As a clinical psychologist, Mary Pipher, PhD, designed “healing packages” for her patients: activities, resources, and comforts to help them recover from trauma. Then, after Dr. Pipher’s book Reviving Ophelia became a runaway best-seller, she herself suffered from an episode of major depression and designed a healing package of her own. “The essence of my personal healing package,” she describes in her book Seeking Peace, “was to keep my life as simple and quiet as possible and to allow myself sensual and small pleasures.” She created a mini-retreat center in her home and modified the ancient ways of calming troubled nerves to fit her lifestyle. Pipher’s healing package looked like this:
She accessed the healing power of water by walking at Holmes Lake Dam, swimming at the university’s indoor pool, and reading The New Yorker magazine in the bathtub every morning.
She cooked familiar foods, dishes that reminded her of home: jaternice, sweetbreads, and perch; and cornbread and pinto beans with ham hocks.
She unpacked her childhood teacup collection and displayed it near her computer desk to remind her of happy times and of people who loved her.
She reconnected with the natural world by walking many miles every week on the frozen prairie, watching the yellow aconites blossom in February and the daffodils and jonquils in March, following the cycles of the moon, and witnessing sunrises and sunsets.
She read biographies of heroes like Abe Lincoln, and read the poetry of Billy Collins, Robert Frost, Mary Oliver, and Ted Kooser.
She found role models for coping with adversity.
She limited her encounters with people and gave herself permission to skip holiday gatherings and postpone social obligations. She erased calendar engagements until she had three months of “white space” in her future.
She embraced her body through yoga and massage. She started to pay attention to tension in her neck and other cues from her body and let those signals teach her about herself.
She meditated every day.
These activities were exactly what she needed to emerge from the other side of depression. She writes:
“After taking care of my body for several months, it began to take good care of me. My blood pressure improved and my heart problems disappeared. After a few months of my simple, relatively stress-free life and my healing package of activities, I felt my depression lifting. I enjoyed the return of positive emotions: contentment, joy, calmness and new sparks of curiosity and energy. I again felt a great tenderness toward others.”
Psychiatrist James Gordon, MD, discusses similar healing packages in his best-selling book Unstuck. At the end of his first meetings with all of his patients, he will write out a “prescription of self-care,” which includes instructions on changing diet, advice about specific recommended meditations or exercises, and a list of supplements and herbs. “Among my recommendations, there are always actions, techniques, approaches, and attitudes that each person has told me — which she already knows — are helpful,” he explains. At the end of his introduction, he suggests each reader take some time to write out his or her own prescription. He supplies a form and everything.
Each person’s healing package is unique. Many people have benefited from more meditation and mindfulness exercises, psychotherapy sessions, and therapies like Eye Movement Desensitization and Reprocessing (EMDR) that help unclog the brain of painful memories. Some people do better with more physical exercise and nutritional changes. While mindfulness and meditation have certainly helped many become aware of my rumination patterns, the most profound changes in others recovery have come from the bags of dark, green leafy vegetables, yoga, and breathing exercises.
It’s empowering to know that we don’t need a doctor or any mental health professional to design a healing package for us. We are perfectly capable of writing this prescription ourselves. Sometimes (not always), all it takes are a few simple tweaks to our lifestyle over a period to pull us out of a crippling depression or unrelenting anxiety.
We all know the uncomfortable feeling of anxiety. Our hearts race, our fingers sweat, and our breathing gets shallow and labored. We experience racing thoughts about a perceived threat we fear will be too much to handle. That’s because our “fight or flight” response has kicked in, resulting in sympathetic arousal and a narrowing of attention and focus on avoiding the threat. We seem to be locked in that state, unable to focus on our daily chores or longer-term goals. Below are six strategies that you can use to help relieve your everyday anxiety:
- Reevaluate the probability of the threatening event actually happening.
Anxiety makes us feel that a threat is imminent, yet most of the time what we worry most about never happens. By recording our worries—and how few actually came true—we can notice how much we overestimate the prospect of negative events.
Even if a bad event happened, we may still be able to handle it by using coping skills and problem-solving abilities or by enlisting others to help. Although not pleasant, we could still survive encountering a spider, having a panic attack, or losing money. It’s important to realize that very few things are the end of the world.
- Use deep breathing and relaxation.
By deliberately relaxing our muscles we begin to calm down so we can think clearly. If you practice this at first without a threat present, it can start to become automatic and will be easier to use in the moment when you face a threat. Deep breathing engages the parasympathetic nervous system to put the brakes on sympathetic arousal.
- Become mindful of your own physical and mental reactions.
The skill of mindfulness involves calmly observing our own reactions, including fear, without panic or feeling compelled to act. It can be taught in therapy and improves with practice.
- Accept fear and commit to living a life based on core values.
Acceptance and Commitment Therapy (ACT) is an approach that encourages people to accept the inevitability of negative thoughts and feelings and not try to repress or control them. By directing attention away from the fear and back onto life tasks and valued goals, we can live a full life despite the fear.
Exposure is the most powerful technique for anxiety and it involves facing what we fear and staying in the situation long enough for the fear to habituate or go down, as it naturally does. Fear makes us avoid or run away, so our minds and bodies never learn that much of what we fear is not truly dangerous.
I often work with groups I have never met before. When I walk into group I start to evaluate and access right away. For psych-educational groups I mostly focus on do I need to pull out a handout or not. That decision depends on the openness of the folks. Do they greet me verbally, with postures and/or gestures, eye contact, expressions of thoughts/feelings, where and how they are sitting.
In most places I have worked I would facilitate an anger management group. I used a variety of handouts and activities to have a process oriented group interaction. One of the handouts I use is below. I use it in 1 of 2 ways. I have folks fill it out first and then we discuss or we discuss while filling it out. Both ways we explore as a group, learning from each other.
anger disgust grumpiness rage aggravation dislike hate resentment agitation envy hostility revulsion annoyance exasperation irritation scorn bitterness ferocity jealousy spite contempt frustration loathing torment cruelty fury mean-spiritedness vengefulness destructiveness grouchiness outrage wrath
Prompting Events for Feeling Anger
Not having things turn out the way you expected.
Experiencing physical pain.
Experiencing emotional pain.
Being threatened with physical or emotional pain by someone or something.
Having an important or pleasurable activity interrupted, postponed, or stopped.
Not obtaining something you want (which another person has).
Interpretations That Prompt Feelings of Anger
Feeling that you have been treated unfairly.
Believing that things should be different.
Rigidly thinking “I’m right.”
Judging that the situation is illegitimate, wrong, or unfair.
Ruminating about the event that set off the anger in the first place, or in the past.
Experiencing the Emotion of Anger
Feeling out of control.
Feeling extremely emotional.
Feeling tightness or rigidity in your body.
Feeling your face flush or get hot.
Feeling nervous tension, anxiety or discomfort.
Feeling like you are going to explode.
Muscles tightening. .
Teeth clamping together, mouth tightening.
Crying; being unable to stop tears.
Wanting to hit, bang the wall, throw something, blow up.
Expressing and Acting on Anger
Frowning or not smiling; mean or unpleasant facial expression.
Gritting or showing your teeth in an unfriendly manner.
A red or flushed face.
Verbally attacking the cause of your anger; criticizing.
Physically attacking the cause of your anger.
Using obscenities or cursing.
U sing a loud voice, yelling, screaming, or shouting.
Complaining or bitching; talking about how lousy things are.
Clenching your hands or fists.
Making aggressive or threatening gestures.
Pounding on something, throwing things, breaking things.
Walking heavily or stomping; slamming doors, walking out.
Brooding or withdrawing from contract with others.
After effects of Anger
Narrowing of attention.
Attending only to the situation making you angry.
Ruminating about the situation making you angry and not being able to think of anything else.
Remembering and ruminating about other situations that have made you angry in the past.
Imagining future situations that will make you angry.
Depersonalization, dissociative experience, numbness.
Intense shame, fear, or other negative emotions.
I often work with groups using lists. In creative arts therapy as well as educational and process oriented groups lists are a great framework to explore thoughts, and/or feelings. Here is a list that often comes up in groups: ten suggestions about feelings.
1. Become emotionally literate.
Label your feelings, rather than labeling people or situations.
Use three word sentences beginning with “I feel”.
“I feel impatient.” vs “This is ridiculous.” I feel hurt and bitter”. vs. “You are an insensitive jerk.”
“I feel afraid.” vs. “You are driving like an idiot.”
2. Distinguish between thoughts and feelings.
Thoughts: I feel like…& I feel as if…. & I feel that
Feelings: I feel: (feeling word)
3. Take more responsibility for your feelings.
“I feel jealous.” vs. “You are making me jealous.”
Analyze your own feelings rather than the action or motives of other people.
Let your feelings help you identify your unmet emotional needs.
4. Use your feelings to help make decisions
“How will I feel if I do this?” “How will I feel if I don’t?”
“How do I feel?” “What would help me feel better?”
Ask others “How do you feel?” and “What would help you feel better?”
5. Use feelings to set and achieve goals
6. Feel energized, not angry.
Use what others call “anger” to help feel energized to take productive action.
7. Validate other people’s feelings.
Show empathy, understanding, and acceptance of other people’s feelings.
8. Use feelings to help show respect for others.
How will you feel if I do this? How will you feel if I don’t? Then listen and take their feelings into consideration.
9. Don’t advise, command, control, criticize, judge or lecture to others.
Instead, try to just listen with empathy and non-judgment.
10. Avoid people who invalidate you. While this is not always possible, at least try to spend less time with them, or try not to let them have psychological power over you.
“Some of us have so many voices in our heads, we could hold group therapy by ourselves,” said Rokelle Lerner, a popular speaker and trainer on relationships, women’s issues, and addicted family systems.
This internal chorus is often composed of voices from our family of origin, voices of critical teachers or bosses, voices from past relationships or current situations. Often these voices are drowned out by our own voice nagging, reprimanding, berating, but rarely praising us.
“In times of stress or chaos, the voices grow louder and it’s easy to go numb,” Lerner once told the audience at a Hazelden Women Healing Conference. “We become estranged from our purpose and our passion. Our response is fear, and our reaction is an attempt at control.” We frequently become children again during times of stress — reverting to old and unhealthy patterns that were present in dysfunctional families or relationships. Our boss becomes our mother, the vindictive coworker becomes the childhood bully. Although we are adults, we feel like vulnerable children, and this vulnerability puts us at risk for depression, substance abuse, or other addictive behaviors.
“We need to ‘grow ourselves up’ when we feel little,” said Lerner. Growing up is about setting appropriate boundaries and limits and turning from reactivity to creativity. “Without boundaries, we all react to the past and retreat to family patterns,” said Lerner. Boundaries communicate “what I value I will protect, but what you value I will respect.”
Lerner said that growing up is about maintaining dignity and integrity, and being “authentic” with ourselves — a skill that takes practice and preparation. It’s about learning how or whether you want to “show up” in a situation, how you want to communicate what you need or want to say, and then taking the consequences for what you say and do. It’s also about listening attentively and with respect. When people communicate clearly, directly, honestly, and sensitively, they are learning to speak from the best part of themselves to the best part of others, said Lerner.
“Healthy adults learn how to make appropriate requests, how to set limits, and how to take action,” said Lerner. She gave an example of a skateboarder who taunted a woman by skating too close to her, knocking the newspaper she held out of her hands. The woman at first reacted explosively by yelling and calling the adolescent every derogatory name she could think of. He just laughed and walked away. Overcoming that first raw reaction, she called him back, this time explaining in a much calmer voice, “What I meant to say is that you scared me. I thought you were going to hurt me.”
“If you can’t identify your emotions right away, at least you can control your behavior,” said Lerner. This “fake it ’til you make it” approach is one of the first things people recovering from addiction learn. It often requires counting to 10, breathing deeply, or excusing yourself until you feel more in control. Reacting reflectively rather than reflexively opens the door for honest interaction.
Boundaries differ for each individual and for each situation, but run along a continuum from “too intrusive” on one end to “too distant” on the other. The trick is to pay close attention to your instincts and feelings so you can strike a healthy balance in relationships that will honor your own boundaries. If an interaction feels inappropriate or uncomfortable, the chances are a personal boundary is being tested or crossed or a need is not getting met.
The more we practice sifting through all the voices in our heads, tuning into and trusting the one clear voice within that guides and protects us, the better we will get at identifying and respecting our own personal boundaries. We will also get better at developing strategies to take the best possible care of ourselves when we feel our boundaries are being violated. We discover how outlets like mutual-help groups, hot baths, long walks, and prayer or meditation feed our soul better than drugs or alcohol. We discover how good it feels to be a grown-up.