Are You Moving Towards or Away From Your Best Self?

“What choice do I have but to live through this terrible time?” I have often heard, with a sigh of resignation, or even submission perhaps. It is often assumed that if adversity strikes us, especially if it is beyond our control, then we might as well just cave in, and wait for the difficult moment to pass, often plagued with severe bouts of anxiety and depression. The helplessness makes every moment even more heavy, like a burden you want to get rid of but it just clings on, the more you struggle. And so the loop of misery, despair, and a sense of powerlessness continues to dance to the most nerve jangling tunes.

There is an intervention from the therapeutic model of Acceptance & Commitment Therapy (ACT) called the choice point, credited to Dr. Russ Harris (2017)* which I love because of how it illustrates to someone that however difficult a situation may be, we DO have a choice in how we respond to it every moment. And that could make all the difference in our attempt to attain psychological equilibrium, to not just be functional, but also to be effective and live a life that is worth living.

I like roadmaps, and this is like one of them. Let me tell you how.

You want to visit your dear friend who you haven’t seen in years because she lives in another city. You have always valued this friendship and are now looking forward to seeing her, except she is in a part of town you have never driven to before. So you whip out Google Maps, plug in the address and off you go. In your mindful, attentive state, you keep following directions, making “towards” moves to the chosen destination. But when your mind veers off, or you take a call in the middle of the drive, you miss a turn here and there and end up making “away” moves which takes you away from your desired destination. Yet you persist, through traffic, rain, and masticating cows in the middle of the road, because you are so driven by the goal of meeting your cherished friend. It’s as simple as that.

The choice point is something similar. 😊

I’ll explain using an example of a wonderful woman I have the privilege of working with in therapy. No personal details are mentioned here to protect her identity and maintain confidentiality.

Maya (name changed) has been struggling with severe depression which has impacted her in all major life domains (personally where the self-critical thoughts “I’m not good enough,” “I’m worthless,” feelings of guilt, and lack of self-compassion made her spiral into a low sense of self-worth; interpersonally having withdrawn from friends and prefers being isolated; vocationally being unable to find the motivation to attend important meetings, increased absenteeism, procrastination, and an inability to focus). Her self-care routine had been severely affected, where insomnia struck, coupled with night eating syndrome, making her gain weight and further launching into more self-loathing. Her relationship with her husband and child was severely affected.

When someone is as depressed as Maya, not knowing where and how to begin piecing their lives can be a challenge. The inertia is like quicksand, making you feel like there is no coming up for air. And that’s where it starts with the most basic choices we start exerting.

Let me explain the concept behind the approach before I show you how Maya applied it.

Here’s how it starts. (The script is adapted from Dr. Harris’ work):

Every moment of every day, we are doing things: getting to work, taking care of family, watching Netflix, listening to music, doing some physical activity, engaging in a hobby…that’s what we humans do. We are interacting with life in some way or the other, even if it means wallowing in bed. Some things we do, or would like to do, that make us move towards the optimum life that we would like to lead – being in charge of ourselves, acting efficiently, behaving in accordance with the kind of person we would like to be – those are called “toward” moves.

There will be some things we do which take us away from the kind of person we would like to be, from the kind of life we would like to live, which make us act ineffectively, causing us distress which we may not be aware of, and those are called “away” moves.

When life is going well, things are easy and smooth, and our course is not strewn with obstacles, we get what we want, and it is so straightforward and easy for us to make towards moves. We act adaptively, we treat ourselves and others just right, and we engage in activities and with life that bring about optimal outcomes. But don’t we wish that life was a smooth sail all along? But the reality is, life just isn’t as rosy and easy most of the time, and it doesn’t work in accordance with our wishes and hopes all the time either. So as we go along, we are faced with difficult situations that bring us down, and all sorts of difficult thoughts and feelings arise.

Have you noticed how we get so easily “hooked” to these thoughts and feelings? We latch on to them, we get jerked and pushed around, the mind goes into a tizzy, and we go completely off track which then makes us do more away moves. The things we value doing fade away in the backdrop, and the thoughts and feelings take centre stage. Have you noticed, with those of us who have experienced any form of stress, anxiety, depression, trauma, addictions, that the basis of our distress is getting hooked to these difficult thoughts and feelings and doing away moves?

If we are mindful enough or build that self-awareness that we can unhook from these thoughts and feelings we tend to get back on track and lead our lives in a way that we value and cherish. We get back to behaving effectively, of relating to others, of living a life of purpose. And the more we do this, the better we get at living a good life.

And this is where I ask, when you are faced with all these difficult and challenging situations, and are being pulled apart by these sapping thoughts and feelings, you know we have a choice, right? A choice of how we will respond in this given situation. And the choice is between the following two: Would you like to unhook and do more towards moves? Or would you like to continue to feel overwhelmed and helpless, remain hooked and do away moves?

For most of us, who have rarely observed the impact of thoughts on ourselves and know that we can dive into interventions, it is easy to get hooked and as a result do more away moves. But we can develop unhooking skills, we can introspect and do some soul searching and get clarity on what truly matters to us, where our internal compasses point to, where our North star lies. Having this clarity about our lives makes it easier to keep reminding ourselves that we have to make towards moves. It gets easier and we become more hard wired to choose what will serve us better rather than what will take us apart.

And so we dive into skill building in our therapy sessions. We learn to identify our guiding values which motivate our behavior to lead a life we choose for ourselves. We learn unhooking skills that help us respond to difficult thoughts and feelings in an adaptive way, while we also focus on taking charge such as problem solving, action planning, (active) acceptance, surrender, being assertive, being self-compassionate, and whatever else your self-care tool kit needs based on your own unique situation.

You know, right? We have a choice to work situations through, either through trying to change it, or to respond to it by taking charge of what you can, by yourself. The more towards moves we make, the more our life is one of quality, meaning, purpose, and well-being. Happiness extends from all of this organically.

Back to Maya now.

I asked Maya what difficult situations, thoughts, and feelings was she experiencing. Relationship difficulties for the past 12 years were bogging her down. Her husband was dependent on alcohol, he was recently unemployed, and she had to bear responsibility for providing for her family which included her 8-year-old daughter. Her thoughts centred around feelings of hopelessness. “Things will never get better,” “What’s the point of living like this?” “I must be worthless to not receive the love I deserve.” “I am not good enough because I always get a raw deal in life.”

The associated feelings were of despair, sadness, crippling anxiety, anger, frustration, hopelessness, and helplessness. Which further led to “I don’t feel like doing anything.” “I don’t have the energy or the motivation to do something worthwhile.” The downward spiral continued.

The “away” moves were dancing to a nice tune: Absenteeism from work, emotional eating and binge drinking, demotivated to take care of her child, neglect of grooming, lying in bed all day, long tearful spells that often lasted for days.

We worked on discovering what truly mattered to Maya, what she deeply cared for in her heart. What kind of a person did she want to be? Who were the important people in her life and how did she want to relate to them? What strengths did she want to develop? What obstacles did she want to work through? What excited her about life? What did she want to do with the remaining time she had of her existence? Questions like these truly bring on some deep soul-searching.

She spoke about wanting to become better at managing her own emotions, of dealing with crises and bouncing back to life, of wanting to set effective boundaries so that she was not on the receiving end of abuse, of being a compassionate, caring, loving mother, of focusing on physical and emotional health and well-being. She wanted to stop the avoidance of feared situations, and become a better team player at work, and to show up, whatever distress and state of mind she may be in. Just. Show. Up.

The first priority was to learn “unhooking” skills and Maya and I worked on mindfulness activities that would aid in the process. She had a range to choose from, and we finally zeroed in on what would help her truly centre and anchor herself in the midst of an emotional storm. These were the first set of “towards” moves.

Maya started sleeping on time, and waking up on time, and started exercising 5 days a week, even if for 20 minutes to begin with. She realized how good the exercise felt and notched it up to 30-45 minutes. Getting her child ready and ensuring she attended the online classes on time became her next task, along with logging in to her work and taking accountability. She was beginning to take charge. The intention and action of taking charge, of believing in her own self and the importance of who she wanted to be, became excellent catalysts to bring the transformation. Bit by bit, step by step, Maya started recovering from her depression and taking effective action to manage her relationship with her husband. It still is work in progress for her.

In sessions Maya would often say that whenever she was faced with a difficult situation, thought or emotion, her default question to herself was, “I have a choice to respond to this situation so that I come out with an effective resolution. What “towards” moves can I make?” and that always spearheaded her taking charge. Small wins every day.

Then again, when you’re moving towards being your best self, there are no small wins, are there? :)

We find ourselves chained and restrained by our difficult thoughts and feelings and feel we have no control over them. “If only these thoughts would stop,” is what I would often hear as an earnest request in therapy. But these thoughts are relentless, and they plough and plunder, and that’s when I would like you to remind yourself: That you have a choice, to let go of the shackles that you find yourself bound with, to choose to respond effectively, to focus on your North star, to move towards the best possible version of yourself. You owe it to yourself!

(*Choice Point 2.0 is presented here and is credited to Dr. Russ Harris (2017), adapted from the Choice Point by Bailey, Ciarrochi, & Harris (2013), proponents of the Acceptance & Commitment Therapy (ACT).)            

The Power of Hope in the Midst of a Pandemic

“What is there to hope for, to look forward to when I am surrounded with so much misery, pain, and suffering?” She asked me, and I, as her psychotherapist had to help her navigate that question.

You may be one of us, who have lost loved ones, or known of people who have lost someone precious to Covid-19, the illness that has ravaged the world, and has India in its vice like grip since the past three weeks and counting. It’s relentless and savage, and is costing us a lot more than we ever imagined. We are experiencing a range of emotions from anger, sadness, anxiety, grief, frustration, helplessness, and yes, hopelessness, in times like these.

From frantic searching for beds in hospitals, to dealing with the acute shortages of life saving medical supplies, to the lack of space, privacy and time to conduct cremations, to dealing with grief as losses hit closer home, with some family members being in different countries who can’t even fly to India to pay their respects one last time. How gut wrenching is this? Really, it is a legitimate question: Is there a silver lining, something to hold on to?

I return to the question asked of me. “What is there to hope for?” A concept I had initially observed, and then researched, and attempted to instil as a rehabilitation psychologist in my sessions with people with spinal cord injuries, and which has been one of the bedrocks of my therapy work till today.

Is hope just another word from the pop psychology realm? A false “feel good” emotion that may not have lasting effects and may bring us crashing down when another rough wave comes?

On the contrary, if you truly see its virtue, hope can be like that lighthouse that brings ships home, even in the most turbulent of seas. When we are surrounded by grim scenarios, grief, suffering, and gloom, hope is that panacea that makes a person balance their present reality, however distressing it may be, with better expectations and outcomes in their days to come, however painstakingly long and evasive it may seem. One persists, and prods and uses hope as a crucial coping mechanism in the face of unrelenting crises, to somehow keep finding the motivation to achieve what is meaningful for them, to salvage a situation, or to keep fighting for a better tomorrow, for themselves and/or their loved ones.

Here are my suggestions on how to bring about hope in your everyday living, as India and the world unite against a deadly virus.

1. It is a natural response to experience anxiety, panic, confusion, numbness, inability to focus and problem solve when a crisis hits. When your mind gets stuck in this state, it triggers off a chain reaction. Fear and panic start to narrow your field of vision and cloud your attention, and it becomes harder to access your internal resources, to see the bigger picture, and what needs to be done to take charge. Please focus on calming and clearing your mind, on regulating your emotions and centering yourself using whatever means have worked for you previously. Mindfulness meditations, breathing exercises, a time out, exercise or any physical activity, journaling, talking to someone and finding a support system are highly recommended, in addition to any techniques that you may have tried before. To be able to tackle a situation at hand, you need to mobilize yourself towards problem solving mode while simultaneously working on reining your emotions in.
   

2. Hope is in reality a motivational state, which involves the interplay between goal directed energy, also known as your sense of personal agency, and the pathways you chalk out to meet those goals. I have known of people who have offered necessary support to their loved ones who are quarantined at home and are living at a distance. From identifying delivery of food and medical supplies as goals, to devising ways and means to accomplish those goals (dropping off at doorsteps, delivery services, identifying doctors to consult etc.), as well as working through obstacles to make sure the said goals are met, people have been working round the clock. Resident Welfare Organizations (RWAs) have stepped in to procure medical supplies and oxygen concentrators for their severely afflicted residents, who are being managed by doctors who live in that neighborhood. People have formed helplines and phone trees to enable quicker access to hospitals. A hope for recovery and survival is what directed their energy and made them spring into action. Identify your goals, energize yourself to meet those goals and find ways to get there, for yourself and your loved ones.
   

3. Take charge of some key aspects of your lives as you go through this phase of helping others and reeling under the impact of the pandemic. It will enable you to have some semblance of control, and a feeling of “normalcy”, and autonomy as well. People have struggled to keep up with work, academic, and home routines as they are constantly pulled into several directions of either helping someone, or feeling helpless at the losses they hear about. Cut yourself some slack, be self-compassionate, but take charge wherever you can.  I would highly emphasize kicking in a self-care toolkit that enables you to enhance your sense of well-being across all domains (spiritual, emotional, physical as priority), finding your focus to take charge of work, and also restricting the excessive inflow of news and updates from social media. I am not asking you to avoid facing reality of what’s happening around, but if you are one who is on all possible social media networks, check if it is making you more anxious, depressed, frustrated, and hopeless. And if the answer is yes, then you need to do something about it.
   

4. Grieve your losses if you have experienced them directly or indirectly. It’s OK to cry, to express your anger, to make space for your heavy heart and the bereavement you may be experiencing. Everyone has their own way of feeling the impact of grief. Please don’t suppress it or put it on the back burner or resist feeling them. Emotions need to be worked through because sooner or later they may come up in insidious ways and impact you psychologically. And to bounce back, to be resilient, and to enhance your ability to manage things, grief must get its due.

5. Build your psychological resilience. In challenging times, managing our minds that increases our ability to keep surfing turbulent waves becomes crucial so that we are able to take charge of the crisis at hand. My first question to myself when a crisis hits is: “What can I do to tackle this problem?” It then trickles down to: “Is there something that needs committed action? And if the situation can’t be changed, can I accept what’s beyond my control and take charge of what is?” The struggling medical infrastructure in Delhi especially is beyond anyone’s control at this point. Can I still provide solace and comfort to those who are caught in the grip of it? Can I make space for the grief and helplessness that comes by and let it ease through my mind and body? Can I still bring myself up to providing support as much as I can? All these factors are in my control and I choose to take charge of them.
   

6. Extend compassion to others. We are all overstretched, burnt out, and tired. We are unable to meet our loved ones because of lockdowns in place. But see if you can reach out to people more virtually, with the intention of being compassionate. Ask yourself, “How can I help this person to have a better day?” It could just be to share their burdens, to listen empathetically, to stand next to them in solidarity, to just say you care. Now is the time when we need each other the most. Be the beacon of hope for others by being there. People recognize the efforts we make for them even if they don’t have the desired outcome because the situation is beyond our control. You may also find yourself looking for comfort and solace from people who may be overworked, responding to the needs of the pandemic, or taking care of their own crises, and who may not be there for you physically. They could use some empathy and compassion too. They may want to be there, but they also are tied down by limits on their time and psychological & physical resources.

7. Ask yourself how you are coping with the crises that are affecting you? Maladaptive/ineffective coping looks like this: “Why me?” “Life always treats me badly.” “I have no clue how to deal with this.” “There is nothing I can do.” “The system is to blame.” “I must be strong at all times.”

   Adaptive coping makes you take on responsibility and look for options. You try to take charge of the situation and your emotions as much as possible. It looks like this: “What can I do to make things better?” “What have I learned in the past that will help me get through this?” “How do I want to be in this situation?” What can I do to take care of my own needs in this situation?” “What should I invest my energy in and what should I not?” “If there is nothing I can do, what can I do?”

   We all differ in the ways in which we deal with challenging life events. What stands in front of us today is a common force that we have to contend with. While some of us may give up and experience intense, chronic distress, others persist and face life’s biggest challenges with hope and resilience. The mind expands, our eyes open to what stands in front of us, we acknowledge the crisis, we calm our fears down, and we see possibilities for ourselves and others which may bring us a ray of hope even through the darkest clouds.
   

   However stormy the skies may be, a rainbow emerges as a prism that disperses iridescent light in several directions. It manages to lift our spirits and makes us marvel at the possibilities that emerge. Hope is the same – our mind’s very own personal rainbow.
   
   And so, I urge you to choose hope. Every time. Now. And in the future. Despite the odds.