No matter how hard we try, and no matter how much distress it causes us, there will be situations we cannot change.  This is where we can use Reality Acceptance Skills.  This is a concept developed by Marsha Linehan, who created Dialectical Behavior Therapy (DBT).

The whole idea behind this is that if we have truly tried to problem-solve, and there is no way to change the situation, we will create more suffering for ourself if we refuse to accept reality:

Pain + Acceptance = Pain

Whereas:  Pain + Non-Acceptance = Pain Compounded

Acceptance means -

• Accepting the facts, not an assumed reality based on blind-spots
• Accepting our limitations
• Accepting there is an identifiable cause and effect for most things
• Accepting the situation all the way, with your heart and mind and body
• Accepting with grace and a good heart
• Accepting the truth that rejecting reality does not magically change that reality

Chris Warren-Dickins, Psychotherapist
Ridgewood, New Jersey
www.exploretransform.com

Panic attacks are terrifying and debilitating.  You cannot breathe, your head spins, your limbs are buzzing with energy, and you are sweating like a pig.  At the time you believe that you are going to die, but you don’t.  You are sure that you have something physically wrong with you (perhaps your heart or lungs), but the doctors can find no cause for all of this.

Without any explanation for this, you start to do some of the following things -

• You avoid things because you are terrified that the panic attacks could come on at any moment,
• You become overly dependent on someone for things that you once could do alone,
• You become isolated, physically, and emotionally.

Each time you look back and realize that this is your mind playing tricks with you, rather than a serious physical health concern.

But there is hope for change.  With a bit of guidance, we can help you to -

• Feel the panic less intensely,
• Experience panic attacks less frequently,
• Regain a sense of control over your life,
• Stop avoiding things that you fear might trigger a panic attack, and
• Accept the occasional panic attack.

To plan for the next panic attack, here are some things to consider -

• Physical health? - Are there any physical reasons why you experienced the symptoms of shortness of breath, a spinning head, or sweatiness.  It is worth ruling out any physical health issues, and it is worth reflecting on any substances or stimulants that may contribute to this (caffeine, excess sugar, nicotine, etc).

• Psycho-education - After you have ruled out any physical health issues, it can help to understand why you experience a panic attack.  Your brain has an alarm system to alert you when things go wrong.  You need that alarm system, so your blood can pump faster and get the heck out of there if there is an actual threat.  So, in a way, we should be thankful for this alarm system, because without it we would be in trouble.  We just need to find ways to reset the alarm, so that it doesn’t keep going off for no reason.

• Simple as ABC. Knowledge is power, so you need to track when the panic attacks occur, and why.  A simple log called the ABC log can help you record the following -
  • A is for Activating Event - For example, you were at the supermarket and you started to panic because you thought people were staring at you, and that made your heart race because you feared you might trip and fall and embarrass yourself, and then your mind started to think about getting COVID because you noticed some people not wearing their masks properly, and then you feared that you were going to pass out in front of everyone, which would be mortifying.
  • B is for Beliefs and assumptions - In this example, you assume people are staring at you, and even noticing you in the first place.  You are probably also assuming that they are thinking negatively of you.  You are also assuming that you are at high risk of COVID, and you are assuming that people will judge you for tripping or passing out.
  • C is for Consequences.  This is where you would record the behavioral and emotional consequences.  For example, you may end up leaving the supermarket and returning home without any of the groceries, and along with the panic and anxiety, you are frustrated at yourself for letting your fear of the supermarket get to you.

• I challenge you to a duel.  Once you have recorded the when, where and whys of your panic attacks (in the form of your ABC log), I can help you to identify unhelpful thought patterns and challenge your assumptions.  For example, I could help you to develop a more compassionate voice instead of that harsh critic who assumes that everyone is judging you.  I could also challenge your tendency to catastrophize, and I would do this in two ways -
  • Firstly, how likely is it that the ‘catastrophe’ is going to happen?  Give it a percentage: Is it ten percent likely, fifty, seventy, or one hundred percent likely?
  • Secondly, how bad is that supposed ‘catastrophe’?  On a scale of 0-100, how distressing would it be to trip over?  It may initially feel like an 80 or 90, but when you compare it with other things that could go wrong (for example, a loved one dying), you may realize that the fear of tripping over is actually a 10 out of 100.
  • Only when you stop and realize that this is something that is not very likely to occur, and/or even if it did, isn’t as distressing as other things, you can start to gain perspective.  You can then train your body to react more proportionately (and save the heart pumping and sweating for the stuff that is almost certainly happening, and likely to cause a 90 or 100 level of distress). 

• ​Calm your body, ease your mind.  In previous blogs I have outlined the various ways to calm your body, which in turn will ease your mind, and help you to assess a situation more rationally.  Here are just a few examples (with links to the relevant exercises) -
  • The Four Elements exercise (including visualizing a Safe Place)
  • The Light Stream exercise
  • Square breathing
  • Diaphragmatic breathing
  • Progressive Relaxation

• Exposure and positive coping statements.  Panic and anxiety are made worse when we avoid what makes us anxious.  Gradually, slowly, stop avoiding the things that are triggering your anxiety.  For example, if you get anxious around people in a supermarket, you could start by imagining each stage of going to the supermarket.  You can develop positive coping statements such as ‘I am strong enough to handle this’, and you can use the above-mentioned body-calming exercises to prepare yourself.  Once you have imagined each stage of the event, and you have kept your anxiety levels within a reasonable range, try one stage of the exposure.  For example, drive to the supermarket parking lot.  Try the next stage and the next, continuing to use your body-calming exercises and positive coping statements, until you have conducted a successful trip to the supermarket with only moderate anxiety.
• Stop, Look, and Listen.  One of the most helpful things about panic and anxiety is to focus outwards, away from your own bodily sensations.  Panic is often fueled when we feel a racing heart or sweaty palms, and then our mind starts to race, and then we focus even more on our thoughts and bodily sensations.  Try and take a moment to focus outwards, and even describe everything and everyone you see. 
• Mind your Mindfulness.  I have covered the basic principles of Mindfulness in other articles, but in brief, these include -
  • Using present-moment awareness to anchor yourself in the present, not fearing a future unknown. Usually, you would use your breathing, but if you have found that this makes your panic attacks worse, focus on the texture of your clothes or skin as you gently touch your arms and legs.  Or focus on the colors and textures of objects around you.
  • Non-judgmental acceptance of whatever anxious emotions and thoughts may be arising.  Don’t give them fuel by following them; just let them drift away like bubbles.
• The Past is Present.  Sometimes things that have happened in your past can have an impact on your panic attacks in the present.  For example, I once worked with someone who grew up in a household where anger was not tolerated.  As a result, this client worked hard to repress their anger at every opportunity.  The trouble was that all this repressed energy had to go somewhere, and they ended up having panic attacks instead of assertively communicating their anger.  We had to slowly work through this conditioning and they eventually learned that feeling angry was an acceptable emotion.
• Plan for relapse.  You aren’t going to manage this perfectly the very first time, so this means you might experience another panic attack.  Make plans for this, and reflect on what you learned, rather than making it into a catastrophe.  Some people find it helpful to make a list of the above-mentioned strategies and carry that list around with them (either on their phone or on a small card in their pocket).  This will be a personalized list of strategies that you have found helpful - there is no one-size fits all. For example, the list might include:
  • Positive coping statement:  ‘Solid feet set apart, solid mind and solid heart’
  • Focus on the colors and textures of your surroundings
  • Square breathing (and remembering to pause between sets, and notice that pause)

Panic attacks are scary at the time, but they do not have to rule your life.  There are simple tools for you to use and regain control of your life, and if these do not help, there are treatments such as EMDR (Eye Movement Desensitization and Reprocessing therapy) that can help.  Either way, you do not have to continue to struggle.

Chris Warren-Dickins LLB MA LPC 
+1 (201) 779-6917
www.exploretransform.com

Life is a balancing act between acceptance of the status quo and trying to achieve change.  Depending on your personality, you may lean more towards one rather than the other.  For example - 

• If you like to remain active, and you have a tendency to become impatient, you may jump quickly to change things.  This might have helped to project you through a successful career, but has this energetic tendency cost you anything?  Has your impatience alienated loved ones, or perhaps made your children feel stressed?
• On the other hand, if you have a calmer personality, you may not act when you need to.  Have you found yourself stuck in an unfulfilling career, or unable to leave an unhealthy relationship?  This may be enough for you, you may be willing to settle for second best, but what sort of example are you setting your children?

Find out how you can strike a healthy balance between acceptance of the status quo, and achieving the change you need.  This often involves skills from a type of therapy called Dialectical Behavior Therapy (DBT), and here are a couple of examples - 

1. Check the facts - Sometimes we act (or fail to act) without getting a clear picture of what is going on.  We may have blind spots, or we make assumptions based on gut-level emotions.  Take the time to assess whether you have all the facts to make an informed decision about whether to accept the present reality, or to achieve some sort of change.

2.  Mindfulness - Sometimes we react to old stuff.  We avoid making changes, or we act too quickly, because we are reacting to our past experiences.  The trouble with this is that we limit our potential, because we are not the same person as we were in the past.  We may have many more strengths and resources to use, so we need to focus on the present reality and assess what we need to do.  One way to do this is to practice mindfulness skills.  One includes simply describing to yourself what you are noticing in the present moment.  Use your breath to keep yourself anchored in the present, and describe each aspect of this present issue.  Notice the thoughts and emotions that come up, but do not jump to act until you have a clear picture of the present reality.

3.  Distress tolerance - We sometimes act (or avoid acting) because we are afraid of the discomfort we anticipate.  Sometimes that discomfort never materializes, and even if it does, we end up realizing that we are able to withstand it. When I work with clients, I like to use the term 'surfing the urge'; if we experience an emotion we were previously trying to avoid, we often notice that the emotion peaks but then it subsides.  When our brain experiences this, we get a visceral experience of riding that emotion, and (more importantly) an experience of surviving that emotion.  This is an important learning process, and it shows us that we are stronger than we think.

This is just a few examples of the skills you can develop, and I hope you found these useful.  If you need to find out more about striking a balance between acceptance and change, get in contact today.

Chris Warren-Dickins LLB MA LPC 
+1 (201) 779-6917
www.exploretransform.com

Emotions help us to communicate to others, and they also motivate us.  Listen to your emotions - they may tell you something important.  For example -

• Sadness tells you that you need to mourn certain losses, helping us to recognize what is important
• Fear helps us to respond to potential threats
• Love helps us forge union and a sense of belonging
• Guilt helps us to evaluate whether we have violated any of our values
• Anger allows us to address something that might be obstructing an important goal

Therapy can help you to identify your emotions, and then figure out what those emotions are trying to communicate.  We can then help you to work out what to do about those emotions.

• First, we need to work out if your emotions fit the facts.  This is where we would identify any distorted assumptions or blind spots.
• If your emotions fit the facts, we can work out how you act on them.  This usually involves problem-solving, and this is easier to do with the help of a trained professional.
• if your emotions do not the facts, or it would be unwise to act on them, we can identify ways to regulate those emotions.  This usually involves taking opposite action (for example, if you are sad you could engage in activities that usually make you feel positive).

Chris Warren-Dickins, Psychotherapist
Ridgewood, New Jersey
www.exploretransform.com

Six shades of emotion regulation -

1. Increase present-focused emotion awareness
2. Develop flexibility in your thoughts and assumptions
3. Identify patterns of emotion avoidance
4. Develop awareness and tolerance of bodily sensations
5. Gentle, gradual exposure to the things you avoid
6. Increase your tolerance of those emotions

Chris Warren-Dickins, Psychotherapist
Ridgewood, New Jersey
www.exploretransform.com

​Let's debunk these myths about emotion regulation - 

• It is wrong to feel these emotions, especially anger
• Your emotions contain no useful information
• Emotions prevail over thoughts
• You are a hostage to your emotions, so they cannot change
• If you succumb to your emotions, you will be overwhelmed
• We need to regulate all emotions

The truth is that there is no right or wrong about your emotions, they just exist.  It is what you do with them that dictates the right or wrong of emotions, including anger.

It is important to pay attention to your emotions because they contain important information about what needs to change.  But you need to balance this information with your rational mind.

You don’t have to be a hostage to your emotions; they can change by learning about emotion regulation.  Part of this includes an awareness that emotions (given the right conditions) peak and then subside.  You don't have to become overwhelmed by them.

You can change your emotions by developing skills in emotion regulation, but you only need to regulate the ones that are unhelpful.  This is a useful guide to what emotions are helpful and unhelpful -

• You should regulate emotions that cause more problems than benefits (you can carry out a pros and cons exercise to assess this)
• You should regulate emotions that lead you to act against your values
• You should regulate emotions that are in conflict with your goals

Chris Warren-Dickins, Psychotherapist
Ridgewood, New Jersey
www.exploretransform.com

Stress, anxiety, anger, depression, hopelessness, despair… These are all emotions that can seem to be out of your control.  When they become intense, you can end up feeling trapped and alone.

Here is one way to take control of your emotions, and it comes from Dialectical Behavior Therapy (DBT), an approach developed by Marsha Linehan.  Quite simply:  If you are feeling stress or anxious or angry or depressed or hopeless or whatever other emotion, Check the Facts.

How to Check the Facts

• Take care to describe the event that is making you so stressed or anxious or depressed or whatever the emotion was.
• Use all your senses to do this
• Avoid making any assumptions
• Try not to polarize and end up making black and white statements or value judgments.
• Resist the urge to catastrophic
• Consider carefully what thoughts and interpretation you are making about the event
• Check whether your emotions (and its intensity) fit the facts.

If your emotions do not fit the facts, or it is not wise to act on your emotions, you need to act opposite to your emotions.  For example, if you feel intensely angry at your boss and you have chosen not to communicate this anger (because there is nothing that can change about your job), you will need to force yourself to do everything that would be the complete opposite to what your emotions are telling you to do.  This could include some or all of the following -

• Force a smile whenever you see or think of your boss  
• Force yourself to think positive thoughts about him
• Engage in subtle muscle relaxation (an exercise called Progressive Relaxation is useful here.  Find out more about this exercise)
• Try and leave the room for small breaks so you can build up tolerance around him (or reduce the pressure when you are around him)
• Distract yourself by redirecting your attention to things that engage your attention in a positive way

Alternatively, when your emotions fit the facts, problem-solve instead of acting opposite.  You can find out more about problem-solving here.

Let me know how you get on with this.  If you still need help, get in contact.

Chris Warren-Dickins, Psychotherapist
Ridgewood, New Jersey
www.exploretransform.com

Your brain is a marvelous thing; it has many different layers and functions, and this offers us an opportunity to be flexible and creative when it comes to resolving your problems.  

A useful starting point with all of this is to understand our brain in three different ways - 

• We have a Rational Brain (capable of planning and logic), 
• We have an Emotional Brain (you can probably guess what this is capable of), and
• We have a Survival Brain (enabling us to fight off or flee a perceived threat)

When you work with a therapist to resolve problems, we can help you by using one of two approaches to therapy:

• Top Down Therapy - This means we target our unhelpful thought patterns to make us feel better.  For example, we might use Cognitive Behavioral Therapy (CBT) to identify a tendency to catastrophize (you assume the worst about a situation).  Once you are aware of this tendency, we can help you to assess whether it is really a catastrophe or whether it is a matter of anticipated discomfort.  Finally, we help you to prepare for this anticipated discomfort by identifying your strengths and resources.
• Bottom Up Therapy - This is where we help you to change your bodily sensations and feelings to change your thoughts.  For example, we can use Eye Movement Desensitization and Reprocessing therapy (EMDR) to help your body to let go of distressing memories that may be held in your body.  In turn, you are able to let go of unhelpful thoughts about yourself (for example, 'I am unsafe' or 'I am out of control'), and you can start to look for more adaptive ways to view yourself and the world around you (for example, 'I have ways of keeping myself safe').  You can find out more about EMDR here.  

Whichever the approach, we are here to help you.  Get in contact today.

Chris Warren-Dickins, Psychotherapist
Ridgewood, New Jersey
www.exploretransform.com

When I work with clients in conflict, often we need to clarify what constitutes abusive behavior.  Sometimes there is a reluctance to categorize non-physical abuse as abusive, but it can be no less harmful.

To label behavior ‘abuse’ can help someone make an informed choice about what they need to do next.  Often this decision-making process is informed by someone’s values and the pros and cons involved.  Once someone sees that the other person’s behavior is abusive, this can often tip the balance so that someone takes steps to keep them safe.

Psychologist Beverly Engel offers the following pointers to decide whether the behavior amounts to abuse -

• Domination - A desire and will to control as much as possible; how you think, what you do, how you do it, and how you feel
• Verbal assaults
• Abusive expectations in the form of incessant demands
• Emotional blackmail, usually in the form of silent treatment
• Unpredictable responses, so that you never know what is going to be a good or bad day
• Incessant criticism so that you lose faith in yourself
• Character assassination, so that little mistakes feel like you are endlessly causing catastrophes
• Gaslighting so that you tricked into believing that what is true isn’t really true
• Constant chaos, so that even when it is calm you feel as if you have to walk on eggshells
• Sexual harassment
• Financial abuse

Engel points out that these behaviors constitute abuse if they are

• Intended to devalue the other person, and
• Intended to dominate the other person, and
• Persist for the majority of time, not occasional

If you need help with this, get in contact today.

Chris Warren-Dickins, Psychotherapist
Ridgewood, New Jersey
www.exploretransform.com