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For A Tigress: How To Stop Fighting And Win.

Jul 10

G’day Cobbers! Oh yes, and something special for you know who…..’Oy mate, the word is the “cook’s” not happy with the “bonzer” of a “blue” you pulled! And now to business. I’m going to attempt to accomplish two objectives at once in this post. First, the present model of delivering mental health services is neither efficient nor likely to survive. One patient sitting in the office with one therapist is just not the most efficient way of delivering mental health services. (How long were you told you would have to wait before you could get an appointment with a psychiatrist or psychologist in your area?) I am going to attempt to provide an argument for a more efficient model of delivering mental health services.

The second objective, to demonstrate this model, will be accomplished by using someone I am presently consulting with, who bears a striking resemblance to most (police) psychotherapy patients, including you. All you will learn about her identity is that she is, as you have gathered, female and a police woman. I am about to introduce a psycho-educational model to you by addressing her case in an extremely general fashion. The details of her situation and the prescriptions I make could really fit most of you.

Before we begin, allow me to offer the same proviso that I usually do when I address therapeutic issues. I am not prescribing what I write about for you. I am not your therapist. I simply want to present information. However, what I write about may give you some insight into a different way of addressing painful emotional issues.

And as for you my Tigress, do you remember when I told you to stabilize your attention in the present moment; and that when you were able to stop struggling you would become free, confident, and at ease? What is about to follow is the “how it works” part. Remember how the tiger walks with confidence? She never questions her stripes! She has relaxed into the confidence that she is exquisitely equipped to exist and survive on this planet. She doesn’t need to win the lottery of life!!!! Only to survive!!!!!!!!!

OK here we go, buckle up, it’s gonna’ be one helluva’ ride. My Tigress, can you imagine a psychotherapy that does not have as its’ central objective the reduction or elimination of symptoms, yet achieves this very thing as a by-product? I want to present you with an overview of such a psychotherapy in this article. A psychotherapy that has been very rigorously researched (see Hayes, S.C, 1996; 1999; 2001; 2002; 2003; 2004) and comfortably targets values, forgiveness, acceptance, compassion, living in the moment, and learning how to access an often confusing facet of self (transcendence).

Acceptance and Commitment Theory (and Therapy) is a practical application of mindfulness based treatment that flies in the face of most Western Psychological theory. My Tigress, you are already aware that when working with a trained ACT therapist you will at times use such things as mindfulness, paradox, metaphor, and many other experiential exercises; at times even the use of exercises to identify and surface your personal value system.

The objective of our work together my Tigress, is to assist you in the cobbling of a meaningful life while accepting the fact that pain will be an inevitable part of that product. This approach to psychotherapy is based upon assisting you to take effective action guided by your deepest values in which you are fully present and engaged. This is difficult for some to accept and understand, however it is only through mindful action that human beings can create meaningful lives. And in the creation of such a life, you will inevitably meet challenges, not in the form as those facing our jungle cat, but certainly painful emotion, ugly thoughts, bad memories, and a plethora of other uncomfortable private experiences. It is the objective of this approach, to give you a set of mindfulness skills that have been proven effective and powerful to apply to the inevitable challenges of being human.

Are you still there my Tigress? I think it is time for a brief explanation of mindfulness. Think of your awareness as the beam of light thrown off by a spotlight used to light the sky at major events held at night. The more that beam of light shrinks in diameter, approaching that of a pen-light, the less stuff it can have in its’ beam, the more refined and pointed the area lit up becomes. It is the same with your awareness , or attention. Mindfulness is living in the moment, engaging in the “now”, or to use our example, there is less in your awareness to distract you; fewer thoughts, fewer feelings, fewer memories, etc. When you even begin to do this you are starting to let your thoughts and feelings come and go, to be as they are, in opposition to trying to control them. When you just observe your “inner world” openly, receptively, and most importantly objectively, even the most painful memories, thoughts, feelings, and sensations can seem less important and hurtful. Practicing mindfulness can alter your relationship with those angry thoughts and painful feelings (related to how you have been treated) in a way that makes them less important and less influential over your life in the present.

While we are on the topic of mindfulness, I’ll add that there are more ways to develop it than just formal meditation; and before we are done I’ll introduce you to all of them. They range all the way from traditional meditation to something called “cognitive defusion”.

To many, what I am about to say is confusing; the approach we are taking, unlike traditional Western Psychology does not target symptom reduction or elimination as a desired goal or a sign of success. The research on this method has demonstrated convincingly that it is the consistent fight to eliminate symptoms that created the disorder (e.g. depression, anxiety) in the first place; that’s right, the battle to be well is a major contributor to the origin and maintenance of the disease in the first place. Do you recall the set of symptoms that you manifested following the treatment you received at work? Well, as soon as you or a mental health professional labelled your response as “symptomatic” you likely entered into a campaign to rid yourself of them, as something called a symptom is by definition “pathological”; something to be rid of as soon as possible. One of our major thrusts (if you decide to accept this assignment) will be to reframe your relationship with what you previously identified as symptomatic, into a relationship with transient psychological events that can be uncomfortable at times , but really quite harmless in the long run. (And guess what? In most cases symptom reduction comes about as a by-product; they seem to bother you less as you are no fun….you won’t respond.)

Still there Tigress? Unlike more traditional Western approaches, our method doesn’t subscribe to the assumption of a “healthy normality”. You and I take the perspective that psychological pain is not abnormal in the human condition and that most psychological disorders do not spring from unusual or pathological processes. Actually if you have a read of current statistics in this area you will see that in any year approximately 30% of the adult population will struggle with a psychiatric disorder. The World Health Organization has recently estimated that depression is among the top 3 largest, most costly, and debilitating diseases in the modern world. It seems that in any week of the year at least one tenth of the world’s population is suffering clinical levels of depression, and one in three will suffer from it at some point in their lives. Moreover, one in four adults at some time during their life span will battle a serious addiction to drugs or alcohol. There are now around 30 million alcoholics in the US alone. Nearly one in two people will consider suicide at some point in their lives. Finally consider the many adjustment problems that don’t really qualify as mental illness e.g. meaninglessness, loneliness, the anxiety associated with sexism, racism, bullying, domestic violence, and divorce. It is well supported that even though we enjoy a higher standard of living than at any other time in the past, psychological suffering is all around us.

Now my Tigress reach down deep and hang on tight for I am about to tell you something that you and many others always knew but were hesitant to agree with; that is, the psychological processes of the human mind are often destructive and can be a significant source of human misery. Moreover, you and I can see that the source of this misery is human language. It is readily apparent that our ability to communicate (e.g. words, images, sounds, facial expressions) can be utilized in two domains; the public and the private. Quite simply, you can speak and/or write (public) and you can think and/or visualize (private). The psychological term for the private use of language is “cognition”. Think of how you have used both, especially the “private” to compound a normal human response into pathology.

As the human mind doesn’t appear to be a thing we can grasp, that is an organ like a kidney or a heart, but more like a set of complex cognitive processes including planning, visualizing, analyzing and evaluating that all rely on language, the word “mind” could serve as a metaphor for human language itself.

While human language has been key to the development of the human race allowing us to learn, plan, predict, imagine, create, communicate and thrive as a community, it has a dark side. We also use it to incite hatred, plan violence, deliver injustice, act with prejudice; to fabricate weapons of mass destruction; to lie and manipulate; to slander and libel; to depress ourselves; and to make ourselves anxious by attempting to predict the future.

The result of this is the assumption that it is human language that is at the root of all human suffering. Are you listening my Tigress? Recall that last assignment I gave you? Fully 97% of it was compounding verbiage designed to make it all go away. I ask you……did it work or did it serve to make you feel more hopeless? Has it ever worked? Quite simply it is our ability to anticipate and solve problems reflected in the process of “experiential avoidance” that has provided us with what could be viewed as our single greatest evolutionary advantage. The heart of this problem solving skill is the dual ability to identify problems and to figure out how to defeat them. For example my Tigress, in your work you set your sights on an area of policing that was of great interest to you. You recognized that you lacked training and experience (the problem). You extended yourself and got the finest training available, and then put it to work to gain a wealth of experience working in the area, and to become an expert in the field (the solution). As this problem solving approach works so well in the external world, it is only natural that you would try it in your internal world; your world of thoughts, feelings, urges, and memories. Tragically, like the rest of us, when you tried to rid yourself of the feeling of being mistreated……when you tried so hard to “fill that hole in [your] soul”, you began to create extra suffering for your self.

It seems almost counter-intuitive that the more effort you exert in an attempt to rid yourself of the painful emotion you experience, the more you are likely to create it. The broken heart you experience is a good example. (Dear Tigress, I know you think you are just plain angry–but from my perspective, the anger simply covers a broken heart; a heart broken by a job and an organization that you loved.) It isn’t really the presence of sadness that has fueled the depression you have experienced for years. Think about it!! Sadness is something we all experience when we lose something we value. At the heart of your depression is the obsession with avoiding or getting rid of it. Paradoxically, the more you make of shaking the depression (I know, I know, sometimes it only sounds like getting your employer to admit they mistreated you, but really this is just another strategy to escape feeling so sad) the more emphasis you place on not being sad and the sadder you become at your inability to “get happy”. You, my magnificent Tigress, are caught in a vicious circle that lives at the centre of all emotional disorders. (What is suicide, if it is not feeling extremely sad, and hopeless, about being so sad?).

The approach we are using focuses on an alternative to “experiential avoidance” through the use of a handful of therapeutic interventions. You my magnificent Tigress, like all of your wounded soul-mates want to rid your self of your depression, your anxiety, your grief, your anger, your traumatic memories etc., etc. You may have noticed as they have, that when you work with me, there is no effort made to avoid, eliminate, reduce, change, control, or suppress these internal experiences. Rather, we attempt to mitigate these uncomfortable thoughts and feelings through the effective use of mindfulness as I have earlier explained it. I want you to learn how to stop fighting your internal experiences…..rather, to open yourself to them. I want you to learn that the more you push against your “private hell”, the more it will push back. In other words, you compound and make permanent some thing that naturally would come and go on its’ own.

When you embrace the well founded approach that I am putting forward, you devote yourself to a couple of main tenets: 1) You accept that unwanted, painful experiences are out of your control (think about it, how successful have you been so far) and, 2) you commit yourself toward actively living a valued life. (And what do you think happens to those painful symptoms, just because you pay them no mind?).

Would you like to take a look at some of the core interventions that may occur in a therapy session? In outlining them here, I am suggesting (recall the idea of psycho-education?) that you can learn to monitor your own experience. After all you are no less synchronized with the greater uncontrolled universe than any other organism in it. You don’t stand apart seeking control. You are an expression of it all and have command now of your little piece……something that the Tigress seems to know intuitively.

My exquisitely equipped Tigress, I am sure you are at least somewhat familiar with the “motivational interview”? If so, you will recognize that when your interviewee behaves as you did in your response to me by outlining those times when you were “…….truly devastated, dejected, and wounded…” as a result of the way you were treated by your employer. You were beginning to go down a path of attempted “emotional control” that had not worked previously and most likely would go on this time with no productive outcome. Riddle me this my lovely Tigress, when your garden is continually dry and arid, is it best to continually complain about it? Water it, if you have the resources? Or maybe move to another location? When you hear yourself attempting to avoid or rid yourself of painful internal experiences (and sounding like a broken record by replaying failed strategies, you can gently and respectfully disrupt this wasted motion by asking yourself, “Has this constant complaining reduced my symptoms over time?” ; “What has this wasted motion strategy cost me in terms of time, health, vitality, energy, productivity, relationships, self esteem, reputation?” ; or, “Has this strategy brought me closer to the life I want for my cub and I?”

If you really devote yourself to something different you will discover that none of your strategies have worked across time. No real reduction in sadness, anger, anxiety, or bitterness; just huge costs levied against you and your cub, in terms of your collective health and happiness. So here is the place where most would list all the other emotional control strategies they have used, measure their long term effectiveness and costs to their lives. I’m guessing that you really have no other strategies except “experiential avoidance” and the costs associated with this strategy far outweigh the benefits, and even you see that it is time to “do something different”.

So now that you have unmasked your misguided strategy, what’s next? May I suggest that you might want to increase your awareness that emotional strategies are the real enemy! The key to your “enlightenment” is to recognize that the more you use your emotional control strategies to manage how you feel, you just trap yourself in a cyclone of ever increasing suffering. Some of the metaphors coined by colleagues much more astute than I include; “quicksand”, and “the struggle switch”. My own offerings are the notions of “pure discomfort” and “dirty discomfort”. I’m sure dear Tigress you can see the wisdom in this madness; how many times have we witnessed someone fall into the quicksand? We all know by now what struggle will produce. The more she struggles the faster she will go under! The idea of the “struggle switch” is clearly illustrated. The lesson is clear, don’t compound your initial emotional response with a secondary emotion; when caught in quicksand, turn off the “struggle switch”, know things could be worse and that, “Life isn’t about waiting for the storms to pass, but about learning to dance in the rain”. When you accept the normalcy of any primary emotion (e.g. anger, depression, anxiety) and refuse to fight it, it is now free to rise and fall to fit the demands of context. This is the “pure pain” we spoke of earlier. You can’t avoid it, life is full of “pure pain”. If you have neglected to turn off the “struggle switch”, now you will create “dirty pain” and a world of hurt for yourself. Now comes the ineffective attempts at emotional control including the abuse of sex, food, alcohol, drugs, smoking, gambling; and of course beating up on yourself, endlessly ruminating, blaming others, and so on, and so on.

When you reach an understanding of what has gone before, my magnificent Tigress, you have at least begun to question your previous agenda of “emotional control”. Next in line are the basic principles. I shall save them for a future article.

“Don’t push the river, it flows by itself”.

Dr. Mike Webster
Reg’d Psych (#0655)

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3 Comments
  1. Heather Gray permalink

    This is a crucial and necessary new age way to deliver desperately needed services to many people who are suffering from debilitating injuries/illnesses (PTSD et al). It’s revolutionary delivery mechanism is simplistic in appearance but complex in its layering and, in the hands of a highly skilled and talented psychologist, potentially highly successful for those who choose to embrace it. The road to wellness could now be accessible to many who access it…….easily.

  2. Anonymous permalink

    Thank you Dr. Webster, your article came at just the right time. I understood this a few months ago, but allowed myself to get sucked back in to this negative cycle as a tribunal has been approaching and in the preparation I had to go through the whole experience again. I want a new location as you describe the arid ground, and I understand the quicksand. I also understand exactly what you describe as the struggle switch. I consciously applied it at one point and I don’t know why I allowed myself to forget it. Your article sums it all up. I’ve seen enough. My job is not serving me anymore and I want out and I’m going to make it happen. Even saying that makes me feel brand new.

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