Category: Emotion Regulation

Has Anyone Told You “Don’t Be Sad?”

Sadness is one of those ordinary, human, connecting, important emotions. What happens when people can’t acknowledge sadness.

Sadness is related to loss, and every person at some point in their life goes through loss when change occurs. Graduating from school, having a baby, getting married, moving, and getting a new job are all examples of changes that could generate sadness. Even when better things might be coming along, there is generally a loss of familiarity, old routine, social environment, and schedule. The loss of predictability takes up energy and attention that can be unsettling and even overwhelming.

In many families and cultures sadness is considered something that is problematic, and is often talked about with disdain, contempt, or pity. Sadness has been equated with being pathetic, not having a backbone, being weak, or being worthy of ridicule. When is the last time you used the word sadness in your vocabulary, and how did you use it? Was sadness used in a way that enhanced a connection with another person, or was it a disguise or judgement about how another person should express themselves? Did you get embarrassed when others cry or express sadness? Did you try to shut down their feelings, fix the problem, or ignore the emotion? Or was your verbalizing sadness an open invitation for a person to share openly, feel deeply, express themselves better, or to be understood?

The lack of acknowledgement of sadness can result in disconnect, alienation, confusion about one’s emotions or feelings, or even anger. Expressing or experiencing distress related to loss is an expression of vulnerability; a need to band together with the people we care about, a way to bring community together. Ridiculing, berating, or scapegoating people because they struggle with grief only makes it worse.

Grief is one of those things that has its own timetable, and can show up at unexpected times. There is no right way to go about it, and everyone has their own process to work through. So many people think that no one else feels the way they feel, and this often inhibits expression or discussion of what people are missing the most. People frequently start apologizing for crying, and some have suggested that if they cry they deserve be locked up in a psychiatric hospital or “the looney bin.” Others inform me they spend a great deal of energy suppressing, inhibiting, ignoring, or distracting themselves from how they feel.

In some cases, sadness can take up residence in a person’s life and become depression. The open expression of sadness is generally one of connection and deep support, whereas the behaviors of depression can reduce connection with others; such as irritability, low frustration tolerance, complaining, expressions of hopelessness, or threats to give up.

A normative expression of sadness is generally moving, touching, and connecting. Consider what movies or music you may have seen or heard that have moved you deeply, and if sadness was part of that process. Consider what brings about sadness in your life, and how/ in what ways are you able to share it? What losses have you endured or gone through? In what ways have you been inhibited from expressing or sharing the pain of what happened? In what ways can you honor or acknowledge your own sadness; even if no one else can do it for you?

Quick Tips For Figuring Out What You Feel

  • Use a list of emotion words to help you identify emotion words. A lot of people have a limited range of description words. Use the internet or google Marsha Linehan’s Observing and Describing Emotions handouts to help you.
  • What does your experience tell you? In your history of having certain experiences with certain situations, is your gut trying to get you to pay attention to something that is hard to pay attention to?
  • What actions do you tend to take or do when you have feelings? Sometimes identifying the behavior of an emotion (withdrawing, avoiding) can help you identify feelings (sad, anxious).
  • If you have a feeling ask yourself where you feel it. Some have a “gut feeling” or “gut instinct.” For myself, when I am ruminating or angry, I feel my head spinning or grinding. Some people feel a constriction in their chest or a change in how they are breathing. Some feel a deep pit or heaviness in the bottom of their stomach.
  • Is there a metaphor, animal, or weather that matches how you feel? Sometimes feelings are best described in the visual arts. If you could draw or paint how you feel, what image might show up?
  • When did you first start having the feeling? Does the intensity go down or up, and if so, what changes its intensity? How long does it last?
  • Is it hard for you to have mixed feelings, or feel opposite things? For instance, being both sad and glad about changes, or angry and in love with the same person?
  • What do you want your feelings to communicate? If someone else were to take action because of how you are expressing or communicating your feelings, what action would that be?
  • Make a list of all the things that are stressing you out right now. Think of as many as you can, and identify how stressed you are about each one on a scale of 1-10. Sometimes we don’t connect the feeling experience with the life stressors, and this can be both validating as well as help you move towards problem solving.
  • Are you avoiding any feelings that are difficult or painful? Consider what distractions are no longer working for you and what it might mean to hold space for yourself with tenderness and compassion.

Your Emotions Aren’t Causing You To Behave That Way

What causes your emotions?

Most people have stories about why they did what they did, and they often sound like this:

  • My anger caused me to (hit, yell, escalate)
  • My anxiety caused me to (leave the grocery store, avoid a person or situation, or have a panic attack, not go to class)
  • The reason I could not (do anything, come to my appointment) is because of my mental health issues
  • Because I have PTSD, I am not able to (fill in the blank)
  • My mental health problems caused me to (fill in the blank)

The odd thing about these explanations is that no one seems to be very invested in what exactly causes emotions. If we could explain why people behave the way they do because of emotions, it seems the obvious solution would be to make emotions go away, not have emotions, or refuse to tolerate the discomfort that emotions create when situations or events evoke our emotions. If we can’t identify what causes, predicts, or controls emotions; we would have a lot of difficulty managing or controlling our own behavior. Most people want to feel in control of themselves, especially when their emotions seem to control their lives.

Although many mental health professionals believe that emotions are the cause of problems, I do not share this point of view. If we all believed that the reason you can’t get out of bed in the morning is because you are depressed, and the reason you are depressed is because you can’t get out of bed in the morning, we would have a massive problem of rhetorical reasoning.

Also, we don’t have a solution. Or a treatment plan.

The behavioral perspective (hence, my perspective) is as simple as this:

  • Antecedent (what comes before behavior, such as someone doing something mean or hurtful)
  • Behavior (ie, attacking, arguing, badgering)
  • Consequence (what happens as a consequence of yelling)

Anger, as it stands, is an emotion that naturally makes sense under the conditions of someone doing something hurtful or mean. Yelling is an action that a person does when experiencing anger.

If anger functions to prevent further hurt or harm or not be a doormat, effective and skillful solutions could be employed, such as:

  • Skillful advocacy
  • Holding someone accountable
  • Giving someone feedback about what they are doing so they can make changes
  • Acting confident
  • Making changes to reduce future problems
  • Alerting community members to the issue

Consequences generally come to the forefront when problematic behavior creates more problems than solutions (ie, vindictive blaming, domestic assault, relationship destroying behavior).

Here is the question for you: Do you need to change your behavior (ie, become more skillful, manage emotions differently), or do you need to change your emotion? Sometimes, you can manage your emotion by changing your behavior.

Are You Crazy!? What Does Being Out Of Control Do For You?

What does it mean to be out-of-control (OOC)?

Out-of-control (OCC) behaviors often are extreme to the situation and create consequences for others that are problematic, painful, and in some cases generate even more problems. Most of the time the OOC behavior doesn’t necessarily fit the context or the the situation. In other words a person may behave in a manner that is more extreme than necessary and often don’t solve problems- in many cases it makes problems worse. OOC behaviors can occur with intense and magnified emotions.

In out of control situations emotions often take over, and emotions tend to take the blame. Some examples of out of control behavior can include:

  • Antagonistic arguing
  • Coercive communication
  • Escalating, barraging, interrupting, and dominating a conversation
  • Verbal attacks
  • Stonewalling / shunning other people

While OOC behaviors are often problematic, many people don’t understand why they occur, what could prevent them from occurring in the future, or how to stop/ change/ fix the OOC behaviors. OOC can be downright scary, threatening, and disruptive to families, children, and relationships. However, if there was no good reason why an OOC behavior should occur, it would not happen. Here is a look at how OOC behaviors can work or function for people. OOC behaviors might:

  • Justifies a response
  • Gets someone’s attention
  • Allows a person to be taken seriously
  • Gets a certain reaction or response from someone else
  • Gets someone to respond
  • Maintains an identity as (fill in the blank)
  • Sends a message
  • Validates the seriousness of the situation
  • Makes a person feel in control

However your OOC behavior works for you, some of the basic outcomes of the above can be better done through means that are more skillful, enhance and improve relationships, result in stronger connections, and ultimately a more successful means to an end.

OOC behaviors are problematic mainly because they create unwanted consequences. While some people may not be deterred by the havoc and pain they create, others are looking for ways to step outside of the cycle and patterns of transgenerational trauma and start living a more fulfilling and less crazy life.

Skills learning, acquisition, and generalization helps people to identify more effective means to have influence, power, self control, acceptance, and self-esteem by looking at the role of OOC behaviors. The idea is to manage emotions while being effective- what do you need to communicate- and can you do it in a way that doesn’t include shooting yourself in the foot (and keeping important relationships along the way).

Why You Need Your Emotions

Emotions exist to solve problems. All primary emotions have certain functions; that is, all primary emotions are helping us in some way. Some functions of emotions include:

  • Organizing action
  • Communicating to others
  • Letting us know how important something is
  • Clarifying our values
  • Connecting more deeply with others
  • Preventing or stopping being taken advantage of
  • Validating oneself
  • Letting us know what we care about or what matters
  • Taking care of the people we love

Getting in touch with emotions is hard for many people, and often scary if you have little practice doing it.

Problems generally come when people have secondary emotions, that is, emotions about an emotion. If a primary emotions helps us to solve problems (justifiable), secondary emotions are emotions about emotions (confusing). Secondary emotions are problematic because we often blame the secondary emotion or ourselves when emotions become intense or extreme, which makes can make things more intense or extreme.

Common examples of secondary emotions include:

  • Getting angry (secondary) about being hurt or sad (primary)
  • Feeling guilty (secondary) about desiring something or wanting something/ jealousy (primary)
  • Becoming blaming or self critical (secondary) about something that is uncomfortable (several primary emotions).

Sometimes secondary emotions become third and fourth generation “emotions”; such that a person feels guilty that they feel angry that they are upset that they ever were emotional in the first place. The cascading discombobulation of emotions often makes figuring out how emotions work in the first place.

Working on identifying primary emotions is, after all, “work”, but when people are well connected to their primary emotions the overall time spent avoiding difficulty feelings is much less problematic.

How To Survive Painful Life Situations

  • Accept that pain will come your way. The more you pretend that pain is not there, the worse it will get.
  • Write down a scenario in which you imagine coping well.
  • Let go of what you can not control. Stop doing what you can not do. 
  • Rehearse acting according to your values and believing you did the best you could despite the circumstances. 
  • Don’t avoid doing things that are a little bit hard just because you are suffering; approach tasks that give you a sense of accomplishment. 
  • Increase your connections with other people. Pain allows us to be vulnerable, soften our stance, and let others in. Bearing pain is easier when we are not alone. 
  • Find people in your life and express appreciation to them openly. 
  • Are your actions effective? Do what is needed to get through the situation. Don’t do something that will make it worse. 
  • Assume that you are not the only one who is suffering. 
  • Contribute, help out, help others solve their problems; find ways to make other people’s lives easier. 
  • Do one thing to nourish your body and your soul.
  • Write yourself a compassionate letter in which you acknowledge the pain and difficulties you are facing. 
  • Find one thing someone else can do to lighten your load and see if they would be willing to do it. 
  • Find three things a day that you are grateful for and share them with someone else. 
  • Stop comparing, judging, or evaluating your emotions. 

 

What are Dialectics and Dialectical Behavioral Therapy Skills?

What is Dialectics?

Dialectics is based on the idea that two opposing concepts can both be equally true. One truth does not trump or rule out another, which undercuts the dichotomy of a “I am right you are wrong” type of relationship. A common dialectic is that you are perfect as you are (acceptance), and that in order for things to turn out differently in your life, you need to do things differently (change). One is not more true than the other, and one truth does not rule out the other truth. Sometimes people need acceptance, and sometimes people need to be challenged. Both belonging and growth are an inherent part of being in relationship.

Dialectics challenges the idea that one person is always “right”, because when you take into account diversity of perspective, other truths often arise. Being “right” often fails to take into account effective communication and the value of the relationship. Experience and emotions get ignored. A set agenda of being “right” often gets people stuck in a very rigid, dichotomous, black and white, non-dialectical stance. Dialectics are important in that sometimes you can find the one thing you have in common with your enemy instead of focusing in ways you are different. Relationships exist in context of conflicting truths, yet relationships are the glue that carries us through life.

What are the four Dialectical Behavior Therapy Skills?

DBT is a complex treatment that has confusing origins in terms of how it was developed and who it was for, and has been tailored to a wide range of populations and settings. The DBT skills are universally applicable materials that help people with extreme and painful emotions, intolerable life situations, and relationships. The four skills sets are as follows:

Core Mindfulness: Mindfulness is a skill that helps people focus attention, regulate arousal, calm the brain, quiet the mind, and settle in. Being mindful is a way to steady and anchor oneself in order to observe quietly and not “react” to what is going on. It is inherent in all of the other skills in that it requires a steady, quiet, secure stance in the face of demanding life situations. It takes spaciousness to know what is going in with your body, your self-experience, your wants and desires, and your life. If you don’t pause the moment and check in with yourself, it is easier to get “caught up” in the banging and thrashing of what life throws in your direction. Mindfulness can be a spiritual practice of quiet contemplation, a way to press the pause button, and way to regroup. Core mindfulness skills taught from the DBT material include skills of observing and describing without judgement. Other traditions, spiritual practices, health care services, and therapies teach mindfulness, so it is not “new” nor is it confined to just DBT skills; its roots are actually in Zen Buddhism. There are multiple ways of accessing mindfulness including mindfulness based programs, meditation groups, trainings, and apps. DBT groups are known for implementing a mindful practice or exercise in every group, and like many spiritual traditions are simply considered part of a daily practice.

Emotion Regulation: This is a set of skills that helps people to observe and describe what they feel (you can see the overlap with mindfulness) in order to help regulate arousal, understand what they feel, and know the reasons why they feel the way they feel. Skills cover ways to reduce emotional suffering through mindfulness and opposite action, and ways to reduce vulnerability to emotional suffering. Skills are quite complex and take practice, feedback, and validation. Since emotions can be tricky, elusive, (and just plain unbearable at times) the emotion regulation content is not something you could “quick learn” and be done with it. Sometimes people are not always aware of how or what they feel in general, and there is nothing pathological about this. It is a process! Knowing oneself and knowing one’s emotions is a lifelong task not subjected to any particular type of disorder, and does not end just because you have had a first exposure to all of the skill content. That is why working together on ways to regulate arousal given varying life circumstances can best be done over time in small group settings that promote cohesion and intimacy.

Distress Tolerance: In order to regulate emotional arousal, finding ways to endure the “I-can’t-stand-it-itis” of painful and extreme emotions is critical. Surviving painful life circumstances well means doing so in a way where people do not lose self-respect, forget their values, give up what is important to them, or react in such a way that makes things worse. Sitting in the fire and not reacting is often harder than picking a fight, poking the fire, making others suffer in order to prove a point, exacerbating pain to let others know how bad things are, undermining a person where it hurts, forcing the university to prove its point, perseverating on being “right”, asking “why me”, or engaging in self-defeating or relationship destroying behaviors. Being willing to tolerate the unknown, be zen with the universe, stop fighting reality, and do what works is skillful practice. We all want things to do our way or to turn out for the best. In reality, a lot of people are suffering a great deal and need everything they can to survive well. Distress tolerance skills encompass not only change strategies (if you can do one thing make it better, why wouldn’t you?), but acceptance and willingness skills. Anyone who has successfully undergone any type of exposure treatment for anxiety knows that the benefit to tolerating anxiety is a decrease in overall anxiety. There is an inherent truth that reality is easier to face once you stop fighting it, thus freeing you up to do what is needed to effectively solve problems.

Interpersonal effectiveness: True to the concept of the dialectical philosophy of DBT, it is better to be effective than it is to be right. The interpersonal skill content encourages readers to identify objectives in situations (what exactly it is you want or don’t want), how the relationship may be impacted, and if self-respect is at stake. Balancing the three helps people to look at natural barriers and consequences of interacting, and enables readers to problem solve the cost/ benefit of ignoring each. For instance, you can ask for what you want at the expense of the relationship, or you can give into a relationship but sacrifice self-respect. The balancing act of relationships is an ongoing challenge for everyone, and some give and take is part of how people stick together, find intimacy, and keep people close. Interpersonal skills also include ways to get out of or decrease contact with toxic or unwanted relationships, set limits, say no, and to identify barriers to doing so. Direct rehearsal in terms of “what to say and how to say it” benefits group members in that they can try out and receive feedback in both verbal and non-verbal forms.

A book of all the DBT skills is available for purchase via this link: https://tinyurl.com/y2qad6sk

Here is a short video of me on YouTube with an overview of the skills: What Are the DBT Skills? DBT Skills with DrReneeHoekstra

Got emotional problems? What are you going to do about it?

The following options are adapted from Marsha Linehan’s DBT Skills Training Handouts and Worksheets (see link under books I recommend on my website) page 10.

Solve the problem if now is a good time to solve it. Most people who avoid solving their problems end up avoiding their problems. When people avoid problems, problems tend to build up or become even worse. It is not a good feeling to know you are avoiding a problem, and solving problems is a practical and understandable path towards reducing distress. Skill building, practice, rehearsal, obtaining feedback, breaking things down into steps, evaluating the effectiveness of the steps, and challenging yourself slightly are all ways to approach problems. Emotional problems generally get us to take action or are telling us to do something about it. Consider this statement: Everything is as it should be unless or until something is done to fix or change it. In other words, don’t sit on your hands if you have some responsibly to speak up or do something about it.

If now is NOT a good time to solve it, don’t make it worse. Now may not be a good time to solve it because extreme emotions get in the way or extreme emotions make your attempts at problem solving ineffective. In this case you may need to work on regulating your moods, which can entail identifying your feelings, figuring out what the threat is or the trigger that sets you off, looking at how you interpret the incident, and coming up with a more adaptive means of interpreting and responding to the event. As Lori Gottlieb reminds us in her recent book, Maybe You Should Talk To Someone. And (of course), skills from the Dialectical Behavioral Therapy Handouts and Homework worksheets could be of assistance.

If you could do one tiny thing to make the current situation better, what might it be? Sometimes treating yourself or someone else with kindness, gently avoiding the situation for the time being, doing something to shift gears (self-soothing, exercising, activities, engaging your brain or body differently, or focusing on something or someone else for a while) can make you feel better. People who can’t do anything about a painful life situation generally want to ease their experience. Finding compassion for oneself generally generates an easier time of things, rather than critical self-blame or self-defeating behaviors.

Focusing on accepting and/ or tolerating what you can’t control. Resisting reality, throwing up one’s arms in defeat, doing something to make the situation worse, or staying miserable when there is something you could do to feel better about the situation generally don’t get people unstuck. Acceptance is a hard task and does not necessarily mean approval or passivity. It just means a willingness to bear with the uncertainty or difficulty of what you’re going through.

Why Your Psych Meds Aren’t Working- A Bitter Pill To Swallow?

Psychiatric meds actually do work, and they very well may be working. Psychiatric medications have helped numerous people with many different things, including nightmares, anxiety, symptoms of bulimia, public speaking, mood regulation, paranoid thoughts, and depression.

However, there is one thing that medications will never do, and that is get rid of emotions. Emotions are hard wired, biologically adaptive responses to situations that help people survive. They give people important information about threatening situations and painful circumstances. The allow people to know what matters, what to hold close, what to pursue, what risks to take, and what to avoid. Without emotions we would not have important information about ourselves, our circumstances, our environment, and other people.

People have tried numerous and unsuccessful things to get rid of emotions. This might include drinking, drug use, numbing out, hurting oneself, picking fights, avoiding, sleeping, dominating a conversation, being coercive, smoking marijuana, or being violent. The simple truth is, emotions can’t be eliminated. If they are temporarily eliminated, they come back.

Some people don’t like their emotions because their emotions show up when other people tell them what to do, how to think, how to feel, or how to react. Thus they minimize or inhibit their emotions in these situations because they are trying super hard to fit in, avoid conflict, live up to someone’s standards, please a parent, or survive in their environment. However, this can lead to a very unhappy life and can be very painful.

Sometimes people are very sensitive to emotions, thus they tend to have strong reactions to things that may, to others, not seem like that big of a deal. While this can lead to bigger, out-of-control emotional problems, it is also important to learn how to discern when a threat is actually a threat, vs. when a person develops a fear or phobia about something that is not a threat.

Emotions are often related to eccentric, atypical, or problematic behavior. If you have a behavior that you are trying to stop doing, just consider if not doing that behavior brings up any discomfort, anxiety, or restlessness for you. Asking people to stop doing behaviors such as self-harm, drinking, escalating an argument, threatening suicide, doing a behavior excessively or repetitively, or picking a fight is quite hard. The benefits if these behaviors can sometimes include getting a point across, expressing an emotion, getting taken seriously, reducing anxiety, or getting another to be validating or affirming. Sometimes significant others don’t react at all until another person escalates or flips out, which makes the problem behavior even harder to stop. (After all, it worked!).

If you think your psych meds aren’t working it may be worth asking yourself: What feelings do you have that are intolerable? What do you think your feelings might be telling you? What feelings do you try to ignore? What feelings are trying to get your attention? How willing are you to bear with some of the discomfort of what is going on for you? If you honored your feelings and what they were telling you, what sort of action would you take?

Understanding, naming, managing, and controlling moods are a lot of work. Thankfully, there is are services available that are focused on doing just that- and aren’t focused on dosages or prescriptions. While meds do wonders for people- they are not, thank goodness, the only way of helping a person solve emotional problems. In fact, the entire basis of the group services that I provide help people with all of this- managing mood, understanding emotions, listening to one’s wisdom, and taking necessary steps to tolerate feelings better. Getting rid of what you feel is just not an effective long term strategy for solving emotional problems.