Takes One to Know One

A few years back while at a conference, I met a British psychiatrist named Greg. With his full white beard, glasses, and flowing hair, Dr. Greg very much looked the part of noble psychiatrist – like a gentle, sober Ernest Hemingway.

Greg had an interesting life, in that he treats people with depression or who are suicidal, and yet at many points in his life Dr. Greg told me he’d also been severely depressed and suicidal. He related to me over dinner one evening about his experiences being admitted to a psych ward and his years long battle with mental health issues.

Dr. Greg now had very strict rules for his life, boundaries that he does not stray from lest the Noonday Demon return. No alcohol, regular exercise, strict sleep schedule, a rhythm to his days and weeks that is sustainable. He carefully monitors his thought life to ensure he isn’t spiraling into negativity, and if he is becoming overly pessimistic there is a support system for him to check in with. By setting his life up this way he found himself able enjoy life to the fullest and avoid the darkness that’s plagued him in the past.

Just like Dr. Greg, I’m also a mental health clinician and part of the reason I’m so good at what I do is I’m just about as nutty as the people I’m working with. I have anxiety, I ruminate, I spiral. I’ve been depressed and know what it takes to get through that difficult disorder. It takes one to know one, so the therapeutic prescriptions I give to people are not just something I read in a textbook. It’s stuff I use on myself.

You see, Dr. Greg, myself, and many of my clients have what you might call “low emotional metabolism”. That means that unlike my wife (who has the mental constitution of an astronaut) I have to be more careful about what I take in and how I structure my life. One little slip up and my negative emotions hang off me like a holiday ham.

We all have a certain bent in the way we think. On a scale of 0 to 10, ten being a rainbow colored friendly dragon dancing atop glitter covered sprinkles and zero being the most negative person you’ve ever met, I have a baseline of about 3 or 4. My wife on the other hand is right up there with a solid baseline of 9. When she’s having a terrible day it’s sometimes barely noticeable, whereas on a below average day I seem to be acting out the final scene of Hamlet.

Through much trial and error, I have labored to find strategies for staying positive and healthy. From years as both client and clinician I offer the most helpful 3 things for managing my low emotional metabolism. These are the Cliffs Notes that I give to you, dear reader, for free. If I could get everyone who comes to my clinic to consistently follow these three things, I’d soon be out of a job and working the drive through at Starbucks instead.

Feeling Good: The New Mood Therapy

Therapy is expensive, which makes me wonder how so many open mic comedians are seemingly able to afford it.

Nevertheless, if you’re a normal person like the rest of us, chances are you can’t afford therapy or your insurance plan only offers limited sessions. Therefore, may I present to you perhaps the greatest self-help book ever written.

Dr. David Burns book Feeling Good: The New Mood Therapy (it’s not that new since the book was published in the early 90s) is an introductory manual to using cognitive behavioral therapy for yourself to change the way you think and thereby improve your mood and functioning. For those of us with a negative bias to our thinking and low emotional metabolism, it instructs us on the basics of challenging our overly pessimistic view of life and finding alternative, more helpful ways of approaching the world.

Cognitive behavioral therapy (CBT) is one of the most widely used forms of counseling in the world. Its theories are not overly complicated, but its application is robust. The basic framework for CBT is counterintuitive: your emotions follow your thoughts, therefore what you think is how you will feel. Burns lists 10 “cognitive distortions” or patterns of negative thinking that crop up when we are feeling bad. A list of these can also be found online: 10 Cognitive Distortions

Chances are if you can pick out one or more of these patterns in your thinking it is contributing to your foul mood. Therefore changing the way you think can provide quick relief.

There is so much packed into this book. Of course, it’s even better to work through the material together with a trained therapist, but if you’re on a budget or in an area of the world where services are unavailable, this book is an excellent self-help alternative.

Link to Feeling Good book: https://www.amazon.com/Feeling-Good-New-Mood-Therapy/dp/0380731762/ref=sr_1_3?crid=FY5IRWQV7G7A&dchild=1&keywords=feeling+good+by+david+burns&qid=1633114455&sprefix=feeling%2Caps%2C190&sr=8-3

Meditation

When a person begins taking an antidepressant, such as Zoloft or Prozac, it often takes four to six weeks for the medication to reach its full therapeutic potential. When they ingest that first pill, nothing magical suddenly happens. In the first week or two the person may not notice any positive changes in their mood. Instead, they may only feel the side effects from the medication with none of the beneficial aspects. So in the initial stage of taking medication, things can seem to be getting worse not better.

I wonder if meditation is often a similar process. When you first begin to practice regularly, the sessions uncork all the subconscious mess you’ve been bottling up for years. Thoughts and fears run rampant through your mind as you try to sit in Buddha-like silence. Mentally things seem to get worse before they get better. There’s no magical breakthrough on that first try, but much like medication, if you stick with it for four to six weeks something may begin to shift in you.

I’ve previously written about Centering Prayer – which is a form of Christian contemplative meditation that I try to practice regularly. There are also many books and apps out there for other non-religious forms of meditation, the most widely known of which is probably the App Headspace.

Meditation and medication are only one letter different and funny enough their uses for mental health are also similar. Much like medication, meditation is not an end-all be-all silver bullet for your problems, but rather it provides a stability that enables you to tackle issues more effectively. Just as an SSRI probably won’t fix all your problems, it instead provides a foundation from which to pursue wellness in all areas of your life.

If you’ve been struggling lately with anxiety, depression, or other issues, try a six week twice daily prescription of meditation and see if you don’t notice a difference by the end of the time.

Meditation resources:

Centering Prayer https://www.contemplativeoutreach.org/

Centering Prayer app https://apps.apple.com/us/app/centering-prayer/id844280857

Headspace https://www.headspace.com/

Healthy Rhythms

Now that there is an infant in our house, I’ve been doing some reading on babies. In Tracy Hogg’s outlandlishly named book The Baby Whisperer Solves All Your Problems she teaches us to get babies into a rhythm using the acronym E.A.S.Y. – (1) Eat, (2) Activity, (3) Sleep, (4) You (parent) time.

When a baby is out of rhythm chaos rains in the castle. But even when a baby is in a good rhythm, their rhythms grind against ours.

I apologize for the sports metaphor, but babies are like general managers and parenthood is the most brutal rebuild known to man. They come into your life and fire everyone. All your priorities go on the chopping block, your star preferences traded away for future draft picks. They burn it down to the studs and start over.

Babies do this with their rhythms, which are so foreign to ours. They eat every few hours, sleep most of the day, and want to be held for a majority of the leftover time. You may find there’s very little you can accomplish somedays. Like a college student you’re finally taking a shower at two in the afternoon, but unlike a college student you don’t have hours on end to mindlessly fritter away.

Yet there’s a value to their rhythms interrupting our own. On some level we are forced to take stock of how our life is structured. We are made to reflect on our own daily rhythms, both healthy and unhealthy.

Though we are fully grown now, we are not so much unlike babies and Hoag’s E.A.S.Y. acronym is still highly relevant.

In clinical practice, I find many clients’ mental distress sits atop a shaky foundation of a disordered life. Sleep, diet, exercise, purpose, social connection, and sobriety have all been chaotically arranged in a manner that all but assures the emergence of psychiatric symptoms – anxiety, depression, panic attacks, nightmares. No amount of clever analysis or psychotherapeutic brilliance can substitute for rhythm and balance in life.

For clients with unhealthy rhythms, therapy is like going to the gym to work out with your personal trainer. You can lift heavy weights and run on the treadmill all day, but if all you eat outside of sessions is McDonald’s, don’t be surprised when you don’t lose weight. (Perhaps those with extremely high emotional metabolism will look good regardless, but I’ll be like Morgan Spurlock on day 30)

So, I tell clients (and myself) – maybe take a month off the sauce, go for a walk, get some sunshine, turn off the Lions game. See if your cognitive distortions don’t start to clear up a bit or you feel more motivated to get things done. It’s no secret that what you put in is generally what comes out, so prioritizing sleep, diet and exercise can go a long way towards maintaining a healthy mood. Much like Dr. Greg, maybe we should try finding a good balance before we move on to more complicated solutions.

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All of the above are wonderful, but of course there are times when you may need a little extra push to get back on track. Talking with a therapist can be helpful for anything from processing unhealed traumas to increasing motivation and mood. So, if you or anyone you know needs help finding a therapist, be you in Asia, North America, or Europe, feel free to contact me. And if you’re really struggling with thoughts of hurting yourself or wishing you were dead, say something.

Reach out to a trusted friend, family member, or mentor to get the help and support you need.

Emotional Metabolism