Are you running the Boston marathon today?

 

Since this is the day of the Boston marathon, I thought I would write a blog post about running.

Running!

Some people spend their lives running. Running is a way of getting away from something. It’s a matter of going fast. It is a way of living life in fast forward. It is a way of being busy and not having stillness, quiet, or calm. It’s a way of being busy, distracted, and pre-occupied. It’s a way to move, skirt around, avoid, and leave painful sensations behind.  Some people run away in their hearts, their minds, or their bodies. Some people run because they are afraid that:

  • If they don’t run they will start crying, and if they start crying they will never stop.
  • If they don’t run they will become angry, and then do something they regret.
  • If they don’t run they will be anxious, and therefore they will stay anxious forever.
  • If they don’t run they will feel sensations in their body, and the sensations will overwhelm them.
  • If they don’t run they will feel things they don’t want to feel!

Do you have any idea about what you are running from?

 

Should you change your behavior or change your beliefs? A closer look at self-compassion.

Social psychology research indicates that it is easier to change behavior than it is to change attitudes or beliefs. Part of what characterizes third wave behavior therapies (such as DBT) is behavioral activation. In other words, there is a focus on changing behavior over changing attitudes.

Here is one of the most predominant ways this shows up in DBT: A client with extreme self-hatred or self-blame won’t do things that are nurturing, caring, or compassionate towards oneself. The argument goes something like this: “I don’t deserve, I would feel guilty, I have to take care of everyone else, it’s always my fault anyway, I deserve to be punished…” It is easy for others to follow up with this argument by challenging, cajoling, or even opposing the argument. “Why do you think this way, of course you deserve, you can’t cater to the whole world, stop talking that way…” The dialogue of I don’t deserve/ yes you do deserve can become rather exhausting. If you’ve ever participated in one of these conversations, you could probably relate.

Part of the skill set for tolerating distress has to do with treating oneself with compassion. More specifically, engaging in behaviors that are self-soothing, calming, respectful of sadness, and a soft acknowledgement of the rough and painful aspects of life generally help people through the rough times. People who don’t do enough of this and treat themselves harshly are going to have an even harder time getting through the roadblocks of life. Self-attacking just isn’t a very effective way of solving problems.

If you are extremely miserable and you would like to feel better you may have to change your behavior despite whatever argument is going on in your head. If you could do something to make your current distress more tolerable, why wouldn’t you do it? If you could treat yourself with kindness and compassion, be understanding, and acknowledge your deepest fears and hurts- at least to yourself- why wouldn’t you? If this made your life easier, more livable, and more hopeful- why wouldn’t you do it? Arguing about deserve-ability certainly isn’t doing anything for you.

In order to feel differently you have to act and behave as if self-compassion and kindness matters. You may have to tolerate some guilt, set some limits on your time, or even say no to the demands of others. The point is that you should get started on acting and behaving in ways that are worthy or deserving of you. Over time, your attitudes may change right along with your behavior. And in addition to feeling better because you are behaving as if you have more self-respect, you will have more resources for coping when other people put you in demeaning situations, take advantage or you, or assume that you are willing to be treated poorly.

10 ways of getting through a crisis:

  1. Remember what matters- Connect with those you care about. Bring to mind, relive, remember, and cherish the connections you have and what your current relationships mean to you.
  2. Look for meaning in the current situation. See if there are any positives. Sometimes being in a lot of pain makes you more sensitive to others who go through the same thing.
  3. Keep in mind the “bigger picture” and long-term goals. If you don’t have a “bigger picture” or long term goals, start making them. Working towards long-term goals also produces positive emotions and a sense of mastery and achievement.
  4. Consider what you have that other people don’t have, and how other people could be jealous of what you have. Look for what this is- whether it is a job, an able body, health, a place to live, a relationship, or a child.
  5. Take care of what you need to take care of in the current moment.
  6. If you can’t solve the problem right now, do something restful and restorative.
  7. Maintain balance in your life by giving your mind a “break”- plan adaptive distractions that have nothing to do with your current life stressors.
  8. Remember that physical activity can help you “shift gears” by releasing endorphins and changing your physiological arousal. Since changing physiological arousal is also associated with emotions, this can also help you with your emotions.
  9. If overwhelmed, focus on doing what you can do. If you are able to achieve or accomplish one step, then you can move on to the next. There is only one way to get through a crisis- and that is one step at a time.
  10.  Consider your options for how you typically respond to a crisis, and see if your options include complete avoidance, making things worse, or escalating in a way that doesn’t solve problems or is not helpful. Take the first step towards doing what works and what will get problems solved the fastest.

Boston traffic and jammed T stops: How to practice willingness

Often, when we don’t want something to be the way it is, we fight our way through it. We complain loudly, we tense up, we try to do it quickly in order to get it over with, or we avoid doing it all together.

Willingness is the idea of doing something with receptivity. Doing something willingly doesn’t really mean that we have to like it or want it. Doing something willingly is doing something because it needs to get done. I like to think of it like this: The universe requests us to do things that we just sometimes have to do. Sometimes those things include speaking up for ourselves, saying no and being willing to tolerate conflict, telling someone how deeply we care about them, or taking responsibility for something that we don’t want to take responsibility for.

There are many things that challenge our willingness to be willing on a daily basis! But this is how it works: When we stop fighting or avoiding our capacity to deal with life (on its own terms), life itself gets more tolerable. Seems paradoxical!  May not change it. May not be ideal. May even mean experiencing pain.

Inviting yourself to be willing involves relaxing your face, being gentle with yourself, quieting your breathing, and getting into a willing posture. Quit tensing your jaw and relax your shoulders. No glaring. No harsh words. It may even mean changing your tone of voice to invite compassion and kindness.

One great way to practice willingness is when you get stuck in bad traffic or when you get stuck on the T (the subway here in Boston).  Practicing willingness with the less important day-to-day life issues is one way to get you started on the path towards willingness. Imagine this as an opportunity to radically accept that the universe is throwing you a bone- and your task to survive it with the least amount of suffering possible.

 

Are the people around you giving off too much negative emotional energy?

If someone is ranting and raving, throwing stuff about, yelling loudly, talking in an accusatory fashion, complaining loudly, or noisily expressing a great deal of rage- it can be just plain difficult to be around them. Emotionally sensitive people- the observers who have to bear witness to these scenarios frequently- may absorb the intense emotion like sponges.

If you are an emotional sponge who often soaks up negative emotional vibes from other people, you might want to try a mindful task. Simply step back and take notice of what is actually going on. When you are able to observe rather than react, options for responding will open up.

In truth, this is much harder than it seems. Especially if you have a tendency to fix, problem-solve, or take care of the situation while the person is yelling at you or treating you badly.
Gently stepping around the person- while allowing them to vent all their emotional energy- will help you avert yourself as a target. Here are some suggestions on how:

• Avoid urges to react “back”
• Notice urges to take care of the situation, fix the problem, or reassure the person
• Notice what you do to avoid confrontation or appease the person- and if you simply stopped doing this- what would happen. Notice if there is anything you would have to tolerate that would be hard for you.
• Consider the problematic relationships this person may have (given how they are acting). Consider if this is something that you really have control over.
• Try to figure out how you would describe this behavior and its consequences in a matter-of-fact and non-judgmental manner- and consider doing it when emotions aren’t as high
• Acknowledge openly what is- instead of pretending that something isn’t
• Quit blaming yourself

Conflicts offer us lots of opportunities to be effective, solve problems, and have difficult conversations. Emotions often energize us and get us moving. However, in some cases, emotions mobilize movement but don’t effectively help solve problems. Sometimes, letting others live with the consequences of behavior (as opposed to reacting and fixing everything) gives us a little more power and can be a lot less work.

Are clients with Borderline Personality Disorder too needy? Follow up thoughts from attending the NEA BPD conference.

This past week I attended a conference hosted by the National Education Alliance for Borderline Personality Disorder. Dr. Alan Fruzetti presented on Dialectical Behavior Therapy and Dr. Anothony Bateman presented on Mentalization Based Treatment (an alternative treatment for BPD). Then they both did a “role play” of a session (with the same client and same presenting concerns)- each demonstrating the theory and application of the treatment they represented. It was a wonderful opportunity to see two very skilled clinicians at work.

During the role play, the acting client identified a great deal of difficulty when her boyfriend suggested that he did not want to “cuddle” with her- as he wanted to “take things slowly.” She expressed a great deal of distress about this situation- including thoughts of suicide.

At the end of the role play, Dr. Fruzetti asked the audience if they believed that the client was “too needy.” Several people raised their hands. He then suggested that he did not believe the client to be “too needy.”

I really appreciated that he did this- mainly because of the stigma in the field around borderline personality disorder and neediness. Having, wanting, needing, or desiring things in the first place has somehow been interpreted as pathological and problematic- and gets punished. (“It should not be as it is. You should not be as upset as you are.”) It also seems to defy self-acceptance. Clients often have some deal of difficulty sorting out confusion regarding self-experience (ie, not feeling real, confusions about experience and feelings, acting or behaving in ways that are inconsistent with intentions). It seems that pathologizing the wanting only makes things more confusing- and creates more problems- and I regret that it is so common in the mental health field to do so.

Being clear about what is wanted is a sign of improvement. Knowing adaptive and effective ways of getting it involves skill. Attacking oneself for wanting or desiring something in the first place is not an effective way of solving a problem. In addition, attacking oneself for wanting or needing things in the first place reinforces this idea that reality should not be as it is. Accepting how things are also involves acceptance of oneself- even though wanting something very badly can be painful.

Relationships and misery

Ever think about why people hang onto things that would be easier to let go of? Have you ever had anyone in your life drive you crazy because they are stubborn, rigid, inflexible, or demanding?

Sometimes it is really helpful to consider the benefits of staying miserable. Most people would probably not think of this as a conscious decision, or even consider the business of misery as anything that has to do with choice. Sometimes this behavior is so automatic that persons aren’t even aware there are other options.

The cost associated with NOT changing behaviors- continuing to do things that are hurtful or intentionally adding insult to injury- is sometimes very big.  If a person had to stop doing such behaviors, they would have to tolerate something. They would have to stay still, not take action, not do or say mean things, or even act in a way that is different or opposite of what they are doing. This may also involve a concerted effort to attend to and stop to automatic behaviors. In addition, other options must be available (conscious) in which alternative ways of communicating are effective (getting the point across) and the person doesn’t have to be mean or lose face (diminishing self-respect).

Sometimes it is easier to find compassion for others when we recognize ourselves in these painful moments- moments in which we did not want to accept painful realities-and change our behavior for the better. We wanted to hang on to something, to stay miserable, to fight back, to add insult to injury, and rant and rave in our corner of the universe.

However, finding compassion for ourselves and finding compassion for others generally opens the door for acceptance, receptivity, and openness. In sorrow and pain we can experience joy.  When we can soften our stance, we can get along better with others (and ourselves), move towards understanding, create some breathing space, and work with less harshness and rigidity on solving problems.