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

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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.

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

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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

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‘Brave’ doesn’t always feel like certain, or strong, or ready. In fact, it rarely does. That what makes it brave.♥️
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#parenting #mindfulparenting #parentingtips
We teach our kids to respect adults and other children, and they should – respect is an important part of growing up to be a pretty great human. There’s something else though that’s even more important – teaching them to respect themselves first. 

We can’t stop difficult people coming into their lives. They might be teachers, coaches, peers, and eventually, colleagues, or perhaps people connected to the people who love them. What we can do though is give our kids independence of mind and permission to recognise that person and their behaviour as unacceptable to them. We can teach our kids that being kind and respectful doesn’t necessarily mean accepting someone’s behaviour, beliefs or influence. 

The kindness and respect we teach our children to show to others should never be used against them by those broken others who might do harm. We have to recognise as adults that the words and attitudes directed to our children can be just as damaging as anything physical. 

If the behaviour is from an adult, it’s up to us to guard our child’s safe space in the world even harder. That might be by withdrawing support for the adult, using our own voice with the adult to elevate our child’s, asking our child what they need and how we can help, helping them find their voice, withdrawing them from the environment. 

Of course there will be times our children do or say things that aren’t okay, but this never makes it okay for any adult in your child’s life to treat them in a way that leads them to feeling ‘less than’.

Sometimes the difficult person will be a peer. There is no ‘one certain way’ to deal with this. Sometimes it will involve mediation, role playing responses, clarifying the other child’s behaviour, asking for support from other adults in the environment, or letting go of the friendship.

Learning that it’s okay to let go of relationships is such an important part of full living. Too often we hold on to people who don’t deserve us. Not everyone who comes into our lives is meant to stay and if we can help our children start to think about this when they’re young, they’ll be so much more empowered and deliberate in their relationships when they’re older.♥️
When we are angry, there will always be another emotion underneath it. It is this way for all of us. 

Anger itself is a valid emotion so it’s important not to dismiss it. Emotion is e-motion - energy in motion. It has to find a way out, which is why telling an angry child to calm down or to keep their bodies still will only make things worse for them. They might comply, but their bodies will still be in a state of distress. 

Often, beneath an angry child is an anxious one needing our help. It’s the ‘fight’ part of the fight or flight response. As with all emotions, anger has a job to do - to help us to safety through movement, or to recruit support, or to give us the physical resources to meet a need or to change something that needs changing. It doesn’t mean it does the job well, because an angry brain means the feeling brain has the baton, while the thinking brain sits out for a while. What it means is that there is a valid need there and this young person is doing their very best to meet it, given their available resources in the moment or their developmental stage. 

Children need the same thing we all need when we’re feeling fierce - to be seen,  heard, and supported; to find a way to get the energy out, either with words or movement. Not to be shut down or ‘fixed’. 

Our job isn’t to stop their anger, but to help them find ways to feel it and express it in ways that don’t do damage. This will take lots of experience, and lots of time - and that’s okay.♥️
The SCCR Online Conference 2021 is a wonderful initiative by @sccrcentre (Scottish Centre for Conflict Resolution) which will explore ’The Power of Reconnection’. I’ve been working with SCCR for many years. They do incredible work to build relationships between young people and the important adults around them, and I’m excited to be working with them again as part of this conference.

More than ever, relationships matter. They heal, provide a buffer against stress, and make the world feel a little softer and safer for our young people. Building meaningful connections can take time, and even the strongest relationships can feel the effects of disconnection from time to time. As part of this free webinar, I’ll be talking about the power of attachment relationships, and ways to build relationships with the children and teens in your life that protect, strengthen, and heal. 

The workshop will be on Monday 11 October at 7pm Brisbane, Australia time (10am Scotland time). The link to register is in my story.
There are many things that can send a nervous system into distress. These can include physiological (tired, hungry, unwell), sensory overload/ underload, real or perceived threat (anxiety), stressed resources (having to share, pay attention, learn new things, putting a lid on what they really think or want - the things that can send any of us to the end of ourselves).

Most of the time it’s developmental - the grown up brain is being built and still has a way to go. Like all beautiful, strong, important things, brains take time to build. The part of the brain that has a heavy hand in regulation launches into its big developmental window when kids are about 6 years old. It won’t be fully done developing until mid-late 20s. This is a great thing - it means we have a wide window of influence, and there is no hurry.

Like any building work, on the way to completion things will get messy sometimes - and that’s okay. It’s not a reflection of your young one and it’s not a reflection of your parenting. It’s a reflection of a brain in the midst of a build. It’s wondrous and fascinating and frustrating and maddening - it’s all the things.

The messy times are part of their development, not glitches in it. They are how it’s meant to be. They are important opportunities for us to influence their growth. It’s just how it happens. We have to be careful not to judge our children or ourselves because of these messy times, or let the judgement of others fill the space where love, curiosity, and gentle guidance should be. For sure, some days this will be easy, and some days it will feel harder - like splitting an atom with an axe kind of hard.

Their growth will always be best nurtured in the calm, loving space beside us. It won’t happen through punishment, ever. Consequences have a place if they make sense and are delivered in a way that doesn’t shame or separate them from us, either physically or emotionally. The best ‘consequence’ is the conversation with you in a space that is held by your warm loving strong presence, in a way that makes it safe for both of you to be curious, explore options, and understand what happened.♥️
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#mindfulparenting #positiveparenting #parenting

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