Here are some paragraphs from this book:
“When the bottom falls out and we can’t find anything to grasp, it hurts a lot. It’s like the Naropa Institute motto, ‘Love of the truth puts you on the spot.” We might have some romantic view of what that means, but when we are nailed with the truth, we suffer. We look in the bathroom mirror, and there we are with our pimples, our aging face, or lack of kindness, our aggression and all that timidity– all that stuff.
This is where the tenderness comes in. When things are shaky and nothing is working, we might realize that we are on the verge of something. We might realize that this is a very honorable and tender place, and tenderness could go either way. We can shut down and feel resentful or we can touch and I met throbbing quality. There is definitely something tender and throbbing about that groundlessness.
Things falling apart as a kind of testing and also a kind of healing. We think that the point is to pass the test or to overcome the problem, but the truth is that things don’t really get solved. They come together and they fall apart. Then they come together again and fall apart again. It’s just like that. The healing comes from letting there be room for all of this to happen: Room for grief, for relief, for misery, for joy.”
Going into the bookstore has always been a positive experience for me. I am always filled with wonder at the millions of things I feel I could learn when I visit a big bookstore. I get the sense that I could just pick up a book, read it, and acquire a new skill, craft, or some time of knowledge that wasn’t there previously.
A few years ago, though, I wanted to write my own book. I was working on The Emotional Extremist’s Guide to Handling Cartoon Elephants. I would go into a bookstore and I would have the sensation that there were so many delightful, treasurable, and competing ideas and books that it almost felt as if I would just become one more competing voice. That my contribution wouldn’t make a difference. That all the ideas were taken. That people had accomplished so much more than I would ever be able to accomplish. The experience of going into the bookstore, as exciting as it was, had the potential to tap into my anxiety and prompt me to stop writing my book.
Sometimes “good” stressors open up in our life. What we really want is at our fingertips. Feeling good, contributing our own ideas, finding our voice, speaking up, influencing the world, and getting out of a place of feeling trapped, helpless, or stuck becomes an option. It’s there in front of us. We have the choice to be powerful and make a difference.
Sometimes these options cause us to shy away, shut down, stop believing in ourselves, not think we are good enough, or feel as if we are undeserving. These types of beliefs get in our way of taking action, having a better life, and surrounding ourselves with things we really want.
Here is a question for you: What is the cost of sitting back, becoming inactive, or avoiding what you want the most? How might your life be different if you approached -and got- what you want?
Ultimately, I was able to finish my cartoon elephant book. My confidence may still vary when I am around lots of beautiful books, smart people, or fabulous contributors to society. But I know that by not giving up on my goals, people have enjoyed my cartoon elephants, given me positive feedback about my book, and have found the cartoon elephant book to be a fabulous resource in addressing their own painful emotions.
Try softening your stance, gently relax your face, and allow your muscles to become loose and less tight. Put a hand over your heart with an intention of lovingkindness, and try repeating the following statements with a tone of voice that conveys self-compassion:
May I bear this pain with kindness to myself
May I safely endure this pain
May I accept the circumstances of my life
May I find peace in my heart
May I let go of what I can not control
May I remember that others are also suffering
Often people with self-hatred, shame or self-criticism get “caught up” in a thought process that includes a fair amount of self-attacking. This thought process can include arguments with oneself, reasons a person should not be the way he/ she is, or a rationale for how he/she “should” be feeling. Sometimes this thought process is associated with muscle tension, headaches, the suppression of emotion, the inhibition of interactions, or the shutting down of expression and experience.
People sometimes think that by punishing themselves in a self-hating dialogue is an effect way to change thoughts, feelings, or reality. Almost as if they are somehow being “deserving” of “bad” things someone sets things right. The difficulty is, it typically is not an effective strategy for changing thoughts or feelings! It might temporarily suppress feelings, shut down hurt or sadness, make one feel more empowered or less vulnerable, or even distract from other problems. But the bottom line here is this: Does actually work to reduce suffering? Does it get rid of emotions in the long term?
Being mindful, or starting to observe this process, is really the first step towards making some changes in this process. Being able to notice the thought, step back, practice using a gentle tone of voice, and practice saying “I am noticing the thought that…” is one way to start to just notice thoughts, rather than try to change them.
Next, assess your willingness to “shift gears.” Often people who are stuck in a ruminative process somehow believe that if they keep ruminating, something will change. That’s not to say you have the power to immediately “stop” ruminating, it just starts to get you thinking about an alternative.
If you feel miserable, want to stop hating yourself, and invest a lot of unproductive energy into engaging in self-hating thoughts, the option of doing something different just might be appealing. Once you decide to try something different, you can try softening your facial expression and relaxing your shoulders. Consider being curious about the physical sensations in your body that accompany the thought. What uncomfortable sensations might you be pushing aside in order to invest in the thought? Practice accepting physical discomfort and think about how you might approach or move towards it instead of away from it. If you could be curious about your pain and your emotion, you might be able to work with it a little bit differently. Remember to stay non-judgmental.
Finally, try out the phrase, “May I be at peace.” Try stating this phrase quietly and softly to yourself. Make sure you keep your face and shoulders relaxed, and practice acceptance. Try doing these steps several times throughout particularly difficult days, knowing that practicing new behaviors (and getting “good” at them so they are more automatic) takes effort and rehearsal.
How did this class help you? Here is the feedback from four parents who took the Spring 2015 class:
“To try and react better..To try and anticipate my daughter’s behavior triggers..try to find out what is causing the extremes and deal those triggers… By accepting emotions and where they are coming from; not to deny my emotions but they are there for a reason. To validate how I feel as well as my daughter. To be calmer. “- Parent 1
“To better understand my emotions, and that they have a purpose…To explore that purpose. Better able to identify escalation in my daughter. I’ve learned to buy time, to put some time in between responding to my daughter and others. What was most helpful was the overall impact of the course which has left me better equipped and more curious about DBT.” -Parent 2
“It made me more willing to bit my tongue, take a deep breath, and not focus on ‘fixing things’. Acceptance was important, both dealing with my own emotions and allowing for acceptance of my child’s emotions. Using mindfulness techniques to tone down my level of arousal was also important. Understanding that emotions might be valid but ineffective in some circumstances. I thought the (video content shown in class) outlined some very pragmatic examples and techniques.” -Parent 3
“To be more present with my emotion. To validate how I feel as well as my daughter. To be calmer, to think things through. Being able to listen to others’ experiences. Each class was built on each other. Have learned many skills to be more effective with my daughter.” -Parent 4
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The problem with figuring out if anger is “good” or “bad”; “healthy” or “unhealthy” doesn’t allow any opportunity to figure out what anger does, how it works, and why it makes sense.
Think of your living room couch. Is it a “good” couch or a “bad” couch? Wouldn’t it sort of depend on a bunch of different things- such as comfort, style, how old the couch is, how many people can fit on the couch, or if the couch actually suits you? Usually if a couch has a use, serves a purpose, or does what it is supposed to it is considered valuable. While it is possible that you are sick of your living room couch- perhaps you think it is time to get a new one- your couch may be necessary to hang on to for now. On the flip side, you may be very happy with your living room couch. This could make it more likeable and increase your tendency to say, “It is a good couch.”
Emotions- like anger- are like couches. Instead of thinking about anger as being “good” or “bad”, it is more important to consider the following:
How is anger serving a purpose, fulfilling a function, or doing something useful? Anger can function to communicate, get someone to back off or change behavior, or change a situation for the better. Think of it like a red flag, a signal, or a message.
Is the way in which the expression of anger is effective? In other words, is the way you communicate your anger working for you? What a person can make use of their anger by being aware of it (experiencing, tolerating, and understanding what it does for them) it increases the opportunity for effective expression (ie, another person heard, understood, and responded accordingly). On the other side, ranting or attacking often hurts relationships and doesn’t always send a clear message about expectations or desired change.
What are the relationship consequences for how the anger is being expressed? Relationships at some point might undergo rifts, misunderstandings, and irritation. The ability for people to tolerate these things in relationships sometimes help people grow, initiate important discussions, and bring about change or intimacy. On the other hand, anger that is overly intense can damage relationships, hurt other people, or add insult to injury.
First of all, I’m going to say that focusing on the why this behavior occurs is probably not the most effective approach to addressing adolescent self-harm. I’ll give you some reasons why teenagers self-harm in a minute, but the one fallacy that people often have is that if they could explain why behavior occurs, then they would actually have the tools to fix or change it. More specifically, teenagers who may not understand the behavior themselves can often be put in an awkward situation in which they are forced to explain the unexplainable. If they don’t understand why the behavior is occurring in the first place, they may end up giving inaccurate reasons simply to appease their environment.
Self-harm behaviors likely have something to do with emotional pain. Possibilities include ways to control feelings, ways to control oneself or one’s behavior, ways to increase intensity of feeling (ie, the need to feel “real” or the need to feel “something”), or ways to decrease intensity of feeling (“If I didn’t cut I wouldn’t have been able to tolerate the situation”). Understanding how emotions work and what they do for people may is critical in understanding the role of self-harm behavior. For instance, feelings are functional in that they give useful information about what matters to us, communicate to ourselves and others, and help us become organized and prepare for action. Without feelings we just wouldn’t care.
In adolescence, self-harm behaviors may play a role in identity, communication, and intimacy. Self-harm may be kept very private or it may be made public. It may be an attempt at controlling one’s environment or letting someone else know that the person doing the self-harm cannot be controlled. The function of the behaviors may communicate to oneself (I know I matter, I know what I have to say is important, I can’t stand by and let nothing happen, I am not pleased by the situation, This is my way of making a statement), or to others (Back off, This is too much, I can control your reactions, I know you will be upset and freak out, There is nothing you can do about this, You can’t claim to know me, You think you know everything and you don’t).
Treatments for self-injury are not as simple as publicizing behavior (ie, making sure that others know about it), invading privacy by doing body checks, or just stopping doing it. If there was no benefit to doing it, no one would do it! That’s just simply how it works. Knowing the benefit can help someone to organize an effective solution. Teenagers who can obtain help in identifying, accurately labeling, understanding, and communicating their feelings effectively will have more options for what they can do when the urges to self harm show up. Increasing options, understanding the short and long term consequences of this behavior, and providing alternatives for how to tolerate intense, painful, and negative emotions is certainly one way to start.
It’s important to remember that teenagers also have their own feelings about this behavior. Some are opposed to changing it, some don’t want anyone to know about it, some want everyone to know about it, and some feel really hopeless that they can’t stop doing it. Most have some degree of mixed feelings. Assuming and communicating that a teenager simply doesn’t want to change is probably not going to help solve the situation. While it might be a likely, blaming a teenager for doing it usually only serves to communicate a parent’s frustration.
Similarly so, parents have their own feelings about it and may feel disgusted, hopeless, overwhelmed, inadequate, or guilty. How parents communicate and address painful emotion will also impact the situation; and thinking through the effectiveness and intensity of one’s own responses may be part of the work involved in addressing teen behavior.
I think it is important to consider that the problem of self-harm behavior has solutions. Sometimes providers, teachers, parents, and community react with an abject horror that stirs the pot, gets everyone all worked up, and in some cases emphasizes the solution (self-harm) and not the problem itself. Emotional problem solving is really just that- emotional problem solving. If a person can figure out how to problem solve (ie, address, tolerate, understand, deal with, validate, survive) painful emotions, then their way of solving problems (ie, self-harm) may decrease. Finding effective solutions means having an adequate way to assess and address these behaviors with a skilled professional who understands the role that these behaviors serve.
Individual outpatient therapy with adolescents can sometimes be limited in that
1) It can fall into Question and Answer sessions-losing the spontaneity and flow of a helpful interaction
2) Adolescents have shorter attention spans, and keeping them focused on painful topics on purpose can be, well, painful!
3) Sharing personal information with an adult you don’t know, but were paired up with because your parents are making you, doesn’t always have the desired results.
4) Adolescents aren’t necessarily going to do things differently because an adult is telling them to.
Group therapy has several advantages in that
1) Its members will be able to tell your daughter if they like it, how it is helpful, and what it has done for them.
2) It is private (no one knows each other outside of the groups) and participation can be minimal (it doesn’t have to be about you all the time).
3) Group members can help each other think things through, make decisions, look at consequences, generate feedback, and put words on experiences in way that an adult provider may not be able to.
4) Talking about peer situations leads to identifying oneself in peer situations- thus what matters is sometimes brought up by someone other than yourself- or an adult, who may not have a clue.
(Hey! I’m not in high school anymore!)