Tapping into the Calm

Anxiety pushes us to plan and prepare. We are doing that already: staying well-informed (while limiting our news and information consumption) and following guidelines for physical distancing and handwashing. The call to action in the previous blog post helped me find other things within my control and feel like I am still living as fully as possible in our current context. Even so, there are moments when anxiety and worry vine their way through the cracks in the foundation. So much of current circumstances during this pandemic, and during our pre-pandemic lives, is outside of our control.

We can transform the power of imagination that helps drive anxiety. Often our brains cannot distinguish between something that is really happening and something we are just imagining. Whatever it is we are worried about has not happened yet, and may never materialize, but we imagine it so vividly that our bodies react as though it has: breathing gets shallow, muscles tense, the jaw clenches. Let’s use that power to calm the body.

During the development of Eye Movement Desensitization and Reprocessing (EMDR) clinicians found that bilateral stimulation (BLS) could activate and strengthen clients’ internal resources (e.g. patience, resilience, perspective taking) helping them feel better able to manage their emotional distress. Clients would bring to mind the images, sounds, smells, and felt sense of being in a calm place, with a caring person, or back in a pleasant memory, as clearly as possible and begin to tap alternatingly on either side of their bodies. This could help with falling asleep, calming down before doing something challenging, or taking a break from strong emotions. You can try the meditation exercises below to strengthen your own inner abilities. Each meditation follows the same steps, below:

Find a comfortable place to sit or lie down. Close your eyes. Imagine whatever internal resource you would like as vividly as possible. What do you see? Hear? Smell? Feel? How does that experience show up in your body? When you have a strong positive feeling, begin slowly alternating right-left tapping on the tops of your knees or by crossing your palms in front of you, hooking your thumbs together, and resting your palms on your chest, slowly tapping on your chest like the flapping wings of a butterfly. Check in with yourself. If something does not feel right, stop right away. You may continue tapping for as long as it feels good to you.

Choose your focus:

Go to a Calm Place: Bring to mind a place that feels calm to you, whether real or imaginary. Maybe it is a tropical beach you saw in a movie, the kitchen of your childhood home, the site of your dream vacation, or the first place you will go when you can leave the house again. Imagine the breeze, the smell of cookies baking, the novelty of travel, or the familiarity in visiting your favorite place in town. Notice what signs your body gives that it is relaxing. Add a few slow taps while you notice.

Reminisce About Spending Time with Loved Ones: Especially during this undefined period of physical distancing and limited social interaction, recalling the felt sense of being with loved ones can fool our brains into feeling, in this moment, like we are connected to them in a closer way. Recall the warmth in your chest and arms that you felt during your last hug or bring to mind the encouraging words of a friend. What felt so good in those moments? Notice that and add a few slow taps.

Recall Accomplishments: In the loss of employment many people have lost their sense of self, defined through their work and sense of accomplishment. In addition to using this time to explore other facets of yourself, you can tap in past experiences of accomplishment. Recall how it felt to be recognized after completing a project at work or to finally understand a difficult concept in a homework assignment. Do you feel yourself sitting up taller, pulling your shoulders back, raising your chin? Notice that. Play the memory through while you notice the sensations in your body and tap left-right.

Come back to the here and now. Take a moment to notice the sensations in your body. Going into your imagination for just a moment can shift how you think, feel, and behave in a productive way. Throughout the rest of the day observe that expanded sense of capacity. Are you approaching tasks with more ease, confidence, or from a different perspective? Notice that and let it carry you forward. If you recalled an accomplishment during the exercise just now, you might try visiting your calm place before bed tonight. Experiment to find out what works best for your life.

Jordan Jones, LICSW

Edited by Nehjla Mashal, PhD

Image credit: Photo by Pixabay

Image url: https://www.pexels.com/photo/beach-beautiful-boulders-calm-waters-315987/

Resources:

Bisson, J. I., Ehlers, A., Matthews, R., Pilling, S., Richards, D., & Turner, S. (2007). Psychological treatments for chronic post-traumatic stress disorder: Systematic review and meta-analysis. The British journal of psychiatry, 190(2), 97-104.

Cusack, K., Jonas, D. E., Forneris, C. A., Wines, C., Sonis, J., Middleton, J. C., ... & Weil, A. (2016). Psychological treatments for adults with posttraumatic stress disorder: A systematic review and meta-analysis. Clinical psychology review, 43, 128-141.

Parnell, L. (2008). Tapping in: A step-by-step guide to activating your healing resources through bilateral stimulation. Sounds True. 

Shapiro, F. (2017). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures. Guilford Publications.

Loosening your Grip on Perfectionism

People with perfectionistic tendencies are usually aware of the fact that their perfectionism contributes to their suffering, that their stringent rules create experiences of failure almost by definition. But something happens when perfectionism and anxiety have always been accompanied by goal striving. The two get conflated. You might think you need that merciless perfectionism to be productive. Some feel that if they were to loosen their grasp on their perfectionism, they’d never have a worthwhile achievement again. The perfectionism seems like the engine of every success, and as a result, it grows.

Comparing ourselves to others can maintain perfectionism. Perceptions of others are at best an incomplete story. We know everything about ourselves, including the less shiny stuff. We then compare ourselves to what we can see about others whom we admire at a distance, seeing all of their shiny stuff and none of their struggle. There is an even bigger problem with perfectionism: you’ve lost before you’ve even begun. My work brings me into contact with individuals who are accomplished and even exceptional, and not once has that exceptionality and excellence translated into perfection. That’s because perfection is an impossibility.

Perfectionism may have fueled goal striving, but it’s also costly in every sense of the word. Practicing a talk for five hours will lead to improved performance, but will that performance be significantly better than if you practiced for one hour?  Accomplishments can feel less triumphant because it seems the effort required is so much more effort than others need to put forth. Things that could be completed in half the time take twice as long. Acceptance and Commitment Therapy talks about the “bigger, faster, better, harder” mentality that fuels our chasing an impossibility. We can lose touch with what we care about. Sometimes, we are aware of the futility of the struggle for perfectionism. In these cases, perfectionism can fuel behavioral avoidance. We won’t engage in an activity that would potentially bring us vitality because we know if the goal is perfection, we’ve already failed. Instead, our repertoire narrows to areas of clear mastery, and we further shrink what we are allowed to do and be.

You can be exceptional at whatever it is that you care to do and you will always be imperfect at it. In that imperfection is every satisfaction you’ve ever had. Imperfection not only facilitates growth, it is necessary for growth. Your sense of meaning  and creativity lives there, in that place of challenge between what comes easily now and what you are working towards.

Here are some suggestions to address perfectionism:

-Select an area that feels relatively low-stakes for you and play with letting your imperfect self shine through. Make small mistakes on purpose in the service of growing as a person, teaching you that they are survivable, or saving your time or energy.

-Try something you do not have a natural talent for, something novel that would appeal to you except for the fact that you’re not great  at it. For instance, think bowling if spatial reasoning is not your strong suit, improv if you expend a lot of energy coming across  “just right” in interactions, or painting if you can barely manage drawing a stick figure.

-Reduce checking behaviors & stop overdoing it. Send an email after proofing it quickly and only once. Make small decisions quickly. Choose a meal at a restaurant in under 5 minutes.  Don’t check your appearance after getting ready; just leave the house.

-Remember, what we see on social media is highly curated and is not the whole story. Also, passive social media use, or just scrolling through people’s posts without commenting, is tied to lower well-being, likely because we end up focusing on how we compare to others (Verduyn et al., 2017). If you’re not actively checking in on friends and commenting on their posts, it might be better to take a social media break.

-Be compassionate towards yourself.   To experiment with a different perspective, ask yourself, “If someone I love and respect were in my shoes, what would I say to them about this?” (Greenberger & Padesky, 1995).

-Our minds often engage in misguided attempts to protect us from discomfort. Treat the judgements and discomfort that arrive when trying a novel strategy as an expected and temporary part of creating the positive change you’d like to see. If it were easy, it would already be done (Harris, 2013).

- Consider your goals in a given situation.  Consider whether a "perfect" outcome is actually what you needwant in the situation. Would a "good enough" effort lead to the same outcome and save time?

-Remind yourself what you could access if you weren’t beholden to perfectionism. Maybe it’s more time, a greater sense of self-worth, increased spontaneity, or trying new things.

-Be patient with yourself. Implementing these strategies will get easier over time.

 Nehjla Mashal, PhD

References/Resources:

Egan, S. J., Wade, T. D., & Shafran, R. (2011). Perfectionism as a transdiagnostic process: A clinical review. Clinical psychology review, 31(2), 203-212.

Greenberger, D., & Padesky, C. A. (1995). Mind over Mood: a cognitive therapy treatment manual for clients. Guilford press.

Harris, R. (2013). Getting unstuck in ACT: A clinician's guide to overcoming common obstacles in acceptance and commitment therapy. New Harbinger Publications.

Harris, R. The happiness trap: how to stop struggling and start living. 2008. Trumpeter, Boston, 27.

Shafran, R., Egan, S., & Wade, T. (2018). Overcoming Perfectionism: A self-help guide using scientifically supported cognitive behavioural techniques. Robinson.

Verduyn, P., Ybarra, O., Résibois, M., Jonides, J., & Kross, E. (2017). Do social network sites enhance or undermine subjective well‐being? A critical review. Social Issues and Policy Review, 11(1), 274-302.

Finding Verve, Even While Freezing

I have hit the wall. I’m done. Energy and motivation: gone. Effort to do things: minimal. In the “Bold North” most of us hit the wall in mid-February (some of us hit it after the first cold snap in November). This year is particularly difficult with record snowfall, and today, an expected high temperature of zero degrees. How do you keep going when nature dares you to stay on the couch and fill your body with stew? Adapting to your environment. “Hygge” has been everywhere lately. It’s the Scandinavian concept of creating a warm, convivial atmosphere; think sitting next to the fireplace chatting with a friend or drinking hot cocoa over a board game. Essentially, it is connecting to the present moment.

Sharing our time, energy, and warmth doing activities with others helps rejuvenate what feels depleted. I use the concept of hygge to help me practice willingness in subzero temperatures. Despite my temporary discontent, I enjoy living somewhere that has all four seasons. I like living near my family. This means that I have to adapt to my circumstances to live contentedly, even in harsh winters. Adaptation looks like wearing three layers of clothing in order to take advantage of the snow that I am tired of so that I can go sledding (identifying positives). Recognizing an opportunity and creating a day of fun out of a cardboard box or inner tube and surplus precipitation is a strength; it takes willingness to find verve while freezing. It is reminding myself that shoveling snow is a full-body workout that justifies the cancellation of my gym membership (reframing thoughts). It is leaving the house to share a meal with people that bring me joy (committed action). Hitting a wall energetically can be a cue to find ways to reconnect to what feels valuable to you. Where in your life have you been feeling depleted? 

Jordan Jones, LICSW

Edited by Nehjla Mashal, PhD

Resources:

Byager, L. (2018, Nov. 23). Your Hygge-obsession is Weird and Misunderstood, Please Stop. Retrieved from https://mashable.com

Harris, R. (2009). ACT Made Simple: An Easy-To-Read Primer on Acceptance and Commitment Therapy.Oakland, CA: New Harbinger.

Linehan, M. M. (2014). DBT Skills Training Handouts and Worksheets. Guilford Publications.

Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2013). Mindfulness-based cognitive therapy for depression (2nd ed.). New York, NY, US: Guilford Press. 

Embracing the Concerted Chaos of Your Life

I had one of those mornings. Hectic, moving at breakneck speed, all to get us all out the door well before 7:00 a.m. As I was trying to tear one packet of Ponzu sauce for my lunch from an accordion of packets, I inadvertently tore one packet wide open. It exploded all over my freshly dressed toddler. Being a toddler, she was, of course, deeply offended and began crying almost immediately. I had to make a quick decision about whether we were going to wash her hair or let her go to day care smelling of Ponzu sauce. My husband looked at me, waiting for my lead on this. Afterall, I had done it so that was only fair. I remember the frenetic energy of that led to this exact place in time; I could feel the tension building in my body (mindfulness of current emotion skill; Linehan, 2014). In that moment, I felt almost overwhelming frustration at the fact that our elegant and tightly paced morning routine was shattered. Ten seconds later, I've made the choice to rinse out her hair. She's definitely a bath baby. She doesn't get the mechanics of showering yet. She's caterwauling at a pitch I've seldom heard before. We sing at high volume to soothe her over her cries and dry her off. Her hair is now sauce-free and clean. Her wardrobe change is complete. A tense then earnest bout of laughter at the mundane absurdity of the situation and we say our goodbyes. Everybody gets where they're needing to go, and only a few minutes late to boot. No major catastrophe occurred. 

One aspect of my work is helping other people to relax, savor, and find some tranquility even amid the stress and churn of their lives. But Ponzu-gate felt like the opposite of serenity. It's also my real life. More importantly, it's part of my value-driven life. In that stress, which sometimes feels very costly, there was room for so much more, like how lucky I am to parent and share my life with someone I respect and love, how my love for my daughter has made me stronger and bolder than I could have ever imagined possible.  Nothing is free and I am willing to pay the cost of the relationships that make my heart sing. Continually reminding myself that all of the banal rigamarole, the spilt things, the mess, and the time pressure are all part of the gift has expanded my capacity for patience in difficult situations and makes them, in Acceptance and Commitment therapy terms, “workable” (Hayes et al, 2006). The concerted chaos is my chaos; I hold it lovingly.  

Nehjla Mashal, PhD

Edited by Jordan Jones, LICSW

Resources:

Hayes, S. C. (2005). Get out of your mind and into your life: The new acceptance and commitment therapy. New Harbinger Publications.

Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour research and therapy, 44(1), 1-25.

Linehan, M. M. (2014). DBT Skills Training Handouts and Worksheets. Guilford Publications.

Swain, J., Hancock, K., Hainsworth, C., & Bowman, J. (2013). Acceptance and commitment therapy in the treatment of anxiety: a systematic review. Clinical psychology review, 33(8), 965-978.

Worry Box Meditation

The Worry Box Meditation:

What would it be like if you could let go of your adversarial relationship with your worries?  This exercise can help shift how you think about your worries, moving them from heavy burdens to a reflection of your concerns and values. Over time, this exercise is meant to cultivate a more compassionate relationship with your worries.

I am inviting you create and spend some time in your own room of comfort. Your room of comfort does not need to exist in reality. It might even be outdoors. All that matters is that when you open the door to this place in your mind, it is full of peace and just rightness. I want you give it as many of your favorite characteristics as possible. I’ll be asking you to think about your favorite  smells, colors, items, time of day, temperature, and sounds so that you can fill this room with these qualities.

Go ahead and get in comfortable position. Close your eyes and imagine your room of comfort. The attributes of this place evoke a sense of peace and pleasure in you. Here, it is the exact right temperature for you; identify that, feel it on your skin. Imagine how the room is lit, how bright or dim is it? What are your favorite smells? What are the sounds of this place? Is there music playing, do you hear birds chirping, maybe the whir of a fan, or maybe it is a place of silence? Bring them to this place. What objects do you see? What are the colors that occupy this space? Where are you sitting-maybe a couch, a desk chair, a porch swing, or even on the ground? Really take some time to study this room you have built in your mind. Breathe in the comforting smells, feel how relaxed you are here, in this serene place of your own making. Now, somewhere in this room of tranquility, there is shelf. Take a moment to find it. And on this shelf, sits a box. Visualize this box in great detail. It can be any type of box, it could be a gift box, a jewelry box, or even a shoe box. The only requirement is that this box is beautiful to you. What color is it? What shape is the box? Really envision it’s dimensions, really see this box in your mind’s eye.

Now rise from where you are seated and bring this box down from the shelf. Feel the weight of it in your hands. Now, place it in front of you. Slowly, open the box and set the lid down next to you. In this beautiful box, sit your worries. Your  worries are an orb of light. The orb glows red, your worries are irritated that you haven’t visited them here, in this space in your mind that is full of serenity and comfort. You hold the orb close out in front of you and carefully lift it to examine it.  These are your worries and they are important because they are yours.  Whatever you are struggling with, whatever you are concerned about, it sits here before you. And as you examine this orb of worry, it begins to change. The orb shifts from red to orange, orange to yellow, yellow to green, and green to blue.  Now, gently set the orb back in its box, replace the lid, and walk out of the room, a bit lighter than when you entered.

*This exercise adapts concepts from DBT’s distraction skill of “putting the pain on a shelf, box it up, and putting it away for a while,” EMDR’s use of light in meditation imagery (Light Stream Shapiro 2001), and CBT for GAD’s strategy of using a physical worry box.

Nehjla Mashal, PhD

Ask for Something, You Just Might Get It

A few weeks ago, while puttering about shopping with my family in San Francisco, I encountered a stranger dressed in brick red and black leather, eyelinered and mustachioed. It was pure kismet that I got the opportunity to witness them step into two shops I like, describe their skills, gender identity, and professional background and ask if there were any openings. It was one of the bravest things I've seen outside a therapy room in a long time. I thought about how they opened themselves up to rejection to get to opportunity. This had to be nerve-racking, but it was so efficient: I watched this strategy work to varying degrees at two storefronts. They likely got a job out of it. This person wasn't a client of mine, just someone moving through life with a level of honest-to-goodness gumption I rarely get to see. They were also intuitively leveraging research demonstrating that we are more persuasive than we give ourselves credit for (Bohns, 2016), particularly when making requests in person (Roghanizad & Bohns, 2017).   So, how can you emulate this person? You can ask for something you need or want, preferably in person. Start with something you view as reasonable, where the barrier to asking is your own fear of inconveniencing the other person. The answer may surprise you..*

Bohns, V. K. (2016). (Mis) Understanding our influence over others: A review of the underestimation-of-compliance effect. Current Directions in Psychological Science, 25(2), 119-123.

Roghanizad, M. M., & Bohns, V. K. (2017). Ask in person: You're less persuasive than you think over email. Journal of Experimental Social Psychology, 69, 223-226.

*We will take a look at the realities pertaining to how race, gender, and disability may impact the success of assertiveness attempts in future posts.

Nehjla Mashal, PhD

Edited by Jordan Jones, LICSW

Stop Multitasking (At Least a Little Bit)

Think of a typical day, see it in your mind’s eye from start to finish. Are you multitasking? I don’t need to know you personally to know that at some point during the day, the answer is yes. We all do it. Now, you might actually believe you are good at multitasking. And you may very well be better at it than your spouse, neighbor, or coworker. But here’s the thing: multitasking hurts our performance, so even if you are better at it than someone else, it is still reducing your productivity. We can only hold 3-5 pieces of information in our minds at once (Cowan, 2010). The implication of this finding is staggering. When we multitask, we are undercutting ourselves in every domain of our lives - - things are taking us longer than they need to, the quality of our work is lower, and we are not giving our full attention to the people and things that matter most to us.

But how do we stop multitasking when this behavior may be encouraged, rewarded, or even required in our work environments and personal lives? Stopping altogether may be impossible but that barrier doesn’t have to stop us from reducing multitasking in specific areas of our lives.

We can begin by committing to spend 5 minutes per day intentionally directing our attention to one thing- a conversation, an important work task, or even a household chore. It might feel different, it might feel better, and it might show you just how effective we can be when we get out of our own way.

Here are some suggestions to maximize your 5 minutes:

·       Pick a specific task or time of day when you feel you have a good chance of being able to intentionally direct your attention to one thing. Eventually, you can use signs of cognitive overload (Nezu et al., 2012) to cue you to stop multitasking. Cognitive overload is that feeling of having “too many tabs open” in your mind; you may feel scattered, frenetic, or simply have noticed your efficiency dropping.

·       If you are tightly scheduled, set a timer. This will serve to contain the exercise and give you a clear beginning and end. It will also demonstrate that the time cost is manageable.

·       Be gentle with yourself when you notice you are distracted. Distraction is part of mindfulness. Moreover, your worries are not produce- they will keep and will be there for you to access at a later time. What is important to keep in mind is that this is about dialing into an experience, not avoiding it. Noticing the distraction and continuing alongside it strengthens your ability to focus far better than arguing with yourself about being distracted.

·       Use the concept of one-mindfulness (Linehan, 2014). Proceeding one-mindfully literally means doing one thing at a time and all the way. If you are in conversation with someone, give them your full attention: focus on their face, their non-verbals and the content of what they are saying. Giving your full attention to the best of your ability during a conversation, and not, say, worrying about what you need to do later that day, will invariably increase the quality of the interaction. If you are listening to music, try listening all the way- hear the layers to the music, the instruments, the cadence. What dynamic thing might live there that you might otherwise miss? Curiosity, non-judgmentalness, and willingness are hallmarks of the one-mindfulness strategy (Linehan, 2014).

·       It can often be easiest to begin with acts of savoring. This means putting your full attention towards something soothing or even the least bit pleasant. For example, closing your eyes and letting sunlight hit your face, eating a ripe orange slowly while doing absolutely nothing else, taking a mindful walk (Nezu et al., 2012) and being aware of your surroundings, or studying the face of someone you love.

Nehjla Mashal, PhD

This post also appears on https://www.pacificanxietygroup.com/blog.

____________________________________________________________________

References

Borkovec, T. D. (2002). Life in the future versus life in the present. Clinical Psychology: Science and Practice, 9(1), 76-80.

Cowan, N. (2010). The Magical Mystery Four: How is Working Memory Capacity Limited, and Why? Current Directions in Psychological Science, 19(1), 51–57. http://doi.org/10.1177/0963721409359277

Linehan, M. M. (2014). DBT® Skills Training Manual. Guilford Publications.

Nezu, A. M., Nezu, C. M., & D'Zurilla, T. (2012). Problem-solving therapy: A treatment manual. Springer Publishing Company.