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3 Strategies and 1 Vital Practice:

Recognizing and Dealing with the Distress of Painful Sensations, Images, Feelings, and Thoughts

 

I think I accidentally crammed 3-4 posts into one here... I thought about separating them, but I provided a quick summary of the whole article at the beginning instead. Please feel free to stop there, but any attention paid through the length of this post would be greatly appreciated. And - in case I have never mentioned it before - feedback is always welcome! You can find my email information on the contact page. 

There is, of course, no ONE right way to deal with distress. Different people require different strategies to handle mental unpleasantness at different phases of life. There are common ways to alter how we approach cognitive and emotional suffering that can make mental life more pleasant, however. Conversely, we can choose patterns of relating to our internal world (or allow them to be enacted automatically) that will propagate experiences of distress and mental "dis-ease", and each time we choose one of these patterns, we increase the likelihood that it will be chosen again. With that said, we should be discerning about what mental skills we cultivate in relation to the inevitable mental distress (and sometime outright pain) all humans will face throughout life.

I will cover three main strategies of approaching the types of thoughts and feelings that may be ruminative, returning, self-judging, distressing, or otherwise harmful. Each of the strategies has their place and proper application according to the individual. The purpose of this post is not to prescribe one over the other (I will do my best, anyway... I am biased toward one in particular), but merely to present them as utility options. It will take the practice and experimentation of the individual to see what is best in a given situation. Lastly, I will present a conceptualization of self-compassion for the purpose of strengthening the mind's capacity to utilize strategies of self-protection and to (essentially) defend the mind from itself.

If you would rather read the "cliff notes" version (this is a long article, after all), here it is:

3 strategies:

Before any strategy is put into place, it is very important to be able to distill a statement or impression of the distress toward which one can direct an attempt at alleviating and around which one can orient self-compassion. Throughout this article, I will typically refer to theses distillations as mental "objects" of distress (an "object" of distress might be a recurring disturbing thought or negative self-talk, for instance). Each individual should serve as the expert of his/her own inner world and discover just the right description of the "object" of distress before attempting alter it. This will look different for everyone, but one great way to work your way to this point is the acronym, "RAIN" (I am "borrowing" this from Dr. Rick Hanson - check out a couple of his phenomenal websites at yourskillfulmeans.com and wisebrain.org; they are filled with information and practices). This will also be used in the 3rd strategy listed below. Recognize the distress (e.g. "There is returning negative self-talk"); Accept that it is occurring (e.g. "These thoughts come when I am in a high-pressure situation"); Investigate the distress (e.g. "When these thoughts return over and over again, my face feels tight, I get an upset stomach, my mind races, my heart is pounding, I feel irritable, I feel scared, etc."); and see the distress as Not-self (e.g. "These thoughts, feelings, images, and sensations are not who I am - they are simply mental and physical occurrences that I can respond to in different ways"). I hope that helps identify the issue being dealt with. Now here are the 3 strategies:      

#1: Change how you behave or act in the face of difficult sensations, thoughts, feelings, or images. Isolate specific distress-related behaviors that occur automatically and concentrate on consistently changing them as they arise. But be careful not to try too much change too soon (like skydiving if you have an emotional fear of heights!), and, alternately, be cautioned against suppressing important information your body and brain are trying to tell you (if you feel sad or have persisting thoughts about something, pay attention to them. Our mind produces thoughts, emotions, and spontaneous images often for very good reasons. They are sometimes ways we shout to ourselves for help or change. Try trusting yourself first, you may be more intuitive than you think). An example of this type of behavioral change might be to consciously smile at specific times in the day during which you typically feel very low - you can do this without trying to change how you think or feel. 

#2: Change how you appraise or give value to your own experiences. The stuff in your skull and skin does a truly astonishing job assessing stimuli from in- and outside of your body and mind. The brain stem orients us initially ("Pay attention, now!"), the limbic region assigns value to what we experience ("Run away!" or "Fight!" or "Freeze! It will hurt less if you don't move!"), and the interpretation the prefrontal cortex makes of these signals leads us to act in one way or another (or not at all). When we provide ourselves with choice, that is where the difference is made - in the PFC; if we do not give ourselves a choice, a default (automatic) choice will have already been made for us - and it will typically be a frantic or extreme one; similar to an animal's reaction to stress and fear. An additional element may include placing enough "mental distance" between yourself and the mental objects of distress to allow yourself to decouple from them. This will prevent over-identification and allow you to re-establish a more integrated relationship between yourself and those objects.  

#3: Approach the problem, become comfortable in its presence, then watch it float by. Called the exposure-extinction approach, this cognitive technique requires bravery and sometimes stamina. Using this skill, we can walk right up to the unpleasantness, stare it in the eye, notice the impact it has on us, and wait for it to leave us alone. It sometimes can take a while, but pulling the rage, fear, or self-damaging worry out of the darkness of your non-conscious mind will illuminate how much stronger your are than the objects of distress you are facing. Eventually, the light of consciousness awareness will be too blinding for them and they will submit the executive control necessary to alter unwanted mental states back over to you. What's next is up to you.

Self-Compassion

The benefits of self-compassion (and compassion in general) to the individual and to society are too vast to cover in a blog space. To summarize what I have provided below, I will just say this: be kind to yourself. You are not alone; everyone is alive, so everyone suffers. Some suffer through feeling wildly out-of-control; some through trillion-pound self-loathing; others feel like they are emotionally paralyzed and can't move a bit; some people may feel crippled by the feeling of meaninglessness or worthlessness. None of these can be equated or even compared - they are all very different (and valid) experiences of being human. The point is that some moments are smiling moments and others are tearful. With non-judgmental and intentional mindfulness, we can more simply experience these and other modes of suffering with self-love and forgiveness. Self-compassion leads to greater physical and emotional health as well as a strengthened immune system, it is applicable to all moments in life, the more you practice the better you get, and it is contagious!  

As with all mental practices, the role of attention is central, and one's ability to sustain focal attention on an object (especially a mental object) or remain open to the mind's multifarious experiences are strengthened through practice. As we routinely devote time strengthening the "muscles of attention" through mindfulness practices/mental exercises - primarily areas in the brain such as the ventrolateral prefrontal cortex (vlPFC) during directing attention and the anterior cingulate cortex (ACC) which detects attentional discrepancies and has also been shown to increase in white matter through meditation - strategies such as those presented below and the virtue of self-compassion will be made fruitfully available as skills of well-being.   

 

STRATEGY #1: FAKE IT TILL YOU MAKE IT - BEHAVIOR REGULATION

The first strategy is a strictly a behavioral one, although, at a certain level, it may impact the way we think and feel also. We can think of this strategy as "behavior regulation". The effect of this approach is to alter, modify, or maybe suppress the way we outwardly express our inner experience. You might think of the difference between "feeling" (the subjective experience of the individual) and "affect" (how that subjective experience is expressed for others to interpret). This may seem easier than it actually is. Modifying one's behavior may entail much more than "doing" or "not doing" a certain act. Altering behavior can include broad strokes of change such as deciding to go to a gathering in the face of profound social anxiety; but it can also involve subtleties that are difficult to detect and even more difficult to maintain over time. Focusing on those subtle changes, you might imagine the situation just mentioned. Someone struggling from mild to moderate social anxiety may decide to "tackle" the problem by accepting a party invitation - I qualify "mild to moderate" here to emphasize the importance of knowing the appropriateness of one's planned behavior change: someone severely struggling with social anxiety, panic attacks, etc. may need to take it a little slower. The acceptance of the invitation and actually going are examples of the broad changes while interacting with others once the party starts involve the subtleties of behavioral change. In this example, in order to maintain the behavioral change, an individual would have to constantly monitor his/her behavior and alter/edit the "performance" as it is happening (incidentally, majorly utilizing the ACC to detect attentional conflict discrepancies). This is difficult. Just holding the attention there while trying to keep up with social convention and tracking conversation is hard enough; but maintaining bodily control down to the detail of the muscles of the forehead, eyes (a primary hub for non-verbal communication), cheeks, around the nose, neck/shoulders (adjusting head and upper body posture as well as visually tracking others), the abdomen (purposefully relaxing muscles to slow down the sympathetic nervous system's reaction to the stress)... you can see how complicated it can get.

Nonetheless, practicing behavioral regulation shouldn't be thrown out due to its difficulty. Especially in conjunction with other strategies or in very specific behavior modifications (smiling more during a struggle with depression, for instance), consciously regulating one's behavior can stimulate a ripple effect of some very significant beneficial changes. Noticing what specific behaviors (specificity is important) you might want to alter is the first step. Next, setting some time to maybe practicing them can be very helpful (in vitro, Latin "in glass") - you feel weird, but practicing facial expressions or bodily gestures in the mirror will help match perceived affect with subjective experience of the actions. Finally, once you are comfortable, putting one or two slight changes into practice in a real, live setting (in vivo, Latin "in a living thing").   

SOME DANGERS OF "PUTTING ON A FACE"

I must note here the danger of applying the "behavioral regulation" approach to mental distress to liberally. Without proper and thorough investigation of oneself, there is a risk of suppressing unpleasant experiences. Attempting to "laugh off" something that you feel enraged about as unimportant or pretend that nothing is wrong when you are buried under anxiety without analyzing how we are affected by it, for instance, can lead to powerfully negative unconscious influence. This unconscious influence will behave like a beach ball you try to hold under the surface of the ocean: it will stay down there with some strain, but you will grow tired and the moment you relent in the struggle to hide it, up it will shoot like a volcano! If you have ever experienced a surprising explosion of emotion that is way too strong for the situation, you will know how emotional response can "build-up". This risk of being hijacked by your emotions (called an "amygdala hijacking" by Daniel Goleman in his book "Emotional Intelligence"), is a very present reality when we ignore initial reactions that our body and brain are communicating to us. Paying attention to the reactions and responding to the circumstances under their command lead us in two different directions down two very different paths.

 

STRATEGY #2: THINK AGAIN - REAPPRAISAL 

Strategies 2 and 3 are cognitive-based; that is, they require a modification of the way we think rather than changing the way we act. In my view, these are two great examples of how the mind can be used to change itself (not to mention the changes in the brain with which the mind co-emerges and the relationships through which we grow and develop). [Please note the citation information at the bottom of this post.]

Strategy #2 is called "re-appraisal". Utilizing this strategy, we essentially notice the mental reaction we have to an unwanted thought, feeling, sensation, or image, assess whether it is one we prefer, and (if it isn't) choose to re-evaluate our understanding of it. I use the word "evaluate" here purposefully. As we will see in the last section on self-compassion, "evaluation" of ourselves rather than non-judgmental observation can lead to damage; however, "re-evaluating" our initial reactions to different things frees up choice to allow automatic judgement to be left alone or to be altered to a more positive view. For example, if a thought enters the mind that is disturbing (like those weird, crazy images our brains randomly conjures up from time to time that sort of freak us out), we might react with "What a terrible thought! I must be a bad person!"; but with the option of reappraisal, we are given room to rethink something like "Everyone has these strange thoughts. It's just a thought, not my belief or my desire; and it certainly doesn't reflect who I am. I can just let it pass and its affect on my will end." The distressing mental object (the disturbing and spontaneous thought) was relieved of its initial and automatic good-bad assignment ("I am a bad person for thinking this") and given a more neutral value tone ("This is a normal human thing to have happen. It is ok and it does not reflect my true character or worth"). In examples like these, the mind shows its adaptive ability by reconstructing the initial emotional and value assessment of what it experiences into something either benign, meaningful, or even beneficial.

Because of the way it handles attention, the region in the brain that has been shown to be related to one's ability to re-appraise mental objects is the dorsolateral prefrontal cortex (dlPFC). Pathways associated with the dlPFC can be thought of as the "how system" (allowing us to decide how we should respond to what we observe); whereas the attention-activated paths that are connected to the vlPFC can be thought of as the "what system" of attention (allowing us to direct attention to assess the features or characteristics of the environment - we will come back to that while discussing the 3rd strategy). Two other important brain regions that are activated while handling mental reappraisal tasks are the orbitofrontal PFC and the ACC.  

It has also been well documented (look up some of Richard Davidson's research and especially his book, "The Emotional Life of Your Brain") that one major way our brain is regulated when we choose to maintain a positive outlook on things has to do with the way portions of the PFC send inhibitory/soothing signals to the limbic region (especially the amygdala) in order to tame an initial over-emotional response to stress and fear. A way we might conjure up an appropriate "PFC-response" could be to change the value we assign the thought/feeling of distress. As mentioned in the "cliff notes", the brain stem does the initial orientation ("Look at this!") and then - milliseconds, mind you, before we are even consciously aware of the object of attention - the limbic region (including the fear-response-expert, the amygdala) assigns that object of initial orientation a quality of value ("That is good, go towards it" or "That is bad, RUN/FIGHT/HIDE!"). It is after all this computation takes place that the PFC - the conscious part of our brain; arguably, the part that gives us the sense of "I am experiencing this" - finally catches up. The mind can then roll with the auto-reaction and be led by the subcortical structures in the brain (the super-fast animalistic and mostly non-conscious parts of our neuroanatomy); or the mind can choose to regulate itself by choosing to assess its current state with another value - the specifics of which seem to involve the specialized solution-seeking "how" system of attention in the dlPFC. When the mind regulates itself, the rest of the brain follows like an animal being domesticated. Excitingly enough, it has been speculated that as we produce more and more positive reappraisals in the face of aversive and distressing mental objects, the better we get at it (meaning, in neurological terms, that neuroplasticity has presumably taken place). This is shown by less PFC activation necessary to soothe the wild and reactive subcortical regions of the brain - this may even be a result of a structural change in the baseline blood flow in the brain which could set us up to respond to distress with a "re-programmed" automated accepting and responsive stance rather than an automatic eactive one. The face of mental regulation is always changing, obviously, so the results will appear varied; and, as always, it takes practice to see results! The means of success, however, can be seen as the executive control of the PFC to change the assignment of value, meaning, and appraisal to be more accurate and preferential to the situation. This is when the rocks at "rock-bottom" can be re-appraised as foot-holds of mental elevation and the foundation of emotional freedom.  

 

STRATEGY #3: THE ENDANGERED LIST OF DISTRESS - EXPOSURE-EXTINCTION

Lastly, strategy #3 is the process of exposure-extinction. As an example of how this strategy works, think of someone who has a fear of spiders (if you are that type of "someone", you can work on leading that phobia toward extinction here! If that sounds terrible, replace "spider" with something less terrifying...). The exposure to the fear may begin with just talking about a spider. As the person is desensitized to the experience of talking about a spider, he/she may move on to looking at a picture of a spider. If that goes well, that person might then watch a video of a spider (this is comparable to in vitro exposure listed under strategy 1 - "in glass"). Maybe after that, visiting a place like a zoo or a spider-owner's house could be arranged to see one in person (this corresponds to in vivo exposure as listed in strategy 1 - "living thing"). Depending on the person and the severity of the fear, an additional step could be added that involved actually handling a spider (under safe and competent supervision, of course)... But, then again, maybe not...  

However the "spider-fearer" faired in that little thought experiment, we can easily see the way that he/she gradually gained exposure to the fear and then (supposedly) saw the extinction of that fear. We have already covered several brain regions that are associated with the way we can re-think what we perceive; and there are undoubtedly areas of the brain that correspond to the process of exposure-extinction. Research shows that the recall of fear extinction activates the ventromedial PFC (vmPFC) and the hippocampus which work together to down-regulate the amygdala. During this process of extinction recall, our amygdala (or amygdalae?... we each have two of them) gets revved up in reaction to distress and the vmPFC recruits the help of the hippocampus - which "recalls" the extinguished context of fear - to deliver a nice big dose of the inhibitory (soothing) neurotransmitter, gamma-aminobutyric acid (GABA) - GABA is the counterpart of the neurotransmitter glutamate which has an excitatory effect on neurons. Neurotransmitters are the chemicals that neurons use to "talk" to one another when a dendrite sends them out to a receiving axon within the small connecting space of the synapse - think of how castles used to send ravens with messages back and forth to communicate (I may or may not have been watching a considerable amount of "Game of Thrones" lately...). In a similar fashion, the right vlPFC (which, remember, is underlies the "what" system of attention) plays a role in motor inhibition and the ventral portion of the PFC also contains inhibitory efferent projections ("efferent projections" essentially meaning "sent out" to other neurons) to the dorsal anterior cingulate cortex (dACC) effecting motor, cognitive, and emotional output in response to different stimuli. The dACC is associated with rejection and social pain as well as the felt unpleasantness of physical pain (a topic for another day: the overlapping systems of physical and social pain! Really incredible!). 

In terms of seeing the extinction of the mental object of distress, however, we might do well just to remember the acronym RAIN coined by Dr. Rick Hanson. The recognition of the object requires a sense of mental proximity that will avoid over-identification with the distress. In other words, you have to separate yourself from it in order to observe it. The next step, involving accepting the distressful mental object, can be very tough. It is at this point that the previous attempts to destroy, ignore, avoid, or forcibly change the distress should be set aside. Acceptance work is handled with open palms, not tightened fists. Releasing the grasp on the distress that has imprisoned you is an act of acceptance par excellence. It is also no joke. It can be very difficult: enter the bravery and stamina mentioned in my summary. Just sitting with the distress and 'being with it' can be some of the best work toward acceptance. This can take time; and self-compassion is a key attribute of how to handle the frustrations inherent in this process (see last section of this post). Even as you become more comfortable "sitting with" the distress, the discomfort that led you to seek change will begin to alleviate. The next step, however, is to investigate the details and experience a fullness of experience within the distressful object. Challenging as it may seem, adding curiosity and openness to the acceptance you have already developed can be done safely. Witnessing all the "in's and out's" of the distressing mental objects can be a practice of seeing things differently; not quite a re-appraisal - you are not changing any value - in fact, as you observe the details of your relationship with the distress, you may begin to see a certain richness or beauty in the way mental phenomena occur. Soon, that depth of experience in the object will lead its way to a dissipation of attention to it. All mental objects, after all, are subject to arising; this means that they are also subject to ceasing. Within this investigative stage, you can cultivate the confidence and comfort it takes to be fully present with your distress - a presence that is a necessary step in transformation. Though this can be achieved safely, it can also be done heedlessly... Being very careful not to overwhelm yourself in the heaviness of the distress is vital. If this is avoided, you can really enjoy a break from the pain that you may have experienced before. This is not the end, however! Just like antibiotics, don't stop just because you don't feel terrible anymore! The last step of re-orienting the object of distress as not-self is crucial to making any change long-lasting. What it means for a change to be long-lasting is for it to be continually "performed". This component of self-transformation is nothing short of a re-conceptualization of what it is to be your"self". You no longer "are depressed" or "are anxious" or "are self-depricating". You are now experiencing the emergence of an understanding of yourself that is more like "I am observing my"self" and that "self" is one who experiences suffering"; and, as we will see in the next section, this is an important revelation about being alive.  

Beginning to see distress as merely a mental object is not only symptom-reducing, it can actually lead to an enlightening shift in the way you see future life-difficulty, daily-challenge, emotional-pain, and mental-suffering. This is where the slight distance you put between yourself and the object of distress as you recognized and accepted its presence then investigated its detail will be extrapolated to the existential plane of categorization: "I am not my distress. I am not my pain. I am not my suffering". This new vantage point is freedom from the bondage of distress. 

 

1 VITAL PRACTICE: SELF-COMPASSION

[Please see note at the end of this post for citation information]

Compassion is a response to an actual or expected experience of suffering marked by a non-judgmental  openness to others' pain; felt kindness toward others; and a desire to see the alleviation of that suffering - compassion's Latin origin, compati, means to "suffer with". Because an inevitable attribute of life is the inclusion of physical, emotional, social, and general mental forms of suffering, one can easily see the usefulness of this when directed inward toward the self. Compassion (and self-compassion) can be considered a "positive emotional state" despite the fact that it is often felt in the face of negative states of being (i.e. suffering), and increased positive emotional states have been linked to the improvement of psychological well-being as well general physical health [two aspects of health that are tremendously interdependent - for instance, a type of glial cell in the brain (smaller than even a neuron) called microglia operates as a profoundly "intelligent" communicator to other glial cells and neurons impacting our mental/emotional state as well as affecting the overall trajectory of the cells in our immunity system throughout the body]. It has also been shown that positive emotional states also allow us to give stronger attentional focus to and more thoroughly process negatively-valued information about ourselves.  

Dr. Kristin Neff (see note at the beginning of this section) has proposed that there are 3 elements of self-compassion: "(a) self-kindness - extending kindness and understanding to oneself in instances of pain or failure rather than being harshly self-critical, (b) common humanity - perceiving one's experiences as part of the larger human experience rather than seeing them as separating and isolating, and (c) mindfulness - holding painful thoughts and feelings in balanced awareness rather than over-identifying with them." I would point out in this last point ("...balanced awareness rather than over-identifying...") that Neff seems to indicate a certain integrated relationship with painful mental events. That means that we do not attempt to forget them or pretend they are not there (as is sometimes the case with "putting on a face"), but rather to familiarize ourselves with them at a "mental distance" toward the aim of understanding them deeply - a key component of the practice of mindfulness: bringing something to attention with open non-judgement and allowing it to exist as it is without making efforts to change it. I am unaware of any empirical data that show specific neural correlates to self-compassion (although Kristin Neff's work may provide future information and Antoine Lutz and Richard Davidson have done significant research on the brain and loving-kindness meditation), but these three components will serve the "self-compassion aspirant" well as he/she moves toward a self-position deplete of harmful judgements and scathing criticism.    

REMOVAL OF THE "SELF-EVALUATION" PROCESS   

A brief excursion here may be warranted to give a quick and dirty sketch of how I view the "self" (a voluminous and by no means fully conceptualized topic) - skip this paragraph if you have no interest. I have come across several accounts of the "self" variously describing it as: a plural verb rather than a singular noun; purely constructed through our social interactions; wholly illusory and absent of substance or essence; and permanently solid and unchangeable. I do not wish to take these each apart - they all have their merits and shortcomings in my opinion - but I will distinguish my own view from those listed here in a couple of ways. The "self" as a process of relating to one's own and others' experience of 'being' seems to be an important qualifier. Further, regardless of our own personal definition of "self", it seems to be the case that we are all in relation to the "self"; that is, we have a relationship with the "self" throughout our conscious lives. Considering this relationship, I would claim that the "self" has the seemingly peculiar quality of being more fully observed as we pull away from it (as we "un-identify" with it) which leads to the paradoxical conclusion that we might become more fully "ourselves" as we "disassociate" from our"selves". [I will forego the rabbit-hole-discussion of how one might claim the absence of a self due to its persistently observable quality: "If I can step back from it to observe it, it's no longer the observing "me". Since I can repeat this process ad infinitum, there is no "me"; no "self"!... We are already in too deep for a blog post on self-compassion!] Our ability to apply distance to the relationship we have established with our"selves" is another important mental skill that is at the heart of much mindfulness work. 

Continuing on with self-compassion... 

I would like to set self-compassion up against a probably-more-common concept: self-esteem. Appropriately developed self-esteem is likely a great thing. It would, however, be prudent to understand that self-esteem has an inherent "social comparison" element that drives its value-generating work. The development of self-esteem includes assessing one's value ("Am I good or bad"), deciding a standard to refer to ("What is good?"), determining that it is important to be "good" at this or that ("How important is it that I am good?"), and finally calculating the social impact of one's level of value ("How will others see me?"). One can see the built-in social component of self-esteem which essentially leads to the reliance on the perception of others' opinions - a partially-dependable model of assessment at best. When we establish high self-esteem, we essentially develop a habit of believing (in other words, we develop a mental model or a schema) that we are doing better than a certain set of other people. "At least I'm doing better than that guy" seems to be at the core of much self-esteem. Compassion for others can, of course, be cultivated alongside self-esteem, but the two seem to be separable. That being said, it is worth pointing out some potential negatives of a high self-esteem. Namely, high self-esteem has been associated with higher levels of prejudice toward those not in one's own "group"; due to its social comparison component, efforts of raising self-esteem can lead to a habit of seeing the worst in others; and defending one's self-esteem can also possibly lead to self-centeredness and even aggression. With self-compassion, on the other hand, compassion for others, an increased (but linked) proximity with one's "self", and the removal of self-value-assignment is built-in. 

As a way of modifying how you might look at yourself, think of the word evaluation - the task of self-esteem. 

"Evaluation" (e- + value + -ation):

'e-' (variant of the prefix 'ex-' which means 'outside of' or serves to 'form nouns expressing a former state') 

value (regard, importance, worth, usefulness) 

'-ation' (forms nouns denoting an action)

Removing self-evaluation by practicing self-compassion (with its 3 traits of self-kindness, recognition of a common human experience, and mindfulness) can help us avoid objectifying ourselves (e-), questioning our own overall value or worth (-value-), and convincing that our (negative) value is permanent through the nominal habit of repetition (-ation). 

PUTTING IT TO USE

As with many of the topics I have covered in the last few posts, self-compassion is a skill that must be practiced to be maintained. Just like focused attention, empathy (which can be thought of as "feeling as" whereas compassion can be thought of as "feeling with"), various cognitive skills, and following the breath to promote relaxation and self-exploration, self-compassion will fade when not used. Our brains are built to get rid of excess. In fact, an important part of our early development includes a period of brain transformation called "pruning" during which under-utilized neurons die off and are cleaned up by the numerous glial cells in the brain. Somewhat unfortunately, the phrase "if you don't use it, you lose it" seems to apply to brain development; and since the brain's structure and function is directly impacted by mental activity (as mentioned in a previous post that included a discussion of neuroplasticity), we have to do something to keep new skills: practice them. So, if you do decide to try on one of the three strategies listed above and it doesn't go quite as well as you had hoped, try mindfully treating yourself with kindness and remember that you are not alone in your occasional (and hopefully not to frequent) struggles in life - everyone else who has every existed knows something about what it is like to feel less-than-enough, lonely, out-of-control, devastated, lost, stuck, meaningless, worthless, under-valued, or overly-stressed. Try to take comfort in your collective participation in the redeeming pleasures and unavoidable pains of being alive. If you want to take it a step further - and I strongly encourage it - do some pre-emptive work with having compassion for yourself. Write yourself a compassionate letter. Keep a journal of compassion-filled days and days of ego-centrism and suffering (note what make a difference; what choices did you make that changed things?). Notice when your mind starts to take you down the possibly well-worn path of self-pity or self-hate and begin to practice altering that mental route toward self-compassion. Importantly, in the first genuine and mindful encounter with the items being treated with self-compassion (items like self-doubt, sadness, and other thoughts and feelings that you might not like about yourself) you may initially feel more pain and distress as opposed to less. This is a result of the stance of hyper-discomfort in reference to the suffering we are trying to deal with. While developing more and more of a sense of self-compassion, this discomfort will turn into a refined sensitivity. A major part of this transformation is to remember that every failed attempt is a moment of choice. We can choose the easy-but-often-painful option of giving up and identifying with failure, or we can develop the motivation to find purpose in our own imperfections (motivation is a happy byproduct of self-compassion, too, by the way) thereby translating the experiences of suffering into the seeds of resilience.   

 

[Citation note: Most of the information from the sections on Re-appraisal and Exposure-Extinction come from two main articles - "Why Rejection Hurts: A Common Neural Alarm System for Physical and Social Pain" by Maomi Eisenberger and Matthew Lieberman from UCLA; and the amazing piece of research, "How Does Mindfulness Meditation Work? Proposing Mechanisms of Action From a Conceptual and Neural Perspective" by Britta Holzel, Sara Lazar, David Vago, Tim Gard, Zev Schuman-Olivier, and Ulrich Ott. Much of the information and all of the quotations from the Self-Compassion section come from the article "Self-Compassion: An Alternative Conceptualization of a Healthy Attitude Toward Oneself" written by Kristin Neff from the University of Texas at Austin originally published in the journal Self and Identity. I highly encourage anyone with an interest in this subject to read it! You can also check out her website, selfcompassion.org. You will find great self-compassion exercises and audio guided meditations. You can find all of these articles on the Research page of my website.] 

September 15, 2016