I come across many models that don’t seem to hold up when I compare them to different studies or how I see them working with my clients.
One model that seems to keep proving it’s worth is Dr. Saj Ravzi’s Stress Response Hill, shown below. Check out his entire video, it’s worth the investment of time. The one point of his I want to highlight, is that most of us are operating at the “1”, we are slightly activated most of the time, and when we try to do mindfulness or relaxation exercises to get to the “0”, we may actually fell more agitated. It’s common to then think the exercise must not work, when actually the agitation in the body increases before it fully relaxes, so the increase in agitation means it’s working. I find this model extremely helpful to explain to clients prior to beginning relaxation exercises, as it helps them understand the increase in anxiety is part of the process.
New experiences can bring up opportunities to examine childhood wounds and begin healing them. A common new experience I see people having is their first child or their first child that’s the same gender they identify with. Seeing the child grow to be ages the parent was when different traumas happened can bring up old childhood pains. While it can be very challanging, the experiences can also be a blessing allowing us to see parts of ourselves that need love, understanding, and forgiveness.
If you or a client is going through a new experience and has a response that exceeds the circumstance or seems like it belongs to a younger self, take the time to examine that response. What’s its’ message? What is it needing to heal? Provide the piece of the self that responded in this way with compassion.
What new and challanging experience can you try this week? Be mindful while doing it and see what emotions or sensations arise. If any parts of yourself are uncomfortable, take the time to comfort them, and be thankful to the new experience for showing you this piece of yourself to heal.
I will be releasing a podcast soon about burnout, and we did a great job about speaking about the internal factors.
I did not cover the external factors though. Sometimes the systems that we work in are not conducive to our health. You are not broken, the system is. It’s okay to walk away from moral injury. Each of our decisions of what systems we choose to work in are valid.
It is not your fault if you are feeling exhausted and ineffective in a convoluted system. It is your responsibility to choose how you want to handle the circumstance you are in. You may decide to stay and work on your boundaries and adding emotional fitness skills. You may decide to leave and work for a smaller practice, where more of your energy can go to serving clients instead of working to change the system. All choices are valid, worthy, and acceptable. Listen to yourself. Take action on your wisdom.
For more information on Moral Injury, see Dr. Z’s video on how it’s effecting the healthcare system.
Arianna Huffington spoke on Masters of Scale about how her organization is using AI to monitor call centers. After an operator hangs up with a difficult caller, the AI detects the intensity in the call, and instead of patching through another caller, the operator will get a Thrive call. This Thrive call is a 30-60 second guided call, which could be on mindfulness, gratitude, breathing, etc. Arianna’s company Thrive understands that these small investments in emotional fitness pay for themselves. Emotional fitness supports the operators and the callers both have better experiences. What emotional fitness practice can you begin incorporating today?
FYI – A recent meta study on breath work comparing 8 types of breathing showed that all types of breathing were effective for a portion of the participants. There wasn’t one style that was effective for everyone. So explore different emotional fitness practices, what seems most supportive for you? The exercises that seem the most supportive may also change over time. Try keeping a list in your phone of what works and even what doesn’t work for you, so you know where to turn after a more intense moment, since most of us don’t have Thrive calls coming in to remind us what there is to be grateful for.
When you think of physical recovery after an intense workout or running a race – what comes to mind? Possibly:
Intense physical exercise, focused on the same muscle groups, day after day, is counterproductive, as it doesn’t allow for the repair cycle, and instead causes repetitive small injuries. While the small injury that occurs after one intense workout is beneficial with rest, as the muscle is allowed to repair itself and becomes stronger.
When you think of emotional recovery after an intense session or a multiple hour session due to a safety planning intervention for suicide – what comes to mind and are we as diligent at applying these recovery methods?
Prioritizing our emotional recovery with the same awareness we allow ourselves to recover from physical exertion, I believe, could support healers in growing and becoming stronger from the intensity we experience in supporting others.
What steps can you take to support yourself in emotional recovery?
Joseph Campbell, renown for unifying concepts from literature across many different cultures, developed the philosophy of The Hero’s Journey. The Hero’s Journey seems to identifiable and meet warmly in many different contexts. When I see clients, especially those re-entering their life after a residential stay for substance abuse, able to structure their story similarly to the Hero’s Journey, they seem to be welcomed back and offered support.
What are ways you identify with the Hero’s Journey?
What are ways you can support your clients in identifying with the Hero’s Journey?
Without guidance it’s easy for members of group therapy to do old patterns of secret keeping when trying to maintain confidentiality. Clients, especially those with parents that experienced trauma and/or addiction, may have been instructed as a child to not speak about what goes on at home. Without a clear explanation of what is okay to speak about in regards to group therapy, it’s easy to repeat historic patterns. When asked about a group, and a client says “I’m not allowed to talk about it”, that’s actually not true. So what can clients speak about while maintaining confidentiality of other group members?
It’s important for clients to be able to speak about the topics covered in group therapy. Speaking about general topics, such as childhood trauma and the long term impacts, can support the client in educating their support network about what they are working on and ways others can offer them support.
Clients may speak about their personal experience in group therapy. It’s important for clients to be able to speak about their insights, challenges, hopes, and practices to others in their life.
While the therapist must maintain confidentiality of all group members, and group members must maintain confidentiality of all other group members. Anything the therapist says or does may be talked about to others. Clients are encouraged to bring up concerns or disagreements to the therapist and practice direct communication. The clients may relate lessons or stories shared by the therapist to others.
Finally, it’s also important to speak to and have a written agreement about the consequence of not maintaining confidentiality.
There’s many ways to choose which person to lead with in a group session, and I will cover some other options on how to choose llater on. The choice I repeatedly make is by choosing a group member who has been vulnerable in check-ins and warm ups. This member can role model to others in the group and in turn support the releasing of overly protective parts in other group members so deeper work may be done.
What comes to mind when you think of ways to maintain or improve your physical fitness?
For me, I think of high intensity interval training, strength training, mobility & stretching, setting new goals for myself in gymnastics training, sleep, hydration, and nutrition.
Now think of ways to maintain or improve your emotional fitness and how frequently you engage in them.
I was oblivious for years, and then for years ignored, ways to improve my emotional fitness. Now, I engage in several techniques on a daily basis. The techniques shift over time, just like my interests in different physical fitness techniques change over time, yet I still engage in regular practices. Our emotional wellbeing can be shaped similarly to our physical fitness with different exercises and practices.
What’s an emotional fitness technique that you are willing to begin practicing daily?
What did you believe in five years ago that you no longer believe in today?
This is a question Peter Attia, MD, frequently asks his podcast interviewees.
I believe this question is vital to ask ourselves on a regular basis.
The scientific method never proves a belief, we can only see it as not yet wrong. As our understanding of the world grows, both individually and within the research communities, it’s valuable to recognize the changes and incorporate them into our world views.
Some things I believed five years ago that have changed include…
Previously I believed: SSRIs are unlikely to have negative effects and may be helpful.
Now I believe: SSRI’s are likely to have negative effects for most people. While they may still be beneficial for some people, it’s important to support clients in treatment methods with minimal risk first.
Previously: CBT is highly effective and can be used in many circumstances.
Now: CBT may have been subjected to an amplification of benefit and overgeneralization in usefulness. It’s still useful in some areas, yet not as many as I used to believe in.
Previously: Clients in emotional distress need psychological counseling interventions, and if not improving a referral to a psychiatrist.
Now: Clients in emotional distress may be due to cause that’s not physiological. Wellbeing may be found though a combination of interventions including psychological, nutritional, medical, lifestyle, spiritual, physical, social, or another area.
What are things you believed in five years ago that you now have new beliefs around?
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