Coping techniques
that actually work!
New clients frequently complain about the ineffectiveness of coping techniques they have been taught. Below is a list of techniques that my clients have found to be genuinely effective.
cold water technique
Place your face (and not your body) into cool water for 1-20 seconds. You can do this in a full sink or by pooling as much water as you can into your hands and repeating it several times. A cold compress may also work, but is often not as effective. Make sure to hold your breath and not let water go in your nose. This gives immediate results by quickly deactivating your fight or flight response.
In - sniff - slow exhale
If you have tried breathing exercises in the past and they have not helped, this is very different. Like the cold water technique, the purpose of this technique is to quickly deactivate the fight or flight response. Research shows that it is also as effective as meditation if you do it a handful of times in a row every day. Learn it here.
Texture grounding technique
When you find yourself beginning to dissociate or lose control, grounding techniques can be very effective in keeping you connected with reality. Unfortunately, many of them have not been very effective, at least not in the experience of my clients. There is one, however, that almost always works, and it is very simple. All you need to do is place your palms on two different types of textures (eg., denim of your blue jeans and the arm rest of the chair in which you are sitting) and rub them, focusing on the minute differences between the two textures, temperatures, and any other physical sensations you may notice. Keep doing this until you find yourself no longer pulled away from reality.
Texture grounding technique
When suffering from intense anxiety, my clients have found it very helpful to focus on how you are feeling in the present. Is there any pain or discomfort? Is the temperature okay? Is anything really bad happening to you in the moment? Is there anything you are experiencing right now that is intolerable? Usually, the worst feeling you'll notice is a little tightness in your chest or stomach, which is almost always tolerable. Instead of worrying about the future, focus on being grateful and taking advantage of the current comfort. If the worst happens in the future, all the more reason for you to enjoy the comfortable present while you have the opportunity! Keep doing this until the thing you fear actually happens -- but even then, you may find that much of the time you are still doing okay. This works primarily because the vast majority of the distressful experience is in our heads, both in what we fear will happen in the future and in how we perceive symptoms in the present. In truth, the thing we fear very rarely happens, and even when it does, the actual experience is not anywhere nearly as intolerable as our perception of it tells us it must be.
half smile and open hands technique
This is a strange one, but it has shown to be very effective. So much so, it is one of the most common techniques taught in DBT for distress tolerance. It is very simple, but don't underestimate how effective it can be at reducing the severity of emotional distress. To do it, force your mouth into a half-smile and hold out your palms facing up as though you are open and willing to receive whatever God or the universe has to give you. The half-smile has been shown to increase one's mood, as the brain monitors our facial expressions for clues as to how we are feeling, and will thus put us closer to that mood in order to be congruent with it. The willing hands also require us "letting go" of what we are trying to control, and into a state of "acceptance." This can have a powerful effect on us. Learn more here.
thought records
Thought records is one of the main tools we use in CBT for challenging negative thoughts and beliefs. The easiest way to do it is to go to cbtemail.com and fill out the blanks. It will then email the results to you in the form of a standard thought record, which you can print out and bring to your counselor if you have one. The simple act of going through and writing the thought record, even if you don't save it, can have a major impact on your negative emotion. On cbtemail.com, there are a number of some of the best challenges you can use as inspiration to figure out which challenges work best for you. For many, figuring out the cognition/thought/belief behind the negative emotion or behavior can be difficult. Some struggle knowing the difference between the thought and the emotion. Emotions are one words (eg., sad, anxious, angry, afraid, etc.) and not "I feel like no one likes me." "No one likes me," would be the cognition/belief, and something like "sadness" would be the emotion. Once you can identify the thought/belief, you can learn how to challenge it. Cbtemail.com guides you through this process.
opening up to a friend or support system
This is pretty self-explanatory, but for many today this is difficult. Even those who have friends or a support system, it can be difficult at times opening up to them or asking for help. Think of it this way: If one of your friends came to you asking for help or opening up about emotions they were dealing with, how would you respond? Expect them to respond similarly. If they don't, they aren't really your friend. We humans are made to live in groups of people who help shoulder each other's burdens, and in general people are much more agreeable to help than we think. Don't deprive them of the opportunity to help their friends and feel blessed in the process. Them helping you also benefits them emotionally as well.
Dancing/physical activity
I know, we all need more exercise, and that is not something you want to hear. But here's the thing: Doing exercise because you have to -- whether to lose weight or be more healthy -- is extremely difficult to make yourself do. However, doing a physical activity because it will make you feel better and impact your mood later in the day, is much more positive and easier to motivate yourself to do. Dancing, especially, has been shown to be very effective at increasing mood and lowering negative emotions. Yoga has also been shown to be particularly effective for men, and strength training has been shown particularly effective for women -- the opposite of what you may expect. Some studies even found that physical activity can be as effective as medication for depression. To make this work long-term, it is important to shift your thinking from focusing on making choices based on how you feel in the present, to how you want to feel later. What you choose now is what affects your mood later, and what is affecting your mood right now is what choices you made earlier. In other words, we are living life several hours (even days) behind. Once we start focusing on the future, we will quickly catch up and end up living life in a much better place.
Doing a normally pleasurable activity
Like physical activity, regularly engaging in normally pleasurable activities will affect our mood later. When we stop doing these activities because we don't "feel like it" in the moment, or don't find them pleasurable due to lowered mood, we end up creating a cycle in which we feel even worse in the future. Again, instead of making choices based on how we feel in the present, we need to shift our thinking and make choices based on how we want to feel later. Even if we don't find the activity pleasurable this time, it still has a positive effect on us later, and is very important to helping us dig ourselves out of a depression (or the beginning of one). Do not neglect the activities you normally find rewarding or pleasurable, especially ones you do with other people. Treat these activities like medication -- do not neglect them!
Read or listen to music
For me, the thing that heals me more than anything is music. When I am emotionally shaken or am struggling with strong negative emotions, I listen to a playlist of music I cultivated over the years that I find emotionally healing. Music doesn't have this effect on everyone, but if it does for you, buy some good headphones and cultivate a playlist to listen to when you need your emotions healed. Some of you may find a similar effect in reading books. If that is the case for you, take time out and read whenever em
connect with nature
Research shows a significant effect on our mental health when we are in the proximity of natural "greens and blues," meaning plant and fresh running water. We are designed to be drawn to natural indicators of fresh water and vegetation, as this is what kept our ancestors alive. Having plants in your house and running fountains can help as well, though nothing beats the real thing. Of course, genuine sunlight exposure on your skin (in limited, healthy doses) is not only beneficial, it is a necessity. Sunlight in the morning and in the evening is the most effective as it helps calibrate our biological clock and keeps us in sync with nature.
crying
Sometimes, what we need is to breakdown and cry. Prolonged crying over multiple days is obviously a different issue, especially in cases where days of crying are a regular response (beyond a typical season of grieving, of course). But in most cases, it's important to allow ourselves to have that breakdown. Crying is meant to help heal. Not only does crying have a chemical effect, it also motivates others (who witness it) to want to comfort and help heal us.
isolation (maybe)
While isolation can often make the problem worse, there can be more extreme cases where a temporary sabbatical from people may be needed to recharge. However, it is very important to stay active and creative during this time, and not be stuck at home online or watching TV. It is also important to eventually begin working on having positive social experiences again -- starting slow if need be and working back up to normal levels of socialization.
spiritual practices
For those who are religious or spiritual in some way, prioritizing time spent focusing on prayer, meditation, Scripture, podcasts/messages, or whatever else is helpful to keep you spiritually connected can be very important. Spiritual needs are legitimate needs, and not luxuries. Given that many reading this do not consider themselves spiritual, it is important to clarify and define what exactly this means. Broadly speaking, "spiritual connection" is anything that reminds us on a deep level how relatively small we and our problems are in comparison to something much, much bigger and more important. One atheist friend of mine, for example, had a deeply impactful spiritual experience seeing a complete solar eclipse, as it put his existence in perspective of not just the power and enormity of space, but of the realization that this experience connected him to mankind throughout the history of our species -- the feeling he had witnessing totality was a similar feeling people have felt since their arrival on this planet.
taking a warm/hot bath
A nice hot bath can have a similar effect as a muscle relaxer for me. If getting to sleep is a problem, taking a hot bath right before bedtime can help.
progressive muscle relaxation
While not helpful for everyone, PMR can be very beneficial to those for whom it works. Similar to a guided meditation, PMR helps relax the body when anxiety causes tension. The biggest benefit, however, comes from frequent use, as you learn how to control the tension and relaxation of individual muscles. Eventually, you can target the exact muscles that are in tension as a result of anxiety, and make them relax whenever you need to. You can listen to a great example of a guided PMR session here.
mindfulness training/meditation
To perform mindfulness meditation, you can use an app (though I strongly suggest researching to find one that is science-based, as most are not). Alternatively, you can just follow the directions below:
* Set a timer for 5 minutes (you can increase this later if you like).
* Sit comfortably with your back straight (so you can relax without falling over).
* Keep your eyes open, and focus on the textures of something you are holding or rubbing your hands on.
* Attempt to stay completely in the present moment -- nothing exists before or after the moment you are in (you will fail at this, and that is okay. If you could do it without failing, you wouldn't need the mindfulness training).
* Allow all (physical and emotional) feelings and thoughts to come and go. Simply observe them as though you are an alien experiencing what it is like to be in a body for the first time.
* Try your best not to judge whether any thoughts or feelings are good or bad. Just be curious, and describe your thoughts and feelings/sensations as though you have no idea what they are (eg., there's a tightness in my chest and stomach; the muscles in my neck are contracting). This is the most important step.
* When you notice your mind taking you out of the present or wandering off to other thoughts, simply acknowledge what has happened, let go of that thought, and return your focus 100% to either your breathing or the textures you are feeling.
NOTE: If your mind has wandered, this does not mean you have failed. In fact, it is this very process of recognizing your mind has wandered and returning focus to the present that is helping build the “muscles” of mindfulness. If your mind didn't wander, you wouldn't be able to get the "reps" to strengthen the muscle.