Making space for your jumbled, confused, disorganized, messy, or incoherent cartoon elephants (emotions!).

This is a picture of what your elephants (emotions!) might look like if they get bunched up like a bad traffic jam.

A lot of effort may need to go into sorting, identifying, labeling, and describing your elephants. It is quite possible that you neglect to do this because you do not believe in the existence of cartoon elephants. Or maybe you do not think your elephants are important, other people tell you your elephants are not important, other people blame you for the situation that you are in, or other people do not offer very much space to allow the assortment and organization of your true cartoons.

Here are some tips for sorting your elephant situations: Gently notice your elephants. Make space for their messiness, disorganization, or lack of words. Don’t get hung up on WHY you feel the way that you do. Often people feel if they can not explain what they feel, then the unexplained should not have the right to exist.

When you start to make space for experience, elephants will slowly start to sort themselves out. When people can’t really organize and articulate experience, it can result in incoherence. People need coherence to feel organized, communicate effectively, and exert influence.

If you have nothing more right now than a jumbled pile of elephants going on, make sure that you make some space to be curious, allow elephants to exist (cartoon elephants do, indeed, exist!), and give them a bit of breathing room. It is possible that this task is twice as hard when people around you are unable to do this with you. Remember to be patient with your elephants, because impatience can often result in a bigger jumble. And, if you’re not used to making space for your elephants, it may take a lot of practice.

Don’t give up!

When problems with eating isn’t just about the food

Here are some questions to consider if you are trying to change behaviors around eating habits and may need some additional help getting at the core of the problem. These questions may also help you determine if severe or extreme eating habits are related to extreme distress, painful emotions, or other psychological difficulties:

Is your eating behavior is a way to prove a point, get back at, or communicate something to someone or yourself? Is it a way to self-validate, keep a secret, empower you, or to protect you in some way? Does it prevent or block others from getting too close or getting to know you?

Does your eating behavior have anything to do with preventing feeling? Does it have a numbing effect? Does it block, thwart, or get rid of feelings? Or does it release strong, intense, or unwanted feelings?

Does eating large quantities of food soothe, take care of, provide, or fulfill psychological desires? Does it fulfill emptiness, loneliness, or aching? Do your eating habits have an immediate impact in reducing intense psychological distress or anxiety?

Do you have difficulty tolerating fullness, satisfaction, or contentment? Do you feel guilty if you feel “good”? Is feeling empty/full equated with punishment or success?

Does digesting food have anything to do with digesting your emotion? If you have a tendency to get rid of food through self-induced vomiting or other compensatory mechanisms, what would it mean to you feel full, digest food, or keep what you’ve eaten?

If you were to be completely honest with your eating habits, what would you have to risk? What would be the cost/ benefit of sharing this with someone who wouldn’t judge or blame you?

Sustained and focused attention

When emotional arousal is super high, attention and concentration gets fragmented. Thoughts race, conclusions are jumped to, and worse case scenarios play themselves over and over again in our minds.

The business of being mindful has to do with purposefully directing our attention towards something. That is, we control what we pay attention to. If we control what we are paying attention to, then we are less prone to be being distracted and overwhelmed with racing anxiety and non-useful scenarios.

Out tendency to act without thinking has to get interrupted, thwarted, and re-directed. Ranting and raving, calling or texting people multiple times to seek assurance, and speaking very rapidly are some examples of what people do when on emotional overwhelm. Stopping yourself from doing these things can be very hard and take multiple tries. Especially when you’re on a roll, and your emotional energy is behind you!

The agenda of learning DBT skills is to learn how to slow yourself down. In other words, if you are clear and calm when you interact with people, they will be more likely to take you seriously. In fact, you might even be more able to take yourself seriously!

Focusing on one thing in the moment is one of the distress tolerance skills. Focusing on one thing at a time can be very “moment-to-moment”. Since the moment is constantly changing, you will have to constantly be refocusing. Sound hard? I can’t always do it either.

I was reminded a week ago of how pleasant it can be to work on a task for a sustained period of time without interruptions. (In fact, I was painting cartoon elephants!). I placed my interrupting gadgets away from me and put on some favorite music. I felt different. I was reminded of the difference in how it felt to concentrate on one thing, vs. how it felt to constantly be jumping to many different tasks in the course of an hour.

I have to say, it felt really good.

Dead Like Me

When I was in graduate school I got hooked on the series “Dead Like Me.” This is a show about an 18-year-old girl who dies when a flying toilet seat drops from the sky and kills her. As a dead person, she acquires a job as a grim reaper, which entails touching people who are about to die. Her assignments come on post-it notes with the estimated time of death from a boss who doesn’t provide a lot of answers to the questions she has.

Somewhere early in the season (as she is learning her new job as a grim reaper) she is given an assignment to “touch” a young girl who dies in a train crash. She rebels against this job, as she doesn’t see any reason for this young girl to die.  She begins questioning her control over death as well as the non-sensical aspect of it, and refuses to follow through in “allowing” this girl to die. In the end, it creates additional problems, but she eventually comes to terms her assigned task.

I really liked this episode because it really got me thinking about acceptance and death. When people can’t accept or tolerate that horrendous things happen, there is a way extremely painful events can sort of “not happen”. And it kind of makes sense, because who does want to accept painful realities?

On the flip side, the piece about acceptance that continues to intrigue me is that acceptance is such a critical aspect of grieving. People who stanchly refuse reality get stuck. Really really stuck. Every time the person is reminded of the pain/trauma/death, there is an active effort to avoid it at all costs. The active avoidance or inhibition of grief can actually make things worse.

The painful process of grief involves extremely intense emotion- the ups and downs- the ebbs and flows. It is different from being stuck. Not everyone can be accepting at all times. But moments of acceptance bring moments of movement. And if movement is happening than “stuck” is not happening. And when movement happens, change comes, and when change happens, growth happens. And this is the process of bearing with intolerable life situations.

Ice and emotions!

Emotional arousal= activation of the sympathetic nervous system.

Emotional de-arousal= activation of the parasympathetic nervous system.

One way to get intense, long-acting, and no-longer-useful-but-highly-activated emotions to go down quickly is to activate the parasympathetic nervous system through the use of the dive reflex. This is a reflex in mammals (picture seals diving in cold water) in which the heartbeat is slowed and major blood vessels are restricted. This means that less oxygen is needed in the bloodstream and thus the oxygen can be utilized for major organs. Bottom line: intense emotional arousal goes down.

Here are some suggestions:

1)      Splash cold water on your face. This option may be more feasible if you are not at home and don’t have much time or privacy.

2)      Cover an ice pack with a cloth or towel and press it against your face.

3)      Fill a basin with ice and put your face in it; holding your breath for as long as you can.

PS. I assume there are some risks associated with cold cold water, take heed and use caution. I got these ideas from research studies available online related to the dive response.

Living in fast forward

Unnecessary, restless, and agitated energy; difficulty sitting still, feeling a constant need to be “on the go”, fixing things, running around and trying to keep everyone happy- anxiety sometimes gets us to act in a way that perpetuates more distress. Sometimes people feel as if they are not doing something, then things would fall apart. Or maybe they would fall apart. Perhaps, if they were to slow down, they would not feel worthwhile. Thus frenetic action is about trying to feel better. Or different. Or not feel at all.  So slowing down is avoided at all costs.

While taking action can bring about a desired result (thus serving an important function), sometimes anxiety loses its usefulness as an emotion. It is too much. It doesn’t make sense, it doesn’t help people accomplish goals, it manufactures more chaos, and it leaves people in a dizzy tizzy.  Life is lived in fast forward.

Mindfulness is about pausing living one’s life in the here and now. In just this moment. Sometimes when people start to pay attention to this moment, they start to get in touch with all that busy business they are trying to avoid. The slowing down, the feelings within their body, the unpleasant sensations that accompany worries about being valued, being worthwhile, living up to expectations, and failing. And sometimes it hits hard: the tears, the pain, the realization of change or loss.

Yeah, that stuff.

Overwhelming, perhaps at first. But if you take it taken moment by moment, then you can be mindful of what is right in front of you instead of all that is beyond you. And if you take care of the present moment, you will be taking care of the future.

Treatment for panic disorder

Panic disorder has a lot to do with being afraid of panicking. A comprehensive treatment will address fear of fear, which generally involves approaching verses avoiding fear. This is known as exposure. The basic concept of exposure is that a person stays in the presence of a threatening stimulus long enough for his or her fear to go down, at least a little bit.

When a person has a panic attack it is not uncommon for the person to fear the panic itself. This has the paradoxical effect of making the panic worse. For instance, it is normal for a person’s heart to race when exercising. A person who has panic attacks may start to become hypersensitive to feeling his or her heart racing.  This may result in the person’s avoidance of going up or down stairs. While the intention is to avoid panic, this can be problematic as more situations become associated with the panic. Eventually the panic is more in control of the person than the person is in control of the panic.

Most of the time, the situations, events, or circumstances the person is afraid of are not harmful. Treatment generally consists of educating people on panic and non-useful ways of thinking, It involves helping people regulate anxiety through breathing exercises, controlling their body with progressive muscle relaxation, and facing feared situations over and over again until the fear goes down. Part of emotion regulation training encourages persons to identify the function of the fear (Does it truly help them avoid harmful situations? Or is the fear getting them to avoid living the life they want?). Too much fear may be fear worth trying to change. The DBT opposite-action-to-emotion skill is to approach, which is exactly on target with evidence-based treatments for treating fears and phobias.