Mind and Emotions (14 page)

Filling out the worksheet helped Laura think about the situation more flexibly. It softened her sense of outrage and helped her get over feeling angry about her mom’s behavior. The next day she called her mom to say she understood how her mom felt.

Applications

Each category of negative appraisal will influence some emotions more than others. Anxiety, for example, is primarily driven by negative predictions and underestimating the ability to cope. If you’re anxious or fearful, be on the lookout for these types of appraisals and focus on the exercises that target them: Calculating the Validity Quotient, Keeping a Predictions Log, and Drafting a Worst-Case Coping Plan.

Anger is most often generated by negative attributions and shoulds. If anger is an issue for you, focus on cognitive flexibility exercises such as Transforming Shoulds into Preferences, Understanding Reasons for Breaking the Rules, and Finding Alternative Explanations.

Guilt and shame are most often triggered by focusing on the negative and shoulds. Exercises to emphasize include Transforming Shoulds into Preferences and Understanding Reasons for Breaking the Rules. Also work with the exercises Using Big-Picture Awareness and Seeing Both Sides of the Coin.

Depression can be driven by all five categories of negative appraisal. If you’re struggling with depression, start with the exercise Keeping a Thought Log to see which types of negative appraisal show up most frequently for you, then focus on the cognitive flexibility exercises pertinent to those categories.

Duration

It will take at least two weeks to work your way through this chapter and do the relevant exercises. You may be able to skip the exercises for some categories of negative appraisal if they aren’t an issue for you. That may save a little time. For appraisals that you struggle with, you’ll need to work with the exercises for two to four months for new cognitive habits to set in.

Chapter 8

Self-Soothing

What Is It?

Self-soothing is any activity, experience, or pastime you find relaxing and pleasurable. It can be listening to music, taking a hot bath, practicing yoga, going for a walk, doing relaxation exercises such as deep breathing—whatever you like doing that reduces stress. As straightforward and easy as self-soothing can be, many busy, stressed-out people need to learn how to incorporate it into their lives. Another important point is that self-soothing isn’t a license to do anything you like. Dangerous or unhealthy pleasures, such as reckless driving or overindulging in alcohol and hard drugs, aren’t considered appropriate self-soothing.

Self-soothing is one of a set of distress tolerance skills taught in dialectical behavior therapy, which has a long history of clinical effectiveness (Linehan, 1993).

Why Do It?

Many self-soothing and relaxation exercises can be done quickly, in virtually any setting, and without a lot of practice. At the very least, relaxing and soothing yourself give you a chance to rest and recover from stress. In addition, feelings of relaxation and enjoyment become a benchmark of serenity and a point of comparison that will help you recognize more stressful periods in your life. Finally, self-soothing and relaxation are healthy coping strategies because they involve nondamaging pleasure.

Self-soothing addresses the transdiagnostic factor response persistence by providing an alternative to habitual, ineffective ways of reacting to painful emotions. It expands your adaptive repertoire to include new and varied activities that serve as positive coping strategies you can use instead of the negative coping strategy of avoidance.

When Not to Do It

Practitioners of acceptance and commitment therapy consider self-soothing and relaxation exercises to be forms of emotional avoidance that can interfere with learning to desensitize to painful emotions (Eifert and Forsyth 2005). To make sure that you aren’t using the skills taught in this chapter to avoid your feelings, don’t self-soothe in these situations:

• Don’t self-soothe to avoid the arrival of a painful emotion.
  Let’s say a good friend has announced that she’s moving away to a distant city. Every time you even start thinking about her, you suppress your feelings of loss and grief by playing your guitar, watching a video, or firing up your computer to surf the Internet. This is an inappropriate use of self-soothing because it’s an attempt to avoid fully experiencing normal feelings of loss and grief.
  
• Don’t self-soothe in place of an appropriate emotional response.
  If you’re angry about being passed over for a promotion at work, an appropriate response might be using that anger as motivation to dust off your résumé and inquire about openings in other departments. If you respond to the first twinge of anger by heading to the break room for a pastry, you might not get around to planning a positive, active response.
  
• Don’t self-soothe in a way that interferes with valued or necessary experiences.
  For example, if you want to help your daughter with her homework, but every evening you turn on the TV instead, that form of self-soothing is keeping you from an important opportunity to bond with and help your child.
  
• Don’t use self-soothing or relaxation techniques during emotion exposure exercises.
  Doing so will block your habituation to your feelings and make the exercises useless.
  

What to Do

Self-soothing can take an infinite variety of forms, and what works for different people is highly individual. In this section, we’ve divided the possibilities into two main categories: practices that promote relaxation, and suggestions for a wide variety of sensory experiences that can serve as self-soothing techniques.

Relaxation

The exercises in this section will help you learn to relax profoundly. The first involves a specific breathing technique and the second involves relaxing all of your muscles as much as possible. In the third you’ll use a cue word to help you relax, and in the fourth you’ll visualize a safe place. Try all four exercises to see which suit you best.

Diaphragmatic Breathing

When you’re upset, your breathing becomes fast and shallow. By consciously slowing your breathing and taking air deep into your belly, you send your body the message that everything is all right and there’s no need to panic or be upset. Diaphragmatic breathing is simple, but its stress-relieving effects are dramatic. The diaphragm is a wide, strong sheet of muscle beneath the lungs. When you inhale, your diaphragm moves down and out, pushing out your stomach and drawing air into your lungs. When you exhale, the diaphragm moves up and inward to push air out of your lungs. Here are detailed instructions on how to practice diaphragmatic breathing.

Find a quiet place where you won’t be disturbed for five minutes. Sit up straight and put one hand on your stomach. Close your eyes and take a slow, deep breath in through your nose. Feel how your stomach pushes out against your hand. Then exhale slowly through your mouth, noticing how your hand moves inward again. Continue to breathe in and out slowly and deeply, feeling your hand moving out and in with each breath.

Notice how each inhalation expands your stomach like a balloon. Also notice how your body feels more and more relaxed as you continue to breathe this way. Try to keep your focus on your breath. If your mind wanders, you can try counting during each breath to focus your attention on your breathing. Slowly count to four as you inhale, then slowly count to four again as you exhale.

Practice diaphragmatic breathing for five minutes twice a day, or whenever you feel the need to relax.

Body Awareness

The relaxing effect of this exercise relies on the fact that you can’t feel tense and nervous when all of your muscles are in a state of relaxation.

Find a quiet spot where you can lie down and not be disturbed. Lie on your back with your legs uncrossed and your hands at your sides. Close your eyes, take a long, slow breath, and put your attention in your feet. Become aware of any tension you’re feeling in your feet. Say to yourself, “calm,” “relax,” “serene,” “easy,” or another cue word of your choice. As you say the cue word, imagine any tension draining out of your feet.

Next, move your attention up to your calves and shins. Notice any tension in your lower legs, and say your cue word to yourself. As you say the word to yourself, imagine any tension draining out of your calves and shins.

Next, do the same thing with your upper legs—the large muscles in your thighs. Continue moving your relaxing attention up your body: to your buttocks, then your stomach, then your chest, then your back, and then your shoulders. For each area of the body, become aware of any tension, then say your cue word and let the tension fade away.

Next, do the same for your hands, then your forearms, then your upper arms, then your neck, and finally your head, in each case noticing any tension and using your cue word to dissolve the tension. When you’ve scanned your entire body in this way, you will have significantly reduced your overall muscular tension, profoundly relaxing your body.

Practicing this exercise once or twice a day for a week will teach you a lot about where you carry tension in your body. It will also make you much more adept at relaxation.

Cue-Controlled Relaxation

Once you’ve gained some experience and skill with the body awareness exercise, you can use your cue word for quick relaxation anywhere, anytime. Close your eyes for a just a few seconds and scan your entire body for tension. Notice where your muscles are tight, and then say to yourself, “relax,” “calm,” or whatever cue word you like and let your whole body relax.

Safe Place Visualization

This exercise takes advantage of the fact that your mind and body will react to an imaginary peaceful scene almost as strongly as they would to a real location. Think of a place, real or imaginary, that makes you feel safe and happy. It can be someplace from your childhood, a vacation spot, a church or temple, a setting from a book or movie, or even a historical setting—absolutely anywhere you like. If you can remember the following instructions, just close your eyes and paraphrase them to yourself. Otherwise, you might want to record the instructions in a calm, quiet voice, and play them back until you’ve practiced this technique a few times and are familiar with the process.

Find a quiet place where you won’t be disturbed for twenty minutes. Sit in a comfortable chair with your feet flat on the floor and your arms in your lap or on the arms of the chair. Close your eyes and take a deep breath, inhaling through your nose. Hold your breath for five seconds, and then exhale slowly. Take another deep breath and hold it for five seconds, and once again release it slowly. Continue to breathe slowly and deeply without counting or holding your breath.

Imagine that you’re entering your safe place. Use your sense of sight first, and imagine seeing the shapes and colors of the place. Fill in the details. Are there any people or animals there? Watch them do whatever they’re doing. If your safe place is inside, notice what the walls and furniture look like. If it’s outside, observe the sky, the horizon, the ground, and any plants or water. Continue to observe until you have a clear, vivid visual impression of your safe place.

Next, concentrate on your sense of hearing. Can you hear the wind? Waves? People talking? Is there music? Do you hear any birds or animals? Choose something soothing to hear.

Next, notice what there is to smell in your safe place. Perhaps it’s a scent you remember fondly from your childhood, like flowers or freshly baked bread. If you’re outside, smell the ocean, the grass, or whatever aromas surround you. Take a moment to enjoy the fragrances.

Next, notice what you can feel with the sense of touch. Are you sitting or standing in your safe place? Is there any breeze against your skin? Is it warm or cool? Focus for a moment on what your sense of touch can tell you about this place.

Next, imagine that you can taste something in your safe place. Eat or drink something and imagine how delicious it is.

Continue to enjoy your safe place, breathing slowly and evenly and noticing what you see, hear, smell, feel, and taste. Realize how safe, relaxed, and content you are in this place. This is your personal, private safe place, and you can return to it at any time. Whenever you feel sad, afraid, angry, or guilty, you can come here for a break and feel this same sense of relaxation and security.

Look around one more time and fix the details in your mind. Now focus again on your breathing. Keep your eyes closed a bit longer, as you remember what the actual room you are in looks like. When you feel ready, open your eyes and return your focus to your surroundings.

You can practice this exercise whenever you need a soothing mini vacation. Once your safe place has become very familiar to you, you can close your eyes for a few seconds during a busy day, visualize your safe place briefly, and feel calmer and more relaxed.

Sensory Self-Soothing Techniques

Below, you’ll find lists of soothing activities organized by the five senses: touch, hearing, sight, smell, and taste. All are designed to give you a soothing moment of peace, but people are different in what they find most soothing. Look over the lists and choose activities that are likely to soothe you, and also be willing to try new activities to see how they work for you. Some people find jazz or classical music very relaxing, while others find it energizing or nervous-making. If you try a suggested activity and it doesn’t feel soothing or actually makes you feel worse, move on to another activity.

Self-Soothing with Touch