Synergies in Treatment

A series of articles written by Dr. Gelbart for the Northern California Psychiatric Society Newsletter. These articles are a bit more “technical” than others on this blog, but they can help anyone interested in how mindfulness, positive psychology, Wellness approach, and skills training can help with self-esteem, anxiety, depression, motivation, and other difficulties. It may help you in choosing a therapist, and/or bring up questions for discussion with your therapist or friends.

  1. Introduction
  2. Judgmental Thinking
  3. Mindfulness and Psychiatric Treatment
  4. Teaching The Patient To Swim
  5. Focusting On The Positive
  6. Changing The Shoulds To Wants
  7. Mindfulness Psychotherapy And The Brain
  8. Which Tool When

Part IV: Being Present and Filtering Your Emotions

Actions and Consequences

“I think you should take your job seriously but not yourself-that is the best combination.”

Judi Dench

If your mind is in the past, thinking about your mistakes, blaming yourself or others, feeling resentful about things, then you’re NOT in the pilot’s seat. If you are worrying about tomorrow, then you’re NOT in the pilot’s seat. If you’re judging yourself, wondering if you’re good enough for the job, then you are NOT in the pilot’s seat. When you notice yourself slipping out of the pilot’s seat, simply remind yourself to get back into it. One way to do that is to remind yourself to be present, take a slow deep breath, focus on your chest, on the physical sensations of the air going in, and then as you exhale focusing your attention on the sensations of the air coming out. This brings you physically and mentally into the present from wherever you were. Each time you notice yourself leaving the pilot’s seat, and nudge yourself back in, you’re practicing mindfulness.

Now that we’re starting to work on staying in the driver’s seat we can begin to look at the control panel. Reading our emotions properly and responding in healthy ways can help us navigate around obstacles and reach beyond our dreams. Trick is, we can’t always trust the instruments. Sometimes when an alarm goes off, it’s a false alarm. Doing something drastic might get us in trouble. This is how it is with our feelings and impulses. So we have to understand what can get in the way-how beliefs we formed in childhood distort, and stick-how what we think we know, and what we don’t know we don’t know, can blur our view.

Let’s go back to our three important questions.

PAEJO

  • Are my Perceptions Accurate?
  • Emotions Justified?
  • What are the possible Outcomes?

PAEJO. Perceptions Accurate?, Emotions Justified?, Possible Outcomes? I try to remember it as the consequence guy, Jo, waiting to be paid if I don’t carefully consider the outcomes of my actions and reactions.

Let’s talk about consequences. We want to move away from blame, whether it’s blaming others or blaming our self. Instead, the healthier, more effective model is that there are consequences to our actions, and we must accept them, learn, modify our behavior. So accept that we are lifetime students. Blaming and kicking ourselves, or others, only distracts from the learning process by adding hurt, shame, anger, and other negative emotions on top of the original mistake. We can’t change other people who tend to kick themselves or people around them, but we can choose for ourselves to get out of that kind of obsessing and abuse of ourself and of others. Getting rid of blame from your life is related to living nonjudgmentally. You’ll see that this is also the key to dealing with self-esteem problems.

Mind Gem # 4: Blame is a distraction. And
4a: Make a mistake, make a correction.

Part III: Don’t Let Your Emotions Control You

Hijacked by Our Emotional Mind

Be practical as well as generous in your ideals. Keep your eyes on the stars, but remember to keep your feet on the ground.”

Theodore Roosevelt

Here’s an example of a simple but powerful new concept that can start you off. Most of the time when we feel an impulse or emotion, we don’t have to do anything! We almost always have time to hold back our reaction on what we say or do, and give ourselves extra time to process what’s happening before we act. As I become older, and theoretically wiser, I can’t tell you how often I’ve found that keeping my mouth shut, or not lashing out when I feel like it, has lead to the better outcome.

Emotions are there to grab us, to suddenly hijack our mind and our body and set us into motion, without having to think. Anger is there to mobilize us to attack, fear is there to help us defend, love is to help us connect with others, and to regenerate our species.

The sudden hijacking of our mind and body is usually quick and strong, and if you don’t act on it, it sets up a physical struggle inside. You can learn to win that struggle as you listen further.

Mind Gem # 3: Next time you get hijacked by an impulse to act, consider if you can give yourself time to think about how to respond to it. Usually you can.

An impulse can suddenly try to yank us out of the pilot seat. It’s like an alarm, sometimes it’s the real thing but it may also be a false alarm and reacting without thinking can be disastrous. Emotions can be sudden but they can also build, and we can find ourselves being swallowed up by them before we realize it. We may not be aware that we’ve left the pilot seat. We can get lost in our “emotional mind.”

Mindfulness will teach you to find the driver’s seat and stay in it. If you hear alarms (strong emotions), and think you have to act immediately, gem number three reminds you to process what’s going on before acting.

Introduction: Harnessing the Power of your Mind

from the text version of the Potent Mind audio CD

Do you understand your emotions? Do you judge them? Do you ever wonder if you’re going crazy, or what your mental disorder might be? Would you like to understand yourself and your emotions better? If you did, you would probably learn that you’re more normal than you think.

Do you ever ask yourself: why do I feel the way I do? Is what I feel important? In what ways? When can I trust what I feel and when should I not? How can I “feel better?” How can I make other people feel better?

Have you ever had difficulty letting go of resentments toward others about things that happened? Do you ever blame yourself, perhaps beating yourself up or kicking yourself emotionally, repeatedly, even when you can see there’s no benefit to it? Do you find yourself obsessing around and around, about the past, or perhaps about what’s going to happen in the future? Do you ever feel insecure, about whether you are “good enough”, or “adequate”, or whether or not other people will judge you as such? Are you afraid to say no? Are you afraid of people who might “emotionally persecute” you? Do you ever feel like you’re marked with a “V” for victim? Do you tend to jump in and rescue people? Do you ever lose control of your anger and say or do things that you later regret? In addition to the emotional suffering this causes it wastes much of our precious mind resources with preoccupations and unnecessary concerns. That removes so much of our consciousness from out of the present, where it’s really needed. I’ll teach you specific techniques and skills which can eliminate those obstacles.

In this course I’ll teach you how to:

  • let go of hostility, resentment and guilt
  • worry and obsess less
  • reduce stress. Even better, do more and have less stress
  • find tranquility in this chaotic world
  • be more present, enjoy life more, and have more clarity in decision-making
  • accept yourself and also strive to become better
  • have more love and compassion in your life

What do we mean by a Potent Mind? We would want clarity of thinking, being able to focus on what we want to focus on when we need to, thinking objectively even in the midst of distracting information and emotions. We would want to be able to relate to, but act independent of what’s going on around us. We would want to have a sense of calmness, peacefulness in our mind, to be relatively free of negative emotions such as guilt, resentments, hurts, or fears. We might also want a sense of comfort with our self, and adaptability to varying situations. You can have this!

We can be most effective and healthy mentally when our mind is clear, our emotions calm, our attention is in the present, and we are aware of our goals and priorities. It is said that we only utilize 10% of our brain. If we could learn to utilize another 5% that would be a huge increase! You can learn to utilize parts of your brain that have been mostly dormant, or used only spontaneously or accidently.

New technology such as functional MRI can show us live in real-time what areas of our brain become active (or quiet) when we relax, or when we feel certain emotions such as anger, fear, or compassion. We can now connect findings of these scans with what we know about sickness and wellness and understand what we need to do in order for our mind to be healthier and more effective. By strengthening our mind, we will also be strengthening our body, our relationships, and our potential to contribute to society, the planet, and the universe.

Evidence is increasing that stress and anxiety are costly in terms of physical damage to our body, via cortisol, the cardio-vascular and immune systems, and direct damage to brain cells. Most people would agree that holding in anger, resentment or other emotions creates many problems in terms of tension and frustration, hostility, and sometimes depression. This can also become distracting, reducing our effectiveness, and interfere with our relationships and goals. Most would also agree that low self esteem– lack of confidence, excessive self-doubt are handicaps. Anxiety, stress, maintenance of dysfunctional and sometimes self-destructive patterns, pride, resentment, as well as other emotions and impulses frequently get in the way of reaching our full potential.

A recent article in a neuropsychiatric journal described functional MRI studies involving resentment and forgiveness. A study using cognitive therapy for post-traumatic stress disorder showed improvement in symptoms related to learning how to be more forgiving. That is, letting go of resentments. These exciting scientific studies are starting to bridge huge gaps between Buddhist and religious themes of forgiveness, compassion, and mindfulness, on the one hand and Western psychological models of emotions and psychodynamics on the other.

Studies with similar types of scanners have shown that a specific part of the brain lights up when we focus on ourself as different and unique from others, versus another part of the brain which is utilized when we lose track of ourselves, and focus more on the universe, our interconnectedness, and more cosmic and spiritual types of things. Each has advantages and disadvantages and there are times when one focus is more beneficial than the other. We can learn to utilize the part of our brain that will be most useful to us in the moment.

I hear some people say, in effect, I don’t do feelings. We may often wish that we didn’t feel, or that we could only feel positive and not negative emotions. Emotions have evolutionary value. Doing feelings wisely can reduce the suffering from negative emotions and give you a sense of peace and fulfillment. Doing feelings wisely can help you not only to survive but to thrive.

There are many skills that you can learn and practice wherever you are in the spectrum of psychological wellness to psychological illness. The model that I present, and the skills I introduce can be put to use by most anyone. If you’re serious about this, apply what you’re hearing, seek additional guidance through books and CDs (see bibliography), workshops and groups when you can find them. If you run into trouble a therapist might be helpful. The rewards for your work to strengthen your mind will be multiplied as you see the effects on your body and physical health, on your relationships and your career, in having a better sense of a place in the universe, and overall quality of life. In a practical, nuts and bolts fashion, this audio will outline how to get from here to there.