mental health

Therapy, Feelings, and Ikea

I spend a lot of my day talking about feelings. I get to observe people sifting through their feelings, getting stuck, and trying to problem solve. It strikes me that a lot of our relationship with our emotions is centered around trying to change them, control them, or blaming ourselves for having them. For many of us, the only acceptable states to be in are happy, calm, and attentive to the needs of others. Probably one of the most common questions I get asked about feelings boils down to something along the lines of: “How do I make this feeling go away?”

Feelings are sort of like Ikea furniture: confusing, awkwardly constructed, sometimes surprisingly heavy, and, more often than not, just a pile of nonsensical, disconnected pieces until you finally put them all together. You might discover that you have to go back to the store to get some missing parts. You might need tools that weren’t included in the kit. You might need someone to hold up the other end of whatever thing you’re building at just the right angle for you to put it together. A great many of them may have odd names in a language you don’t quite understand. But if you want them to make sense, you’re going to have to slow down enough to read the instructions, organize the pieces, and move forward intentionally rather than just going ham with that tiny Allen wrench.

Somewhere along the way we got it into our heads that instructions are not important, that we can just power through; work harder, be stronger. Under those conditions it’s your fault if the MALM you were trying to build falls apart or looks nothing like the picture on the box. “Just hide the extra bits that didn’t fit, lean it against the wall, and pretend it’s fine.”

But here’s the thing: no amount of hard work and Allen wrenches will suffice if what you actually need is a hammer, a drill, and a friend to hold the other end of the thing you’re building so it doesn’t fall and crush you. No amount of strength will make up for the random dowel you’re missing.

If we keep leaving these things out the whole thing falls apart. We fall apart and it’s not our fault. It’s not because we’re not strong or smart or hardworking. It’s because we don’t permit ourselves and others the time, compassion, and support to put our feelings together in a way that is safe and coherent.

So, to whoever needs to hear this today: you’re enough and it’s not your fault that MALMs are a pain to assemble.

If you’d like support holding up the heavy pieces, or just want some new tools for your toolbox please don’t hesitate to reach out for support!

Urge Surfing

If you’ve ever found yourself standing in the kitchen mindlessly eating string cheese at the end of a very long day, you’re probably familiar with the powerful mechanisms that create and maintain stress-related coping habits. You may not have intended to eat three cheese sticks in a row, but there you are 10 minutes later, looking at the curled up, empty cheese packets on the kitchen counter, feeling slightly puzzled as to how you got there. Or maybe that’s just me?

Your way of coping may have nothing to do with string cheese, but perhaps you find yourself in your own version of what I’ve just described. Your version may involve ice cream, shopping, sex, alcohol, or self-harm. The mechanism is the essentially the same. We experience an intense emotion: stress, sadness, anxiety, anger, numbness and we look for ways to cope. The more often we repeat a particular pattern of coping the more hardwired it becomes in our brain’s neural network.

Our ability to cope with emotional distress in ways that promote our health largely depends on our ability to manage our immediate urges in an intentional way so we can help our brain build new neural connections in response to stress. Sounds fairly simple, but will actually feel like you’re trying to dig a path through 6 feet of snow. This is one of those expectation vs. reality internet meme situations.

There are a few important things to remember here: the fact that it’s hard to generate new responses to stressors when you’re experiencing overwhelming emotion is completely normal and not a sign that you are bad, weak, or broken. What’s actually happening in that moment is that your neocortex (the bit of your brain that makes logical, rational, well reasoned decisions) gets hijacked by your limbic system (the bit of your brain that contains all the structures that produce the neurotransmitters that make you feel emotions) and your neocortex becomes physiologically unavailable.

In simpler terms: think of what happens to a lightbulb in a power surge. If your emotions are the electricity and your neocortex is the lightbulb, then too strong of an electric current will make the lightbulb flicker and burn out. This is why it’s so hard to think when you’re feeling stressed. Depending on the intensity of the particular surge, the damage done may vary. So if you’re feeling a little blue, you might have a good cry in the car and some ice cream and feel better. If the surge is great enough to trigger overwhelming hopelessness, you might find yourself engaging in any number of much more dangerous behaviors including self-harm and suicidal ideation.

Urge surfing is a mindfulness practice that invites us to focus on our urges and extend our ability to tolerate their presence without acting on the urge itself. Think of it like upgrading our electrical systems to handle power surges by modulating the intensity of the current, like installing a surge protector. Emotions are inherently wave-like, meaning that they naturally flow, peak, and ebb. The better we can tolerate the flow of emotion the less intense the peaks become and the sooner the emotion and the subsequent urges will ebb. On average most emotions will ebb in somewhere between 5 and 20 minutes. Over time, urge surfing allows us to reduce the power surges of emotion enough to be able to implement new behavior patterns in response to the emotions creating the urge.

Here are some ways to practice urge surfing:

  • Practice square breathing (4-count inhale, 4-count hold, 4-count exhale, 4-count hold) for 5 minutes when a strong urge comes up to increase the time between the urge and the action. Evaluate if you still want to engage in the target behavior after taking this space or if another behavior may better meet your needs. Repeat as needed.

  • Practice progressive muscle relaxation for 5 minutes. For this practice you will tense individual muscle groups with your inhale, hold the tension, and then relax with your exhale. For example, inhale, clench your firsts, hold, then relax your hands as you exhale. Repeat with each group of muscles. Evaluate if you still want to engage in the target behavior after taking this space or if another behavior may better meet your needs. Repeat as needed.

  • If you’re struggling with a recurring target behavior: create a decisional balance list. This is basically a fancy pro-con list. You’ll need a grid of 4 boxes: pros of your target behavior, cons of your target behavior, pros of not engaging in your target behavior, and cons of not engaging in your target behavior. Always start with the pros of your target behavior; this will help avoid the dreaded shame spiral by reducing judgement and validates the reality that our behavior is just an attempt to cope. It also increases the likelihood that we will actually follow through on our intended replacement behavior if we’re more compassionate to ourselves in the process (I find this is last bit tends to be true for most things in life; see this post on building self-compassion). Once you have the list, take a picture on your phone or stick the list on your fridge or some other visible space so you can easily revisit it to remind yourself of why you are working to build new behaviors.

  • Make your urges less accessible. If you struggle with impulsive shopping don’t have your credit cards readily accessible, saved on store websites, or in the auto-fill function on your devices. If you struggle with self-harm, make it harder to access those methods. It’s important to be honest with yourself here about your behavior patterns; don’t make it harder on yourself than it needs to be. You might go so far as to writer out a behavior chain to help you identify triggers, vulnerabilities, and links in your behavior patterns. The more space you create between the trigger and the behavior the more opportunities you have to re-evaluate.

  • Body-based mindfulness: for more advanced mindfulness practitioners you may work on identifying where in your body the urge resides, take time to explore the sensation of the urge, and ask yourself what the urge is in response to. Usually there is some unmet need there that we can give ourselves the opportunity to address in more adaptive ways.

As with everything else, please remember to be gentle with yourself in the process and seek additional support from your natural support systems and mental health providers when working through intense and/or potentially harmful behaviors. You can also check out the additional resource page if you are in need of immediate support.