Do emotions tend to get out of control in your family?

Do people in your home trigger or escalate each other just when they both need the most support?

Does a family member yell at you when you’re hurt or scared?

You might need to learn how to break cycles of emotional contagion if you or a family member has a sensitive nervous system.

Here’s how to understand what’s going on and what to do about it:

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Do you allow yourself to be open to whatever emotions, desires, and beliefs come up for you in a given moment- or do you try to control your inner reactions?

Although our mental states (thoughts, feelings, beliefs, and desires) often arise automatically and sometimes even without our awareness, many people do not want to believe this. They only want to acknowledge that they have feelings, desires, thoughts, etc. that fit in with their judgments of the kinds of mental states that are permissible.What is permissible or not varies by the person, and often by certain rules or injunctions developed in childhood, based on experiences such as having certain types of feelings responded to with rejection, anger, or dismissiveness.

Some people have internal rules prohibiting feelings of anger, even if they are not acted on and would seem justifiable on an objective level. At times, as a therapist, I may sense that someone is angry, annoyed, or irritated- either because of their body language, silence, or perhaps reaction to a given situation; or based on a situation that seems to be good cause for anger (or at least a less intense version of the emotion- such as annoyance), such as not getting what they want over and over again. However, when I try to reflect this in what seems like a simple statement to me, such as “Maybe you feel angry about that”, this is met with resistance or dismissal- often with the use of logic. I might be told things like, “That’s just the way things go, why should I be angry about it?” or “I know they couldn’t help it/didn’t mean it so why would I be angry?” or even “I never get angry”.

Now, you may be wondering why it even matters. Well, the reason that it matters is that feelings that are unacknowledged or suppressed express themselves indirectly. The feelings leak out in other ways. And we can’t deal effectively with the leakages because we haven’t allowed ourselves to see clearly the source of the problem.

And it’s not just angry feelings that some people have “rules” against or avoid acknowledging. For some people, feelings of excitement feel dangerous and have to be immediately deflated; for others, feelings of shame have to be covered over with something more “macho” like anger; and even feelings of fear are anathema to those who want to prove their own fearlessness to themselves. Certain desires can be “forbidden as well”, such as when a tired mother desires momentarily to go back to the days before her infant was born- despite loving her child with all her heart. It’s not the specific emotion or desire that’s the issue, but the idea that a person is not fully open to the full range of emotions or mental experiences available to the human race in response to situations, perceptions, and needs that arise from moment to moment.

Trying to control our automatic thoughts and feelings stops us from getting important information about ourselves, our needs, and our surroundings. We miss out on information that could inform our intuitive and rational decisions because we don’t want to see the whole picture of our responses. We also lose out on the opportunity to empathize with others (such as our children, partners, or friends) who may be experiencing similar feelings or wishes. But even more importantly than this, it costs us so much mental energy, physical strain, and cognitive load to try to control, bury, and hide from ourselves the normal moment to moment responses that arise inside of us. And doing this for long enough can lead to a number of consequences, whether it’s depression or helplessness (because how can we address our needs effectively when we aren’t aware of them?), anxiety (the signal we get when there is something in our unconscious minds that is frightening to us- that exists but can’t be allowed into our awareness), or signals from the body that something is amiss (such as stomachaches or headaches).

So, the price we pay for the belief that only certain feelings or thoughts should be “allowed” into our experience, is a steep one. It may work for a while to believe that we are always in control of what goes on in our unconscious, automatic mind- but the fact is, that our emotions register in our bodies long before our minds have a chance to decide whether they’re permissible or not. So we put ourselves at odds with our own selves when we refuse to take information in from the bottom up- letting our bodies inform us of what we’re experiencing, and then trying to appraise and make sense of our responses. Often, the mind has become a substitute for the original caregiver who taught us to ignore our own cues, needs, and desires- the mind is now the authority who judges our feelings, dismisses them, rejects them, denies them, or criticizes them.

We can all learn to make peace between the different parts of ourselves, to let our emotions, bodies, and minds live in a more peaceful co-existence. If you want this, then now might just be the time to open yourself up with more curiosity to that which arises within you- and you may just be surprised at what you discover!

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Recent trends encouraging mindfulness have pointed our awareness to the benefits of directing our full attention to one thing at a time, giving that thing our full focus and presence of mind. When it comes to things like eating mindlessly, multi-tasking, checking facebook while our loved ones are talking to us- to name just a few examples- learning to slow down and pay full and complete attention to the moment or task at hand- can be extremely beneficial. Staying in the moment helps us do things right, stay aware of what we are doing, feel complete in the quality of the interaction or experience, and protects us from feeling overwhelmed by racing thoughts and competing attention-grabbers.

But there are also times when paying attention to more than one thing at a time has its upsides. And I’m not just talking about learning to juggle the millions of things that are pulling for our time and attention, nor am I talking about dividing our conscious attention (trying to pay attention on purpose to certain information or stimuli) to more than one thing at a time.

What I’m referring to is the helpful effect at times of dividing our attention between non-conscious tasks and more focused mental processing. Splitting attention in this way can help with emotional regulation, conversations in relationships, and distress tolerance.

For example, most people know how much easier it can be to engage a teenager in a difficult conversation when either one of you is doing something else at the same time…such as when you’re driving, the two of you are cooking together, or he/she is playing with his/her cellphone. EMDR (eye movement desensitization and reprocessing) therapy relies on a similar dual attention model in which attention is simultaneously split between some form of soothing stimulation and trauma-related experience, as well as between a focus on the past as well as the present. And child therapists know that children talk and process their experiences much better while they’re doing something else at the same time that engages a different part of the mind/body, such as playing, hearing a story that connects to their struggles, or engaging in some form of creative expression. And for those who tend to get lost in negative feelings or racing thoughts, trying to do something that requires focused attention from a different part of the mind- such as doing a puzzle or working out- can be a helpful way to think things through without getting totally lost in them.

Can you think of other examples of how split attention helps us process our mental experiences? I’d be interested to hear about them!

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Emotion Regulation: Shame

Jul 13, 2014 12:38 am | Mirel Goldstein

Most of us have experienced feelings of shame at some point in our lives…feelings of wanting to hide, wishing we didn’t exist, feeling painfully exposed to others and their judgments. For some, the sense of inner badness can even be so strong as to make a person feel toxic to others, as if others could become contaminated just by being close to them. For others, the shame might come at a time when we feel we don’t fit in- when we feel too awkward, too ugly, too fat, or too shy…somehow painfully set apart from everyone else. Shame might also show up when we feel like we aren’t living up to our own internal standards, when we make mistakes, act on desires that feel “forbidden”, or come across clumsy and unpolished.

One of the problems with shame is that it makes it hard to think, especially for those who already have difficulty with emotion regulation. There is something about the vulnerability of a shameful moment- that rush of heat through the body and the wish to hide or escape- that can flood us with such an intense impulse to do something to make the painful feelings go away. Shame can instantly transport us into an  “emergency response mode” in which we find ourselves unable to use our thinking minds to process the situation. And, because the shame is so painful, once the feelings subside enough for us to think through the situation effectively and try to get some perspective on it, we often avoid going back to the situation to think it through. Shame is a strong breeder of avoidance. We’d rather just forget about whatever it was that we felt so ashamed of. And of course this leaves us vulnerable to future shame attacks, because the source of our shame and the ability to tolerate it remain like shadows in the dark…shadows that would no longer seem so threatening if we could simply shine some light on them.

Many of the behaviors that people use to manage or escape feelings of shame also lead to more shame, as most of us know is the case when it comes to addictive behaviors and the shame cycle involved. Behaviors such as eating, using substances, self-harm, compulsive shopping, angry outbursts, and avoidance help us escape the immediate feelings of shame, but often lead to even more feelings of shame and of being “out of control” once the immediate tension is released and the behavior is over. Many people try to manage the feelings of hyper-arousal that come with shame (feeling flooded, adrenaline rushing through the body, anger, etc) with behaviors that can release the tension in the short-term, but that lead to a crash of hypoarousal/sadness/numbness, and more shame, afterwards. Trying to get into a “window of tolerance” is hard when it comes to shame, because shame is often intolerable at any level.

So what are some healthy ways to deal with shame? A DBT skill called “opposite action” teaches us to do the opposite of what we feel like doing when we are having an intense emotion; in this case, the opposite of the urge to hide is to “come out”. Sharing our shame with a safe and trusted other is often the last thing we feel like doing but an important antidote nonetheless.

Brené Brown’s Ted Talk, on vulnerability, is a great resource for getting up the courage to do this. Talking to other people, even just being around other people, and talking about the shameful event, are all antidotes to the urge to hide and the secretiveness that breeds even more shame. But we have to be careful to find the right people to talk to, and the right places to open up, because opening up to people who will invalidate us will likely lead to more shame. Most of us have a sense of who it might be safe to open up to, as well as those people in our lives who usually make us feel worse when we’re already feeling bad about ourselves, but sometimes we don’t listen to those instincts and we seek out people who will confirm our worst fears about ourselves. Learning how to break that cycle and seek out healthy attachment figures and validating supports is an important step in breaking away from shame. Another helpful skill is learning to validate ourselves. Validation is very soothing and can help restore our ability to think when we feel the rush of shame through the body. Validation is a simple way of getting our “language mind” online and using words to bring us down from a hyper-aroused emotional state. A great resource on self-validation can be found here: Self Validation.

What step are you going to take right now to break your shame cycle??

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Many of us are afraid to spend quality time with ourselves. We manage to run away in all sorts of ways, trying to escape the unsettling quiet of being alone with our own minds, or noticing how loud our feelings can be when we actually pay attention to them. Some of us mask the “quiet” by constantly talking to other people, chattering endlessly with others and filling up silences the minute they appear. For others, a frenzy of activity offers the desired distraction. And for still others, turning to substances or behavioral addictions such as food, shopping, or watching TV are also ways of avoiding what can be uncomfortable feelings associated with being alone or engaging in mindful awareness.

While introverts and extroverts may differ in terms of whether they enjoy quiet and solitude (a great resource on this topic is Susan Cain’s work on “The Power of Introverts”), I don’t think this is just about one’s temperament; even introverts can fill their minds with endless thought or become hyper-absorbed in a project or work, to avoid the painful experience of the unknown that comes with sitting with ourselves, letting go of control, and opening ourselves up mindfully to whatever seems to come up for us. I often think this is about the ability to be comfortable tolerating uncertainty and surrender, as we let whatever happens happen, and open ourselves up to feelings and experiences that might surprise us. Advanced cognitive therapy and behavioral therapy techniques (third wave cognitive therapy and behavior therapy) are now helping us learn how to have a different relationship with our own minds. It’s no longer just about changing the content of our thoughts (as in earlier techniques from cognitive therapy), nor is it just about changing our behaviors- therapists now know just how important it is to help people start to have a completely different relationship with their minds.

As a therapist, there are times when clients come in and talk so much and so fast, that they don’t even seem to come up for air; it gives me the feeling that they worry that stopping for a moment might force them to acknowledge deeper feelings that perhaps they don’t even know they have. Sometimes I might ask such a client to just pause for a moment and allow for a bit of silence, only to find the person instantly bursting into tears! It seems that this simple pause allows a rush of pent-up emotions to suddenly come to the surface. In a different scenario, many clients struggling with compulsive and addictive behaviors also describe how unbearable unstructured times such as the weekends can be, when the routines (and often frenzy) of activity and interaction of the week are suddenly gone, and there may be way more alone time than is comfortable. Many people fear their minds, complaining of racing thoughts or frightening thoughts, or simply wanting to control their thoughts- believing that thoughts themselves can actually be dangerous. As a matter of fact, many people seek out cognitive therapy for the simple fact that they want to “get rid” of something from their minds.

So what makes it so hard for some of us to simply be open to our own, uncensored experience? Here are a few of my thoughts. For some people, longstanding patterns of being put down by others or criticized for one’s thoughts and feelings may have caused underlying feelings of inferiority and low self-esteem, leading to an underlying belief that simply “being oneself” in the moment may not be ok. There is a sense of needing to constantly control who we are and how we think and feel. For others, internal experiences that are painful or that feel unacceptable (such as upsetting memories, or “taboo” emotions such as anger) are at-risk of coming up in a moment of quiet awareness that is not being blocked by distraction; this can be quite scary. I think there are also those of us who can feel empty when it’s quiet, when we’re not experiencing a rush of energy and adrenaline that tells us we’re real, alive, reacting. And, of course, for those who have experienced trauma or abuse in the past- not knowing when they might suddenly be caught off guard or victimized- quiet moments may be experienced as “the calm before the storm” rather than as ports of safety.

So why does it even matter whether we can tolerate being with ourselves or not?

Well, for one, constant activity, distraction, and stimulation can be very depleting, and can also stop us from reflecting on deeper parts of our experiences that may need to be dealt with. For example, blocking out anger might stop us from making changes to address things in our lives that are unsatisfying or disturbing. Avoiding painful memories may stop us from getting new perspectives on situations we may have overreacted to or taken too personally; we can often get very different perspectives from our initial reactions to upsetting events, if we manage to reflect on them once they’re behind us and we already have some healthy distance. And, not being able to tolerate discomfort as we tune into what we notice in our bodies and minds can make it hard to slow down compulsive behaviors such as eating, spending, or excessively surfing the net.

Which kind of mindful awareness is most difficult for you? When you are alone, is it hardest to be with what you experience in your body, in your thoughts, in your feelings, or memories that come up? Simply noticing what comes up when you pay a little attention can be an amazing first step to learning how to have a healthier relationship with the one person who will always be with you- your self!

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Distress Tolerance in Parenting: Lessons from Dialectical Behavior Therapy (DBT)

Aug 10, 2014 12:01 am | Mirel Goldstein

Although pain and distress are inevitable parts of life, many of us lack the skills to manage our pain in effective ways (Dialectical Behavior Therapy skills can be learned, so don’t worry if you need help with this!). Sometimes this comes from growing up with overprotective parents (who shielded us from having to learn skills to cope with discomfort), or from life experiences that were so painful that we learned to avoid pain because we were often overwhelmed by it.

Now, most people do not appreciate hearing about the benefits of learning to approach, accept, and manage their pain! After all, most people are looking for ways to get rid of their pain or distress, and they certainly don’t want to hear from a therapist that the answer is not to try to make the pain go away. (That’s why the emphasis on “acceptance” in dialectical behavior therapy is so radical!)

I don’t want you to get me wrong here though…there are plenty of situations in which it makes perfect sense to try to get rid of pain or a distressing situation. This is just part of having good survival skills and problem-solving instincts.

However, what I am talking about are situations in which it makes sense to accept some discomfort- either because it will help us reach a goal, or because we can’t make the pain go away (or at least not in a healthy way). So, when we lack the skills to cope with distress, we limit ourselves from being able to choose to accept pain when it makes sense to do so. (Hence, the emphasis on “distress tolerance” in dialectical behavior therapy).

Unwillingness to tolerate discomfort can also lead us to do unhealthy things to “make the pain go away” that actually make things worse in the long run (or even the short-run), like using drugs; or to avoid taking healthy risks.

(I define a “healthy risk” as a risk in which the possible negative outcomes are not severe or dangerous, while the potential benefits can contribute to a person’s health or quality of life. For example, going to a social event that might cheer you up or enhance your relationships, despite the risk of feeling awkward or shy, would be a healthy risk.)

So, going back to those things that we do to try to get rid of distress when we lack the skills to deal with it, what kinds of things am I talking about?

I’m referring to any activity, behavior, or substance that distracts or numbs us from the pain. It could be eating, shopping, drinking alcohol, or any number of other behaviors that very quickly take us out of our experience of discomfort.

These behaviors (often mindless) often have consequences of their own that lead to even more pain, or at the very least, don’t get rid of the original pain for long…once the effect of the distraction or substance wears off, the pain is often right there where it was in the first place.

On the other hand, healthy distractions would be actions that we choose to use that don’t have negative consequences, or that don’t stop us from focusing on the pain when we need to learn something from it (for example, constantly distracting ourselves from feelings of pain in a relationship might prevent us from evaluating whether there is a problem that needs to be solved or something we need to do differently to prevent future pain).e us out of our experience of discomfort.

These behaviors (often mindless) often have consequences of their own that lead to even more pain, or at the very least, don’t get rid of the original pain for long…once the effect of the distraction or substance wears off, the pain is often right there where it was in the first place.

On the other hand, healthy distractions would be actions that we choose to use that don’t have negative consequences, or that don’t stop us from focusing on the pain when we need to learn something from it (for example, constantly distracting ourselves from feelings of pain in a relationship might prevent us from evaluating whether there is a problem that needs to be solved or something we need to do differently to prevent future pain).

And when I speak of avoidance, I am talking about all the ways in which we try to control or prevent pain from happening, leading to a number of possible problems: not being able to make decisions because we’re too worried about what could happen if we do; avoiding social events, job changes, committing to relationships etc. because of the risk of discomfort involved; or simply being up at night worrying about things that could go wrong or lead to some form of pain.

In parenting, teaching our children distress tolerance skills is especially important. One thing that can help with this is trying to find a balance between keeping our children completely comfortable, versus abandoning them/failing to protect them from unbearable levels of pain.

The best time to help our children learn how to manage discomfort is when their discomfort is in a “window of tolerance” for them, meaning that they are uncomfortable enough to be practicing/learning something of how to deal with discomfort, but not so uncomfortable that they can’t think or reason, or allow themselves to be soothed or helped with coping. This might be saying “no” to a toy that the child wants, or to a play-date request, or allowing a child to struggle through a learning experience that is difficult (such as falling while learning to walk) without protecting the child from small failures involved in the learning process.

Our own ability to tolerate distress will influence how well we can cope with seeing distress in our children without feeling like we automatically need to “do” something to make it go away (of course, there are situations where we should try to stop the pain or protect the child).

The same holds true for ourselves. It’s best to practice different ways of coping with pain and distress by putting ourselves in bearable painful situations on purpose. This means pushing ourselves out of our comfort zones so that we get used to being somewhat uncomfortable, but not so far beyond what’s comfortable for us, that we feel overwhelmed by the experience.

Some examples of uncomfortable situations that we can put ourselves in to practice distress tolerance skills are: noticing an itch without scratching it; holding ice in one’s hand until it hurts and just noticing the pain/sensation; expressing a difficult emotion in a safe relationship; making a mistake on purpose (such as a spelling error in an email); thinking about a painful memory and just noticing the images, feelings, and sensations that come up with it; or going to a social event where we don’t know anyone.

Healthy distress tolerance is about knowing how to choose to approach situations that might be uncomfortable, but aren’t dangerous (or are unavoidable), as well as knowing how to distract ourselves, soothe ourselves, or simply “bear” painful feelings mindfully when we find ourselves facing the inevitable discomforts that life sends our way.

The important thing is to look at uncomfortable situations as opportunities for building up tolerance, which will make us more flexible and more confident about being able to handle situations that might be difficult, and trusting that we can cope when challenges come up.

Which of your favorite “distress avoidance” methods are you willing to give up?? (For more help with this, you may want to contact a therapist or coach who teaches dialectical behavior therapy skills!)

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Learning from Experience and Distress Tolerance

Sep 28, 2014 11:11 pm | Mirel Goldstein

It’s a well-known and sometimes paradoxical thing, but I do think it’s true: People often repeat painful experiences over and over again simply because they are afraid of the unfamiliar. Sometimes what we know, even though painful, is much easier than opening ourselves up to something new. However, even more problematic than our fears of the unfamiliar, can be our fears of focusing on the negative long enough to learn from it.

This came up recently with a young woman I was working with; I’ll call her Sonia. Sonia seemed stuck in a terrible pattern of starting to make progress and changes in her life (which was extremely chaotic when she initially came to see me) for short periods of time, only to have these beginnings of stability be immediately followed by periods in which she would completely wreck everything up.

For example, she might find a job and start to make money, only to sabotage it just when she needed the money the most. She would get into fights with people just when they were about to help her out. And she would break the rules and get evicted from her apartments just when she had finally settled in. Although this pattern was a bit frustrating to me as her therapist, since I could only seem to help her a little bit before she would be even worse off than when we started, it was extremely painful and excruciating for her. What was even more vexing was that this woman did not feel any sense of agency in these situations; she did not see her own part in creating constant crises, but rather viewed these situations as events that would happen “to” her, completely out of her control. I slowly learned not to get my hopes up when Sonia would start to be successful, because I knew that she would destroy it all just at the moment when things seemed to be going the most well. Sonia herself did not seem to be able to learn from experience; even when I could “catch” her beginning to self-sabotage herself, she often felt invincible- only to be completely caught off guard and blindsided when “events” would again “conspire” against her.

Eventually, I realized that it was important for me to remind Sonia of negative events from the past, just when she was feeling the most hopeful about the future. Sonia did not appreciate this; as a matter of fact, she felt that I was ruining her “good feelings” and trying to “bring her down” just when she was up. However, I was well aware that Sonia’s difficulty paying attention to past negative experiences once she was feeling “better” was part of what made it so hard for her to learn from the bad and to sustain the good, rather than just experiencing it for brief amounts of time before automatically recreating “crisis mode” for herself, completely oblivious to her part in this process.

As Sonia slowly became able to tolerate my comments about her pattern of self-sabotage, even when she was feeling “on top of the world”, we came to understand that Sonia was so used to being in crisis all the time, and living in survival mode, that it was simply too scary for her to get through the “weirdness” and unfamiliarity of allowing a sense of calm and stability to go on for some time. We were able to slowly look at the discrepancy between what Sonia was saying she wanted, and what her actions were saying- two very different things.

Although it was extremely painful for Sonia to acknowledge her “dark” side when she was feeling really great, that’s really what it took for her to see her part in bringing herself back to painful crises over and over again. Besides for hating the “not knowing” and uncertainty that came with feeling new feelings that Sonia wasn’t used to (such as staying calm and being surrounded by safety and stability), Sonia also hated to have her “good” experiences tainted by memories or predictions of more painful times; she felt that she deserved to feel “all good” when the crisis passed, because of how much pain she had previously endured. However, slowly and together, we both realized that Sonia needed to be able to pull together the bad memories with the good in order to break the cycle of ups and downs that she couldn’t seem to get out of.

While it might feel good in the moment to “split” the bad from the good, and to stay with “black or white thinking” about our circumstances, it’s only when we integrate our full experience that we are able to have a sense of control over the whole picture. There are some losses involved in this process, but doesn’t all learning include just a little bit of that? And, isn’t it worth the price to get to learn from experience rather than endlessly repeating it?

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