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

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

[irp posts=”2090″ name=”What Butterflies Can Teach Us About the Mind/Body Connection: A Shrink’s Guide to Listening to Your Gut (by Dr Sarah Sarkis)”]

[irp posts=”2283″ name=”Circling the Storm Drain – The Origins of a Narcissist (by Dr Sarah Sarkis)”]

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Feeling seen, safe, and cared for is a biological need. It’s not a choice and it’s not pandering. It’s a biological need.

Children - all of us - will prioritise relational safety over everything. 

When children feel seen, safe, and a sense of belonging they will spend less resources in fight, flight, or withdrawal, and will be free to divert those resources into learning, making thoughtful choices, engaging in ways that can grow them.

They will also be more likely to spend resources seeking out those people (their trusted adults at school) or places (school) that make them feel good about themselves, rather than avoiding the people of spaces that make them feel rubbish or inadequate.

Behaviour support and learning support is about felt safety support first. 

The schools and educators who know this and practice it are making a profound difference, not just for young people but for all of us. They are actively engaging in crime prevention, mental illness prevention, and nurturing strong, beautiful little people into strong, beautiful big ones.♥️
Emotion is e-motion. Energy in motion.

When emotions happen, we have two options: express or depress. That’s it. They’re the options.

When your young person (or you) is being swamped by big feelings, let the feelings come.

Hold the boundary around behaviour - keep them physically safe and let them feel their relationship with you is safe, but you don’t need to fix their feelings.

They aren’t a sign of breakage. They’re a sign your child is catalysing the energy. Our job over the next many years is to help them do this respectfully.

When emotional energy is shut down, it doesn’t disappear. It gets held in the body and will come out sideways in response to seemingly benign things, or it will drive distraction behaviours (such as addiction, numbness).

Sometimes there’ll be a need for them to control that energy so they can do what they need to do - go to school, take the sports field, do the exam - but the more we can make way for expression either in the moment or later, the safer and softer they’ll feel in their minds and bodies.

Expression is the most important part of moving through any feeling. This might look like talking, moving, crying, writing, yelling.

This is why you might see big feelings after school. It’s often a sign that they’ve been controlling themselves all day - through the feelings that come with learning new things, being quiet and still, trying to get along with everyone, not having the power and influence they need (that we all need). When they get into the car at pickup, finally those feelings they’ve been holding on to have a safe place to show up and move through them and out of them.

It can be so messy! It takes time to learn how to lasso feelings and words into something unmessy.

In the meantime, our job is to hold a tender, strong, safe place for that emotional energy to move out of them.

Hold the boundary around behaviour where you can, add warmth where you can, and when they are calm talk about what happened and how they might do things differently next time. And be patient. Just because someone tells us how to swing a racket, doesn’t mean we’ll win Wimbledon tomorrow. Good things take time, and loads of practice.♥️
Thank you Adelaide! Thank you for your stories, your warmth, for laughing with me, spaghetti bodying with me (when you know, you know), for letting me scribble on your books, and most of all, for letting me be a part of your world today.

So proud to share the stage with Steve Biddulph, @matt.runnalls ,
@michellemitchell.author, and @nathandubsywant. To @sharonwittauthor - thank you for creating this beautiful, brave space for families to come together and grow stronger.

And to the parents, carers, grandparents - you are extraordinary and it’s a privilege to share the space with you. 

Parenting is big work. Tender, gritty, beautiful, hard. It asks everything of us - our strength, our softness, our growth. We’re raising beautiful little people into beautiful big people, and at the same time, we’re growing ourselves. 

Sometimes that growth feels impatient and demanding - like we’re being wrenched forward before we’re ready, before our feet have found the ground. 

But that’s the nature of growth isn’t it. It rarely waits for permission. It asks only that we keep moving.

And that’s okay. 

There’s no rush. You have time. We have time.

In the meantime they will keep growing us, these little humans of ours. Quietly, daily, deeply. They will grow us in the most profound ways if we let them. And we must let them - for their sake, for our own, and for the ancestral threads that tie us to the generations that came before us, and those that will come because of us. We will grow for them and because of them.♥️
Their words might be messy, angry, sad. They might sound bigger than the issue, or as though they aren’t about the issue at all. 

The words are the warning lights on the dashboard. They’re the signal that something is wrong, but they won’t always tell us exactly what that ‘something’ is. Responding only to the words is like noticing the light without noticing the problem.

Our job isn’t to respond to their words, but to respond to the feelings and the need behind the words.

First though, we need to understand what the words are signalling. This won’t always be obvious and it certainly won’t always be easy. 

At first the signal might be blurry, or too bright, or too loud, or not obvious.

Unless we really understand the problem behind signal - the why behind words - we might inadvertently respond to what we think the problem is, not what the problem actually is. 

Words can be hard and messy, and when they are fuelled by big feelings that can jet from us with full force. It is this way for all of us. 

Talking helps catalyse the emotion, and (eventually) bring the problem into a clearer view.

But someone needs to listen to the talking. You won’t always be able to do this - you’re human too - but when you can, it will be one of the most powerful ways to love them through their storms.

If the words are disrespectful, try:

‘I want to hear you but I love you too much to let you think it’s okay to speak like that. Do you want to try it a different way?’ 

Expectations, with support. Leadership, with warmth. Then, let them talk.

Our job isn’t to fix them - they aren’t broken. Our job is to understand them so we can help them feel seen, safe, and supported through the big of it all. When we do this, we give them what they need to find their way through.♥️
Perth and Adeladie - can't wait to see you! 

The Resilient Kids Conference is coming to:

- Perth on Saturday 19 July
- Adelaide on Saturday 2 August

I love this conference. I love it so much. I love the people I'm speaking with. I love the people who come to listen. I love that there is a whole day dedicated to parents, carers, and the adults who are there in big and small ways for young people.

I’ll be joining the brilliant @michellemitchell.author, Steve Biddulph, and @matt.runnalls for a full day dedicated to supporting YOU with practical tools, powerful strategies, and life-changing insights on how we can show up even more for the kids and teens in our lives. 

Michelle Mitchell will leave you energised and inspired as she shares how one caring adult can change the entire trajectory of a young life. 

Steve Biddulph will offer powerful, perspective-shifting wisdom on how we can support young people (and ourselves) through anxiety.

Matt Runnalls will move and inspire you as he blends research, science, and his own lived experience to help us better support and strengthen our neurodivergent young people.

And then there's me. I’ll be talking about how we can support kids and teens (and ourselves) through big feelings, how to set and hold loving boundaries, what to do when behaviour gets big, and how to build connection and influence that really lasts, even through the tricky times.

We’ll be with you the whole day — cheering you on, sharing what works, and holding space for the important work you do.

Whether you live with kids, work with kids, or show up in any way, big and small, for a young person — this day is for you. 

Parents, carers, teachers, early educators, grandparents, aunts, uncles… you’re all part of a child’s village. This event is here for you, and so are we.❤️

See here for @resilientkidsconference tickets for more info https://michellemitchell.org/resilient-kids-conference

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