Archives for posts with tag: distress tolerance skills

“Wise mind” is a mindfulness concept in the class that my family has been taking. Wise mind is used when “emotion mind” or “reasonable mind” get out of balance. Wise mind is, well, wise and validates both emotion and reason.

If you look back at my last post, you can see moments where either emotion mind or reasonable mind got out of balance. There is a mindfulness skill called, “ask Wise Mind a question.” No, I kid you not. The judge-y part of my brain has thoughts like, “That sounds silly and dumb.” Fortunately, I am really trying to learn as much as I can from this class so I’ve been able to keep Judge-Y at bay, for the most part.

On Monday, while I was lying on the ultrasound table, feeling fear, scary thoughts, and starting to try to reason myself out of them with arguments that now seem kind of ridiculous, I thought, “Wise mind, what should I do?”

Within a fraction of a second, I noticed that my heart was beating fast and started using paced breathing to slow it down. My heart rate is particularly responsive to breathing techniques so that helped settle me down considerably. It also gave me something to focus on, something in the present, which was much preferable to my worrying about the future.

“Wise mind, what should I do?” was a question that got me unstuck. It helped me shift my attention and thoughts, to cope more effectively, and to make my anxiety much more manageable.

I am finding, more and more, through my practice of mindfulness and the other techniques taught in this class that I am able to limit my suffering around scans to shorter periods of time. Another skill I used is called, “Coping Ahead”. It is not a mindfulness skill. Mindfulness is powerful but it is not always useful. Coping Ahead means identifying a stressful event that you know is happening in the future, identifying skills for handling it, and visualizing yourself successfully applying these skills (mental rehearsal).

When we covered this skill, I knew that my scan was coming up so I made a plan. To be honest, the plan was not perfectly laid out but I put many elements into place. I decided that the most difficult part of my anxiety around my scans was that I am irritable and on edge and end up getting upset with my family for no good reason. I have not only coped in a way that increases my own suffering but that of the people around me. I imagined what I would be like if I was not that way and identified the skills that would help me get there.

As it turned out, the actual scan and the hour or two around it, were much more stressful than I expected it to be. But I didn’t snap at my family. In fact, we had a wonderful weekend together.

When I wrote my last post, I was trying to convey the experience that many of us have as cancer patients. Although I have not had known cancer for nearly three years, I still consider myself to be a cancer patient. I don’t know if that will ever change. I wanted people to understand that. I also wanted people to understand that meaningful and joyful life is still possible, nonetheless.

There are aspects of my life that are scary. I feel my feelings. I think my thoughts. Some of you described my last post as “harrowing”. That’s a pretty intense adjective. I was a bit shocked by the reaction and then felt sorry for having distressed people. But if I really think about it, I was describing the experience of trauma cues and fears of being sick again. That’s pretty hardcore.

My writing and my mindfulness exercises help me put my terror in a transparent box, so that I can examine it, like a specimen. It is still painful. It is still scary. But it is a way for me to move forward without hiding from myself.

“Wise mind, what should I do?”

Live my life.

Every day.

I am a thinker. You may have noticed. I am also a deep feeler. You may have noticed that, too. I am also a fairly reasonable thinker. This last characteristic was later in coming to my life. I had a friend tell me once that I “hid behind my intellect”. Out of context, that sounds a little mean. It really wasn’t meant that way and it wasn’t the way I took it at the time. But I did think, “Are you kidding me? I have worked hard to use my intellect to help me live a less sloppy, crying, worrying life. This is NOT a negative.” (By the way, those comments were made in my mind, to myself, not to my friend.) Our higher brain functions can help us a great deal, like a lot lot. However, there are aspects of our more primitive selves that can come in handy.

Our bodies communicate with ourselves. The nervous system is amazing. Our Central Nervous System (CNS), which includes our brains, is a marvel. Nonetheless, often the fastest of our communications are less than sophisticated.

Case in point, there are fundamental, often called lower brain functions that try to keep us from dying. They are on the alert, vigilant, but also kind of simple. If you have ever seen prairie dogs constantly dark out of their holes and call to each other, you know what I mean. They are trying hard to avoid being food for an animal higher up on the food chain. Vigilance is a type of assessment, a scanning of environments for danger.

But guess what? Like prairie dogs, our CNS is often alarmed for no damned good reason. It is very sensitive to possible problems but makes a lot of false positives. In other words, the CNS can work like a mammogram; it is sensitive to danger but not specific. False alarm! False alarm! False alarm!

These alarms, are compelling and can trick the more reasonable parts of our brains into freaking out. “My heart is racing, I feel scared, therefore there must be SOMETHING REALLY BAD HAPPENING.”

This can also work with anger and with depression. There are parts of our brain that can go to a bad place really fast and if it is compelling enough, it convinces fancier brain parts to follow. “My life is horrible because people are doing bad things to me in a long-term and fancy way. And yes, this is based on mind-reading but I am fancy and know how to read minds. And by the way, why do you all hate me?”

Cognitive therapy was originally based on getting ourselves to be reasonable with ourselves. What is the evidence for our depression inducing thoughts? We are jumping to conclusions. And no, we cannot mind read. There are a group of higher brain tools that we can use to get ourselves to calm the Hell down. And they are very handy tools.

We don’t always have to start at the top, however. We can work our way up by changing more basic and fundamental communication systems. Most of us are familiar with deep breathing techniques as a way to reduce stress and anxiety, as a way to reduce distress. The way we breathe that is the least stress inducing is the way we breathe when we are asleep, when we don’t even have to think about it. Deep breathing, or relaxation breathing triggers the parasympathetic nervous system, which is the state of our CNS at ease, relaxed, and feeling safe. “Fight or flight”, the sympathetic nervous system is triggered by fast breathing, higher in the chest. Breathing this way raises blood alkaline levels. This is the how, by the way, the main characters killed the blood invading aliens in the movie, The Andromeda Strain. It is the perfect breathing for danger but it causes a lot of trouble when we do it when we are not really in harm’s way.

I am learning some more “bottom up” calm down techniques in my class. The latest is the “half smile”. Our facial expressions not only serve to communicate with the outside world, but they also communicate with the inside world. Feeling irritable? Turn the corners of your mouth up, ever so slightly into a half smile. There’s even research on this. It often helps people calm down.

It sounds a little like a magic trick. However, what’s it going to hurt to wear a Mona Lisa smile from time to time. It might feel awkward but not nearly as awkward as when I lose my temper and not only embarrass myself but find myself filled with regret. Not to mention the relationships that need mending.

So I have been trying the half smile. It’s a perfect time to practice. I’ve been working a lot with the move of our private practice. I am frequently annoyed in these kind of circumstances. Stress, when it involves a lot of logistics, has a way of pissing me off.

I can’t say that I am looking like Mona Lisa all of the time but I have to say that I notice a difference and it works many times when I try it. It’s not a permanent solution but it helps get me in a better frame of mind to use other coping strategies. I have also tried doing a half smile on my walks, hoping that this will help associate the half smile with the ease I feel when I am exercising.

I also can’t say that I haven’t felt stressed or overwhelmed at times, with this move. But it is less so than would be in the past, I think. All of the tools I have been using have been helpful.

Try it out and see what you think! It may work and it may not. But it’s free and easy.

Heart Sisters

For women living with heart disease

George Lakoff

George Lakoff has retired as Distinguished Professor of Cognitive Science and Linguistics at the University of California at Berkeley. He is now Director of the Center for the Neural Mind & Society (cnms.berkeley.edu).

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