O'Grady Psychology Associates

Psychotherapy, Marriage Counseling, Neuropsychological Assessment

By 4 Comments

Working with Emotions: How mindfulness and awareness help

hiding from emotions is never a good strategy
Hiding from emotions is never a good strategy

Bringing the hidden to light is an important part of psychotherapy, sometimes achieved through focus on intellectual reflections. But in recent years, mindfulness-based therapies emphasize awareness of how feelings and physical sensations are related. It is enlightening to notice what happens in the body when we feel strong emotions.

As an example of how lack of mindfulness can hurt, I would sometimes react with anger at my husband when he disagreed or corrected me. But rather than seeing my point of view, he only experienced my anger as defensiveness, while I experienced him as overbearing. The result was that I felt worse.

This pattern continued until I learned to slow down my automatic reaction of anger, by becoming aware of the physical sensations that accompanied my feelings. This allowed me to become aware of the small, fleeting, and easily overlooked span of time between my internal commentary about his comment and my emotional reaction.

What was surprisingly helpful in doing this was to become aware of physical sensations; in mindfulness practices, we call this “mindfulness of the body.” Sleuthing out my emotions when corrected by my husband, I could actually feel my hackles go up. It was subtle but unmistakable.

Sensing our Hackles Before a Fight

When a dog’s hackles go up, the hair between their shoulder blades becomes erect as an automatic reaction to feeling threatened. As Adrienne Janet Farricell, a certified dog trainer explains, special muscles attached to hair follicles “are innervated by the sympathetic branch of the autonomic nervous system and are therefore not under conscious control. The function allows the dog to appear larger, taller and therefore more intimidating than it is. This is a ‘fight or flight’ response triggered by adrenaline.”

Paying attention to my physical response after my husband criticized me, I began to sense that distinct feeling of my hackles going up. But what surprised me even more was what followed:  I felt myself contract, my shoulders dropping and my chest becoming slightly concave. I submitted instead of fighting, just as a dog lies submissively on the ground. In the animal world, cowering is a useful and self-protective signaling “I am not a threat to you, so you don’t need to attack me.“ But when we humans do that, we lose some of our power.

Paying attention to this small and subtle sequence of physical sensation help us notice the physical reactions that often precede the ultimate expression of strong emotion. Without being aware of how we succumb to our initial reactions we are unable to address the problem that’s making us react.

Making the automatic conscious is liberating on many levels. First, we gain some control over our automatic responses—something dogs cannot easily do. Second, greater physical and emotional awareness lets us link direct relationship to felt experiences. Being able to name an experience or find an image for it, as I did with the hackles example, opens our understanding, bringing meaning to what on the surface looks like plain old anger.

It is important to know that an angry outburst is not always a bad thing. Anger is a reaction that often stands in for other feelings that are less available to us. Let’s imagine a typical couple’s situation of the sort I see in my practice.  When Jill got angry at Sam, she didn’t always stop to feel what that anger signified. Their arguments escalated as they each get more flooded with emotions. But when Jill reflected on her anger, her felt-sense was of being small, childlike, and without a voice of her own. Childlike? Sure enough, just as she’d felt in her family growing up with three older brothers, she experienced Sam as being dismissive of her opinions and dominating her in a situation where she was powerless.

Sam, meanwhile, had no idea she was feeling this way, because all he saw was her childish, to him, outburst. He tagged Jill as being easily out of control, making him feel all the more self-righteous toward her, which further reinforced Jill—and Sam–feeling like Jill was the problem in the relationship. Sam was off the hook, and did not have to look at his role.

Pausing Before Reacting

As this example shows, our reactions and feelings may mean more than we consciously know. In some traditions such as Tibetan Buddhism, mindfulness translates as “to remember.” This process of witnessing our emotions and our physical sensations requires remembering to push the pause button before our automatic reactions take hold. In a disagreement between couples, this may mean agreeing to a time-out, or the pause may be as subtle as one breath—a period between two sentences. Pausing gives us the space to be aware without becoming stuck in automatic reactions, attacking back, or inwardly growing smaller and losing the essence of our feelings, which are usually quite valid.

This pause also gives us time to consolidate our understanding of our self. Jill recognized an old memory: that of being discounted, unheard, or dismissed. She also understood that when anger dominates, the more important issues get lost.

Being Alert to Underlying Emotions

Of course, staying calm while having hard conversations can be challenging. It helps to recognize the early and subtle signs that you are becoming flooded. Once flooded, meaningful conversations come to a grinding halt or turn into a yelling match. Be alert for automatic reactions. Remembering to pause before automatically reacting allows us to tune into the deeper, less conscious feeling: what emotions and what physical sensations are triggered?

At this point, we have a choice. We can either use our awareness to ask directly for a bit of time to get back in emotional balance before continuing. Or, we can use the pause to go deeper into what may be coming up from within. This doesn’t have to be a lengthy process; with practice, that pause can take mere seconds for insight to come.

And in that pause, when we bring awareness to physical sensations like raised hackles or a churning gut, we can use these as signals to look more deeply into our role in what is getting triggered. Too often our automatic response is to assume fault lies outside us, not within. As Cassius says, “The fault, dear Brutus, is not in our stars, but in ourselves.”

While taking responsibility for what is arising in us, we also need to be aware of its impact on others. When we do this, hackles go down and the back and shoulders lengthen, bringing real power, liberating the Self to be more fully alive and present. Our defense mechanism was only masquerading as power, and that briefly.

What is Your Role?

Taking responsibility does not result in guilty self-recrimination but liberation and power. Once we take ownership of our contribution to conflict, we can more readily bring insight and thus control over our automatic reactions. It may reveal qualities within us that are active and useful in opening us up to be freer, more whole in ways we‘ve barely glimpsed.

Being aware of our default defense mechanisms can help us deal more effectively with difficulty. While many defenses help us cope—psychologists call this defense in service of the ego—they can backfire and hurt us. Because defenses are unconscious, it’s difficult to be aware when they emerge. The best clue that our defenses are lurking is when we react with strong emotions or behaviors, such as rage or sharp criticism.

Some of the most common defenses are projection and denial. They are related in that both mechanisms protect a person’s sense of self by attributing to another (projection) or rejecting (denial) their own unacceptable impulses or feelings, which are made unconscious. Let’s see how that worked with Amie and Jon, who were locked in a cycle of blame when they came to counseling. Amie saw Jon as extremely self-centered, and Jon felt Amie was too emotional, always criticizing him and trying to control him; meanwhile, each felt innocent of playing a role in this cycle.

With therapy, both Jon and Amie could see how they projected unacknowledged parts of themselves onto the other. Amie never gave herself permission to ask for time to be with her friends or to play. She then criticized Jon for taking time for himself instead of spending time with the family. Further examination revealed that Amie’s mother was a martyr and never let anyone in the family forget it. Amie grew up feeling that taking time for herself was selfish. She denied feelings of wanting to take time for herself and projected her anxiety about selfishness onto Jon. Meanwhile, Jon disowned his own anger by projecting it all onto Amie.

This dynamic created misunderstanding and distance. Once both Amie and Jon saw their role, they not only reduced conflict but had more access to dormant passions. Replacing anger with understanding brought new ways of relating. Sex reentered the marriage, along with play and a deeper acceptance of each other.

When your hackles go up–whenever you have a strong emotional reaction–you have an opportunity to learn something new. By pausing and paying close attention to your bodily sensations and your thoughts, you can discover something unexpected, something that ultimately empowers you.

By 2 Comments

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

By 1 Comment

Learning to Stay Calm During Difficult Discussions

By the time couples come to couples therapy they have a built up a lot of tension around recurring problems. For instance, when Joe and Amy came to therapy they had been arguing about who has it harder with respect to chores and child-care. Each felt they were sacrificing more than the other. This led to the typical quid pro quo or tit-for-tat scenario. Many of their arguments were just different versions of the same core conflict. Their discussions quickly escalate.

Couples come to therapy to resolve conflicts and learn better ways to communicate when disagreements arise. When the same issues arise again and again—often over seemingly simple daily routines like who does what in terms of housework, childcare, or social and recreational time— we call this a perpetual problem. Stressful times or life transitions such as retirement, job loss, childbirth, empty nest, or illness can activate these perpetual problems, leading to increased conflict and negative feelings about the marriage.

When a couple first starts therapy, one or both partners will be thinking negative thoughts about their partner.

Gottman Method Couples Therapy, developed by Drs. John and Julie Gottman teaches couples to manage conflict rather than eliminate it, and learning to stay calm during difficult discussions is an important tool in managing that conflict. The stress of arguments creates a “fight or flight” response that is both physical and emotional: the heart rate increases, muscles become tense, blood flow decreases to the hands and feet. These physiologic signs are signals that one is overwhelmed or “flooded.”

Studies have shown that this level of heightened arousal affects the ability to accurately recall events, stay focused, and listen to another. Feeling flooded can also lead to the defense mechanism of stonewalling, or shutting down.

Shutting down serves to protect the stonewaller from the discomfort of increased flooding, but it effectively stalls further communication. Indeed, stonewalling is the fourth and most dangerous of the “Four Horsemen of the Apocalypse,” emotional patterns that can sabotage a relationship, according to John Gottman’s book Why Marriages Succeed or Fail.

The Importance of Self-soothing During Conflicts

Calming down, then, in the midst of a conflicted discussion allows both partners to continue to work on the issue in a more productive and compassionate way. In couples therapy, when one partner is flooded, I gently stop them and ask them to become aware of their arousal level. I have seen profound effects from this simple intervention. It is one of the cornerstones of the Gottman approach and one that has proved to be immensely helpful. This step alone increases the client’s attention to their own reactions and can take them away from the blame game. Later, clients can be taught to recognize for themselves the sometimes subtle onset of tension that can quickly escalate to anger.

Simply noticing heightened arousal may not be enough, and this is where therapists can help teach self-soothing techniques. Many couples therapists will tell their clients to “take a time out” when overwhelmed with emotion. However, many people who come to counseling simply don’t know how to relax during a difficult conversation. Taking just ten minutes of a session to do a relaxation exercise—focusing on slowing breathing, heart rate, and noticing sensations of warmth and letting go of unnecessary muscle tension—can give that necessary pause before resuming a dialogue that has become heated. When Joe and Amy become flooded in a session, they stop looking at each other, shrug their shoulders, and stop talking. Other couples may raise their voices and talk at each other, rather than with each other. It is at this point, that I may ask them to take a few minutes to pay attention to their breathing.

That’s especially important because when one partner is flooded, both are flooded: the emotional build-up is reciprocal. Teaching self-soothing in the moment will lead to new skills in communication and will improve conflict management. The awareness of cues that lead to over-arousal is the first step in helping a couple slow down enough to effectively process and continue a conversation. What we are in fact doing is teaching a form of mindfulness, even during an argument.

Using self-soothing during a couples session when one or the other partner is flooded is surprisingly easy. Perhaps couples’ therapists do not use this powerful technique because they assume that it will take the couple away from the issue they are discussing in a therapy session. However, to let an argument continue to the point of emotional and physical flooding will only leave the couple feeling worse at the end of the therapy hour. Taking just a few minutes of the session to be guided into a relaxation exercise can have profound effects because it will slow things down enough so that the discussion can continue in a more productive and caring way.

It is my deep belief that teaching a couple to self-soothe and ultimately to soothe one another brings depth and empathic attunement to the marriage. This obviously benefits the couple but has a ripple effect on the family. As we know, children model their parents’ emotional regulation or dis-regulation. When kids are able to feel safe around parents, even in the midst of an argument, they will gradually internalize the ability to do their own self-soothing.