"Phenomenal cosmic powers ..."

Medicine has had its moments of magic, like the polio vaccine and penicillin, where the discovery practically wiped out a major health problem. Some believe the “magic” of medicine may have reached its limit and advancement now will be in people actively working to prevent illness through the choices they make, such as nutrition and exercise.

The moments of magic may have misled many people into being passive about their healthcare and constantly looking for a new approach or a new medication without careful thought as to how the new treatment makes sense and why the old treatment isn’t working.

People often ask, “What did the doctor do?” rather than “What are you doing?” when change is needed.

Therapy has been viewed as magical as well. Some saw it as “flawed” magic and may still see it as ineffective. In the early years of its development, the therapist was viewed as the expert and the client was not expected to understand the process. Limited information was shared with the client. The therapy and what the therapist did was seen as main change agent.

The science of therapy has come a long way in the past few years. In many therapies today, the relationship between therapist and client is not hierarchical, but equal. The “magic” of therapy is not in the client’s problems being changed by going to therapy, but by the client making behavior changes based on the knowledge and understanding of the problems and possible solutions that he gains from working together with the therapist. It’s hard work for the client.

Therapists may teach many specific strategies about how to manage emotions. However, change does not come from reading or listening. Change comes from the client truly learning and practicing  the strategies taught. If you go to a skills group or therapy session but don’t ask questions, think of how to apply the skills, and don’t practice the skills, very little is likely to change. Unfortunately you may then believe the therapy didn’t work and feel more hopeless about your situation. Your misery is likely to increase. No one wants that result.

To make the most of the knowledge your therapist gives you, consider the following strategies when learning emotion regulation skills.

1.  Aim for a complete understanding. Ask questions. Think about how you would apply the information or skill to various situations in your life. If you aren’t sure how the skill applies to you, ask for help.

2.  Learn the skill completely. Being able to state the definition of a skill does not mean you know how to use the skill. Memorizing the words is not true understanding. Try explaining the skill in detail to a friend or to your mirror. Also do the skill multiple times until you are clear about how to use it. Expect learning skills to be hard work.

3.  Ask about what you don’t understand. If you don’t know the meaning of a word that is being used, ask. Consider the skill being taught and consider what would be good questions to ask. Think of questions. If you are in a group setting, listen with the idea that you will ask at least one question each time you attend. You may find yourself being more actively mindful of the material.

4.  Practice with less difficult situations first. Waiting for a crisis to apply emotion regulation skills is like watching and reading about how to drive a car but never trying until you need to rush a sick family member to the hospital.  Practice when the bus is late, when you have to stand in line, when your favorite dessert is sold out, when you are on hold for a customer service rep, and when you don’t stick to the new nutrition plan you committed to. Then when you have to cope with your best friend moving or the neighbors spreading gossip about you, you will have practiced.

5.  Cherish those times when the skill doesn’t work. The times when you aren’t successful in managing your emotions effectively give you a lot of information. Think through what happened, what you could do differently. Understanding why it didn’t work will give you needed information for future successes. Look closely.  Sometimes what seems obvious is not the issue at all.

6.  Change your social support group.  Unfortunately, it is true that if you surround yourself with people who overeat, you are likely to overeat. If you surround yourself with people who drink to numb their feelings, you will see that as normal. If you are hanging out with people who are not using effective coping skills, you are less likely to practice the skills yourself. Consider looking for connections with people who are using effective coping skills.

7.  Expect your first efforts to be clumsy and awkward. When learning new skills, our first efforts are not likely to be close to being on target. Emotion regulation skills take time to learn, just like it takes time to learn the piano or how to play golf. Drop the perfectionism and jump in! Consider your first efforts to be like a rough draft. Taking the first steps, seeing what you did that worked and what didn’t, is the key to making the skill yours and truly knowing how to use it.

8.  Keep a willing and open mind. Sometimes when people hear information they have heard before, they are quick to reject the information. “I already knew that and it didn’t help,” is a common reaction to input that isn’t new. Remember though that just having heard the information before is different from truly and completely understanding the skill and actively practicing the skill. Be willing to try the skill multiple times and make changes as necessary before rejecting it.

Being open to new ideas, even ones that don’t seem new or helpful, also gives you the opportunity to think of new ideas yourself. One idea seems to flow into others. If you shut down ideas with all the reasons they won’t work,  it is difficult for new thoughts to come to you.

9.  Expect the skill to have more usefulness and effectiveness over time. Changes in your life will take time. Using the skill in one instance may be helpful, but the major changes you will see will come from using skills effectively over months and years. The decisions you make, the confidence you develop and adding positive experiences instead of destructive ones to your life will have a ripple effect much later. Major changes are usually achieved by making small steps, one at a time.

Being an informed, active participant in your healing is more difficult than taking a pill or a magical cure but it’s more realistic, at least at this time. Being active in your sessions, knowing the research behind the therapy you are participating in and practicing new skills will help you achieve the changes you want to make.

Hopefully in the near future we’ll have an emphasis on prevention skills in mental health, just like is developing in health care for the body.

Note to Readers:  Healing Hearts of Families is a Houston conference for those with borderline personality disorder and their families and friends. Please join us on November 10 for informative presentations by experts in the field.

My sincere thanks to everyone who has completed our second survey. If you haven’t participated, please consider answering the survey questions about being emotionally sensitive.

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