emotions, that either overwhelm us, refuse to go away, or both.
Though emotions are normal and healthy, when emotions are not understood and handled properly they commonly manifest as symptoms- namely the symptoms of anxiety, depression and irritability.
So hopefully, if you follow the advice of this blog and seek assistance when you need it, you can prevent a troubling mental illness in the future.
Most people experience emotions as an internal feeling, a sensation in the body, that is interpreted and often misinterpreted by various parts of our mind. One very simple and useful way to think of emotions is to consider them the body’s way of communicating to us and asking us for help. Of course emotions heavily involve the entire neuroendocrine system, including our social mammalian brain, called the limbic system, but for now we’ll simplify and just consider those as part of the body.
If you know what your body is saying to you and what it is asking for, emotions are no longer confusing and overwhelming, they are just information and motivation that your body is providing for you, and you can respond, in a compassionate and responsible way. Please note that emotions do beckon a response from you either internally or externally, and they will stay there in one form or another if an appropriate response is not reached. In my experience, medications are not nearly as helpful as the appropriate response to a situation. Therapy amongst other interventions, is meant to help people find that response.
The emotions I am going to cover here are the ones that people most frequently have trouble with: Anger, Fear and Sadness.
The first emotion that I am going to cover is anger.
Anger is an emotion that says “someone crossed a boundary with me. Would you please kindly help me to re-set that boundary, so that it doesn’t happen again?” It may not always ask you that nicely, but that’s what it means. You may notice that it frequently gives you the energy and motivation to help set that boundary. You can and should use the energy of anger to help you do so, just make sure you're cognitively involved in this process as well.
The questions to ask ourself or parts of ourself when we feel anger is, “What boundary has been crossed.” “What’s the most effective way to communicate this and set the boundary so that it doesn’t happen again?”
When anger was evolving as an emotion boundaries crossed were typically physical, and they needed to be set physically. Nowadays many boundaries are crossed verbally and socially, so they need to be set verbally and socially, not physically. They can also usually be set without crossing someone elses boundaries and thereby provoking more boundary crossing in your direction.
This part you may need some coaching on from a wise friend or a therapist, but I typically advocate being direct and honest, starting by simply by stating your experience- and your experience at that point would sound like “I am angry.” From there, have a conversation and compare information about what boundary was crossed and how to keep it from happening in the future. These can be very complex situations, however, and again, may require some preparation from a professional, and sometimes mediation.
Fear is another emotion that frequently gives us trouble when we don’t know what it means. Fear is simply your body telling you, “There is a threat present. Please stay alert, and help me get to safety or to minimize that threat.” Often we experience fear in the form of anxiety, which what occurs when we see a potential threat coming in the future.
The first question to ask yourself when you experience anxiety is “what is the threat, what am I afraid might happen?” Then you can ask yourself, or someone you trust “are there any ways that I can prevent this from happening?”
Often what you are afraid of is something you have absolutely no control over. This is where most people get stuck, by trying to prevent something that they have no control over. Remember in this case, that though you may not have control over the outside world or the behavior of other people, you DO have control over how you respond if that dreaded threat were to happen. If you have a backup plan or a way to minimize the damage if that feared event actually happens, that will usually help the resolve your anxiety so you can be present.
Sadness is complex emotion that has a very important purpose. It’s our body saying to us “we just lost something very important to us. Can you help me to make meaning out of what just happened?” You’ll notice that the very energy of sadness tends to stop us from our normal day to day activity, bring us inside and prepares us to contemplate. MRI’s show that it activates a region of the brain that helps us to ruminate (overactive of course in depression). The act of crying brings people around, so that, in a healthy environment, we can be understood and assisted with different perspectives.
If we can seize the opportunity of sadness, we can learn something from our losses and gain a new direction that will help us in the future. Four questions can help us to do this.
The first question to ask yourself in sadness is, “what have I just lost?” If you take a look at it, chances are there are more things you lost than you realized. When one loses a relationship, for instance, they lose many of the experiences they hoped to have in the future with this person.
The second question is “are there any other emotions that I’m feeling in addition to this sadness?” If there is still anger or fear that we have not responded to in appropriate ways such as those mentioned above, the sadness will often not leave us alone.
The third question is “do I understand how and why this happened?” Often we don’t, and the sadness is there to help us to stop, contemplate, make meaning out of the situation.
The fourth and final question is, "having made some sense out of the situation, how will I move forward differently in the future, and how might my life change because of it?" This helps us make sure that, despite our loss, which is usually irreplaceable, there is some value gained in lessons learned.
Do be aware, these are not easy questions, and they often require help of trusted friends, family, mentors and sometimes professionals to figure them out. Remember, we never evolved to go through loss alone.
Emotions Without a Source
Not every emotion comes from an ongoing life situation. Often there are emotions that stick with us that seem out of place in our lives. Remember that if an emotion is not appropriately responded to, it just stays there, and it will feel as though part of us carries this emotion, and often associated thoughts and beliefs, around everywhere. All too often, we carry emotions from childhood or from past difficult experiences, because we did not have the internal or external resources at the time to process the emotion and make a useful meaning out of what happened. Fortunately these resources are developing and being aggressively researched.
Internal Family Systems Therapy (IFS) is the safest and most effective way that I have found so far in my experience as a psychiatrist to process emotions from the past, though there do exist many other methods of doing this. IFS is also quite useful for processing and finding appropriate responses to ongoing situations, and managing thoughts, desires, interests and emotions that seem to be in conflict within you.
This does cover the majority of overwhelming emotions that people see me for, although there are many more emotions our body provides us with, which can all be used in very productive ways. If you are curious to know more, I highly recommend the book Language of Emotions by Karla McLaren. This book is practical, and was immediately applicable to my life and the lives of many of my clients.