O'Grady Psychology Associates

Psychotherapy, Marriage Counseling, Neuropsychological Assessment

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Accepting Life’s Turbulence: Fasten Your Seatbelt

Life brings ups and downs and finding a way through the stormy turbulence takes courage and grace.
Thunder Cloud from 37,000 ft

This dramatic cumulonimbus was captured at 37,000 feet over the Rocky Mountains in Colorado. Pilots know to avoid going near these thunderclouds, charting a course around them for the comfort of passengers and safety of the aircraft. Even coming close will cause turbulence—the jet trembles and shakes, often violently.

Pilots rate turbulence as mild, medium, or severe. Thankfully, excellent communication between pilots means that patches of bumpy air can be predicted well ahead of time and avoided by changing elevation or course. But sometimes turbulence is unavoidable. In that situation, fearful flyers grip armrests, pop benzodiazepines, and turn up the volume on their headsets. Eventually the air smooths out, and everyone releases their breath…and their grips.

Staying Steady During Turbulent Times

Jet travel is a great metaphor for life. Sometimes the bumpy moments are so extreme that there’s nothing you can do but sit with it and hope you don’t have to pee. But sitting with the rocky ups and downs of life isn’t always easy.

When a pilot acquaintance asked me how to survive the turbulence of his current marriage problems, I asked him what he tells his passengers to do when the flight encounters a rough patch.

He said, “I tell them to fasten their seat belts.” We have all heard the familiar words, “The captain has turned on the seat belt sign. Please return to your seats and fasten your seatbelts.” Now, I confess I sometimes use this moment to zip down the now suddenly empty aisle to use the lavatory (but only in mild turbulence.)  But basically, in bad weather you need to stay seated and wait it out.

I enjoy flying, but that wasn’t always true. I was a fearful flyer for about six years. I wasn’t phobic, I didn’t avoid flying or have panic attacks, but I was alert to every squeal of the engine, movement of the wing flaps, or ring of a cabin bell,. During euphemistically described moments of “bumpy air,” I would glance up at the flight attendants’ faces to see if they were showing signs of concern.

I wasn’t afraid of heights or of being in an enclosed space—my fear was simply of crashing. Kaput, end of life, and the imagined 60 seconds of sheer terror I expected to feel going headlong into death.

We have no control over death. Once I came to terms with accepting that I could die in a plane crash, I became less afraid. It wasn’t that I was convinced by statistics showing how rare such deaths are; fearful flyers are rarely comforted by the statistics. Acceptance, in contrast, goes a long way in dealing with the bumps we encounter in life.

I found out this week that I have a 50/50 chance of having the genetic mutation associated with hereditary breast and ovarian cancer (HBOC). My family on both sides has had lots of cancer. But through advanced genetic testing, I now know that my family members have the BRCA2 mutation going back three generations. As I await the results of my blood test, I am again reminded of our lack of control. For me, it’s the toss of a coin: I either have it or I don’t. If I do, I have an 85% chance of developing breast cancer and lower risk of other cancers (ovarian, pancreatic, melanoma, and stomach). I am not comforted by those odds.

Flying has infinitely better odds. But after a week of emotional turbulence, I will meet my fate with HBOC with as much grace as I can muster. It hasn’t been an easy week, to be sure, veering between certainty of bad results and certainty of escape. So while I wait and hope that I end up on the happier side of the 50-50 split, I will fasten my seatbelt and try to steer as safe a course through the thunderstorm as I can, with all the support I’ve gathered over the years: family, friendship, work that I love, and resources (such as FORCE). Coping skills, like seat belts, keep us safe. While we generally don’t enjoy restraints, a seatbelt helps to contain our emotions so they are less likely to overwhelm.

I am reminded, once again, of a lesson taught by Thich Nhat Hanh: “When we have a toothache, we know that not having a toothache is a wonderful thing.” (Peace Is Every Step: The Path of Mindfulness in Everyday Life, 1992, p. 38). Finding comfort in the face of difficulty is possible—by riding out the painful moments and trusting that the next moment contains a potential fullness, some simple pleasure waiting to be noticed. So when the seatbelt sign is again turned off,  you are free to move about the cabin. Add take a deep breath.

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Learning to Notice What is Already There: The Rose Itself

Being aware of pleasant events is an important skill in mindfulness and Mindfulness-based cognitive therapy.Behavior therapists have long used a technique to distract clients from their difficult thoughts. The client wears a rubber band around their wrist; when they have an upsetting thought, they snap the rubber band so that the sting wakes them up and interrupts the thought. This always seemed silly to me. And when I tried it myself, it didn’t work very well. The reasoning behind the rubber band is that distraction from a difficult thought will interrupt, not just the thought itself, but also the chain reaction that painful thoughts set in motion.

Distraction works for children quite well. If a child is crying about a lost toy, we show them another toy and they forget what they were crying about. But as we get older, emotions become more complex. The typical pattern is that when something difficult happens, we make a negative appraisal about it. Then we start thinking about the difficulty, which brings up negative feelings, sending us down the rabbit hole of rumination and worry. For example, a co-worker points out an error you made. Your thoughts might go, “Oh no, a mistake. I shouldn’t make mistakes. I’m a fraud and my co-worker knows it. I’m going to lose my job. Everything always goes wrong for me.” Our often-silent judgment triggers mental elaboration of what could have been simple awareness of a thought or feeling in the moment: “I made a mistake. It feels bad to get things wrong.”

We often go through the day thinking of what’s next. We plan dinner and dread the grocery store even as we’re walking around our home or office, long before we actually get to the store. Being 20 steps ahead of where we actually are misses opportunities that exist in the moment. But what if some of those moments aren’t very good? Wouldn’t avoiding them just make sense? The problem is that avoiding thoughts and feelings that evoke sadness or anxiety usually just postpones problems while they get bigger. There are endless ways to distract ourselves from even benign feelings such as boredom, or the effortful focus needed to complete a project. Constant phone checking may keep us from feeling bored or focusing on what we should be doing in the moment.

I did 6 Google searches for ‘North Coast silver cuff raven steals the light’ –to find information about a bracelet I purchased at a thrift store over the weekend. Do I feel better for putting off writing this post? No I don’t feel better after my  search, but I tell myself, “Ok, that wasn’t a great use of time, but now I am back to it.” I don’t need to chastise myself, but I don’t need to continue to distract myself either.

Being able to experience our thoughts and feelings without judging them opens up the possibility for experiencing the richness of the moment. It may be as simple as feeling engaged with what we are doing, or acknowledging our humanness and bringing forgiveness to the moment.

In practices like mindfulness-based cognitive therapy (MBCT) and mindfulness-based stress reduction (MBSR), therapists have people keep track of pleasant and unpleasant moments in their day. This doesn’t have to be a tiresome homework assignment; it’s just jotting down, at the end of each day, something you noticed that was pleasant, or the opposite. By doing so, you can more easily increase awareness of the experiences when they are happening.

The most important component of mindfulness is attention to the moment. This awareness helps us notice what triggers ruminative thoughts. Rather than mechanically snapping a rubber band, we notice the thought and where our minds want to take it next. We don’t need to add to the thoughts, take them further, or elaborate on them. We also don’t need to classify or analyze them. Being attentive but nonjudgmental in this way helps us not only to let go of negative thoughts, but to notice pleasant things that may escape our awareness because we so often rush around, either literally or in our heads. As a result of paying attention to small bursts of pleasure, happiness grows.

In a commencement address to Colorado College, the poet Billy Collins described the power of mindfulness as being like an atom smasher:

Matter is composed of atoms and subatomic particles. Through the use of a particle accelerator it is possible to make these tiny bits collide which releases energy. Time, on the other hand, is composed of moments. And by arresting one of those moments, by concentrating fully on it, by smashing it under the intensity of your gaze, an energy will be released.

Poetry, Collins says, can help you slow down and pay attention, but you don’t need to be a poet. What do you notice right now? Are you aware of something pleasant—the shape and feel of your coffee cup and the color of your coffee, the song of a bird, or the light coming in the window?

In the same talk, Billy Collins says that gratitude “for simply being alive” goes along with mindfulness:

The taking of breath, the beating of the heart. Gratitude for the natural world around us—the massing clouds, the white ibis by the shore. In Barcelona a poetry competition is held every year. There are three prizes: The third prize is a rose made of silver, the second prize is a golden rose, and the first prize: a rose. A real rose. The flower itself.

Though we spend so much time worrying about the future or the past, it’s what’s real and present in the moment that is “the flower itself. “ To tell it another way, there’s an old Zen koan (teaching story) that illustrates these concepts.

 

Muddy Road

Tanzan and Ekido were once traveling together down a muddy road. A heavy rain was still falling. Coming around the bend, they met a lovely girl in a silk kimono and sash, unable to cross the intersection.

“Come on, girl,” said Tanzan at once. Lifting her in his arms, he carried her over the mud.

Ekido did not speak again until that night when they reached a lodging temple. Then he no longer could restrain himself. “We monks don’t go near females,” he told Tanzan, “especially not young and lovely ones. It is dangerous. Why did you do that?”

“I left the girl there,” said Tanzan. “Are you still carrying her?”

The whole way back to the temple, Ekido missed the birdsong, the breeze, and the fragrance of the cherry-blossom trees—and thereby deprived himself of the pleasure around him, just so he could fume and ruminate about what someone else did.

To increase mindfulness, try printing the chart below and filling it in each day. Make a point of remembering to notice just one thing each day that you find pleasant. If, like Ekido, you are still carrying unpleasant feelings, notice how far you take them, and see if you can find something in the moment that is even briefly pleasant.

Awareness of Pleasant Experiences

Instructions: For one week, be aware each day of one pleasant experience or occurrence while it is happening. At the end of the day, on this calendar or in your journal, record in detail what it was and your experience of it. (Click on image for a larger view.)

Keeping track of pleasant experiences during the day is a core component of MBCT and MBST.

 

 

 

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We Fear What We Cannot Control: Acknowledging Pain and Suffering

Learning to live with the things we have no control over.The German airplane crash by a suicidal pilot, the Florida shootings, the Boston bombings. Every week, we read about innocent people getting hurt or killed. We try to avoid pain and suffering; we teach children to look both ways before crossing the street, wash their hands after using the bathroom, and not to get into strangers’ cars. Even as we reassure our kids that no monsters live under their beds, we know that in the apartment down the street, there lives a convicted sex offender. How do we cope with life’s uncertainty and fear?

 

The Monster Under the Bed

We are saturated with information. Not long ago, we’d read a morning or evening newspaper and maybe watch the evening news; today, the news cycle is 24/7. And, because dramatically scary stories get our attention, the media makes sure to foreground them—not just what’s happening locally, but world-wide. We end up perceiving fearful threats all around us. The truth is, though, that we tend to overestimate certain kinds of risk while underestimating others. For example, as the Vancouver Sun notes, “We warn our kids not to talk to strangers even though 90 per cent of sexual abuse is committed by someone a child knows. And we freak out about plane crashes despite the fact driving is about 65 times more dangerous.” (“How much risk do you live with?”)

Studying how people evaluate threats, or “risk perception,” helps show why this is so. Psychologist Paul Slovic has studied the subject for many years; here, blogger Sara Gorman sums up his findings: “People tend to be intolerant of risks that they perceive as being uncontrollable, having catastrophic potential, having fatal consequences, or bearing an inequitable distribution of risks and benefits.” Plane crashes feel more uncontrollable than car crashes; strangers feel scarier than people we know. But control is an illusion. Life is full of uncontrollable things, people, and events, so how do we handle risk?

We cope by using reason and denial. Reasonably, we know that life always involves some risk and that we have a natural tendency to inflate threats. You can probably think of one thing you tend to worry about needlessly or unproductively. Can you really do anything about it? Needless worry robs us of a sense well-being; straining to control things beyond our reach only creates tension. But wait—denial? Isn’t that supposed to be a bad thing? Yes, denial is counterproductive when it keeps you from acknowledging harm that you’re doing to yourself or others, like smoking, cheating on a spouse, or abusing your child. But psychologists recognize that the use of denial can be advantageous in many situations. According to the Mayo Clinic, “A short period of denial can be helpful. Being in denial gives your mind the opportunity to unconsciously absorb shocking or distressing information . . . . For example, after a traumatic event, you might need several days or weeks to process what’s happened and come to grips with the challenges ahead.” Be patient and gentle with yourself in the wake of trauma.

We also must learn to balance risk against what we lose by being too careful. When we’re too sensitive to fearful possibilities, we become paralyzed. Not letting your daughter walk home from school with her friends because a car could run a red light, or a vicious dog might be on the loose, may seem protective. But overprotectiveness is harmful because it deprives children of practicing the mastery and independence they need to grow up successfully. And, more subtly and unintentionally, your anxiety seeps into her without either of you knowing the source.

 

What if the monster under the bed survives because your imagination feeds it every night?

 

Kids need to find their own strength by testing themselves in the world. That can start as early as learning to sleep alone, in their own beds. (While in some cultures sharing a family bed is the norm, children may be given other opportunities to practice self-soothing and frustration tolerance.) Kids and parents often resist the stage when they need to soothe themselves to sleep. When we know our child is distressed and may be fearful, we rush to give comfort. But allowing a child to sleep between her parents can come at the expense of intimacy in the marriage. By resisting letting a child sleep alone, parents deprive them of learning to calm themselves and tolerate frustration. For a fuller explanation of this problem and how to address it, see Dr. David O’Grady’s “Help Your Child Sleep Alone: The Snoozeeasy Program For Bedtime Fears. ”The important thing is that we convey trust that our child can manage the little and big things that come their way and feel they have the ability to self-regulate their emotional reactions.

Of course, being able to manage emotions doesn’t mean that bad things don’t happen. In mindfulness practices, we teach that suffering is an inevitable part of living. Sickness, accidents, money problems, frustrations, and worries: There is much in life that we have no control over, and as if worrying about the present isn’t enough, we tend to ruminate over past events or future possibilities.

Even spiritual people who actively practice mindfulness can’t escape suffering. In fact, “life is suffering” is the first Noble Truth of Buddhism. I remember listening to an audio interview with the Dalai Lama, the Tibetan Buddhist leader known for his calm serenity. He coughed and hacked his way through the interview, clearing his throat every few minutes. It was an unpleasant sound, but because I was on my treadmill, I didn’t want to stop and find another CD. I suffered along with the Dalai Lama. At the conclusion of the interview, he took questions from the audience. The question was asked; “Dalai Lama, do you suffer?” He answered, “Of course I suffer, I have been coughing this entire time and it is very uncomfortable.”

And as if present suffering isn’t enough, letting worry about the past or future take hold leads to more suffering. When we suffer from the fears we have about the dangerous, uncertain world we live in, we may think the answer is to run away somehow: shopping, clicking, using drugs or alcohol, or eating when we’re not hungry, for example. But pursuing pleasure doesn’t make our painful fears go away. Instead, our efforts backfire because we feel guilt, or dig ourselves deeper into debt, or become unhealthy—and the fear still exists.

Learning to look at our suffering and accept that it exists is a skill. Meditation or relaxation training can help us develop the skill of self-soothing, thereby enabling us to feel less afraid of both real and imagined monsters. As we do this, we also help those around us to be calmer and stronger.

 

How to Self-Soothe

 

Practice some form of deep relaxation, meditation, or yoga daily. This will change your psychophysiological baseline so that you are generally more resilient when worry or stress takes over.

  1. Accept that that suffering is part of life. We suffer, our children will suffer, and strangers we hear about in the news suffer. Acknowledging suffering helps because we are not pushing fears down, which paradoxically only makes them grow larger.
  2. Develop a spiritual practice. This helps us develop the strength to look deeply at our suffering; the insights gained about ourselves provide perspective and something to hold onto when our fears run amok.
  3. During difficult moments, use a short breathing practice (such as the Three-Minute Breathing Space or just silent focus on your breath) to stay calm during difficult moments. Being conscious of our breathing brings mindfulness to the present moment and helps pause the thought stream of rumination.
  4. Recognize your suffering without judgment. Some fears are truly awful, yet by staying in the present moment, we avoid getting trapped by our thinking. Look deeply at the source of your feelings, find their roots, and work on transforming the fears that need to be changed. This will allow space to nourish the feelings that bring peace and well-being.

This short relaxation exercise may help you to develop skills to relax in moments of anxiety and worry, as well as provide a foundation to help change the automatic, reflexive ways your mind and body respond to stress.  https://youtu.be/TCCA1kGSnB8

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Standing Behind the Waterfall: Learning to Change Distorted Thinking with Mindfulness

Giving yourself a ledge to stand on as you watch your thoughts will help get perspective.
Getting a Different Perspective

Thoughts are not facts. When we’re upset, our thoughts seem valid—yet it’s exactly when our emotions get stirred up that our thinking can easily become distorted. Conclusions based on distorted thinking can’t be trusted.

When my friend Sharon returned from a business trip, she was feeling disturbed and uncomfortable. As she described her experience, she clarified why: She had been working remotely in Africa and knew few of the other participants in her company’s conference. She wanted to be included, but wasn’t part of the main team; she felt uncharacteristically shy and felt that her participation wasn’t up to her typical style. Sharon was aware of the tremendous talent that surrounded her and wished she’d had more opportunity to interact with her co-workers.

Taking a Different Vantage Point Gives Perspective When Thoughts Are Overwhelming

Sharon observed her feelings and thoughts with great skill, teasing out the mixture of sometimes conflicting emotions she felt, but importantly, she wasn’t condemning herself or anyone else. If her thought had been “I’m so inept, I can’t compare to these other people,” she might have gotten carried away with ruminations about her inadequacies. By asking herself “What is this I am feeling, in this moment?” Sharon gave herself a vantage point—feeling anxious is not the same as being worthless.

Teachers of meditation often use the image of the sky to illustrate how thoughts, like clouds, come in and out of our mind. The sky is always there, even when dark clouds momentarily obscure the sky. In another moment, the sky might be a brilliant blue with white downy clouds moving slowly or swiftly across its surface. We use these images to show that clouds come and go changeably, just like our thoughts, but mind and sky always remain. Sitting in meditation, we witness the changes of thought and feeling but don’t partake in them, just as the sky is unchanged by the clouds.

One of the exercises used in mindfulness-based cognitive therapy is that of standing behind a waterfall. Standing behind the rushing water and watching it without getting swept away by the torrent gives us a ledge to stand on, just as meditation gives us the perspective to look at our thoughts. We don’t have to believe everything we think, and we don’t have to be deluged by ruminations arising from anxiety or depression.

Try this short meditation:   

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The Present Moment and Transformation

Mindfulness and transformation.Research reported in the respected journal Science, in an article titled “Just think: The challenges of the disengaged mind” by Timothy D. Wilson et al. (345, 75 [2014]), presented results summarizing 11 studies where participants were first given an electric shock; all participants admitted that the shock was unpleasant, and said they would pay to avoid it. Researchers then asked the subjects to sit in the empty room and entertain themselves with their thoughts without cellphones, iPads, or other distractions. There were only two rules: you can’t get out of your chair, and you can’t fall asleep. Participants did have the option to press a button and receive a shock again.

The mind is its own place, and in it self

Can make a Heav’n of Hell, a Hell of Heav’n.

 John Milton, Paradise Lost

 Very much to the researchers’ surprise, the study found that 70% of the men and 25% of the women chose to shock themselves instead of just sitting there with their thoughts—remember, for no more than 15 minutes.

Researchers ran the test in a lab with college students, but also with older subjects (recruited from churches, farmer’s markets, etc.) in their homes, and they tried to replicate the study with a wider sample of people minus the electric shock. They found that these folks also had difficulty sitting still for 15 minutes alone to entertain themselves with their thoughts. Over half the people admitted to cheating by using their phones. The majority said that hated the experience—it was boring.

What is going on here? Why is it so hard to entertain ourselves with our thoughts that people will actually resort to painfully shocking themselves just for something to do? Why not just stay in the moment and wait it out? Partly, reflecting back and looking ahead are just human nature, something our big brains allow us to do and a big reason for our evolutionary success. Because we can think ahead and formulate goals, or review the past and learn from it, we can accomplish stunning achievements like writing novels, building bridges, and curing diseases (not to mention more ordinary but still essential accomplishments like saving for retirement). But that’s not the whole story.

While being past- or future-minded can have benefits, it’s clear that mindfulness—staying in the present moment—offers essential benefits as well. The present moment is the only one that truly exists. It’s only in the present moment that we can feel peace, fulfillment, and harmony. And it’s only in the present that we’re free to choose. That’s why people meditate and why so many religious traditions include some kind of mindfulness exercise.

But researchers in the study found that even subjects who had experience with meditation and mindfulness found it only slightly easier to sit still without distraction. I’ve found this in my own practice. When I explain mindfulness to my psychotherapy clients, they understand the concept and its value on an intellectual level, and may even experience a sense of pleasurable release during some meditations. Even though my clients have come to me for help in dealing with life’s burdens, and even though they get good results from meditating, it’s still not easy for them to practice mindfulness regularly.

So, what comes up for people when they sit alone with their thoughts? We experience restlessness, discomfort, boredom, and irritation. Sitting in stillness, letting moments come and go and staying with the quiet space, gives room to encounter the self. We come face to face with our anger, our envy, our jealousy and our pride. Those feelings are unpleasant and it is easy to want to be quickly rid of them. Switching the channel in our mind to a diversion such as a show, a game, or a piece of chocolate cake takes us temporarily away from the difficult emotion. We don’t want to feel like a jealous person, for example, because that gives way to other feelings such as guilt—which makes us feel worse. Our self-concept takes a beating when we give it time in the quiet moments.

But if we are to enlarge our Self and be fully alive, we have to face the darker sides. As Goethe writes in “The Holy Longing”:

 And so long as you haven’t experienced this: to die and so to grow,

you are only a troubled guest on the dark earth.

To be at home on earth, learn to sit with yourself in the present moment.