Who's steering this thing?...& other thoughts of panic

Many times when a client comes to me for the first time they are eager to learn and implement new coping skills. In my first year as a therapist I heard from many clients striving to implement new skills that the skills “Weren’t working”. To this I typically ask what do you mean when you say “work or doesn’t work?”. Clients will usually respond with something along the lines of, “I use the skill and I still have anxiety”. This is where a reframing of coping skills is necessary to the therapy process. There is not a skill in the world that we can practice that will entirely alleviate painful or challenging emotions. If there was, we would all know about it, there would be countless books, podcasts, and resources about it, and ultimately there wouldn’t be a need for coping skill therapy. So instead of framing skills in the black and white mindset of “working” or “not working” there are a few shifts that may be beneficial. Use Scales When working with clients I often encourage them to capture distress on a scale. For example, on a scale of 1-10 with 10 being the most distressing anxiety you could imagine feeling, how intense does this feeling feel to you right now?.This means that when applying a skill we’re hoping for a decrease in intensity knowing that complete alleviation is not likely. It can be comforting to use this approach to measure something like anxiety before and after a skill, noticing that if that number decreases even by one, the skill is worth engaging in. Notice & Be Curious When applying coping skills I am however less concerned about a decrease in a distress score then I am about noticing and naming experiential, physical, and thought related changes. For example, the anxiety feels like a knot in my stomach, or I noticed my heart rate slow during the exercise, or the pace of my thoughts slowed following use of the skill. This means adopting a curious and alert mindset to notice what is happening before, during and after skill use in our emotions, thoughts, and body. Ride the Wave When working with a new client I often hear pathologizing and praising of certain emotions (joyful=good, sadness=bad etc). Emotions may be challenging and painful to feel at times but categorizing them in this way is typically unhelpful and can lead to loneliness, shame, and avoidance. Freeing ourselves from categorizing emotions allows us to see every emotion as a wave that rises and falls in intensity. Some rise and fall rather quickly, some last longer, but all emotional experiences are simply a part of our human experience. When we learn to ride the waves of emotions instead of boxing them up into categories it allows for freedom to feel and relief in the reality that intensity of a feeling will decrease over time. So when you think about using your coping toolkit in the future I’d encourage you to take on a curious mindset, scaling intensity of a feeling, with the reassurance that the intensity will naturally decrease over time and perhaps even more so with utilizing your new coping skills.  Rachel Schelhaas, LMSW is a therapist at Restore Therapy Collective. Rachel enjoys working with clients to increase their insight and understanding of themselves in order to bring their best self to the relationships that matter most. In her spare time you can catch Rachel going for long walks, cooking a tasty meal, reading an audio book, or searching for unique finds at the thrift store.

I feel like I am getting to know a different aspect of my grief each day. Grief for me is like one of those people that you are intimidated by. You think you know everything about them, but then they do something unexpected and completely take you by surprise. The kind of person that is unpredictable but not in a bad or unhealthy, manipulative way. The kind of person that cannot categorize their personality type in a number, because they are more complex than that. The kind of person from whom you feel there is so much to learn, even though you’ve known them forever. It never gets boring, but it’s a bit exhausting because sometimes you just want to be around simplicity, predictability, and even boring, as you do not always feel up for an adventure. So anyway, imagine that person, but it’s not a person - it’s an emotion instead. That is how I experience my grief! Recently, I have realized that my grief makes me want to take action. It gives me the “sense of urgency” to act on a thought or an idea. The action step is not always in line with my values, what would be in my best interest, or what would benefit my relationships. I sometimes find myself wanting to provide a manual for my clients who are going through grief. To be able to tell them when their grief is going to end or be more manageable. Why do I want a manual? This is a question I battle with a lot in my line of work. Because most things are so abstract, I crave a manualized approach to tell me what to say or what to do. When it comes to grief especially, I also think I need the manual to have some sense of certainty and familiarity, so the process of grieving does not get more overwhelming than it already is. Grief feels distinct from other emotions in this way, as it has a quality that never ceases to baffle me. Like, you do not know when it’s going to hit you, even if you identify and go through every single possible scenario you can imagine to know what to do and how to take care of yourself when you’re reminded of your loss. It is like the universe finds a clever or sneaky way to surprise you when you expect it the least. Let’s talk about anxiety, for example. Anxiety can be sneaky too and manifest in subtle ways sometimes. Not the intense physical symptoms that feel like you are going to have a heart attack and die, but when you experience rumination, can’t stop overthinking something, when you are being short with your partner or feel irritated and agitated. That is easier to chalk up to anxiety for me. For some reason, it is easy for me to understand and conceptualize anxiety. To understand the impact of anxiety on relationships, for instance, is easier to grasp and come to terms with. If I am anxious and easily annoyed, I will relate to others in a way that will reflect the ‘not so pleasant state of my mind/being.’ When it comes to grief though, it feels as if all of a sudden, I do not know how to be a human and do humanly things. When I am grieving, I do not always understand how I feel physically or regard the sensations in my body - or even the energy around me - as a reflection of my grief. For some reason, it is very hard to make that mind-body connection for me in the context of grief.It is also hard to put this into words, as I feel like I am trying to describe something so intangible. It’s as if you have to experience it to know and to understand. I recently realized that “the urge to do something and fix it” comes from a place of hurt, sadness, and powerlessness attached to the grief related to a loss I experienced a few years ago. Not wanting to come to terms with something that is so unfixable, so irreversible. Not wanting to accept that there is no chance to make it better anymore. It is over, and I have to accept that I must move on.Yuck! Even writing this in a very clear and conclusive way right now evokes uncomfortable feelings and sensations in my body. Hello there, grief! I see and recognize you now! Finally, not suppressing or ignoring the presence of my grief is helping me not make impulsive decisions or take actions when there is no action to take. For example, calling that person that my brain somehow convinced me was such a good idea, even supporting its argument with persuasive reasons that provided a sudden (false) sense of relief. I felt like I was finally on to something. Finally, I found a way to reverse the situation and make everything go back to what it was before. I am excited, hopeful, and it feels too good to be true. Then reality sets in. After engaging in some reflection and feeling more grounded in the painful reality, I realized my “protective part” was trying so hard to not let me feel the pain of loss and grief. One time, my protective part worked so skillfully that I even convinced my therapist that I was making the right decision with the action I was planning on taking. My therapist even told me jokingly that I should be a lawyer. Apparently I was so persuasive. I really want to give credit to my protective part for working so hard to keep me safe. I initially was so upset and embarrassed about that protective part that ran the show that day, for going to such lengths to prove her point right, not caring about the consequences of her almost-impulsive actions. Then, I realized it was that protective part that would not let me develop a relationship with my grief - so much so that I felt numb when my body was screaming for help, begging to be seen. With the help of therapy, I was able to understand the incredibly hard work my protective part was taking on so that I did not feel the pain of loss. Only then did I start to have compassion for this amazing, courageous, kind, younger part of me. I reassured her that despite the pain, I was glad to be in touch with my grief. Because feeling disconnected from the pain also meant I was disconnected from the other positive things that were going on in my life. I was just an observer of myself - of my life - like watching myself in a movie as an audience member, not knowing I am the main actor and I can change the course of things. How exciting and empowering! But also scary and risky. That was when I realized I’d rather live in reality and learn ways to manage my grief (just like I did with anxiety) than live in a fantasy world, hoping and wishing that someday my brain will find a way to get back what I have lost. Witnessing so many of my clients who are in different phases of their grief journey and their relentless attempts at cognitive bypassing made me realize how important it is to find manageable ways to allow grief to exist. Simply acknowledging the presence of grief and being honest with myself about the intensity of the pain helped me relate to my grief in a different way. It did not become this scary thing or a danger zone I never wanted to go near. Instead, I realized I had to learn to honor its existence and adaptive function in my life. Easier said than done- I know. However, coming to this realization gradually brought me an unexpected sense of relief - knowing I do not have to fear grief. Because when you add fear to the mix, it’s as if the thing you are avoiding intensifies by multitudes. I think what helped me a lot was curiosity and openness to this new entity that was coming my way. Also, resourcing myself - expanding my capacity to handle big emotions (positive and negative) - was necessary if I was going to take an honest look at my loss. It required a lot of courage that I didn’t have at the time - not realizing courage was something I could cultivate when I opened up more space for the unknown and embraced the fear. And embracing the fear didn’t look “cute,” like what you see in the movies, when somebody finally confronts and overcomes their fear. Inevitably, I will experience another loss in life, but having a stronger relationship with grief itself - knowing more aspects of grief and having an open and curious attitude towards it - means grief finally does not feel like such a strange territory, like the person I was describing in the beginning. It also does not take control of my life or does not dictate my decisions. I, at least, have more neutrality towards it, rather than completely denying its presence. I can’t say that I am excited to interact with it at all times or that I look forward to its unannounced arrival. However, I am interested in listening and hearing what it has to tell me. At the very least, I do not find myself fantasizing about a manual to help me interact with my grief anymore (I never read them anyway). And I am happy with that progress. Hande Walker, MA, LLP is a therapist at Restore Therapy Collective. In her free time Hande enjoys long walks or a hike in the nature. Besides spending time with friends and family, Hande loves reading-especially psychological thriller books. To schedule an appointment with Hande, please send a secure message through our contact form .