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)”]

3 Comments

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.

Reply
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 https://www.heysigmund.com/different-ways-to-practice-mindfulness/. Hope that helps to make sense of things.

Reply
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

Leave a Reply

Your email address will not be published.

Follow Hey Sigmund on Instagram

Anxiety is a sign that the brain has registered threat and is mobilising the body to get to safety. One of the ways it does this is by organising the body for movement - to fight the danger or flee the danger. 

If there is no need or no opportunity for movement, that fight or flight fuel will still be looking for expression. This can come out as wriggly, fidgety, hyperactive behaviour. This is why any of us might pace or struggle to sit still when we’re anxious. 

If kids or teens are bouncing around, wriggling in their chairs, or having trouble sitting still, it could be anxiety. Remember with anxiety, it’s not about what is actually safe but about what the brain perceives. New or challenging work, doing something unfamiliar, too much going on, a tired or hungry body, anything that comes with any chance of judgement, failure, humiliation can all throw the brain into fight or flight.

When this happens, the body might feel busy, activated, restless. This in itself can drive even more anxiety in kids or teens. Any of us can struggle when we don’t feel comfortable in our own bodies. 

Anxiety is energy with nowhere to go. To move through anxiety, give the energy somewhere to go - a fast walk, a run, a whole-body shake, hula hooping, kicking a ball - any movement that spends the energy will help bring the brain and body back to calm.♥️
.
.
.
#parenting #anxietyinkids #childanxiety #parenting #parent
This is not bad behaviour. It’s big behaviour a from a brain that has registered threat and is working hard to feel safe again. 

‘Threat’ isn’t about what is actually safe or not, but about what the brain perceives. The brain can perceive threat when there is any chance missing out on or messing up something important, anything that feels unfamiliar, hard, or challenging, feeling misunderstood, thinking you might be angry or disappointed with them, being separated from you, being hungry or tired, anything that pushes against their sensory needs - so many things. 

During anxiety, the amygdala in the brain is switched to high volume, so other big feelings will be too. This might look like tears, sadness, or anger. 

Big feelings have a good reason for being there. The amygdala has the very important job of keeping us safe, and it does this beautifully, but not always with grace. One of the ways the amygdala keeps us safe is by calling on big feelings to recruit social support. When big feelings happen, people notice. They might not always notice the way we want to be noticed, but we are noticed. This increases our chances of safety. 

Of course, kids and teens still need our guidance and leadership and the conversations that grow them, but not during the emotional storm. They just won’t hear you anyway because their brain is too busy trying to get back to safety. In that moment, they don’t want to be fixed or ‘grown’. They want to feel seen, safe and heard. 

During the storm, preserve your connection with them as much as you can. You might not always be able to do this, and that’s okay. None of this is about perfection. If you have a rupture, repair it as soon as you can. Then, when their brains and bodies come back to calm, this is the time for the conversations that will grow them. 

Rather than, ‘What consequences do they need to do better?’, shift to, ‘What support do they need to do better?’ The greatest support will come from you in a way they can receive: ‘What happened?’ ‘What can you do differently next time?’ ‘You’re the most wonderful kid and I know you didn’t want this to happen. How can you put things right? Do you need my help with that?’♥️
Big behaviour is a sign of a nervous system in distress. Before anything, that vulnerable nervous system needs to be brought back home to felt safety. 

This will happen most powerfully with relationship and connection. Breathe and be with. Let them know you get it. This can happen with words or nonverbals. It’s about feeling what they feel, but staying regulated.

If they want space, give them space but stay in emotional proximity, ‘Ok I’m just going to stay over here. I’m right here if you need.’

If they’re using spicy words to make sure there is no confusion about how they feel about you right now, flag the behaviour, then make your intent clear, ‘I know how upset you are and I want to understand more about what’s happening for you. I’m not going to do this while you’re speaking to me like this. You can still be mad, but you need to be respectful. I’m here for you.’

Think of how you would respond if a friend was telling you about something that upset her. You wouldn’t tell her to calm down, or try to fix her (she’s not broken), or talk to her about her behaviour. You would just be there. You would ‘drop an anchor’ and steady those rough seas around her until she feels okay enough again. Along the way you would be doing things that let her know your intent to support her. You’d do this with you facial expressions, your voice, your body, your posture. You’d feel her feels, and she’d feel you ‘getting her’. It’s about letting her know that you understand what she’s feeling, even if you don’t understand why (or agree with why). 

It’s the same for our children. As their important big people, they also need leadership. The time for this is after the storm has passed, when their brains and bodies feel safe and calm. Because of your relationship, connection and their felt sense of safety, you will have access to their ‘thinking brain’. This is the time for those meaningful conversations: 
- ‘What happened?’
- ‘What did I do that helped/ didn’t help?’
- ‘What can you do differently next time?’
- ‘You’re a great kid and I know you didn’t want this to happen, but here we are. What can you do to put things right? Do you need my help with that?’♥️
As children grow, and especially by adolescence, we have the illusion of control but whether or not we have any real influence will be up to them. The temptation to control our children will always come from a place of love. Fear will likely have a heavy hand in there too. When they fall, we’ll feel it. Sometimes it will feel like an ache in our core. Sometimes it will feel like failure or guilt, or anger. We might wish we could have stopped them, pushed a little harder, warned a little bigger, stood a little closer. We’re parents and we’re human and it’s what this parenting thing does. It makes fear and anxiety billow around us like lost smoke, too easily.

Remember, they want you to be proud of them, and they want to do the right thing. When they feel your curiosity over judgement, and the safety of you over shame, it will be easier for them to open up to you. Nobody will guide them better than you because nobody will care more about where they land. They know this, but the magic happens when they also know that you are safe and that you will hold them, their needs, their opinions and feelings with strong, gentle, loving hands, no matter what.♥️
Anger is the ‘fight’ part of the fight or flight response. It has important work to do. Anger never exists on its own. It exists to hold other more vulnerable emotions in a way that feels safer. It’s sometimes feels easier, safer, more acceptable, stronger to feel the ‘big’ that comes with anger, than the vulnerability that comes with anxiety, sadness, loneliness. This isn’t deliberate. It’s just another way our bodies and brains try to keep us safe. 

The problem isn’t the anger. The problem is the behaviour that can come with the anger. Let there be no limits on thoughts and feelings, only behaviour. When children are angry, as long as they are safe and others are safe, we don’t need to fix their anger. They aren’t broken. Instead, drop the anchor: as much as you can - and this won’t always be easy - be a calm, steadying, loving presence to help bring their nervous systems back home to calm. 

Then, when they are truly calm, and with love and leadership, have the conversations that will grow them - 
- What happened? 
- What can you do differently next time?
- You’re a really great kid. I know you didn’t want this to happen but here we are. How can you make things right. Would you like some ideas? Do you need some help with that?
- What did I do that helped? What did I do that didn’t help? Is there something that might feel more helpful next time?

When their behaviour falls short of ‘adorable’, rather than asking ‘What consequences they need to do better?’ let the question be, ‘What support do they need to do better.’ Often, the biggest support will be a conversation with you, and that will be enough.♥️
.
.
#parenting #positiveparenting #mindfulparenting #anxietyinkids

Pin It on Pinterest

Share This