In this new zine I discuss both why we get so shut off from our feelings in a wider culture which values some emotions far more highly than others, and how we can go about shifting our patterns of avoiding and fighting some feelings, and craving and grasping for others. It covers both therapeutic and spiritual practices for staying with our emotions.

You can download or read the zine here.

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When I saw that the main characters in Inside Out were a person’s emotions I knew that I absolutely had to go see it. I wasn’t disappointed. In fact several times I was moved to tears by how familiar the experiences were, and by this hugely important, complex, and rarely-expressed message being communicated so simply and profoundly in a ‘kid’s film’.

If you’d rather not be spoilered for the movie then please do go see it before reading the rest of this post. Also do be aware that it may well tap into lots of different emotions as you’re watching it – if you’re anything like me – not just the joyful ones. As we’ll go on to see that may not be a bad thing!

The rest of this post is divided into three sections:

• Experiencing all of our emotions
• Shutting down our emotions
• How to sit with our emotions: A practical guide

Experiencing all of our emotions

Inside Out follows an eleven-year-old, Riley, and her emotions – Joy, Sadness, Disgust, Anger and Fear – as her family moves from Minnesota to San Francisco. Previously her inner world has been dominated by Joy. Joy has made it her business to ensure that Riley remains as happy as possible, building up a store of mostly joyful memories which have, in turn, shaped her personality. However, following the house-move, many of these memories become tainted by Sadness – who can’t seem to stop herself from touching them and turning them blue.

In her attempts to prevent Sadness from causing any more damage, Joy manages to get both of them ejected from the control room to the outer reaches of Riley’s inner world. This leaves Anger, Fear and Disgust in charge while Joy and Sadness try everything they can to get back before Riley runs away from her new home.

The message of the movie is that we require all of our emotions: not just the so-called positive ones. We soon realise that Joy’s tendency to ignore and suppress Sadness is actually getting in the way of them finding their way home. It seems like things work pretty badly when just one of the emotions takes charge, and much better when they all work together through being equally valued.

One of the most poignant moments in the movie is when Riley’s old imaginary friend is devastated to realise he’s lost his last chance ever to be with Riley. Joy’s attempts to cheer him up or force him to keep going fail. However, when Sadness sits with him and shows that she understands how hard it is for him, he’s able to experience his own sadness, to cry, and eventually he’s ready to move again.

The theory that kept coming back to me as I watched the movie was Emmy Van Deurzen’s compass of emotions. In this, Van Deurzen imagines the emotions on a wheel which we travel round all of the time, moving from ‘high’ feelings like joy and pride, through anger and fear to low feelings like sadness, and then up the other side through envy and hope, to joy again.

Critically, Van Deurzen argues that we need to be able to experience all of the emotions to go around the compass like this. If there are emotions which we shut down or avoid then we’re likely to get stuck in certain places. Paradoxically, as in Inside Out, if we disallow one emotion – like sadness – we’re likely to become stuck and find that we stop experiencing joy much too. If we lose the capacity to experience some of the emotions entirely – as when Sadness and Joy are lost in the film – we risk falling into depression and all of our emotions becoming shut off. This is rightly depicted as the darkest moment in Inside Out.

It may not be that we always move in the same direction on the compass, or that certain emotions always follow others. Indeed, as Inside Out shows, we can often experience seemingly opposing emotions at the same time (e.g. joy and sadness, anger and hope, fear and determination). Indeed, when the first memory comes in that reflects these kinds of mixed feelings we see that it is perhaps even more beautiful and valuable than some of the ones which reflected only one of the basic emotions on its own.

Shutting down our emotions

The problem is that, through our lives, most of us learn that certain emotions are not acceptable: either to express or – often – even to experience.

This is what moved me to tears several times during the film as I remembered moments in my own childhood and adolescence when – like Riley – I learnt that certain feelings were unacceptable. It made it even more powerful that – for me like Riley – a critical time was the sudden experience of starting a new school with strange and different rules. However, of course, these moments are different things for different people, they happen at different points in life, and they can be gradual, or sudden, or both.

The film underlines what a terrible impact such messages can have as elements of Riley’s personality – that we’ve previously enjoyed watching – turn grey and gradually disintegrate entirely when her emotions are lost. Most devastating for me was the moment when Goofball Island disappeared. Now that it wasn’t safe for Riley to experience all of her feelings there was no way that she could goof about in the way she used to as a child.

Where does this shutting down come from? We can see it on multiple levels like those I wrote about in the recent zine that I posted about here.

On the outer level our wider culture gives us strong messages about which emotions it’s okay to feel and which it isn’t. Generally in western cultures we’re encouraged to have happiness and ‘positive’ emotions and not ‘negative’ ones. The British ‘stiff upper lip’ also discourages expressions of fear. And messages also differ depending on our individual identities, with certain emotions being seen as more or less acceptable for people of certain genders, classes, ages, or nationalities, for example.

On the next level in, our communities and institutions also reinforce many of these messages. In the movie we see how, in her new school, it isn’t acceptable either for Riley either to show too much enthusiasm for the things she’s passionate about, or to show sadness about what she’s lost. The cool girls will judge her for it. It’s easy to find ourselves joining in this kind of tone-policing in our communities – of whatever kind – whereby certain emotions are deemed unacceptable to admit to or express – for certain people or across the board. It’s worth being mindful of this whenever we find ourselves judging how somebody ‘should’ or ‘shouldn’t’ feel about something.

At the interpersonal level we learn a great deal about acceptable and unacceptable feelings from our close relationships, particularly from the family and friends who are around us growing up. In Inside Out Riley’s parents inadvertently give her the strong sense that they appreciate her being happy and strong during the house move. She takes this as a message that it isn’t okay to be struggling in any way about it. Riley is even described as their ‘happy girl’: fixing her in this way. We then see how Riley’s – and Joy’s – attempts to keep her joyful tragically have the opposite effect. By trying to sustain her joyful persona in the face of great pain she actually becomes angry, anxious and cut-off, and risks losing the love of her parents as they don’t recognise her any more. In another key moment Riley’s old friend doesn’t seem to realise how envious Riley will be of her new friendship. When envy doesn’t feel acceptable, Riley goes straight to anger, and ends the friendship.

How to sit with our emotions: A practical guide

Fortunately for Riley, Sadness and Joy are able to make it back to the control room – once Joy recognises the value of Sadness. Then Riley is able to take the risk and show her parents how sad and frightened she is. Even more fortunately, perhaps, her parents are able to accept her emotions, to share some of their own, and to let her see that they love her as much when she’s sad as they do when she’s happy.

Most of us are not so lucky. Our parents – and the other close people in our lives – live in the same wider culture as we do with all of its crappy messages about unacceptable feelings. They’re also part of institutions and communities that have done a number on them. And they’re in their own family systems wherein certain emotions have been deemed too dangerous or threatening. So they may well have responded to moments like Riley’s by giving us a clear message that our fear, sadness, anger, joy, disgust, or other feelings, were not something that they could be around, or even that they couldn’t love us if we expressed them.

We will have internalised this. Either we’ll have managed to find a way of shutting down those emotions entirely, or – perhaps – in trying to shut them down we’ll have managed to make them shout even more loudly so we’ve become defined by them. Or a bit of both. There are so many ways that this can go.

The urgent question is what we can do now. Here we are, as adults, with all these imbalances, exaggerations, and silences in our emotional states. What can we do about it?

The answer that many different therapies, meditation practices, and belief systems have come up with is the idea of ‘sitting with’ our emotions. I’ll briefly describe one of these practices – a person-centred therapy technique called focusing – here, but there are several similar practices in other therapeutic and spiritual approaches if this one doesn’t work for you.

Focusing reveals perhaps the main flaw which I found in Inside Out which is the fact that the emotions are located in Riley’s brain and not in her body. It’s good that Inside Out doesn’t buy into the popular idea that emotions and rationality are separate things. Instead it expresses the existential view that we’re always in emotion: propelled towards things or away from things by our feeling states. However, the film does buy into another ‘dualistic’ split: that of separating the mind and the body, and seeing the mind as the most important bit. Actually, this kind of focus on the mind can be part of how we lose touch with our emotions: We stop being able to tune into our bodily sensations and the important things we can learn from these about our feelings, and instead try to figure things out, or fix things, on a purely intellectual level.

In focusing practice the attention is right on these bodily states. It’s most basic form goes like this:

• Sit comfortably and quietly and bring your attention slowly to your body and how it’s feeling.
• Ask what wants your attention. Focus in on any sensation that you notice in your body (a tightness of the throat, a clenched stomach, or a sense of emptiness, for example).
• Say ‘hello’ to that sensation: welcome it warmly, like Sadness sitting down with Riley’s imaginary friend.
• Really listen to the sensation, try to find the best way to describe it (e.g. it’s like a dense ball stuck in my throat).
• Check back in with the sensation to see whether that description fits well enough, or whether you need to change it or add to it (e.g. it’s not just stuck, it’s like it’s rammed in there, like a cork in a bottle).
• Sit with the feeling, with interested curiosity, not trying to change it, or to force it to communicate: just being with it gently and curiously. Try to understand it from it’s point of view. Notice any words, images, or metaphors that come to mind. In focusing books and websites you can read about different questions that you could ask it at this point, if it feels okay to do so.
• When it feels ready to finish you can express gratitude to the feeling, and to your body, and reassure it that you’ll keep coming back to listen to it – and other feelings – in this friendly way.

Going back to Inside Out this is a lot like Riley actually giving kind attention to each of the emotions inside her whenever any of them want her attention, instead of putting one of them in charge, or trying to get rid of others. However, when we do this practice what we often find is that the feelings we become aware of are the ones that are preventing us from feeling other feelings (like Joy in the movie). You might start feeling a sensation of fear or sadness, for example, and then a strong feeling of anger or disgust at yourself for having that feeling. When we have these feelings-about-feelings the thing to do is to sit with them just as gently and curiously as with the original feeling. It can help to remind ourselves that – like Joy in Inside Out –  these feelings are trying to keep us safe, even if what they are actually doing is the opposite.

Of course, given how many years most of us have spent suppressing and avoiding certain emotions, it can take a while to open up this kind of line of communication. Practices like focusing can feel very unfamiliar at first and can take a while to get the hang of. There are ways of doing them with a friend, or with a therapist, if that feels easier and more supported than doing them alone.

However I am convinced of the power of these kinds of practices. Elsewhere I wrote about what happened last year when I sat and noticed a couple of feelings that usually felt too overwhelming, or too insignificant, to sit with.

Earlier this year I went to a focusing workshop. In the first practice I found it fascinating to see how my own throat tightness shifted and opened up when I finally gave it some gentle attention. In the second practice I used focusing to go back to a specific memory when I hadn’t treated myself very kindly. sitting with the memory I suddenly became aware of a side of myself that I hadn’t seen there before: A playful side of myself that wanted to do something silly and outrageous to cut through the situation. I got a strong image of Mr. Tickle from the Mr. Men books. So much so that I went out a bought myself a Mr. Tickle mug the following week. Perhaps my own Goofball Island hasn’t been completely destroyed after all!

Find out more

The ideas in the post are also presented in my Staying with Feelings zine.

You can find out more about the compass of emotions in this book and video by Emmy Van Deurzen.

A great book about the messages we receive about emotions is Transforming Emotion by Glenda Fredman.

If you want to find out more about focusing practising, The Power of Focusing by Ann Weiser Cornell is an excellent introduction to it (and nowhere near as wacky as it looks from the cover!) There are also lots of resources on The Focusing Institute and British Focusing Association websites.

Note: Some of the images in this post are Copyright (c) 2015 The Walt Disney Company and Pixar Animation Studios, to whom I express my grateful thanks.

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For the last few months I’ve been thinking a whole lot about the social side of mental distress. It feels really important to me to recognise how our suffering is embedded within our relationship dynamics; our workplaces, communities and other institutional systems; and our wider society.

I often notice what a relief it is for me – and my friends and clients – when we realise this social element to our suffering: particularly how the self-criticism that we do so constantly is something that everybody else does as well, because we’re all in this self-critical culture. It’s not that there’s anything wrong with us. It’s understandable.

This week I’m speaking at a few conferences which touch on themes of inequalities, individualising and intersectionality, and on mental health and mindfulness. So I thought – instead of the usual stand-up presentation – I’d make a zine that captures my experiences of these things, and makes some suggestions about how we might creatively engage with them.

It was also a good opportunity – for me – to get back into making comics: something I’d love to do more of, especially now I’m working on a comic introduction to queer theory with a professional artist. Here’s one of the comics I made for the zine. You can download the whole zine at the end of this post if you’d like to read it more clearly.

For my zine, the comics really helped me to understand how intertwined all these social levels are – as are the inequalities that we suffer from, and benefit from, and the ways in which we are individualised and individualise others.

You can download the zine as a pdf by clicking on the link below. I’d suggest printing it out as a booklet to get the full zine experience – or just reading it online. There’s also a whole book on mindful therapy by me here (including more comics!) if you’re interested in reading further on the topic.

SocialMindfulnessZine

The post New Zine! Social suffering and social mindfulness appeared first on Rewriting The Rules.

I’ve come across different versions of this process in a number of places. It forms the basis of several therapeutic approaches (particularly many existential, humanistic and psychodynamic forms of therapy) and it’s also fundamental to the Buddhist mindful approach which I find so helpful, and to various other kinds of meditation. But I’ve also noticed that many friends and clients have developed something along these lines more spontaneously, without necessarily following a particular approach.

I would summarise the process something like this:

Noticing -> Understanding -> Engaging

The core idea is that before going on to attempt to understand a situation, or to engage with it, it is important to fully notice it. Another way of putting it is that any time you find yourself struggling, you just go back to noticing.

Why is noticing so important? One of my favourite authors, Pema Chödrön, uses the metaphor of a glass of dirty water. This one particularly connects with me because I often start my days watching the Thames, which is, as we know from The Kinks, a ‘dirty old river’! I imagine a glass of Thames water in front of me. It is murky and unclear because it’s all churned up with mud and silt and rubbish. We can’t see anything clearly when it’s like that, so what we have to do is to let it be still for a period of time. That allows the dirt to settle at the bottom of the glass and the water on top to become clear.

Pema suggests that part of why we often don’t want to allow this to happen is the fear that we have of what we might see once it all settles. I imagine that the bottom of the Thames is a pretty scary place with all the junk and slime and probably even skeletons that have accumulated there over the years. What might loom at you out of the murky gloom if you gave it the chance? But the point is that any kind of understanding of our own accumulated mess – and the things we’ve tried to bury in there – is only possible if we allow the water to settle.

Rushing past noticing

Generally when I’m struggling with something I don’t give things time to settle – quite the opposite. My habitual response is generally to rush to either the engaging or the understanding parts of the process.

I think that rushing to engage is probably the most common one for me. I start my day with something bothering me from the previous day, or just a general sense of anxiety, unease or irritation. Instead of giving that any time I get straight into my work. Or perhaps I’m at the end of the day and something that’s happened is troubling me but I just launch into watching TV or socialising. When I do that, often there is a sense of something under the surface which is getting bigger and more frightening the more I try to push it down under all the busy-ness and distractions. When I finally stop work or turn of the TV it can feel much more fearsome than it did at the start, and I often realise that I haven’t really been present to whatever I was working on, or enjoying what I was watching, because it is nagging away in the background.

Rushing to engage also often takes the form of trying to stop the feeling before it gets a hold by reacting immediately. This is what happens when I respond straight away to a difficult email, or I lash out at somebody who has upset me, or I make a snap decision about a tough situation. Often when that happens I’m aware that I haven’t dealt with the situation as well as I might have: I’ve passed the difficult feeling on to someone else in a crappy kind of domino effect, or I’ve exacerbated a problem rather than helping with it. The idea of refraining from acting until I’ve spent some time noticing is helpful to me in these situations.

The other alternative to rushing to engage is rushing to understand. This is something I often do when my emotions are particularly painful: feeling really low, panicky, or angry, for example. I’m very troubled by how tough it feels. It doesn’t seem to make any sense to feel this bad. I’m desperate to understand it because I think that will stop the feeling. What often happens is that I end up going round and round and round analysing it and trying to find an answer. It’s easy then to layer more and more difficult feelings on top of the original feeling. I’m worried about feeling down; and then I’m angry at myself for being worried about feeling down; and then I’m depressed at the fact I’m angry at myself for being worried about feeling down – and on and on and on.

The struggle to understand can easily land me in a place where I decide there must be something wrong with me for having this out-of-proportion reaction, or there must be something wrong with the external circumstances in my life (this job is bad, this relationship is wrong, it’s this other person’s fault). So I can tip into either depression or conflict with another person or situation.

What is noticing?

An alternative to rushing to either engage or to understand is to slow down and stay with the original feeling or situation, and just to focus on noticing it. Each time I feel drawn to trying to understand it, or to get up and do something, I can try to bring myself back to the original experience and just really notice what it is like.

When I have managed to do this there is a real sense of things beginning to clear like the water in the glass. A kind of understanding begins to emerge naturally from the process of noticing, in a very different way than when I’m attempting to force myself to understand what is going on. By the end of the process I can have a much clearer sense of how to engage, often becoming aware that there are many options and that nothing has to happen immediately.

It’s important to emphasise though that it is often extremely hard to stay with difficult emotions and experiences like this. There’s a reason why we rush to distract ourselves or try to force the feeling to go away. This noticing is such a radically different approach that it takes time to cultivate.

Pema suggests that noticing involves regarding difficult feelings as friendly and supportive rather than as fearsome and threatening. That is one of the hardest parts for me. In the last week I’ve tried to approach two of my least favourite emotions in this way: one I call ‘the plummet’ which feels like falling into a deep dark pit of despair and self-loathing with no warning and no time to catch hold of the sides. The other is a kind of gritty grainy feeling of being slightly bored and pissed off and bothered by everything. Neither of those states feels friendly to me. I do not want to look at them closely. I just want to find a way never to experience the plummet ever again, and to shake off the grainyness when it comes on.

But this week I tried to just be with the feelings and notice them, trying to describe their texture, temperature and colour; really experiencing the sensations that arose in my body; widening out to notice how they unfold in time (What happens immediately beforehand? What is the overall situation I’m in when they happen? How do they tend to play out?) I tried to assume that the feelings were sensible, helpful things to have happened, it was just that I didn’t know yet why they were sensible, and I needed to listen more carefully and kindly to them until they did make sense: however long that took.

I found that after some time of staying with them, and curiously noticing them in this way, lots of things started to occur to me that hadn’t before. It was like a process of joining the dots as all sorts of connections started to come to me. There was a feeling of weight lifting and being able to see things much more clearly and calmly for a while.

How could we build this into our lives?

I think there are two major challenges to building such noticing practices into our lives. The emotional challenge is that it is generally the very last thing that we actually feel like doing when we feel bad. The practical challenge is about when and how we actually do it.

Pema suggests that it can be good to start with emotions that are not too difficult rather than launching in with the really tough stuff. You can even start when you’re not actually in that emotional state, but rather when you’re feeling okay. Just remembering the last time you felt a bit bad and trying to notice what it was like. You can just do it for a few minutes at first, and then do the same thing for a positive emotion to balance it out a bit. In this way the process of noticing can be gradually built in in ways that don’t feel too threatening.

Another important thing is giving ourselves time for these processes. Often when a tough thing hits we’re not in a position to go off for an hour and sit with it. We might not even get that opportunity for several days. So what I’ve started to do is to ask other people in my life for time, and to give time to myself. So, for example, if a difficult issue comes up, I ask the other people concerned to let me slow down and think about it for a while, and I also schedule in some time for myself to do that. And if that isn’t enough I ask for more or give myself longer. I’ve got a list of decisions that I want to consider and conversations that I want to have with people and a rough idea of when I’m going to get to them (some this week, some next month, some next year!)

As for the question of when we do these practices, obviously it is tough to build noticing into busy lives, and I know that I’m extremely privileged to have a job which is more flexible than most and which actually involves thinking and writing about this kind of stuff regularly. Different things definitely work for different people, but I find it helpful to have some check-in time for noticing at the start of the day. I take a cup of coffee outside wherever I am and sit for however long I have available. I often find it helpful to read or listen to a helpful book for a while beforehand, often on the journey to wherever I’m going that day, to get me in the right state of mind.

Something that I’m sure would be helpful, but which I struggle to do, is to take a few minutes out for noticing whenever something difficult bubbles up during the day. People sometimes use such moments to go to the bathroom and have a couple of minutes breathing space alone. Similarly the end of the working day can be a good point to take ten minutes before embarking on the evening, and/or it can be good to take some time just before going to sleep. I should emphasise that I do none of these things regularly myself – it is not easy! Also I’ve avoided using the word ‘meditation’ here. That can be offputting because it sounds like a ‘special’ kind of practice and can come with a lot of baggage. Whilst I have found formal meditation to be a good place for noticing, the most helpful noticing I’ve had recently happened while I was sitting on a train looking out of the window and listening to music on my phone. Other people find that they do noticing on long walks, or while they’re cycling or driving, for example.

Noticing doesn’t have to be a completely internal thing. I’ve always found that writing helps me a lot with it. So I take an hour in a café once a week to write in a journal about all the things that are going on, trying to focus on describing them rather than attempting to figure them out. A combination of just sitting and reflecting for a while and then writing can help. Drawing or other forms of expression work better for other folks. And, of course, some people use therapy as a place to do this kind of noticing with another person to guide them through the process (finding the right person, who you have a good rapport with, and who helps you to create such a space, is the key here). Or you can set up times with friends where you’ll each take turns to help the other person to talk through what’s going on for them, with a focus on noticing rather than trying to explain or solve the problem.

Sometimes what you notice when you are noticing is that the thoughts and feelings you’re having just shift and change by themselves; other times the noticing leads to more of a sense of the water settling and seeing things more clearly; sometimes all you notice is just how hard noticing is, and how you spend the whole time drifting off, or trying to analyse it, or wanting to stop. And if those things happen then they, in themselves, become something to notice.

Find out more

There’s more about how to do these practices in my zines on Staying With Feelings and Plural Selves.

The post Dealing with the tough stuff: The value of noticing appeared first on Rewriting The Rules.

I was therefore troubled recently to hear somebody use the idea of embracing uncertainty in a way that was hurtful to their partner. I realised that I’ve been guilty of doing the same thing myself. We hear a frightened partner seeking reassurance and a sense of safety and, feeling limited and trapped by their demands, we point out that life is uncertain and use that as a way out of making any kind of commitment to them. ‘How can we know what’s coming down the road? You need to embrace uncertainty baby.’

Such an exchange can leave us with a comforting feeling that we are by far the more evolved, rational and philosophically sophisticated, person in the argument, as well as absolving us of any sense of responsibility and enabling us to avoid facing up to the pain that somebody we love is feeling. No wonder it is an attractive position.

The last few weeks I’ve been returning to my favourite source on uncertainty, Pema Chödrön, as well as thinking a lot about how it applies to my own life. I want to share some of my ideas about what embracing uncertainty means beyond this kind of basic understanding of life being uncertain (which, of course, it is).

If we subscribe to this more nuanced understanding of embracing uncertainty then we could see it as coming from a place of deep commitment rather than from an attempt to escape commitment. Also, instead of being about a liberation from pain and difficulty, embracing uncertainty becomes about facing up to these things in a way which is both hard and courageous. This is why Chödrön calls it a warrior path.

Going slowly

The first thing about embracing uncertainty is that it takes time. When faced with uncertainty in life we often find it incredibly painful and rush to resolve it as quickly as possible. In the example I gave before, of telling a partner to embrace uncertainty, we are not really embracing uncertainty ourselves. Rather we are rushing to resolve the situation by writing our partner off and denying what they are feeling. To embrace the uncertainty of such a tough situation of relationship conflict we would take the time to really listen: to both our partner and to our own panicky, trapped feelings which are driving our impulse for a quick resolution.

In times of profound uncertainty in life it is tempting to act quickly. We’re having a difficult time at work: quit. Our relationship is in difficulty: break-up. Somebody is out of line: reprimand them. Whether our action involves lashing out or running away, it is a quick response that gets us out of painful uncertainty because we either insist on the rightness of our way of seeing the situation, or escape the situation entirely.

Embracing uncertainty involves being prepared to sit with the situation in all its uncertainty for as long as it takes for us to be sure that we’ve seen it from all angles, and until we know that the response that we have come up with is that which is the most compassionate and ethical possible under the circumstances and for all involved (including ourselves and others).

During the time of uncertainty we need to refrain from acting however tempting it may be to do so. This may also involve asking others to give us the time that we need rather than giving in to their demands to come up with an answer. Thus it can also be quite a socially radical thing to do in a cultural context of quick fixes and immediate responses: being prepared to say ‘I don’t know what I think about this yet’ or ‘I’m not sure how best to respond, let me get back to you’.

Vitally though, embracing uncertainty is not about failing to act at all. Another misuse of embracing uncertainty would be to use it as an excuse for apathy or avoiding doing anything. Instead it is about a commitment to act in the most thoughtful and kind way possible having given ourselves enough time to look closely at the situation.

Leaning into pain

An idea which is frequently mentioned alongside embracing uncertainty is that of leaning into pain. When we take time to embrace uncertainty we are deliberately avoiding our usual instincts to avoid fear and suffering and, instead, determining to turn towards them, to lean into them, to really understand them.

This might sound fine in the abstract but we are actually talking about incredibly hard, messy, difficult work where we will be called upon to look directly at the things about ourselves that we feel most vulnerable and ashamed about. The situation wouldn’t be so uncertain and difficult if it wasn’t touching something deep and painful in us.

Therefore leaning into pain also involves knowing when we need to look at the situation and when we need a break from it to build up our strength . We simply cannot look at the situation constantly. If we do we risk getting so caught up in the tangle of different ways of understanding it that we can’t see it at all. We need to retreat, to look after ourselves, to treat ourselves kindly as somebody in a tough situation, as well as time – when we’re feeling stronger – to lean into the pain.

Leaning into pain involves taking a good hard look at what the situation means for us, what our habitual reactions are telling us to do (Fight! Prove them wrong! Run! Hide!), and why that might be the case. The partners in the example before might usefully ask themselves what they are bringing to bear on the situation. Have there been other times (in their past, in other relationships) when they’ve felt insecure (on the one hand) or trapped (on the other)? What vulnerabilities do they carry from such times? Are they convinced that, on some level, they are really unloveable? Do they believe that they are destined to hurt the ones they love? In what ways do we fear that we are ‘not really okay’ and how is this influencing the current situation?

Whilst leaning into pain can be incredibly hard, the clearer picture that we gain when we face these things that we are so used to running from can bring a massive sense of relief, once we’ve taken the time to really look at them. When we do then have conversations with those involved there is often a similar sense of relief that – however painful those conversations are – they are coming from a place of honesty where nothing is being hidden from view.

Getting off the hamster wheel

The real value – for us – of embracing uncertainty is that it offers us a chance to get off the hamster wheels which we all seem to create for ourselves. Perhaps we are all about gaining approval, or becoming a success, or avoiding danger, or a combination of these and other things.

The ways in which we respond to the stuff of life becomes driven by these motivations such that we find ourselves going round and round in the same patterns.  Perhaps we find ourselves taking on a new project every time we get to a much longed-for endpoint. Maybe we burn our bridges every time we get bored. We might realise that we always shy away from opportunities when they appear. Or we might recognise a pattern of pushing relationships to breaking point.

Whatever our (many) hamster wheels, embracing uncertainty gives us the possibility of stepping off temporarily – perhaps even permanently. Slowing down means that we can see the patterns that we’re embroiled in. Leaning into pain means that we can understand better why we do it: what is so fearful that we are avoiding it by running faster and faster, and still getting nowhere.

When we embrace uncertainty we can start to see our hamster wheels and the ways in which they are hurting both ourselves and others. As well as engaging with the current situation in a more thoughtful, compassionate, and ethical way, we have a real possibility of stepping off the hamster wheel and beginning to forge a different path.

How to embrace uncertainty

So how do we actually do this in practice? The answer to this question will be different for each of us. Some find meditation a good way to slow down and lean into pain, others prefer journal-writing or talking things through with a trusted friend or mentor.  It’s important to remember that balance of retreat and engagement: we need to build in time away from the situation to see it more clearly. I like to go for a walk in a wide open space where the big sky seems to relieve me from the pressure of the tangle, but retreating too will look different to everyone.

It is certainly worth – in calmer times – thinking through what works for us. How will we notice when we have become embroiled in the tangle? And how will we ensure that we take time to embrace uncertainty and lean into the pain instead of reacting quickly to close it down according to our usual habits?

The post Embracing uncertainty: What does it really mean? appeared first on Rewriting The Rules.

I’m about to start writing a chapter for my mindfulness book on depression so I’ve been mulling over what the experience of being depressed Is like, and what things help and hinder when we’re in that place. At the same time I’m becoming fascinated and concerned by the processes of conflict between people which seem to inevitably happen in all the academic and activist groups I’m part of. I’m wondering what might be done to maintain some kind of useful dialogue, rather than people convincing themselves that the other side is wrong and bad while they are right and good, and thus ceasing all engagement. Even as I see the problems in this approach I recognise the same tendency in myself.

As these two lines of thoughts unfurled themselves yesterday I found that they began to weave together into a similar set of ideas, so I decided to write a little about the patterns that I see in how we experience depression and conflict, and in how the experience can shift. Perhaps I shouldn’t be so surprised that these ideas have come together: I deliberately started my book on relationships with a chapter on the self because of the connections that there are between how we relate to ourselves and how we relate to others.

Depression: Tuning out, turning in

When I reflect on being depressed the experience is one of being simultaneously tuned out, but turned in. What I mean by tuned out is that when we’re depressed many of us become terribly concerned with other people and the outside world. We monitor ourselves closely through the imagined gaze of others and judge what we think they are seeing very harshly. We become anxious about what others will see in us, and frightened that we will get it wrong somehow and be exposed in all our uselessness. Decisions become very difficult because we are so tuned out – trying to be okay for everyone else – that it is almost impossible to tune in to what we want and need ourselves. We might find ourselves busily rushing around trying to please everyone and not letting on how much we are struggling, or we might withdraw from contact as much as possible for fear of what others might see if we let them in close.

At the same time as being tuned out, we are also turned in. While we are hugely concerned with what other people think of us or how we are being seen out in the world, we don’t really see or hear the people around us because we are so turned in and focused on our own struggles. We often spend a great deal of time in internal conversations with ourselves about whether something is wrong with us, what it is, and how we might fix it. We view other people in terms of their danger to us (‘they might see me as I really am!’), or the possibility that they might be able to help (‘maybe they have the answer’), but it is hard for us to make the shift that is necessary to understand how they are feeling and what is going on for them. Often we assume that we are the only person who is this bad and full of problems, and we are so fixated on not showing other people that this is the case, or apologising to them for our perceived wrong-doing, that there is no space available to turn towards their experience and let go of all of our own stuff for a moment.

Depression: Turning out, tuning in

When I think about the moments of relief when that heavy tangled weight of depression has lifted, they are often moments when I have managed to ‘turn out’ in spite of all this. Perhaps somebody else’s pain has pierced my bubble, or in professional mode (as a tutor or counsellor) I’ve had to put my stuff down and turn towards another person to hear about their struggles, or I have remembered how this worked and deliberately reached out to somebody else and asked how they are doing. Sometimes the relief just takes the form of sitting on a train or walking down the street and suddenly opening up to the fact that all the people that I see have their own fears and desires, tragedies and triumphs, which are just as precious and concerning to them as mine are to me.

This turning out works on several levels. On a very basic level listening to somebody else, or imagining their world, means that our mind is occupied with something else for a moment and we have a brief relief from the clatter of noisy and critical thoughts that has been exhausting us. Then there is the way that helping somebody else (anything from flashing a kindly smile through to giving them a supportive shoulder to lean on) can leave us feeling better about ourselves: we do have something to offer after all. Perhaps most fundamentally though is the sense of connection to others which is an antidote to the sense of isolation and alienation that is a major element of depression for so many of us. If people let us in through opening up to us, or just reveal their pain on their faces, we might realise that they struggle too, often in similar ways to ourselves. We realise that they are also scrutinising themselves constantly with a stream of critical comments running through their heads. We are no longer alone. In fact that pain is the very thing that links us to everybody else.

Related to this it is often the case that in finding compassion for another person we become able to find a little of the compassion that we need for ourselves. This is an important part of what I’m calling tuning in. Instead of only being attuned to what other people think of us (whether we are normal or abnormal in society’s view, whether or not this person approves of us, etc.) we can tune into our own feelings and experiences. By turning out and really seeing and hearing the other people around us we might realise that they aren’t really that concerned with us because they are so busy worrying about themselves. Or, if they are judging us and disapproving of us, we might realise that they are doing this out of their own pain and anxieties rather than because they are seeing any true flaw in us. For example, it might be that putting us down gives them a brief reassurance that they are okay, when they secretly fear that they are not. Even if there is an element of truth in any criticisms they are making of us, we can manage to hear it and bear it because we are no longer trying to present an unreal perfect image to the world. We are turned out enough to be able to appreciate our impact on other people, and tuned in enough to own up to such things without thinking that it means that we are a terrible person in total.

When we are depressed, or otherwise suffering, it doesn’t really matter whether we start by turning out or tuning in. Either one begins to make the other easier. So it might be that we deliberately try to empathise with other people or imagine what they are going through, and that gives us the space to find a bit more compassion for ourselves. Or we might start by tuning in to ourselves – sitting with however we are feeling without judging it or criticising it – and that might enable us to open up and see the other people around us.

Conflict: Tuning out, turning in

How are similar processes involved in conflict situations? It seems to me that often when a conflict bubbles up our reflex response is to tune out but turn in. We focus entirely upon the badness and wrongness of whatever has been done to us (tuning out), while our concern with the pain and suffering that the other person has caused in us means that we turn in on ourselves and find it almost impossible to hear where the other person is actually coming from (turning in).

This pattern is what leads to the escalation of conflict. Often both people or groups regard themselves as the wronged parties (tuned out) and both are so concerned with the suffering that this has caused to them that they can’t find any empathy for the others involved (turned in). Under those circumstances each thing that one person or group does is interpreted as a slight by the other, who then try to express their pain and anger at what has been done to them which is read as an overreaction and unreasonable response by the original person or group who then responds defensively. We are all prickly and hyper-aware of everything that the other person says and does (tuned out), at the same time as being defensive and protective of the sore spots in ourselves that the other person is (often inadvertently) bashing up against (turned in). This means that we tend to interpret what ‘they’ do in narrow and simple ways, often assuming that they are acting out of malice or personal defects while we are very aware of all of the complexities of the situation that have led us to act in the ways in which we have.

In some ways conflict is the opposite of depression because we are hard on the other person and see them in limited ways, while being much more understanding of ourselves (whereas in depression we are much more forgiving of others than we are of ourselves). However, these kinds of conflicts and depressions often have the same thing at their root: Our secret vulnerabilities and shames which we are afraid might be exposed. In both cases we are hyper aware of others who might be seeing these things (tuning out) and defending against the possibility that they will reveal something we fear is there (turned in). But in depression we defend by withdrawing and separating ourselves off, whereas in conflict we defend by lashing out and trying to make our pain all somebody else’s fault.

Conflict: Turning out, tuning in

It follows that we can also shift conflict situations in the same ways that we shift depression. We can attempt to turn out and/or to tune in. Again it doesn’t really matter which one we shift first, it will probably make shifting the other one easier as well.

For example, we might start by tuning in. Instead of allowing ourselves to react in a knee-jerk defensive way to the other person or group, we might sit down on our own for a while with the aim of listening compassionately to ourselves: Why it is that whatever is happening has hurt us so much? Each time we start trying to list whatever the other person did wrong and why they are so bad we can gently bring ourselves back to tuning into ourselves instead: What are we feeling? What does it remind us of from other times in our lives? Which of the vulnerabilities that we know that we have have been triggered by this situation?

Alternatively we might start by turning out. We might recognise how we are limiting the other person or group by imagining them as just stupid, bad, crazy or malicious, and start trying to open up to the fullness of what they are and really trying to listen to where they are coming from. We may remind ourselves of the complex and multiple reasons that have led to us responding in the way that we have, and try to assume that the same will be true of the other ‘side’ of the conflict. In Rewriting the Rules I suggest we might turn our common accusation ‘how could you do that!’ into a genuine and curious question ‘how could you do that?’ This might involve us on our own imagining all of the different reasons why the other person or group might have done what they did (given what we know about them if they are somebody we know, or just what we know about people). Alternatively, or after this, it might involve us sitting down with them with the intention of really listening to where they are coming from and trying to create a situation where they feel safer to tell us this.

The combination of turning out and tuning in will hopefully mean that during such conversations we can be more aware of what is triggered for us, so that we can respond to the situation itself rather than bringing in all our previous baggage. Tuning in also means treating ourselves kindly so we are less likely to take everything else somebody throws at us. If they are still in conflict mode then we can hear the pain behind their words, while not remaining in situations that are hurting us or taking on board criticisms that are unfair. This may involve, for example, insisting on more time apart before trying to communicate, or asking somebody else to mediate.

Conclusions

Of course every depression and conflict are unique to the people involved in various ways, and I will not have captured here all the different things that they can mean to different people at different times.

With depression there are aspects of the social situations which are involved that mean that another important element is turning out towards wider society and the ways in which it encourages that self-monitoring, critical, way of being with ourselves. I’ve written more about that here and here.

With conflict there are some important things to tease out about how we deal with very real power imbalances, oppressions, and privileges which are often in play. In my view the compassionate approach makes it more, rather than less, likely that people will be able to own up to these things and speak openly about their impact, but I also understand the fear that compassion and empathy for others could smooth over such things and lead to an acceptance of abusive and problematic situations. I write more about those tensions here and here.

I hope that the idea of shifting from tuning out and turning in to turning out and tuning in is a helpful one for thinking through your own experiences of depression and conflict, and I’d be very interested to hear other people’s reflections.

Find out more…

There’s more about how to tune in in my Staying with Feelings zine, and this post about noticing.

There’s more about depression and conflict in relationships here, here, and here.

You can find out more suggestions for practical ways of turning out and tuning in in the Rewriting the Rules chapters on self (in relation to depression) and conflict (in relation to conflict), and in my Social Mindfulness and Self-Care zines.

The post Tuning out, turning in – Turning out, tuning in: Depression and Conflict appeared first on Rewriting The Rules.

The focus on lesbian, bisexual and queer women is appropriate because both women, and lesbian, bisexual and queer people, are particularly highly diagnosed with mental health problems such as depression and anxiety (when compared with men, on the one hand, and heterosexual people on the other). They also self-report higher levels of distress and lower levels of happiness and well-being than other groups.

My brief presentation at the event focused on the social aspects of such suffering. Women’s experiences of depression have been linked, for example, to the ways in which women are socially expected to demonstrate distress (sadness and fear, rather than anger), and to aspects of conventional femininity such as having identities which are strongly bound up with other people’s well-being and feeling a lack of agency over their own lives. Lesbian, gay, bisexual and trans (LGBT) people have higher rates of such problems because of the challenges of living within a heteronormative world and related experiences of homophobia, biphobia and transphobia. Recent research has found that rates of depression, self-harm and suicide are particularly high amongst bisexual and queer people, which is likely linked to their lack of visibility in wider culture. It is difficult indeed to have one’s identity questioned, ridiculed, and/or disregarded by heterosexual and lesbian and gay communities alike.

Suffering is often exacerbated when distress which has such a strong social component is regarded as being something which is internal to the individual themselves. Currently there is a powerful cultural tendency to see all distress as being internally caused. Many people believe that when they are depressed or anxious there are only two possible ways of understanding this: Either they are ill, and they need help, but at least this means that it is not their fault. Or they are not ill, and therefore don’t need help, but this means that they are to blame for their own suffering (the ‘pull your socks up’ attitude). Both of these understandings are internal: either there is something physically wrong, or there is some kind of personal deficiency on the part of the individual. Such understandings can prevent us from seeing – and addressing – any social element to our suffering. They also catch us in a double bind whereby we have to accept that there is something wrong with us or that we are blameworthy, neither of which is a great outcome. Also, either understanding continues to haunt the other even if we dismiss it. If we accept that we are ill we often worry that somebody will discover that we are not really ill and will be ‘found out’ for faking in some way. If we accept that it is up to us to deal with our problems we often fear that there might really be something wrong with us and that that will be exposed.

An alternative to this internal perspective is to see all forms of human distress as complexly biopsychosocial. Of course there are some physical vulnerabilities which we have to experience distress in certain ways, and social experiences like being the victim of prejudice write themselves on our psychology and biology in various ways (affecting brain chemistry, thought patterns, and the way neurons wire up, for example). However, our biology is intrinsically interwoven with the ways in which we experience the world, and the ways in which it treats us. The statistics on mental health problems in women and LGBT people alert us to just how important these social aspects can be, and may leave us asking whether ‘depression’ or ‘oppression’ is the more useful word to apply. Opening up the possible role of social forces also opens up potential for other ways of addressing struggles than the common individual modes of drugs or therapy. Both community involvement and activism because important possibilities to consider.

This finally leads us to the H-word and why I find it somewhat troubling. We hear a lot at the moment about the importance of individuals achieving happiness through positive psychology. However, there is a real danger that this throws us back into an internal understanding of such things: ‘Everyone should be happy and here are some techniques you can use to achieve it. If you can’t achieve it then there is something wrong with you’.

In her book, The Promise of Happiness, Sara Ahmed talks about the ways in which happiness may be more available to some rather than others (often those who can more easily conform to the ‘norm’). She suggests that we require ‘feminist killjoys’ and ‘unhappy queers’ if we are to reach a more equal society where pleasure isn’t always found at the expense of others or by conforming to problematic power hierarchies.

There is a related idea in the mindfulness approach which I find useful. Buddhists believe that it is actually the craving for happiness which is the cause of suffering. Our consumer culture constantly tells us what we need to be happy (more money, fame and success, the perfect partner, the ideal body, the product they are selling etc.). As Sara Ahmed points out, such things are more accessible to some than others, but even for those who can get them they are never enough. Mindfulness advocates an alternative approach of bringing our attention to the here-and-now, rather than constantly striving after whatever we think we need to be happy. It also advocates being with whatever emotions we’re experiencing rather than privileging one (happiness) over all others.

I was interested that the H-word event description talked about finding ‘happier, more meaningful lives’ as if these two things necessarily go together. From another perspective we might regard constantly grasping after happiness as the very thing which will prevent us from achieving it. It might be that in order to have a meaningful life we need to let go of the quest for happiness. If we turn our focus to welcoming all emotional states and what they have to tell us, and to compassionately seeking to improve society through mutual support, perhaps we may find that happiness sneaks up on us after all.

Find out more:

There are more blog posts by me on happiness here and here.

The post The H-word: Happiness appeared first on Rewriting The Rules.

The study itself linked living alone to poor housing in women and low social support in men (something that has long been found to be a risk factor for single men). However they are understood, the findings clearly point to the vital social role in depression: a condition which is commonly understood to be both internally caused, and in need of only internal treatments (such as drugs and therapies). We need to move to more biopsychosocial (or even sociopsychobio) understandings of this experience.

The bounded self

Social psychologist Kenneth Gergen points towards one idea which may help to make sense of findings like these. In his book, Relational Being, he argues that in the past few centuries we have come, in the west, to see ourselves as ‘bounded beings’: as singular and separate from others. This is a culturally peculiar belief, according to Clifford Geertz, but one which we generally take for granted as a ‘fact of life’.

Gergen argues that if I accept this view of myself:

‘I must always be on guard, lest others see the faults in my thinking, the cesspools of my emotions, and the embarrassing motives behind my actions … I must worry about how I compare to others, and whether I will be judged inferior.’ (xiii-xiv)

He argues that this view underlies our education and organisational systems which evaluate us individually and encourage constant competition from the start.

Importantly, for our explorations here, Gergen suggests that depression can be located in this way of viewing ourselves The inner critics and overwhelming fears of failure which are so familiar to us are part and parcel of this view of the human being. As well as the relentless self-evaluation, toxic comparison and defensive withdrawal of depression, the familiar sense of meaninglessness and pointlessness can also be linked to disconnection from others since meaning, for most people, is associated with their relations with others.

Speaking specifically about living alone, Gergen proposes that this is something which only really makes sense under this view of ourselves as fundamentally isolated. Alongside statistics on the numbers of people choosing to live by themselves, he cites evidence for decreases in close friendships and increases in loneliness in recent years.

Gergen proposes that an alternative way of seeing things is to regard ourselves as fundamentally relational rather than bounded. This is a view which is common to Buddhist and existential philosophies (which question the separation between self and others and stress interconnection), and constructionist and constructivist approaches (which point out that we become different ‘selves’ in our relationships with different people, and that our self is something that we construct in interaction).

Bounded selves and living alone/together

Returning to the issue of living alone, we could see this as a situation in which the sense of ourselves as bounded and separated is exacerbated, especially in situations where we are also out of work or retired and have very little human contact day-to-day. It is possible to become very inward focused: listening to the loops of self-judgement and critical commentaries that go on within our heads. A vicious cycle is easily set in motion where our negative view of ourselves makes contact with others a frightening prospect, due to fear that they will confirm our self-perceptions, and we withdraw further into ourselves.

Such challenges are not absent for those of us who live with others. The bounded self view is pervasive and we also relate to other people accordingly: looking to our partners, children or parents to affirm and validate a positive view of ourselves, and fearing that they will do the opposite: seeing us negatively in a way that confirms what we dread is the real truth of who we are. This is what Sartre was talking about when he said that ‘hell is other people‘.

However, given the findings on living alone, it seems that – for many of us – contact with others goes some way towards loosening the tight grip on the self. Perhaps when we live up alongside others we have times when the self-and-other distinctions are blurred: as we share a moment, or physical contact breaks down the barriers, or we recognise our own pain or joy in the eyes of another, for example. Maybe we realise how much our own projects in life are bound up with other people, and how much they need us for their own projects, and a kind of mutuality and reciprocation comes from that.

Also, as we relate to different people in our lives we may notice that they, and we, have different sides in different situations, and also that they, and we, change over time. The recognition of our plurality and fluidity both provide relief from the grip of the bounded self. It makes far less sense to judge and evaluate ourselves (or others) when we know that we are multifaceted, and less sense to compare ourselves against others who are constantly shifting just as we are. If we can find the courage together, intimacy with others may even enable of us to reveal our vulnerability and recognise it as something that connects us rather than being something we have to defend so desperately.

Implications

So what are the implications of such findings on living alone and depression, and this way of understanding them? Clearly they point to the importance of human contact – but importantly contact which encourages a softening of the bounded self rather than further judgement and competition. We should be cautious, as a society, of policies and practices which leave people even more isolated and withdrawn. Such research should feed into current discussions, for example, of benefit systems and of how we treat older people.

Also it would be good to provide more real alternatives to living alone. At the moment, for many people, the decision is between living as a couple/nuclear family and living by yourself (if you are single or separated from such a unit). We need to expand the options and make it both socially and economically viable to live in other arrangements.

It is not that being alone inevitably reinforces the sense of the self as bounded. We can all probably point to moments of solitude in which we felt connected to others and the wider world, and this is something that can be cultivated in meditation and other solitary practices. It is quite possible to respond to the pain of the bounded self by surrounding ourselves with busyness, people and distraction in ways that become equally problematic. It is useful to consider the ways that we all relate to solitude, to being with others, and to wider community. At all levels we can operate as bounded, separate, units, or shift into a more relational, interconnected, mode.

Find out more:

For another perspective on living alone, based on a qualitative research project on those who live by themselves, see I want to be alone: The rise and rise of solo living (The Guardian, March 30th 2012)

The post Living alone and depression appeared first on Rewriting The Rules.

Biopsychosocial Perspectives

I recently heard Saroj Datta give an update on the latest evidence regarding the interactions between genes and the environment in relation to mental health. Saroj was involved in the OU science course on mental health which takes a ‘biopsychosocial’ approach to the issue, and her talk demonstrated just how impossible it is to tease apart those elements: bio, psycho, and social (which is why they are combined into one word).

I already knew about ‘neuroplasticity‘: the fact that the way our brains connect up changes over the course of our lives depending on the experiences we have (this is the way that we learn, of course, but we often forget this and regard brains as static and unchanging). Saroj presented evidence that there is also flexibility on a genetic level. Whilst the set of genes in every cell in our body remains fixed, whether they are ‘switched on’ or ‘express themselves’ is not. Animal studies have shown, for example, that a glucocorticoid receptor gene tends to remain switched off, leading the animal to be fearful and anxious, unless the mother displays nurturing behaviours (due to not being anxious herself) in which case it is switched on, leading to pups who are calmer and less stressed. This research is in its early stages, and needs to be treated with caution when applied to humans of course.

Human research supports the genetic-envionmental interaction, finding that, for example, rates of depression are high when a particular allele of a gene is present and someone has experienced three or more stressful life events, but lower if just that allele, or just the life events, are present. It is the interaction between genes and environment that is vital. There have been similar findings in relation to childhood maltreatment. However, it is important to remember that some people were still depressed without those particular elements in the place (either that gene allele, those life events, or the two together): so this is not the whole picture. Also there is unlikely to be any one single gene involved in any element of human behaviour, but rather many.

Saroj suggested that such ‘epigenetic’ changes are potentially reversible and it has been suggested that this, and neuroplasticity, may explain why there are multiple different routes to repair and recovery.

My own interest has been mainly about the social end of the biopsychosocial composite, but it is vital to remember that this is as impossible to tease apart from the rest of it as the bio end is. The ways in which the society in which we live understands, and treats, people, is vital to the way in which we understand and treat ourselves. And one of the main things our society currently does is to split apart the biopsychosocial in a deeply problematic way when understanding issues of distress or ‘mental health’.

Why I don’t like the 1 in 4 statistic

It is important to say, before I start, that here I am absolutely not doubting the existence of severe distress, or the toll that it can take on people who are struggling and those around them. Rather I am questioning the way that we currently categorise and work with such experiences, and the role of wider culture in them (which so often gets missed).

What sparked this line of thinking, for me, was a series of adverts a few years back under the Time to Change campaign about mental health, which was put together by the Institute of Psychiatry, Mind, and several other mental health organisations, with the aim of ending mental health discrimination. The adverts featured celebrities such as Stephen Fry and Ruby Wax speaking openly about their own experiences of distress, and many quoted the ’1 in 4′ statistic. For example, the poster with Stephen Fry on it said: ’1 in 4 people, like me, have a mental health problem. Many more people have a problem with that.’ Ruby Wax’s said ’1 in 5 people have dandruff. 1 in 4 people have a mental health problem. I’ve had both.’

Clearly the statistic was intended to raise awareness of the commonality of mental health problems and to decrease the stigma of those experiencing them. However, I feared that it was in danger of doing quite the opposite.

The 1 in 4 figure is problematic anyway as it is not clear where the figure actually comes from. Of the few studies which have found something like this figure, some have been measuring families rather than individuals, mental health has been measured in various different ways, and it is unclear whether we are talking about, for example, 1 in 4 people at some point during their life, or 1 in 4 people in the last year, or 1 in 4 people at any given point in time.

However, for me, the bigger problem is the potential impact of the figure. 1 in 4 suggests that 75% of the population do not experience mental health problems. That is a substantial majority. The danger is that this situates people with mental health problems as ‘them’ (compared to ‘us’ who don’t have any such problems). As we know very well in psychology, the creation of any kind of ‘us and them‘ situation increases, rather than decreases, likelihood of discrimination.

Most of us will experience some form of abuse in childhood (if we include ‘bullying‘ by peers, which I think we definitely should); all of us will experience life events such as bereavement of a loved one in adulthood which tend to result in a period of high distress; not to mention the existential givens of life which we all struggle with. Given this, is ‘ill or well’ a useful model at all?

The common dichotomous understanding which I see amongst counselling clients, friends, and students alike when they are talking about their own – and other’s – experiences of distress and suffering is as follows:

Either

I’m ill – I need help – it’s not my fault

Or

I’m not ill – I don’t get help – it is my fault

People commonly feel, deeply and certainly, that these are the only two possible places to be: ill or not ill, and that the other aspects presented here follow from that. Not only is this a splitting up of the unsplittable biopsychosocial which I mentioned in the previous post. It also suggests that there are only two options: biology or choice (social doesn’t even come into it). Mental health problems are seen as an individual – frequently physiological – problem which requires treatment (commonly drugs, sometimes also therapy) to fix. However, if there is no evidence of such an individual problem (if no diagnostic label fits, for example, or if there is suspicion that they are not suffering enough) then the person cannot be ill and therefore any struggles must be their own fault.

This way of understandings things is problematic on all levels. It prevents many people with distress from admitting it because, if they do admit it, they will have to give up control, take on a victim/ill identity, and open themselves up to stigma and discrimination. Those who embrace diagnosis may be disempowered (due to the sense that they can’t help themselves and must require expert help). They may feel that they have to take certain treatments (often drugs) because of the common idea that mental health problems are biologically caused and must be biologically treated, despite the question marks which still exist over whether, and how, such drugs work and whether they are the most appropriate way of addressing such issues in all cases (not to mention the vested interest of ‘big pharma‘ in perpetuating this particular understanding). There is no room here for sociocultural explanations or for more complex involvement of personal agency.

Also, many people oscillate between the two positions as neither side really captures the complexities of human distress. This means that those who don’t identify as having a mental health problem are haunted by the fear that perhaps there is something terribly wrong with them which needs fixing (and hiding this fear, and any signs that they might be struggling, puts them under immense pressure). Those who do embrace a label such as ‘depression’ are often haunted by a huge sense of guilt that maybe they are not really ill and maybe this is all their fault and they are totally to blame (which massively exacerbates any suffering they were already experiencing).

This puts people in a horrendous double-bind when it comes to speaking about their own, inevitable, distress and struggles in life. If we openly disclose as ‘depressed’, for example, (as many people did on the recent ‘world mental health day‘) we run the risk of reinforcing this ill/well split such that those who do not embrace such an identity feel their struggles going unacknowledged and the pain of that invisibility. If we keep quiet about our distress, or resist such labels, then we can equally reinforce the ill/well split as we are read as ‘well’ by those around us.

We need to move to more biopsychosocial model of distress. We need to recognise that distress – in its various forms – happens for complex multiplicity of reasons, and that we can have a personal role in exacerbating and ameliorating it, but that acknowledging such a role does not mean that we are totally ‘to blame’ or ‘at fault’. We need to understand that we can all access support rather than it being something only for a certain few, and that different things work for different people at different times. We need to challenge either/or illness/wellness dichotomies and to consider other possible models and metaphors for distress.

Diagnosis

The common practice within the current mental health system when people are distressed is to diagnose them (to find the category in the DSM or ICD which best fits them) and to treat them accordingly.

Previously I said a lot about why people who are suffering might want to embrace a diagnosis of a mental health problem. After this, I will say more about why practitioners may be wedded to this way of working with distress. Here I will outline some problems with diagnosis in general.

As I mentioned, for people who are struggling, diagnosis is often seen as the only option other than seeing themselves as totally ‘to blame’ for their own distress. Also, it may be the only way to access support and community, and to be taken seriously by employers and others whose understanding they may need as they are struggling. Given that this is the world we currently live in, it is important for those who are critical of diagnosis not to impose that on others. Rather we might explore, with them, the potential losses and gains of taking on a diagnostic label (something explored in the Open University counselling module). Common losses which people express are that no label fits them perfectly, that – if they do embrace a label – they feel trapped by it (that this is all that they are are all that they’ll ever be), and that they are treated differently by other people.

Irving Yalom points out this problem with diagnosis, that it easily fixes people (the way that a kiln fixes a pot) and can prevent us from treating people as whole, complex human beings. Rather, it is easy for professionals to see people as a ‘bipolar’ for example, or as a ‘borderline personality disorder’ (assuming that that category is all that they are, and that this person will be the same as other people in that category). Actually there can be multiple diverse meanings for people who fall into the same category which it is vital to explore. Take agoraphobia, for example, which involves fear of being outside the home. This could be about a fear of social contact, a sense of shame about oneself, an oversensitivity to noise, a genuine concern around violent attack (racist or homophobic, for example), an inflated concern over the risk of crime, superstitious fear of an accident happening, worry over one’s own capacity for anger and violence with others, or many other things (and combinations of things).

The point about fixing people is supported by the famous Rosenhan study ‘on being sane in insane places‘ which was conducted in the 1970s. He got a group of people to present to psychiatrists. They didn’t wash for three days and said that they heard the word ‘thud’. All were admitted to hospital and all were diagnosed with schizophrenia (except one who presented to a private clinic who was diagnosed as manic depressive, which is telling about class and diagnosis). Once admitted, the people said that they were fine and didn’t report any further symptoms. Nonetheless they were kept in for weeks at least and their behaviours were still read as ill or disordered. For example, queuing up for lunch early because they were bored was labelled ‘oral acquisitive syndrome’ and making notes was labelled ‘compulsive writing behaviour’. Science writer, Lauren Slater, repeated the study in the early 2000s herself. She didn’t get admitted, but was diagnosed and medicated by everyone she presented to, reflecting shifts in understanding and treating mental health problems.

Clinical psychologist, Richard Bentall, has pointed out the incoherence of many diagnostic categories: It is possible for two people, categorised in the same way, to have completely different clusters of symptoms. Some symptoms which are generally seen as signs of mental illness, such as hearing voices, are experienced by many people and are not always viewed as problematic.

Also, there are issues with the cultural and historical specificity of diagnosis. The classic example of this is the fact that homosexuality was included as a disorder in the DSM until 1973 and in the ICD until 1992. Other consensual sexual behaviours which are considered ‘outside the norm’ (such as fetishes, sadomasochism and transvestism) are still listed despite lack of evidence linking them to distress and calls for them to be removed.

This raises the question of to what extent diagnosis of disorder represents individuals being in conflict with the norms of society rather than a genuine pathology. There are many other examples of this. For example, the ‘sexual dysfunctions‘ are categories for people who don’t have the amount, or type, of sex that they are expected to have by wider society. Categories of ‘premature ejaculation’ and ‘vaginismus’ suggest that ‘proper sex’ involves penile-vaginal penetration.

We might also think about what things are classified as addictions and what are not (in relation to what is socially acceptable), or what forms of self-harming are pathologised (cutting and burning oneself, but generally not smoking, drinking to excess, risky sports or driving, or cosmetic surgery).

Many have argued that the high levels of diagnosis of depression in women (and the greater likelihood that distressed men will be criminalised as ‘bad’ whilst women will be pathologised as ‘mad’) are related to cultural expectations around femininity and masculinity. Also, black and minority ethnic people are more likely than white people to be diagnosed with ‘severe’ mental health problems and to be hospitalised and treated with drugs, arguably due to the western norms inherent in the diagnostic categories, as well as experiences of racism and social injustice.

Going back to Rosenhan’s study we may regard the world that we currently live in as rather an ‘insane place’ (particularly given the current economic and ecological situation) and question what it means to respond ‘sanely’ to this.Winnicott famously said, of depression: ‘The capacity to become depressed, to have reactive depression, to mourn loss, is something that is not inborn nor is it an illness; it comes as an achievement of healthy emotional growth…the fact is that life itself is difficult…probably the greatest suffering in the human world is the suffering of normal or health or mature persons…this is not generally recognised.’ In recent goals for everybody to be ‘happy‘ there is a danger that we pathologise, even more, quite reasonable forms of distress.

Us and Them in Mental Health

Given the problems with diagnosis covered above, we might ask why practitioners continue to employ these, often without critical consideration, and to maintain a split between the ill and the well.

In her book, Users and Abusers of Psychiatry, Lucy Johnstone suggests that it is very tempting for mental health practitioners to treat clients or patients in an ‘us and them’ way because of how invested they are in the current system. There is the danger that, without such clear splits, their job security would be in danger. Also they would lose the sense of expertise and professional power that they have if, for example, there was a de-medicalising of distress or a de-professionalisation of support for people who were struggling. There is a danger, more widely, that those who have an investment in being seen as sane, in control, and professional require a comparison group of those who aren’t (and this may play out in mental health systems, in families and other groups, and in society at large).

Christina Richards presents a further reason why it may be difficult for practitioners to shift away from an ‘us and them’ approach to distress. She argues that underlying a resistance to change might be a sense of: ‘“I have been doing things this way for years and will continue to do so as this way must be right (because if I have been doing it wrong for all these years look at all the pain I’ve caused/ time I’ve wasted/ good I could have done)”. It boils down to: “I can’t act in the future, because that proves I could have done so in the past”.’

This way of thinking can keep people very stuck on both sides of the ‘us and them’. For practitioners it prevents critical exploration of their current ways of understanding and practising, and substantial revision of diagnostic manuals, etc. which have been used for so long. For clients or patients it makes it difficult to change in ways that might alleviate suffering because changing is seen as acknowledging that one could have changed previously (this is especially difficult because taking personal agency is seen as putting a person on the ‘not ill’ and ‘all my fault’ side of the dichotomy explored in my second post). The more time passes, the harder it can be to step away from the way you have been doing and seeing things. There is a kind of tyranny of consistency which would be helpfully addressed by a model which embraced the fact that people change over time and that it is okay to revise and adapt the way we used to see things or admit that we were wrong in the past.

Richards quotes the great sage, Esme Weatherwax, who said that ‘Sin … is when you treat people as things. Including yourself. That’s what sin is.’ Whilst, of course, we require some kind of language to describe, and make sense of, our experiences of distress, we need to be cautious of ways of understanding that function to trap people and to concretise things rather than enabling them to move. We also need to be alert to understandings which assume that the biopsycho can be disconnected from the social such that it is only the individual who is seen as disordered or malfunctioning, rather than wider systems, and only target treatment at the individual (rather than the family, the school, the organisation, the media, or wider culture, for example). The social aspect is something that I will explore further now.

Self-monitoring Culture and Distress

A friend of mine recently posted a cartoon on Facebook which had Sigmund Freud saying ‘before you diagnose yourself with depression or low self-esteem, first make sure that you are not, in fact, surrounded by assholes’. I responded that I thought this said something rather profound about mental health at the moment. Could it in fact be said that a key aspect of many experiences of suffering is the problem of being ‘surrounded by assholes’ or – to be more generous – being surrounded by damaging cultural messages perpetuated by those around us?

When I first started counselling I became very aware that virtually everybody I saw was convinced that there was something wrong with them that needed fixing, mostly based on the fact that – when they looked around themselves – nobody else seemed to be struggling the way they were. Conversations with close friends, and self-reflection, suggest that this is an extremely common feeling: that everybody else is managing fine so there must be something wrong with me. Of course, when I asked clients how they thought they appeared to other people they recognised that they generally put on a ‘happy, managing everything fine mask’ which probably gave off the impression that they weren’t struggling either.

It strikes me that many experiences of depression, anxiety and other common mental health problems have a strong element of self-scrutiny and comparison to others in them (whilst, of course, I am wary of proposing any universal explanation because these experiences mean many different things to different people and at different times). Michel Foucault used Jeremy Bentham’s Panopticon to explain how people self-police in contemporary society. In the Panopticon prison there is a tower in the middle and cells all around an outer circle, such that a guard in the centre could – at any time – be looking into your cell. Because of this, prisoners begin to monitor their own behaviour rather than having to have huge numbers of guards. This idea has been linked to the high degree of surveillance that we now have, meaning that we could – most of the time – be being watched or recorded.

Foucault suggested that contemporary culture worked in this way more broadly. People are encouraged to scrutinise and judge themselves at all times, with advocations to self-improve, to work on themselves, and to present a positive and successful self to the world. This is linked to consumerism which is all about seeing ourselves as lacking and needing something to fill that lack. Advertising, and many other forms of media, create fears (e.g. we might look bad, be out of date, or be a failure) and then offer products to allay those fears (e.g. beauty products, the latest fashion, recipes for success in various arenas).

Within such a culture it is no wonder that people would be particularly driven to constant self-scrutiny, comparison to others, and presentation of themselves as happy, satisfied and successful (even when they may not be any of these things). This shores up the ‘us and them’ that I wrote about in my second post. Rather than distress and suffering being an inevitable part of everyday life, it is seen as a problematic lack which must be addressed, and is probably outside of the power of the person who is suffering to address.

Perhaps the major challenge for mental health practitioners, counsellors and psychotherapists is the danger that our work can perpetuate this perception: creating new diagnoses and categories and offering an ever-increasing menu of products to fix these (at a price). Even the one-to-one therapy situation is at risk of exacerbating this sense that people are wrong and need fixing, given that one person (the client) is encouraged to express their distress to another person (the therapist) who is generally fairly quiet and certainly not expressing any of their own problems. This is not to say that therapists and counsellors should be inappropriately burdening clients with all their difficulties. But we need to find ways to challenge the idea that the client’s struggles mean that there is something wrong with them, and the perception (which most clients have, even when they are therapists themselves) that the therapist has no struggles, or deals with them all perfectly.

Existential therapy includes the idea, not only that all people will inevitably suffer, but also that all responses to this suffering are sensible so long as we properly understand the person who is responding in this way. This, to me, is a very useful counter to the common assumption of something being ‘wrong’ and the person being flawed and lacking in some way if they do not respond in ways that are deemed culturally acceptable.

Alternatives: Care and compassion for all

Above I have argued for a complex understanding of suffering and distress which is very cautious of applying diagnostic criteria and of dividing people into ‘ill and well’ ‘us and them’ boxes. Perhaps a better model of distress is of a continuum which we all go up and down during our lives, and where we are not fixed at any given point. I’ve also emphasised the importance of not splitting up the bio, psycho, and social in our understandings of distress, and suggested that we must not neglect the social aspect of the biopsychosocial because societal ways of understanding people (which we internalise and which, no doubt, are represented on a neurological level) are involved in our difficulties. This is particularly the case in the way in which we are encouraged into self-monitoring, and in the way in which individuals who are in conflict with societal norms tend to be pathologised as disordered individuals.

If we resist the temptation to ‘us and them’ thinking then perhaps we can make more of a connection with people when they are distressed (rather than attempting to distance ourselves from them in ways that maintain them as ‘them’ and protect us from any sense that we might experience similar things ourselves). Then we might be able to ask questions such as ‘what works for me when I am distressed?’ which may lead to more helpful responses when others are struggling (although, of course, we must be cautious of assuming that everybody works in the same way that we do – perhaps the question is more like ‘given everything that I know about this person, what might they be needing right now?’) We might reflect, for example, on times when we’ve been under chronic stress or when a crisis has occurred in our lives.

Broadly speaking, when we reflect on what is unhelpful when we are distressed we might come up with things like: taking away the aspects which makes the person what they are (things that they regard as central to their identity such as work or relationships), removing people’s sense of personal freedom and choice, and regarding them as inexplicable or baffling, for example questioning why they can’t just stop feeling, or responding, in the way that they are doing. On the other side, we might find that what helps when we’re distressed is not being overloaded with anything else, being treated kindly and patiently and being around those we feel safest with, being reassured that we are still free (but perhaps we don’t have to make lots of decisions right now), and feeling that we are understood and that our response is a perfectly explicable way of responding to this situation (which involves somebody taking the time to understand what it means to us).

The vital role of compassion (from others and towards oneself) has been emphasised by many recently, and is part of the reason, perhaps, why various forms of mindfulness-based therapies are suddenly so popular (as they often encourage practices of self-care and compassion). Compassionate treatment of self and others is, perhaps, an opposite to the judging-comparing-monitoring mode which is so culturally encouraged at present. Rather than fearing that we are lacking, pretending that we aren’t, and trying to prove that we are better than others, we accept that everyone is imperfect, are open about our struggles, and move away from a competitive way of relating with others.

Vitally, an alternative compassionate, or self-caring, form of working with distress does not present this as something that is necessary just for people who are struggling (reinforcing that ‘us and them’). Rather it is seen as something everybody needs to engage in to counter those omnipresent self-monitoring messages (which affect us all) and to address the struggles and distress which we all experience.

Find Out More

• Many of the ideas in these posts are explored, in more detail, in Understanding Counselling and Psychotherapy.
• A very accessible book that covers may of these areas is Richard Bentall’s Doctoring the Mind.

The post Mental Health – Beyond the 1 in 4 appeared first on Rewriting The Rules.

When we wrote the book I thought that it would be great to do another book covering the same areas, for people who are not interested in studying counselling themselves but who just want to know about what different kinds of counselling suggest. As Mick Cooper and John McLeod have recently pointed out: different things work for different people at different times, whereas most books on the market cover just one approach in detail. Maybe I’ll write that book one day, but meanwhile here are what I personally think are the top suggestions from each chapter of the book we did write. If you find them useful of course you can always do the whole module (D240) through the OU.

1 – Introduction

Remember that everyone gets frightened or sad, and everyone also has times in their life when this becomes overwhelming. There is not really an ‘us’ (the professionals) and a ‘them’ (the clients or patients) because all people will find themselves both in the position of struggling and of helping others who are struggling.

2 – Diagnosis

We used the words ‘fear and sadness‘ rather than ‘anxiety and depression’ for the module because there are pluses and minuses to the more diagnostic categories. It can be useful to think about what is gained, and what might be lost, from taking on such labels. For example, they can make it easier to find others who are in a similar situation, to access support, and to feel legitimate in what you’re experiencing. But they can also mean being stigmatised by others or feeling as if you are stuck this way for good. Diagnosis can also be more or less useful for different people at different times, and doesn’t have to be the way you see yourself forever.

3 – Drug treatments and the biopsychosocial approach

People often link diagnosis and medication. It can feel like either you have an illness, you take drugs and therefore it is not your fault that you are struggling, or you don’t have an illness, you don’t take drugs and therefore it is your fault and you should ‘pull your socks up’. That’s a really unhelpful (but sadly common) way of looking at it. We become overwhelmed by fear and sadness for all kinds of complex reasons involving our bodies, our background, things going on in our lives, and the world we live in. Drugs can certainly help some people at some times, but taking them doesn’t mean you can’t do anything for yourself as well. And deciding that you don’t want to take drugs doesn’t mean you are struggling any less or don’t need support.

Interestingly the one thing that everybody we interviewed for this module agreed on (including celebrities like Trisha Godard and Stephen Fry) was that some form of physical activity had helped them immensely. It can be really hard to do when you’re feeling bad, but well worth keeping in mind just how beneficial it can be.

4 – Psychoanalysis

I’m not a great fan of psychoanalysis myself, but the chapter that Ian Parker wrote on this topic for the book was a real eye-opener about the starting points of the ‘talking cure’ of counselling. I loved Freud’s metaphor that we are like those ‘magic slate’ toys which kids have.

When things happen to us it is like writing on the front layer of plastic. Then that gets wiped clean, but there are still traces of the writing on the wax behind that will have an impact on whatever we try to draw next (the lines will get a bit broken and distorted). Freud believed in the value of exploring what there is back there on the wax layer which is affecting us now. And I think that is valuable as we often find ourselves responding to current events in ways that are hugely influenced by what has happened in the past. Making sense of that can help it to feel more manageable and understandable.

5 – Humanistic counselling

A key concept here is empathy. Can we cultivate empathy for ourselves and for other people? Carl Rogers proposed a challenge where each time you speak – in an argument or discussion – you first have to restate the ideas and feelings of the previous speaker accurately and to their satisfaction, before you get to have your say. This might seem a long way from fear and sadness, but many authors are now seeing compassion as centrally important in these areas. If we can learn to be more understanding and kind in our interactions with others we end up feeling less alienated from them, and it also helps us to recognise that it makes sense when we struggle as well, and that we also deserve kindness. When people are feeling really distressed one of the best things they can do is just to make sure that they do one kind thing for themselves every day. It helps to remind them that they are as worthy of kindness as everyone else.

6 – Existential counselling

Existential counselling challenges our common idea that there are good emotions (joy, pride, happiness, etc.) and bad emotions (fear, sadness, anger, etc.) Rather it sees all emotions as important parts of human existence. When we have to make choices we often experience deep anxiety but that is part of embracing our freedom and really living. Similarly there are inevitably points when it all feels too much and we give up and retreat from the world. Existential therapist Emmy Van Deurzen suggests that emotions are on a kind of compass, from happiness (North) through anger (East), down to sadness (South), and back up through hope (West) to happiness again. We move endlessly around that circle – like it or not – so it is worth understanding all those states, and what we get from them as well as what is difficult about them, rather than trying hard to avoid some of them which means we might well get stuck in one place.

7 – Cognitive-behavioural therapy (CBT)

When we find something frightening or depressing we tend to avoid it, but often that leads to it becoming more scary or saddening rather than less so, and we can then become quite paralysed. Our world narrows as more and more things seem difficult. A very basicCBT idea would be to gradually approach the things that scare us rather than avoiding them (starting small and working our way up). Another useful CBT technique is to pay attention to the little negative thoughts we have throughout the day – like an ongoing commentary – maybe noting them down as we are aware of them and challenging each of them. Is it really realistic? What alternative explanations are there? Is it useful? How might I think about this differently?

8 – Mindfulness

Make a little time every day just to sit somewhere peaceful and breathe. The idea is to be comfortable without distractions and just focus on the sensation of the breath going in and out of your body. You will find that you keep getting carried off on thought processes and distracted by sensations and that is absolutely fine. Just notice that it has happened and bring your attention gently back to the breath. Notice how the thoughts and feelings bubble up and then pass away again eventually if you don’t get too stuck to them. The idea in mindfulness is that if we practice doing this regularly we will start to be able to bring the same accepting awareness to whatever is going on in the rest of our lives.

9 – Systemic counselling

The fear and sadness we experience feels like it is inside us and that there is something that we need to do individually to change it. Systemic counselling proposes that actually much fear and sadness is really in between people, in families, relationships, and groups of work colleagues. Think about your own dynamics with people you are close to: do you tend to bounce off each other sometimes in ways that leave one or more of you feeling bad? A nice exercise from systemic counselling is to take some different shaped stones or modelling clay and make a model of your family or group, representing each person as an object, and where they are in relation to each other, by the way you position them. Then you can move it around to show how you would rather it was. This can help you to be aware of how the dynamics in relationships can get stuck and also how they might shift.

10 – Sociocultural issues

Similar to systemic counselling, sociocultural approaches remind us that a great deal of our fear and sadness are about the culture surrounding us and how we are viewed within it. Being marginalised is strongly linked to experiences of distress, and we all occupy multiple sociocultural positions (in relation to race, gender, sexuality, age, class, (dis)ability and so on). It can be useful to reflect on which position you are in on all of these dimensions and what the assumptions are ‘out there’ about people like you. Do your experiences of fear and sadness relate to those assumptions at all? Are there ways of sharing these with other people who are in a similar position?

11- Context and setting

This chapter was all about counselling over the phone and online. One idea from it was to write about a time when you were feeling particularly sad or frightened – noting down what was going on and how you felt about it – without thinking about it too much. This was really an exercise to think about how people express their emotions online or over email, but actually researchers like Pennebaker have found strong evidence that writing regularly about our feelings is hugely beneficial. Private blogs and personal journals can be a helpful way of doing this.

12 – The therapeutic relationship

This chapter explored how different types of counselling involve different relationships between the client and the counsellor. Many people who decide to go for counselling don’t realise how many different types of counselling there are, and how they will all involve very different kinds of relationship and quite different focuses. I wrote a bit about the different counselling approaches here. It is definitely worth thinking about what would work for you and asking counsellors about their qualifications and approaches before committing to it. You should always make sure that they are accredited with one of the major bodies (e.g. BACP, UKCP, BPS). If in doubt, ask.

13 – Outcome research

As well as finding out about what approach might suit you, it is also worth checking out the research that has been done into the kind of counselling you’re thinking of going to. Mick Cooper’s book on this topic is very accessible if you are interested, and even online searches can give you some idea of whether the kind of counselling you’re considering has been found to be helpful for the kinds of issues you have. However…

14 – Process research

…perhaps the main research finding about counselling is that all of the main approaches (covered in this book) are generally about equally effective (with some exceptions like CBT being particularly good for simple phobias). According to the research, a good relationship between client and counsellor is one of the main things which predicts how useful counselling will be. So it is worth shopping around for someone you have a good rapport with. If you are accessing free counselling it is still okay to ask for a different counsellor if you don’t feel a good relationship with the one you have.

15 – Conclusions

There is always a risk with going to a counsellor that this will reinforce the idea that many of us already have that there is something wrong with us that needs fixing. Our commercial culture is very good at giving us a sense of anxiety about the things that we lack, and selling us products to relieve this anxiety. In this culture it is all too easy to think that we are not good enough. Therefore it is important to remember that going to get some support or talk through what’s happening doesn’t mean there is anything inherently wrong with you, and also remembering that counselling is just one of many ways of thinking things through, looking after ourselves, and getting support.

Find Out More:

My Staying With Feelings Zine has a lot more about approaching fear and sadness.

The post Suggestions for Fear and Sadness appeared first on Rewriting The Rules.