Soup
Counselling - General
hart caplan

Are feelings facts?

Here, a feeling is, in actuality, a fact. Let me make a stronger claim: all feelings are facts. They are facts in the same way that the table I am sitting at currently is made of wood and that I am a psychotherapist. All are part of the same category of thing we call facts.

Distracted
ADHD
hart caplan

A Critical Review of an adhd classic: Driven to Distraction

But there is a central issue that I have with the literature on adhd, and this is a problem with this book and with the field more generally. My issue is this: why distraction? Or perhaps the question could be asked in the following way: distraction from what?

Announcement - Orange
Counselling - General
hart caplan

Nightingale’s Senior Clinician Matching Assurance (SCMA)

We are pleased to announce that starting on Monday, July 24, 2023, we will be launching a new way that clients will begin their therapeutic relationships with Senior Clinicians (Senior and Directorial Clinicians) at Nightingale Counselling and Research.

The “Stress Container” Explained, Part I

The Stress Container makes easy sense for most of us when we think of our own daily processing of normal stress, but this model actually makes an important shift in the way we typically think about mental health symptoms. In this model, experiences like depression, anxiety, anger, and panic are not seen as discrete syndromes with various symptoms, but are themselves understood as being the symptoms. This is a profound difference in the way we understand these difficult experiences and provides clinicians access to powerful strategies for treatment. To see how, we need to take a deeper dive into our model.

Stress Bucket
The Stress Bucket Adapted from Claudette Mestayer’s excellent original.
It all begins with the idea that life is fundamentally stressful—in small and large doses, throughout our days and throughout the years, all people regularly encounter stress. Anything can be thought of as a stressor: a heavy barbell, an enjoyable challenge at work, traffic on the way home, the feeling of homesickness, etc. If these simply accumulated without end, we would find ourselves rapidly overwhelmed. But we understand instead that we all have innate capabilities to process stress and regulate the impact that it has on our bodies and minds.

Fifty years of advancement in attachment science and interpersonal neurobiology show that this ability is learned in our formative years, taught by the adults who parented us. These lessons then become “hard-wired” in our brains, like a pattern of movement that becomes easily accessible to us once we’ve been taught, coached, and well practiced. (One of the most profound insights of this science is that managing our emotions is a social activity at least as much as it is an internal activity. This is one of the key explanations of why psychotherapy can be so effective.)

Stress Tolerance:

The size of your container is largely formed during early childhood. Children who are supported in the experience of appropriate stress—neither too much nor too little—can more easily tolerate large volumes of stress.

The skills we learn about managing stress (what psychologists call “Affect Regulation”) can be high quality or low quality, proactive or reactive. Proactive stress management requires two things: first, the sensitivity to perceive small doses of stress, and second, the courage to acknowledge and attend to it. Many people in our culture are taught to ignore “the little things” and over time this limits our ability to “attune and attend.” This leads to reactive stress management, the state we find ourselves in when we wait until we are nearly overwhelmed by the pressure of our circumstances before we turn on our coping systems.

 

Affect Regulation:

The quality of your “tap” is also formed at this time. Children who learn that they are able to attend to their feelings—neither ignoring nor obsessing over them—are empowered to manage stress.

And those coping strategies can also take on a huge range of styles, some of which are better than others. Which coping styles we use depends on which ones we have in our repertoire—that is, which strategies we learned from our parents. It also depends on how powerful of a tool we need, which is why we cope differently with small doses of stress and big overwhelming doses. If we’ve learned to attune to stress, are willing to acknowledge the uncomfortable feeling it gives us (butterflies, anxiousness, sadness, etc), and then proactively regulate those emotions before they become intolerable, we don’t need very powerful coping strategies to get the job done. A healthy dinner with friends, and a quiet walk before a good night’s sleep might do the trick. 

 

 

Proactive Stress Management:

People who learn to attend to stress proactively can more quickly take actions, which bring better feelings.

But other situations demand more powerful strategies. We can become overwhelmed in two simple ways: too much stress or too little coping. Even the best of us are overwhelmed at times: when sickness, loss, insecurity descend on our house, it can be too much too quickly for any coping system to handle. Alternatively, those with weaker coping strategies, or with strategies that once worked but are no longer successful, can find that small doses of stress are routinely enough to overflow the container. In both cases, as distress increases it demands more of our attention. It doesn’t matter whether we are trying to keep up with that enhanced demand or trying to ignore it. In either case it requires substantial resources. We then have less energy and focus for connection with loved ones, less ability to relax or recognize moments of joy, and experience difficulty turning our focus down in order to sleep. 


The Demands of Stress:

In the same way that coping actively diminishes stress, distress makes it increasingly difficult to “attune and attend.” Our standard proactive strategies like exercise, relaxation, and connection are harder to achieve as distress makes demands on our focus and energy.
Demands of Stress

If we learned that being “tough” or “hanging in there” meant ignoring those butterflies, a different story unfolds. Sometimes, it’s true, ignoring does work! But unlike higher quality strategies, this method has a very hard ceiling. We can end up in trouble if our stressors surpass our ability to engage in distractions and ignore them. People who have less experience acknowledging stresses such as anxiousness or sadness often find the discomfort intolerable compared to those who have greater familiarity with those feelings. When the discomfort is so deep, we reach for more powerful tools—we are no longer attending to the feelings but are actively spending personal resources to escape them.

Reactive Stress Management:

Paying attention to stressful feelings lets us see more clearly what is at the root of the matter. With that information, the possibility to attend to, deal with, and resolve the problem becomes possible. It sounds counterintuitive, but it is only by a movement towards that which is difficult that issues in our lives change for the better. The attempt to escape stressful feelings—a movement away from that which troubles us—is the work of desperation. It is a kind of self imposed ignorance, which only makes our own difficult feelings foreign to us.