Where the Science of Psychology Meets the Art of Being Human

Therapeutic Change: It’s not in the doing. It’s in the being. (By Dr Sarah Sarkis)

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Therapeutic Change: It’s not in the doing. It’s in the being.

I am constantly asked by patients, and now by readers, “Ok. But now what?” The insinuation being, “yes I’ve enjoyed the insight, but what can I do?” As a species we do not embrace idle time, maybe because it really is the devil’s play thing. Most of us are uncomfortable with just being in the process; we like to make sure we have a modicum of influence on how the process unfolds, how fast it goes, and what destination we end up at.

This kind of goal directed focus is not a bad thing per se’. In fact, it is part of why we rose above instinct and utilized the substantial brain functioning we have available to us as humans. One of the underlying principles of the work I do is to create a space where an emphasis on the process can unfold in ways that “ordinary” life does not always allow for. Usually when a patient asks me some version of the aforementioned question, I reply, “It’s not in the doing. It’s in the being.” Most of what occurs in the therapeutic relationship is a result of the being, not the doing. That being said, this blog is my best attempt to outline some of the strategies I encourage my patients to “do” to help increase their tolerance for the process of “being.” 

Observe Your Mind.

The development of the capacity to observe how our mind and brain works from a space of true observation is a skill that lends tremendous insight in the process of change and growth. Psychologists call the ability to achieve this state of mind the “observing ego.” In this state we have no horse in the race, so to speak. We just observe our thoughts, feelings and experiences from a place that is conflict-free.

In the beginning, I suggest my patients say things to themselves like “oh there I am doing “that” thing that I do” and then shepherd the mind away from fixating on even that process. Just simply move on. This helps people to begin the process of interrupting the never-ending internal dialogue that most of us have, as we critique our thoughts and feelings on a spectrum of good or bad, right or wrong, comfortable or uncomfortable. But mostly the emphasis is on observation. Just being present in watching how your mind and brain operate.

The great part about starting with this observational mind technique is that you can “do it” anywhere because it is only happening in the quiet (or not so quiet) of your mind. This is different than mindfulness or meditation, which requires a different type of commitment. We will discuss later about the formal practice of mindfulness. This observational practice involves observing your thoughts, feelings and sensations as they are happening while you go about your daily life. Observational practice is what I ask my patients to start from the very first session. We just carve out space to observe how your mind works and experience your feelings and thoughts without any conflict, judgment(s) or any other critique that serves merely as a hindrance at this point in your journey.

Our mind, the way it metabolizes information, fuels our feelings, and organizes our thoughts is the ground upon which progress, change, and evolution occur. The power to develop a strong capacity to observe your mind, without enabling it (I feel anxious, therefore I will avoid that feeling or stimuli), or masochistically abusing yourself (I am such an idiot. What is wrong with me!), or any version of self-dialogue that centers on harsh critiquing is the central groundwork to quieting our central nervous system. For many of us, prior to the development of this ability our reactions to our experiences are hardwired and lack any true sense of free will, as we simply play out patterns of the past in an unconscious and unobserved manner. (Please refer to my last blog post about how the unconscious rules the roost 

Neutralize Intensity.

Remind yourself frequently that all you are experiencing are feelings. Some of them will be intense. Some will be mild. Feelings have a beginning, middle, and an end. Nothing lasts forever and nor will your internal state of discomfort. Likewise, the good feelings will fluctuate and crest and then recede and crest again. Our interior architecture requires dexterity and sway in order to thrive, just as trees and buildings do. The structures that really stand the test of time are able to bend and sway with the ever-changing demands of its environment. So too is our interior world. The more flexible and tolerant of changes and shifts in our thoughts and feelings we are, the better able we are to withstand all the inevitable undulations inherent in being human.

When patients are deeply overwhelmed by anxiety (usually close to panic) I often reflect to them something along these lines:

You are really uncomfortable and you wish you didn’t feel this way. But it is just a feeling. It will pass. Try to find space and fluidity in the pain to simply tolerate it. Tolerance is all we are aiming for here. No one expects you to be graceful under these conditions. Eventually, usually in a few minutes, it will crest and then recede.

In time, this process of neutralizing the intensity of our feelings allows for a deepening of the ability to simply observe your experiences. And with enough practice, eventually you can begin to actually “listen” to the feeling(s) in a way that was previously inaccessible because of the noise of critique and anxiety around the intensity of the experience. Something along the lines of, “I can’t stand feeling this way. What the hell is wrong with me that I feel this way? I don’t want to feel this way. What if this never stops!” All the while your heart rate is increasing and your thoughts start to try and keep pace with the 160 beats per minute and you are, from a central nervous system standpoint, well on your way to a panic attack.

Does any of this ring true?

Fret not, the battle with anxiety is won and lost with the regulation of the central nervous system. It’s biologically impossible to experience profound anxiety if you learn how to regulate the central nervous system through observation, breath, and mindfulness. You will feel anxiety in life. There is no way to completely avoid or eliminate that emotional experience. That is not the goal of therapy. But by observing your mind and neutralizing your reaction you will reduce your propensity towards the more severe expressions of anxiety (panic attacks, chronic worry and anxiety, hypochondriasis, etc).  

Neutralizing our feelings also allows us to gain access to the deeper and more unconsciously held belief patterns that are operating outside of our awareness, but with considerable influence. When we begin the process of observing the first layer of our feelings (in this case anxiety) we will find emotional layers of much more complexity, texture and history that have been protected and hidden by the low hanging fruit of our emotional world. Our goal is to help you rework your internal response to your thoughts and feelings. Neutralizing the intensity of your feelings is one step in that goal towards quieting the central nervous system. Like all the strategies put forth here, consistent practice is the only ingredient necessary for success.

Mindfulness.

When it comes to mindfulness I endorse the style endorsed by Jon Kabat-Zinn called MBSR (Mindfulness Based Stress Reduction). This is the process where we learn to just sit and be present with our thoughts and feelings, observing the content, sensations, etc but without any effort to clear your mind or even influence the content of your thoughts (you are not making any effort to “think positively” or clear your thoughts).

MBSR is a specific practice of mindfulness that asks patients to carve out 45 minutes per day of seated mindful observation. I start out by asking my patient’s to commit twenty minutes per day, broken up into two ten-minute intervals. I suggest doing it first thing in the morning and last thing in the evening. Sit in a comfortable position or lie down flat (before you get out of bed in the morning) and just observe your mind, body and brain. Observe your thoughts, feelings, and sensations. That is all. It is that straight forward. This is a process of addressing long-held central nervous system patterns that lie deep in the parasympathetic nervous system. Maintain the practice daily, even when you feel “better.”   Again, this style of practice yields the best results when it is implemented daily.

The 300 Rule.

I remember when I started to really pay attention to baseball and started to notice what a civilized game it is. Like golf, there are a lot of good life metaphors in the game of baseball. The 300 rule is one of those metaphors. As any good baseball fan already knows, a top hitter in baseball makes contact with the ball .300 times up at bat or 30% of the time. And, by the way, those are the top hitters. The same can be said of parenting and attachment. If you can meet your child(ren)’s needs 30% of the time you are well within the “good enough” parenting bell curve. The other 70% of the time we are merely repairing the inevitable parental strikes or misses.

I encourage my patient’s to view life this way and more specifically therapeutic change. When you first start out with these types of techniques, which are by design subtle, you cannot expect yourself to be a top hitter. These are not grand gestures of change or upheaval; they are subtle shifts in your interior state of being with yourself. In other words, go easy on yourself. Just start swinging the bat, observe your mind, suspend critique, and hope you get a base hit every once in a while. If you expect more from yourself in such a short amount of time, observe that. And just remember, we have the rest of the 70% of the time to make up for all our strikes.


About the Author: Dr Sarah Sarkis
Dr Sarah SarkisSarah is a licensed psychologist living in Honolulu, Hawaii. Originally hailing from Boston Mass, she has a private practice where she works with adults in long-term insight oriented therapy. She works from an existential psychology vantage point where she encourages her patients to “stay present even in the storm.”  She believes herself to be an explorer of the psyche and she will encourage you to be curious about the journey rather than the destination.  She emphasizes collaboration, partnership, and personal empowerment.

She approaches psychological wellness from a holistic and integrative perspective. Her therapeutic style is based on an integrative approach to wellness, where she blends her strong psychodynamic and insight oriented training with more traditionally behavioral and/or mind/body techniques to help clients foster insight, change and growth. She has studied extensively the use of mindfulness, functional medicine, hormones, and how food, medicine and mood are interconnected.  Her influences include Dr.’s Hyman, Benson, Kabat-Zinn and Gordon, as well as Tara Brach, Brene’ Brown, Irvin Yalom and Bruce Springsteen to name only a few.

Please visit her website at DrSarahSarkis.com and check out her blog, The Padded Room

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3 Comments

Margaret O'Quigley Psychotherapist

I totally agree with your suggestion of just being with your feelings as they arise not trying to fight back at them. In the case of anxiety I have found it helpful to write down reassuring words as when one is in such a heightened state it can be hard to remember what to say. Words like this to will pass can be helpful. Many thanks

Reply
Peter

Hi I’m confused with the observe your thoughts situation .my mind just chatters away about things, and I don’t really know it’s happing. Then when you realise , and think stop this , it’s to late it’s happened . So how can you observe your thoughts, it has already happened . I don’t think you can observe and think at the same time. Or do you just observe what you have already just thought. After you realise
Thank you for any comments.

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Karen - Hey Sigmund

When you realise your thoughts are taking you away, come back to your present experience – what can you feel, see, hear, taste, smell? Then, try stepping back and imagining your thoughts as clouds. This is a form of mindfulness and is a way to still your mind and pull back from the mental chatter. Here is an article that will help with other strategies http://www.heysigmund.com/different-ways-to-practice-mindfulness/. Hope that helps to make sense of things.

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