Hardiness Acceptance and Psychological Flexibility : Tools for Therapists

I'd like to welcome everybody to today's presentation on hardiness, acceptance, and psychological flexibility. I'm your host, Dr. Donnisee Snipes. Now, this is a class or a topic that I've covered in previous years. I think the last time was 2023, but there's more. There's always more. Today we're going to define psychological flexibility, discuss the concepts of hardiness and acceptance and how they relate to psychological flexibility, explore how to apply it, and identify the shortcut question. Psychological flexibility is what we can call the willingness to amp. The willingness to amp things up. What does amp stand for? acceptance of things as they are in the moment without judgment. Basically, it is what it is. Making a conscious choice to act and purpose purposefully choosing behaviors, thoughts, and feelings that move them toward a rich and meaningful life as they define it. And you might be saying, "Well, you can't choose feelings." Well, you know, CBT might argue with that because if we change our thoughts, then sometimes our feelings go along. If we identify aspects of the situation that we're not devastated or terrified about, sometimes that can help buffer the emotional distress. So, we can influence our feelings. Psychological flexibility frees up energy that people can use to amplify their efforts to live a rich and meaningful life. I had to get a pneummonic in here because we didn't have one last week. [gasps] Before you can be mentally or psychologically flexible, you must be able to downregulate so you can think clearly. When we are in fight or flight, when our sympathetic nervous system is active, we're not psychologically much of anything. We are acting from the amygdala. We are acting on instinct. We are acting on emotion. And as a result, our brain downregulates our topdown thinking. Which means, which is a fancy way of saying it steals the energy or takes all the energy from our prefrontal cortex where we do our wise mind thinking, all of our executive functioning, and it diverts that energy to our stress response. It diverts that energy to our muscles and whatever else in order to help us fight or flee. When we are in the throws of stress, it's harder to think clearly. Now, it's a continuum. When we are terrified, enraged, you know, as many other words as you can think at the far end of the spectrum, we're not thinking much at all. We are just trying to get safe. we are trying to survive. But then the rest of the time there's a lot of people who spend um a great proportion of their life in kind of what we call no man's land. I played tennis when I was in um in high school. And no man's land is that space not on the baseline but not up at the net. It's just kind of in La La Land where you're open and you're exposed. But anyway, people in life often have chronic stress in one or more pieces of life, physical, interpersonal, emotional, cognitive, environmental, even spiritual. And those things are additive. the more stress they have, the more energy is being diverted from the prefrontal cortex. Which means a lot of times people can think okay. They may not be on their agame. They may not be sharp as attack, but they're thinking okay. However, when we're thinking okay, a lot of times we are sort of on autopilot, which means we're having difficulty doing things that are outside the box, if you will. We are having difficulty exploring other perspectives. We're we have just enough mental energy to do what we've always done or to process the way we've always processed. We don't have energy to step back and think about it and all that stuff. One of the first things we need to do is help people downregulate so they can get into their wise mind. This is such an essential skill for most people whether they're presenting with stress related illnesses or not. The majority of people have great difficulty with down reggulation and spend a lot of time feeling mildly to moderately stressed in one way or another. The ABCDs and we've gone over this before but in with down reggulation ABCDs. Acceptance is the first one. Taking the moment as it is without judgment. It is what it is. So this is how acceptance plays into psychological flexibility. If we don't want it to be the way it is, if we try to bargain, if we try to fight against reality, that's amping up. That's ramping up that stress response. That's not what we want to do because the more we intensify that stress response, the more difficult it is going to be to think clearly. Acceptance of the moment as it is without judgment. It is what it is. I don't have to like it, but it is. B stands for breathing. We're going to slow it. Whether it is square breathing, whether it is chewing bubble gum and blowing bubbles, whether it is, you all know I keep this handy, blowing bubbles with bubble stuff. You can get these, you know, in the wedding aisle at a lot of the um retail stores. Um blowing on a harmonica, humming, singing loudly, blowing up a balloon. There are a lot of different things that we do in the course of our life that causes us to slow our breathing. You don't have to have somebody reflect on their somatic sensations. You don't necessarily even have to have somebody do square breathing, which is breathe in for four, hold for four, exhale for four, hold for four, and repeat. Now, that's easy to remember to do. Not everybody wants to do that. Not everybody's comfortable with that. And when you tell people take a few deep breaths and slow your breathing. Nah, that usually doesn't work. And and when people used to tell me tell me to do that, it was like you were at the doctor's office and you were taking a deep breath and letting it out and taking another one and letting it out and you start to get dizzy because you weren't slowing your breathing. You were just breathing deeper and quickly which doesn't help the process. So, we want to help people slow their breathing. We want to help people understand why slowing their breathing is important. When we slow our breathing, we are basically manually overriding the stress response. We're telling our brain, "Hey, it's okay. We're safe at the moment. We may not like what's going on, but we are safe. So, let's downregulate a little bit so we can figure out how to solve the problem. Slowing your breathing naturally slows your heart rate, naturally reduces your blood pressure, naturally activates that rest and digest uh or your parasympathetic nervous system. When people once people slow their breathing, the adrenaline haze clears and they can think more clearly. It's neurological. It's neurochemical. It is not just a will thing. And that's what so many people get stuck on is I should be able to think clearly. I shouldn't. Well, let's just throw out those shoulds and shouldn't. Let's look at what's actually going on under the hood. This is not a cognitive or moral failing in any in any way. It is your nervous systems trying to help you stay safe. In order to choose a different response or effectively evaluate the situation, we need to get into that wise mind. Compassion is C. Why is compassion so important? Because a lot of times when people accept, okay, it is what it is. They slow their breathing. then they may start getting angry at themselves for getting upset or angry at others or what have you. Compassion is your ability to look at yourself and go, "Okay, this is freaking you out right now. I get it." And and sometimes you may even have a discussion with yourself. That's okay. But having compassion and instead of saying you shouldn't feel this way or you should be able to change the situation, just say it is what it is. I'm going to slow my breathing. I'm going to recognize that I need to potentially take a different step. D stands for distraction and grounding. Sometimes breathing, acceptance, breathing, and compassion aren't quite enough. So, I throw D in here. Distraction is turning your attention away from the threat. Obviously, assuming you're safe, turning your attention away from the threat, focusing on something else, for a minute, not forever. We don't want to perpetually distract oursel because that's avoidance. Turning your attention away for a minute or five. Again, that is you taking charge and telling your hypothalamus and your amydala, hey, it's not that big of a deal. We'll figure this out. We are not in mortal danger right now. So let's focus on this over here. I don't have to continue to look at this right now. I don't have to continue to worry about this right now. I can look over here and I can survive. One method of distraction is grounding. You can do 5 4 3 2 1. Five things you see, four things you hear, three things you smell, two things you feel, and maybe one thing you taste. Or simplify it. Who, what, where, who am I? Say my name. Where am I? Identify that. When am I? This is Wednesday at 11:11 a.m. Central Standard Time. Um, those are techniques you can do because you're engaging your brain and you're saying, "We're not going to think about that right now. We're going to think over here." You're engaging your brain on something that's not stressful. So, guess what? That helps trigger the relaxation response. And by not focusing on this over here, it's sort of telling your brain that this isn't an imminent threat right now. So, let's look over here for a minute. We'll go back there when we can handle it. Other forms of grounding, notice what it feels like where you're sitting with your feet on the ground. Notice all the brown things in the room or all the green things in the room. Everybody has their own different take on grounding, but finding a strategy that can work for you can be really, really helpful. And then S stands for safety. Awareness of your safety. Recognizing I'm accepting what's going on in the moment. I'm aware that I am safe from imminent harm. Doesn't mean that there's not a problem. Means I'm safe from imminent harm. There's not a tiger that's going to eat me at this very moment. And if you don't feel safe, then obviously you need to seek safety. Uh, some people may not feel safe. They may feel out of control. They may feel emotionally overwhelmed. One strategy for seeking safety may be calling a friend. Let me just talk to you so I can that's distraction, grounding, um, and seeking safety kind of allin-one. But the ABCDS are excellent tools for helping people downregulate when they are experiencing distress. It can be dysregulation or it can just be chronic stress. Thinking about whatever's going on in your life and accepting it is what it is right now. engaging those other activities to downregulate as much as possible. So, you're freeing up as much energy and bandwidth as possible for your wise mind to jump in and go, "Okay, let's figure out how to solve this problem." Step one in psychological flexibility is defining your rich and meaningful life. It's almost impossible to figure out what the next best strategy or step is if you don't know where you're going. Relationships in your rich and meaningful life who including yourself is most important to you. And when I have people do this, I believe that a collage is very helpful be and more helpful than doing it just as lists because you're actually seeing the person or the thing. And it can trigger some oxytocin release. It can trigger some endorphin release if you're like, "Okay, that's important to me. You know, I love that. I really want to go do that." What have you. So take the person will have a lot of pictures. They can put it on a poster board. They can put it in a scrapbook. Doesn't matter. But there's a picture. Then they're going to have post-it notes. When we're talking about relationships for each person, again, including themselves, what do they want that relationship to look like? Identify five to 10 ways they can use their energy to nurture or create the relationship that they want with themselves and with others. Um, on another post-it note, because this is not just all rainbows and sunshine and whatever, on another post-it note, identify anything about that person or relationship that causes distress or unnecessarily drains your energy and what you can do about it. Maybe that person tends to be really critical. Okay, you love them. They're important in your life, but they're critical. Okay, what can you do? How can you address that situation or mitigate the impact of their criticism? Attach both post-it notes to the back of the picture and move on to the next picture. Next step or phase. What events, things, and experiences are important in your rich and meaningful life? Now, without our health, we can't do anything. We can't nurture relationships. we can't succeed at work, we can't go on vacation. If we're if we don't have our health, then yeah, so health has to be in there. However, we have to phrase health in terms of health to the extent possible for that person. If you're working with somebody who has POTS and fibromyalgia and celiac disease, they're going to have a different strategy for health and a different outlook on what health is for them compared to somebody who doesn't have those issues. That's okay. We that goes back to living in the end and and radical acceptance. I can live and I can move toward my rich and meaningful life and also have these issues. Yeah, my health's not perfect. Okay. Well, I could either use my energy staying angry about it or I could take these other strategies. Which is the most purposeful strategy to help me move toward my rich and meaningful life? again for work, health, and personal growth things, experiences, and events that are meaningful to you. Identify what aspects of each are important and how you can use your energy to move toward or nurture those things. And on the other post-it note, identify aspects of each that cause distress or may be problematic and identify how you can use your energy to address those issues. That's probably three or four therapy sessions right there. Just really defining your rich and meaningful life and exploring what you want it to look like, what's keeping you from having it right now, and what you can do to move toward it. All right. So, you're on your way to helping people know their direction, which is empowering when you know where you're going and you can ask yourself, is this decision, is this feeling, is this thought helping me move toward or away from what's important in my life? How empowering is that? But now we've got this destination that we're working toward. And finally, clarify values. Not everybody wants to do this one. I like to throw it in there. What values do I want to embody? Or said a different way, what four words do I want people to use to describe me? If you're doing a collage, you can have people write those words on the four sides of the collage. You can do it however you want. This is not as essential in my humble opinion of as the first two aspects, but it can help define a rich and meaningful life. If I want to be known for being compassionate, then how can I use my energy to show compassion? The next step is to recognize toward and away behaviors. toward behaviors cause people to use their energy to nurture, create, or move them closer to what's important in their rich and meaningful life. If I use my energy today after I get off uh out of class today to call my daughter and maybe go down and take her out to lunch, that's a toward behavior. My relationship with my daughter's important to me. Uh, an away behavior would be using my energy in ways that are unhelpful or unproductive. Um, and it could be doing something that's irrelevant in my life instead of using my energy to actually nurture something that's important. It is important to remember that all feelings are normal. They are our body's first response to what it perceives may be happening or may be getting ready to happen. It doesn't mean that they are facts, but it's our body telling us, hey, been in a similar situation before. This is what I'm expecting to happen. We may need to fight, flee, whatever. It's what we do with those feelings that can be harmful. And I use the analogy, forgive me, but it sticks with people of dog poop. I've done animal rescue for years. We've always had dogs and cats. You're sitting on the sofa or in the living room, whatever, and all of a sudden you smell dog poop. Oh boy. Do you sit on the sofa and get angry about the fact that it smells like the dog crapped in the house? or do you get up and try to figure out did the dog poop in the house? Okay, that's the first step. Instead of using your energy just to stew in anger about your assumption that the dog went to the bathroom in the house, you're using that energy to get up and look. You're checking it out to see is it a thing. If it is a thing, you use your energy to clean it up. You're not going to leave it on the floor. You're not going to clean it up and put it in a bag and carry it with you. I mean, those are options you can do, but is that really going to help you move toward what you want? And that's a house that doesn't stink like dog crap. If you get up and you find out that no, there's I don't see anything on the floor. I don't think he made a mistake. Then you can chalk it up to the dog past gas and you can let it go. You're not angry about it anymore. You might even laugh and go, "Oh boy, what did you eat?" But it's a different approach. Recognizing, yes, that feeling of anger or irritation, it's normal and it's spurring us to get up and clean up the dog poop because that's unsanitary. Uh but if the problem's not there, then we can let it go. You can use the analogy of the smoke alarm, but dog poop is just so kind of out there that it usually makes people laugh a little bit. [snorts] Negative emotions are kind of like the dog poop of the soul. If you don't address them, they can permeate your whole being and repel others. If you don't address your anger, if you don't address your anxiety, then it starts coming out everywhere in your relationships with others, in your work product, in your health. >> [snorts] >> We can ask people, "What thoughts do you regularly have that keep you from being happy?" Encourage them to make a list or keep a journal so you can start addressing those thoughts and include in those thoughts the inner critic's commentary. This is something that I often have people do between sessions, just for the next week or two weeks, keeping a log of thoughts that are keeping you from being happy. Repeat. And a lot of times it's the same thoughts on repeat. So, we're stuck. We're not being psychologically flexible. We're in we're in a rut. When you get angry, what thoughts or reactions do you have that keep you stuck in the quick sand of anger? Remembering that resentment, jealousy, envy, and guilt are all different forms of anger. When you have these different feelings, what are your reactions? Do you stew on it? Do you grumble under your breath? What do you do that may keep you stuck in that anger loop? And again, when you're sad or grieving, what thoughts do you have that keep you stuck? When you're anxious or afraid, what thoughts or feelings do you have that keep you stuck? When you're lonely or when you're sad, what thoughts do you have that keep you stuck? And it's important to recognize, these feelings are normal. We're going to have all of these feelings. I hope we want to have a rich repertoire of feelings that we feel. We just don't want to stay stuck in them. We don't want to bathe ourselves in them forever. We want to look if we tend to have a particular feeling and have difficulty getting out of it, getting out of the quicksand of that feeling. What is keeping us stuck? You only have so much energy. It's either used to help you move forward or wasted spinning in circles or going backwards. Encourage people to think about what behaviors and reactions do they have that steal or drain energy that could be used to help them move toward their rich and meaningful life. Emotion focused coping is kind of one of those away behaviors a lot of times. And when I talk about emotionfocused coping, I'm talking about coping that does nothing to change the situation. It's designed to just make unpleasant feelings go away. If I start becoming aggressive, you know, get away from me. That's emotion focused coping. I'm not solving the problem generally. I'm just making it go away for a minute. Distracting ourselves, whether it's scrolling on social media or watching TV, um, or, you know, whatever you do to distract yourself. That is emotion focused coping. I'm not going to think about it. I'm not going to feel that right now. I'm going to pretend it doesn't exist. Addictive behaviors are a form of distraction if you want to think about it that way. But it al they also change our neurochemistry and change our emotions in the moment. Drugs, gaming, sex, shopping, smoking, the list goes on, uh can be used instead of addressing the issue. They're just used to make somebody feel better right now, even though the problem is still there. And sleeping or withdrawing is another form of emot emotionfocused coping. I'm just gonna go to bed and pull the covers over my head and pretend that life doesn't exist. Okay. We want to encourage people to identify emotion focused coping strategies. Recognize that sometimes in certain circumstances some of these strategies might be effective in the short term, not for days on end, but in the short term. Maybe they need to distract. You go to the doctor on Thursday and you get your blood drawn and you have high health anxiety. So, and you're not going to get your your results until Monday or Tuesday. You're freaking out. Okay. Well, we've got a lot of cognitive distortions and things we can address there. And for some people, distraction can be helpful. There is nothing they can do to change the situation until they get the results back. they're in a holding pattern and that's when distraction can be helpful. If you've got a loved one in surgery, you're freaking out, you want to do something, you feel powerless, there's nothing you can do, how can you distract? How can you turn your attention until which point the doctor comes out and tells you what's going on? We want to help people identify all of the things they do when they get upset. reasons they use that particular behavior and what they could do instead. Sometimes they learned that behavior. It's what they've always done. And sometimes they don't have any other skills. They don't know what else to do. If I don't do that, I don't the emotions would completely overwhelm me. Okay. Well, let's look at teaching some other skills for emotion regulation. Encourage people to identify all of the things that they do when they're acting purposelessly, which prevents them from moving toward their rich and meaningful life. Why do they do that? And what could they do instead? And remember, purposeful action means using your energy to move toward or nurture one or more things that's important in your rich and meaningful life. Sometimes we act purposelessly. We do things because it's what we want to do in the moment. And it actually doesn't help us move towards what's important. It may actually hinder us. Playing [snorts] hookie from school or from work. Now, this is not taking a mental health day or taking a day off because you're sick. This is I feel great. I don't want to go to work, so I'm going to call in sick and I'm going to go out, take the boat out, and you know, do whatever you do on a boat. Um that could be purposeless uh binge watching television, poor time management, lack of sleep or poor nutrition, disorganization, spending time with unhelpful people. Um there are a lot of things that we do that when we look at at it from, you know, we step back and we look at it, we're like, that really wasn't a good use of my energy. I remember one time and those of you who have been with the channel for a while have heard this story. I was recovering from surgery. My daughter was 11 and I was scrolling on social media and somebody was being, you know, rude and insensitive about something. I don't remember what now. Shows you how important it was to my life. And I was getting all fired up. And my daughter just looks at me and she goes, "Mom, is that helping you move toward or away from what's important?" I closed the phone, put it down, I was done because she's right. I don't even remember what I was getting all fired upset about. And I was using a lot of energy that could have been being used to heal my surgical wounds. Um, I was getting all upset and using a lot of energy I could have been using to interact with them. Um, and it was a good point. It was a great point. Cognitive distortions form a lot of our um away behaviors when we have rigid thinking patterns that we don't check that we don't um evaluate for their accuracy in this context at this time. We use the pneummonic here called fitcat facts in this context at this time. But we need to look at all the facts, not just cherrypick them. Mental filtering keeps people stressed when and a lot of people will do both of these. They'll magnify the negative and they'll min minimize the positive. I made a mistake at work. I am the worst person ever despite the fact that I've gotten three awards for being a great employee. They're minimizing the positive. They're maximizing the negative. Overgeneralization. All people like this, all dogs, all thunderstorms are going to result in tornadoes. Overgeneralization, taking one characteristic of a thing and applying it to a a huge group where it may not apply. Um, confusing possibility with probability. Is there a possibility this thunderstorm could produce a tornado? Yeah. What is the probability? Well, that's when you go on to the weather channel or whatever YouTube channel, weather tracker you follow, and they will tell you whether there's wind shear and all those other things and and circulation that would tend to produce a tornado. If that's not there, then the probability of that happening is very small. But people will get amped up. They will get stressed out over the possibility. and not even looking at the likelihood that it's going to happen. Personalization, thinking that it's all my fault. This is this has to do with me. You're not happy. It's my fault. Um you're not having a good time at the party. It's my fault. Emotional reasoning obviously assuming that something is fearful or something is horrible because you're angry or you're anxious feelings are not facts in a prior situation similar situation. Yeah, it may have been a horrible situation in this situation. What are the facts in this context at this time? That's emotional reasoning is that fight or flight. We can't really get into wise mind reasoning or fact-based reasoning until after we have accepted and downregulated. Some people get stuck in a the dichotomy of all or nothing. You either love me or you hate me. You either love what I did with this project or you think it's the worst thing I've ever done in my life. Extremes. There's no middle ground. And that's really stressful if for for both people for the person receiving the criticism or what have you that if you criticize anything it means everything I did was a failure. No, you know I didn't like that aspect of it but the rest of it is good. encouraging people facts in this context at this time. What do you know to be true and what are the additional facts? All or nothing is rarely um rarely accurate like saying well I won't go there jumping to conclusions availability heristic and mind readading these all kind of go together but jumping to conclusions is obviously what it sounds like assuming something's going to happen without having all of the facts my best friend didn't text me um when they got home today, so they must have had a car wreck and you know, be in a ditch somewhere. I'm jumping to conclusions. They didn't text me. Maybe their phone died. Maybe they got busy. Maybe who knows what else happened, but I don't know. I don't have all the facts to draw an effective conclusion. The availability heristic is making decisions based on what is most recent or most salient. If somebody has been a good employee for nine months the last three months they've been struggling a little bit. Do you say they're a crappy employee because of the availability heristic? That's what's most recent. You look back over the past three months and go yeah been a crappy employee. or do you look over the whole year and take all of the facts into context? This also applies to things like um plane crashes. How many planes actually take off and land every day without any problem? What proportion of those crash? And it seems like commercial planes or even private planes crash quote all the time because that's what gets televised. That's what gets publicized. There's not a reporter down at the airport going, "Hey, Delta flight 2634 came in with no problems today." Nobody wants to read that. [laughter] I mean, they're glad it is what happened, but that is not news. That is not clickbait. So, you're not going to hear about it. Mind readading is assuming you know what somebody else is thinking. I can look on your face and I know what you're thinking or I know you are. I know you're assuming this about me. Mind reading also can go the other way and cause a lot of friction and distress. You don't care about me. If you did, you would know what I want. No, nobody can read minds. What facts do you have in this context at this time? Blaming. Whether it's blaming the other person or blaming yourself, doesn't matter. It's blaming. When we get stuck in blaming, that's an anger reaction. That's an aggression reaction. It's your fault or it's my fault. Um, and that can keep people feeling unsafe and powerless, which keeps them feeling stressed. Encouraging people to recognize what aspects of the situation they do or did and did not have control of. What aspects of this other situation did somebody have control of or not have control of? If I'm blame you because you didn't get me the gift I wanted for Christmas, well, I need to look back and say, what part of that was in my control and what part of that was in their control? If they didn't know what I wanted, well, then it's not really fair for me to blame them for not getting me what I wanted. And shoulds under these two, I put the fallacy of fairness and the fallacy of control. Life should be fair. That shouldn't happen to good people. Well, it does and it did. And if we get stuck in those shoulds, then it's hard to see a way out. It's hard to accept the moment as it is. Whether it should or shouldn't have happened, it did. What do we do about it? How do we address it? How do we use our energy to move toward our rich and meaningful life? And the fallacy of control and change, especially as it pertains to other people. The fallacy, the belief that I can control and change another person. Not so. Not so. Yes, we can use behavior modification and we can reward certain behaviors and punish other behaviors and yada yada yada, but ultimately we cannot actually control another person. they control themselves. We can't control the weather. We can't There are certain things that we can't change or we don't have as much ability. We We're not as powerful at changing as we would like to think and recognizing those shoulds. Recognizing when we're expecting things that are we're expecting to control things or we're expecting things to happen that just ain't encourage people to think about how each of these cognitive distortions drains their energy or causes additional unnecessary problems. If I am magnifying the negative and minimizing the positive, I'm going to feel pretty bad about myself. How's that going to impact my health, my energy, my relationships, my self-esteem? You know, and you can go through each one of these. Another pneummonic that we often talk about on this channel is feel. Encourage people to address their cognitive distortions by looking at the facts in context. Identify any exceptions. When has this happened and it's actually been safe? when has this happened? And instead of saying it never happens, has it ever happened? So, looking for exceptions to my belief that it always or never happens. Um, explanations. What are some alternate explanations to why my friend didn't text me, to why I didn't get the job, to whatever the the stressor is? What are alternate explanations besides me or besides life is just unfair? Well, and it may be. However, encouraging people to look for alternate explanations um especially ones that they can address in some way. And L stands for likelihood. That that goes back to that possibility versus probability. What is the likelihood? You know, we talked about the person waiting on their blood test results. What is the likelihood that your blood test results are going to come back and there's going to be something wrong? Have you had any symptoms? Have you had bad results previously? You know, there are a lot of facts in context we can look at and help people look more factually instead of emotionally at what's going on. help people develop distress tolerant thoughts. A lot of people that get stuck in the box who have difficulty being psychologically flexible, they have difficulty downregulating. Why? Because they feel unsafe and/or powerless. They tell themselves, "I can't stand this. It's unbearable. I have to stop this feeling. I can't keep feeling this way. I'm going to lose control. Go crazy. I am stupid or unacceptable for feeling this way. You know, there's a whole litany of distress intolerant thoughts. These are the thoughts that people have and tell themselves when they're experiencing distress. Is are emotions sometimes overwhelming? Yes. Are they going to completely overcome and un overwhelm you? you. I can't answer that for any particular person at any particular time. But it's important to recognize the difference between overly intolerant thoughts and you know what might be accurate in the moment. What can we do to help people so they can use their energy more purposefully? Sleep. When people are sleepdeprived, their stress response is more active. When they are sleepd deprived, their cognitive functioning we know is impaired. Therefore, getting good sleep can help them be more mentally flexible. Getting good nutrition, giving their body the building blocks it needs to make the hormones and neurotransmitters to keep the factory running effectively. Exercise is helpful. Move your body. You don't have to go to the gym. You don't have to lift weights. But move your body increases oxygen. And more oxygen up to the brain means the brain's a lot happier. Ergonomics. Paying attention not only at your desk, but in your couch, in your car, and in your bed. The places you spend the most time in a sedentary state. Make sure that those are supporting your body and not contributing to unnecessary pain. Even mild underlying pain increases the stress response. Add positive triggers. I love this one. Decorate your house, your car, your environment in whatever way, visually, um, through smells, through sounds, however you want. So it triggers a sense of calm, a sense of happiness, a sense of joy, um a sense of positivity, a sense of empowerment even. Um I on one wall in our house I have pictures of my family and my kids. On another wall I have a tapestry of the serenity prayer. Um, I have things around the house that trigger a sense of safety and contentment, if you will. Recreate, that's important. Behavioral activation, whatever you want to call it. Recreation increases our happy neurochemicals. When we're recreating, we tend to be more relaxed. We tend to be laughing. Oh, laughing is another way to slow your breathing. If you have a good old belly laugh, if you've ever done it when you've laughed so hard you've cried, you know, you feel like you can't breathe because you're just you're laughing and exhaling and exhaling and exhaling. Well, that's actually slowing your heart rate. But, um, and a good old belly laugh does a lot for increasing the relaxation response. And a lot of times when we recreate, we're also laughing. It's a good thing, but that helps balance out the stress hormones. Think about it like running a bath. Stress hormones are hot and relaxation hormones are cool. Well, if you're going to take a bath, you know, you don't necessarily want to be in a ice bath all the time, but you definitely don't want to scald yourself. And when you have the two of them together, it makes it more tolerable. Uh, relaxation is different than recreation. Recreation, you're out doing things. You're having fun. Um, and I you don't necessarily have to be out, but doing things that are fun. You're recreating. Relaxation is actually downregulating, relaxing the muscles, progressive muscular relaxation, um, massage, just resting and allowing your body to release some of the tension. Social support is important for prevention. Now, not everybody wants to have 15 people all up in their business. No problem. It is important, however, to have someone or for some people an animal um an emotional support animal that they can receive that unconditional positive regard. And and I do bring up the emotional support animals because there are a lot of people who have insecure attachment, who have interpersonal trauma, who really just don't trust other people right now. And the thought of interacting with other people that's going to be down the line. That's probably on the list of rich and meaningful life things, but that may not be where they are right now. What can they do to have some support to have someone or something that can just give them a hug when they need it? And veagal tone improvement. That vagus nerve is our main down reggulation nerve. We can improve that. And one of the easiest ways to do it that I do with clients a lot, I encourage them to get one of those little pulseox monitors that you put on your finger. It monitors your heart rate and your oxygen, but we're looking at the heart rate. I have them go on a walk, not a not a brisk walk, just go on a walk. Notice how their heart rate goes up. I have them sit down and slow their breathing. Ideally, you know, I I usually do square breathing in the office just because it's faster, but if I'm working with younger people or somebody who has a lot of trauma history, I might encourage them to blow up a balloon or something and notice how their heart rate goes down as their breathing slows. First step is to do it intentionally. Intentionally increase the heart rate. Intentionally decrease the heart rate. Then when they start getting upset, when they start ex exhibiting distress in session, encourage them to look at their monitor, [snorts] take a minute and slow their breathing in whatever way works for them. They can start noticing that in session, but in session, you're prompting them, you're I see that you're getting really distressed right now. Let's try activating that vagus nerve. they'll look at it. Um, and I use phrases like activating the veus nerve, not calm down, because calm down automatically triggers a lot of people's stress response. It feels invalidating. So, let's see if we can activate that veagal nerve um, so we can get back into your wise mind and continue processing what's going on. U and then between sessions they keep the little pulseox thing with them. You know, they can get it for a couple bucks um online and they practice when they notice themsel getting up, you know, stressed out. They practice downregulating and noticing that heart rate go down. It's very empowering for a lot of people to see how they can downregulate. I have something called super ventricular tacoc cardia and when that kicks off when I have an episode my heart rate will go up to like 200 and if I get stressed out about it it'll stay up there and it hurts. Um, I have learned that, you know, one of the reasons I wear a um a fitness tracker, I have learned that if I I have to lay down and slow my breathing, I can generally reverse that episode in under a minute. That's very empowering because until I discovered that, it was terrifying because these episodes will come on out of the clear blue. I had one I was scanning something um at the checkout and all of a sudden I had an episode and I'm like I'm in the middle of scanning stuff. I can't lay down in the middle of in the middle of the store. Um and I felt very powerless. But once I discovered that technique now I feel empowered. But as people feel more empowered they will feel less stressed about being stressed. Step two, mindful awareness. Like a cell phone battery, people only have so much energy. They have to decide how they're going to use it to achieve their goals for the day. 4 a.m. When I get up, I have a 100% charge on my phone. My battery needs to last from 4:00 a.m. until 6:00 p.m., which allows me to monitor my heart rate at the gym, listen to music at the gym, make calls if needed, get directions if needed, and receive text messages from my kids. That's about all I do on my phone, but I need to make my battery last. So, I do have that resource available to me. How can I make that battery last? Because my phone's getting older. Brightness, turn it down. music when I listen turn the screen off when I if I have to watch videos for some reason again have the brightness down but generally if I can avoid watching videos then you know don't watch videos because that uses a lot of battery and consider turning off apps that are not actively necessary um so we're not draining in the background toward activities to build happiness. This is the first note under all of the pictures. We ask the person to identify what are five to 10 things you can do to move toward or nurture this thing that's important in your rich and meaningful life. Encourage them to set a goal to do at least one thing each day to move closer to their rich and meaningful life. Not necessarily one thing in each area. one thing each day. That's not overwhelming. I think anybody can do that. But baby steps, if I do one thing each day, like I text my daughter when when class is over, that's one step. That's one way I can use my energy. >> [gasps] >> Hardiness is a tool that is helpful in down reggulation and psychological flexibility because it helps us get out of the box where we're stuck looking at this problem and feels like the walls are closing in around us. Hardiness says step back take a look. Commitment is the first step in hardiness. What things, people, things, experiences, etc. are important in your rich and meaningful life. Because at any point in time, some of those are going to be going great. Some of them are going to be going okay, and some of them are not going to be going so good. That's just the way life is. It's rare that everything in your life is going well all of the time. But that's okay. Hardiness says, "Let's look at all of the things that you're committed to in order to get some balance so it doesn't feel like everything is horrible all the time." All right, we've looked at everything. Recognize what we're committed to and what we want to use our energy to move toward. Control, using our energy to control the things that we can that help us move toward our rich and meaningful life. There are some things that we just can't control like other people like, you know, certain laws and regulations. I mean, we can petition and, you know, talk to our senator or whatever, but it may not do any good. Okay, I did what I could. It's out of my control now. And challenge, seeing hardships or problems as challenges to overcome, kind of like obstacles instead of barriers. Think of an obstacle course. An obstacle course doesn't stop people dead in their tracks. It says, "Okay, you need to be psychologically flexible. You need to get outside the box and think, okay, how can I get over this, around this, under this, or through this? It's not going to stop me. It's just the way I'm doing it right now. You know, this way may not work. So, what are some other strategies I can use?" Barriers stop you dead in your tracks. There is no getting past. We don't have barrier courses. We have obstacle courses. Problem focused coping. Encourage people to think about what about this situation can I change? Maybe nothing but can I change anything in this situation? What do I have the control to change? How can I change how I think about the situation? And this goes back to um acceptance, compassion, evaluating old beliefs and dialectics. I may not love this situation, but I'm going to embrace the good with the bad or the silver lining. Um, most of you know we just recently lost uh one of our dogs that we had had for about 14 years and that was really hard and it felt awful. But during, you know, those last months, it was embracing the good days with the bad days or the good moments towards the end with the bad moments and recognizing how much joy we would have not had in our lives had we not brought Brewster into our life. Recognizing that, yeah, this this part sucks. It really does. And you know there's all this good, all this joy that he brought to our life. And then the other silver lining, once he did pass, he's no longer in pain. Does it make the grief go away completely? Oh, heck no. Um, but we can change how we feel about the situation. I could still be angry about it. Um, but that wouldn't be doing any good. And and that's where encouraging people to look at situations and change how they think about them. Evaluating old beliefs. If I fail at something and I believe my my ingrained beliefs are I have to succeed at everything all the time. See here the cognitive distortions there. Oh my gosh. Um then I'm going to feel horrible. I'm going to feel unsafe. I'm going to feel powerless. I'm going to fear rejection. and it's going to just be awful. I'm not going to be able to think clearly if I evaluate my old beliefs. Do I really believe that in order to be lovable, I have to succeed at everything all the time? Hm. Okay. Well, would I hold my kids to that standard? Heck no. Um, and encouraging people to evaluate. It's not for me to say whether their beliefs are right or wrong. is for them to evaluate in their life whether those beliefs are accurate and helpful. Sometimes we just choose to let it go. You know, we may be angry about something and we're like, you know what? It's not worth my energy. Forget it. Or reaching out and getting social support or help. We can't solve every problem by oursel. And sometimes getting that social support can help us figure out how to either change the situation, change how we think about the situation, or let it go. Encourage people to make a list of empowering, distress tolerant thoughts like, "I've got this. I've been through worse. This too shall pass." What whatever works for them and feels genuine, not just something that they're echoing. If it doesn't feel genuine, it's not going to do anything. Encourage them to make a list of compassionate thoughts like, "It's okay to feel angry, just don't unpack and stay there. It must be a really dark place in that person's head." Or, "I wonder what might be causing them to feel so unsafe." And encourage people to keep a daily gratitude list. That helps keep the balance because we tend to notice the negative and forget about the positive. Add triggers for positive emotions to the room, car, office, common areas, including smells, sights, sounds, and even pay attention to touch like the temperature. That makes a big difference in how reactive we are. Encourage people to become aware of their thoughts, feelings, and urges in the present moment. and without judgment recognizing that they don't have to react. They can unhook. They can say, "I'm having the thought that this is the worst thing ever." Or, "I'm having the feeling that I'm angry. I'm having this feeling right now. What do I do with it? I'm holding it. I'm not angry. I'm having a feeling of anger. I'm having a thought that this is now what am I going to do with it?" So, that's unhooking. It's an adventure. This activity helps clients visualize how much energy they waste on irrelevant things. Have them imagine they're going to create a utopian world where they feel happy, healthy, and loved most of the time. They only get $200 a day to create this world. Use Monopoly money. This money represents their energy. Each time something happens and they make a choice, they spend $10. It's up to them how they choose to spend their $200. have them keep a log of their days for a week, writing down 20 things they do each day. So, for me, um, and I know we're running late on time, um, but basically, you can see I did 16 things this day that were purposeful and moved me toward what's important in my rich and meaningful life. I did four things. Three of them involved getting frustrated or irritated over things I had no control over. Um or holding on to that frustration and anger when I could have let it go and then skipping lunch. Uh so those were four things that actually were not purposeful or useful to moving towards my rich and meaningful life. Ultimately, that shortcut question, are my sh current thoughts, feelings, and actions moving me closer to or further away from my goals and values? Every moment is an opportunity to choose thoughts, and behaviors that will help you use your energy to move toward your rich and meaningful life. Acceptance means accepting without judgment how you feel and the situation as it is instead of fighting against it. It is what it is. I don't have to like it and I may be able to change it, but right now it is what it is. Hardiness means being aware of all things in your life you are committed to. Using your energy purposefully to control what you can and viewing problems as challenges instead of barriers. And purposeful action means choosing to use your energy on thoughts and behaviors that move you to toward your goals. >> [cough] >> Are there any questions?