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The most important things I say as a therapist

The intervention I use most often as a therapist is to simply look at a person who is trying very hard not to allow their feelings to surface and say, “Just breathe.” I help my clients unlearn habits we developed as children: When control is taken away from us, when fears run high, when it’s not safe to cry, we held our breath, stuffed the feelings, and forced ourselves to “white knuckle” (literal expression) through whatever we had to endure.

These unhealthy coping responses are what therapists call, “survival skills.” In our adult lives, we engage in them automatically and instantly. Only with mindfulness and practice can they be replaced with more adaptive strategies.

Recovery of all types (addictions, mental illness, self-harm, eating disorders) is nearly always tied to surviving traumatic experiences. We’re undermined by past betrayals, pain and violations and we’re paralyzed by our fears/avoidance of reexperiencing, feeling, and expressing.

Until we start getting that shit out (released and resolved), the best we can do is function within the ranges of being:

self-limiting àself-abusive à self-destructive

Best thing I’ve learned in therapy school:

“My approach as a psychotherapist is to zero in, as quickly as possible, on the client’s basic philosophy of life; to get him to see exactly what this is, and how it is inevitably self-defeating; and to persuade him to work his ass off, cognitively, emotively, and behaviorally to profoundly change it. My basic assumption is that virtually all ‘emotionally disturbed’ individuals actually think crookedly, magically, dogmatically, and unrealistically.” – Dr. Albert Ellis

Hells, yes! Unfortunately, for people like me, our thinking is simply a product of how we were made to feel and reason as children. Our most basic philosophies of life are based in the false beliefs that we are worthless, hopeless, and undeserving. I have served far too many who described themselves succinctly using the very words their abusers used:

“I should never have been born.” “I’m a piece of shit.” “I’m only good for one thing.” “I’m stupid.”

Recovery creates countless possibilities for changing beliefs and behaviors, all of which are very easy to understand and very uncomfortable to do. Some of the behaviors are subtle: Notice the next time you are frustrated and hit your knee or your thigh (punishment). Some of them are unobservable: Your abuser’s voice in your head telling you how horrible you are. Some are hidden: Cutting, burning, purging, denying yourself food. Some are potentially deadly: using, drinking.

Until we learn, practice, and implement healthier ways to cope, we default to what’s familiar.

I help folks in recovery develop skills and strategies that can become safety plans and relapse prevention plans. These are planned responses to inevitable life experiences:

  1. feeling hurt, scared, or ashamed, otherwise overwhelmed by emotion

  2. being or feeling: rejected, unwanted, dismissed, fired, broken up with

  3. Experiencing painful pieces of the past, whether as a memory, a flashback or by virtue of déjà vu

  4. Having cravings to use or engage in self-harm

  5. Being outside of one’s comfort zone

The toughest (scariest) part of these strategies is the necessity of involving supportive people. What we can do alone is so limited and what we can do together is so great!

Of all the things that are too familiar to us, suffering alone is at the top of the list.

Sponsors, friends, peers, family (if you have healthy folks) are not burdened by us asking for support. They’re most often grateful to take a break from their problems to help us with ours. We must be mindful that just as we feel good when we help folks, we give others the opportunity to feel good by supporting us.

Simple plans:

  1. Check in with yourself multiple times a day

  2. Ask yourself, “How do I feel? What do I need?”

  3. Be honest and withhold judgment. Do not reject yourself for feeling or needing

  4. When things are tough ask, “Who can I ask for help with that?”

  5. Call, text, message, email – cast out some life lines asking specifically for what you need

  6. Show up. Go to coffee, meetings, get togethers.

  7. Share your struggles: admit your fears and the crazy shit going through your head

  8. Let folks reassure you and stand by you.

  9. Get tons of hugs

  10. Write it out.

  11. Ask questions. Learn from other’s experience, strength, and hope

  12. Treat yourself the way you would a friend.

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