In my previous post regarding why people go “over the edge” and act impulsively/internalize suicidal tendencies, I explained a theoretical model that my psychiatrist presented to me while I was an inpatient at a local hospital. To summarize:
- Everyone has a different ‘baseline’ level of distress.
- There are generally two ways in which someone can go “over the edge” – an acute, large source of distress, or more chronic, building source(s) of distress with a smaller acute source of distress.
- Much of the symptomatology of prevalent mental disorders can be filtered down to feelings and thoughts of hopelessness (“Nothing will change”) and helplessness (“I can’t do anything to evoke change”).
In this post I wanted to delve into the intervention points that my psychiatrist explained on this model, and perhaps give my readers an idea of how they can intervene at these points. One thing to note here is that for myself, a combination of all of these interventions was necessary (as I had already reached my “breaking point” and beyond, and needed to try whatever it took to bring me from my near-vegetative state), but it is not necessary to try and address all of these intervention points. Also, throughout my experience, I have discovered methods of targeting these intervention points without necessarily having to seek professional mental health services. In the end, find what works for you, and feel free to use these brainstormed strategies as forms of mental health maintenance.
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5 Intervention Points to Improve Resiliency & Mental Health
1. ”Coping Strategies”
The goal here is that you are able to strengthen your ability to cope with your emotions and thoughts. This means that when you perceive a source of negativity, it gives you less distress than you currently would feel by comparison. My psychiatrist used the analogy of a teacher. Every year, the teacher receives a new cohort of students, and lets the previous year’s students move on to the next grade. They learn to cope with this transition and potential source of distress by developing personal strategies to honour the year and the experiences, but to realize that a new chapter is unfolding.
- Mindfulness practice: practicing being aware of one’s own emotions and thoughts, and honouring them while acknowledging their transience. Personally, I found that yoga and meditation were the best practices to build this practice.
- I recommend Yoga with Adriene – 31 Day Revolution (which I am currently working through), and an app called Headspace for meditation practice.
2. ”Crisis Plan”
The goal here is to learn to control one’s behaviours when thoughts become uncontrollable. This means that when the going gets really tough, you are able to let yourself go on auto-pilot and get yourself the help and support you need. My psychiatrist used the analogy of a firefighter. How does the firefighter cope with the extreme stress of putting out a large fire and rescuing trapped inhabitants? They are trained to follow an extremely precise set of protocol that they follow no matter where the fire exists. They practice this protocol so much that it is ingrained into their muscle memory, and therefore they are much less likely to waver to the hands of stress in the heat of the moment (heh). Thank you, firefighters!
- While this intervention point may seem more applicable to individuals who are really struggling with self-control during stressful times, the reality is that every individual needs to know what their resources are during the rough patches of life. Take some time to get to know what your local support resources are. Trust me, when you are in the moment where you feel stuck, seeking resources in the dark is the last thing you will want to do. Ask yourself the following questions and do a little digging:
- Who can you talk to about anything? (i.e., a spouse, close friend, a sibling, a parent)
- What are your mental health support options? (i.e., look into local helplines, drop-in programs, outpatient mental health services, and counselling services).
- You may also find my post on how to create a crisis plan useful. I include step-by-step instructions and a free printable template to follow.
3. ”Comparing Symptoms/Emotions”
The goal here is to build the ability to distinguish between different emotions and symptoms with a more critical eye. This means that you will be able to understand and discern the difference between closely-linked emotions. My psychiatrist used the analogy of an artist. If I held two shades of blue up toward a non-artist, they would likely say, “They’re both blue”. Well yes, they are both blue, but an artist would look at the colours and say, “The left one is aqua, and the right one is turquoise”. Likewise, although emptiness, loneliness, despair, and other lovely terms are all under the umbrella term “sadness”, each have differences in meaning that describe them in a more descriptive and unique manner. Understanding these differences can make it easier for you to build emotional awareness, which can then make it easier to work on maintaining your mental health. I am a strong believer that this is a life skill that all people (i.e., not only people suffering from mental illness) should learn if our goal is to live with optimal mental health. And who doesn’t want optimal mental health?
- I found that keeping a diary or journal or some sort of emotion tracker was useful to build my own emotional awareness. (Try mood tracker apps!) With a freestyle journal, the trap can become that you focus on the negative events (or even just negative interpretations of neutral events) and leave no room for exploring your own thoughts. To counter this, I began writing with an internal dialogue. As if I was receiving feedback from someone else that I was speaking to about my day. For example, I am struggling with irrational thoughts and cognitions surrounding my primary core belief, “I am a failure”. This core belief skewed my interpretations of many of my life experiences thus far. For example, in the past, if I had made a much sweeter batch of cookies than usual, I’d simply say,
“Not having made these cookies perfectly made me feel bad”.
Well, great Nico, but what does ‘bad’ mean?
“It makes me feel incompetent.”
Ah, there’s a more descriptive word. What does incompetence mean to you?
“That I can’t do anything right. I can’t even do something as simple as baking cookies.”
Could you be overgeneralizing your one batch of ‘imperfect’ cookies to other areas of your life?
“Well, I guess making cookies badly once doesn’t mean I can’t do anything. I mean later that day, I counselled my sister with a friend problem, and she told me I’d be a great counsellor in the future.”
This may feel awkward at first, but it helped me to imagine that I was talking to a close friend. What would a close friend say? Certainly not the automatic thoughts of self-criticism that are typical for someone speaking to themselves!
- Here is a cognitive behaviour therapy-based method of tracking your automatic thoughts and emotions and working toward assessing and re-evaluating these thoughts and emotions.
The goal of therapy is to help identify and change triggers. This means that you will be able to understand your fundamental core beliefs behind your automatic thoughts and interpretations to life events, and work toward building more positive core beliefs to support you throughout your days. I don’t want to scare you off here – therapy does not have to be appointments with a counsellor (though I highly recommend my readers to consider it. You do not need to be suffering from mental illness to receive counselling). There are many self-help books that you can use at your own pace.
Self-help books I was recommended throughout my recovery process by mental health professionals included:
Mind Over Mood, Second Edition by Dennis Greenberger, PhD and Christine A. Padesky, PhD
- An educational cognitive behaviour therapy-based workbook that over 1 million readers have used to conquer depression, anxiety, panic attacks, anger, guilt, shame, low self-esteem, eating disorders, substance abuse, and relationship problems.
You Are Not Your Brain: The 4-Step Solution for Changing Bad Habits, Ending Unhealthy Thinking, and Taking Control of Your Life by Jeffrey M. Schwartz, M.D. and Rebecca Gladding, M.D.
- A book that provides a scientific overview of how negative and irrational thought patterns develop and ingrain themselves in our minds, and provides a four-step method to help you redirect and change these thought patterns.
The Anxiety and Phobia Workbook by Edmund J. Bourne, PhD
- This is a workbook for coping with and conquering all different types of mental illness relating to anxiety, including generalized anxiety disorder, panic disorder, phobias, panic attacks, obsessive-compulsive disorder, among others. It includes the most effective techniques for both assessing and treating anxiety (with evidence-based research to back everything up). These include relaxation and breathing techniques, how to overcome negative self-talk and cognitive distortions, mindfulness practices, bolstering one’s lifestyle, nutrition and exercise habits, and some skills that can help prevent and cope with panic attacks.
Shyness and Social Anxiety Workbook: Proven, Step-by-Step Techniques for Overcoming your Fear by Martin M. Antony, PhD and Richard P. Swinson, MD
- This is a workbook more specifically geared toward those with social anxiety disorder, however I feel that the strategies within can be useful for anyone who feels that they have a level of social anxiety that hinders their everyday lives and their overall quality of life. The workbook provides a complete start-to-finish guide on self-assessing personal goals, exploring one’s fears and anxieties, creating a plan for change, and how to gradually put your personal plan into action so that you can live the life you want to lead.
- I have a post with a distilled, simple version of this process if you are interested. However, full disclaimer: I am not a professional, and my goal in this post is to make self-help for mental illnesses and mental health more accessible.
The Dialectical Behavior Therapy Skills Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation & … Tolerance (New Harbinger Self-Help Workbook) by Matthew McKay, PhD and Jeffrey C. Wood, PsyD and Jeffrey Brantley, MD
- This is a workbook that is grounded in dialectical behaviour therapy (which is different from cognitive behavioural therapy). DBT aims to help individuals who frequently experience overwhelming, high-intensity emotions that hinder their quality of life. It focuses on 4 tenets: building distress tolerance, mindfulness, emotional regulation skills, and interpersonal effectiveness. DBT is the primary form of treatment for some mental illnesses, such as borderline personality disorder.
I want to stress that although these workbooks and educational books seem like they are geared toward individuals with mental illnesses, I have a strong belief that the skills that a person can gain from each are life skills that any person would find useful to navigate their emotions and thoughts throughout life. We as a society tend to focus on illness as opposed to wellness – the difference being that the former focuses on treatment after the mental illness symptoms arrive, whereas wellness focuses on prevention by instilling these skills even before symptoms arise. We research how to prepare healthy foods, the best exercises to build the targeted muscles, and how to become a more likeable person – why not also research how to be the best you can in terms of your mental health? All of the concepts taught by psychotherapists, psychologists and social workers are evidence-based; backed with scientific literature and are not just some BuzzFeed post with questionable validity (sorry BuzzFeed!).
5. ”Reduce Baseline Stress”
The goal here is simply to address the foundational variable in the peaks of distress, which is one’s baseline level of distress. This baseline is determined largely by three main factors:
a) Biological Factors: these are factors such as chemical imbalances and your physical health. The former may only be addressed through medications prescribed by a mental health professional, but you have lots of agency in your own physical health. This includes getting enough sleep and sleeping at regular times, eating nutritious foods, and getting enough exercise. This can also mean reducing alcohol intake, and for some, working on removing substance use.
b) Psychological Factors: these are how you interpret and react to life events, and how you perceive yourself and the world. Usually, how you react to present or future experiences are a function of past experiences. Problems arise when past experiences build personal issues with overarching values and paradigms such as one’s own self-esteem, emotional regulation ability, or trust in others. Changing one’s cognitions is quite the difficult task (trust me, I am currently trying to change mine and it is frustrating). Thus, it is important to employ a close friend or loved one as a source of feedback when you need it, if professional therapy is not an option or a consideration for you.
c) Social/Environmental Factors: these are pretty much everything else. One’s socioeconomic status, housing environment, availability and accessibility to mental health supports, relationship health, social status, etc. These factors can be addressed through a myriad of methods including professional therapy or the building of social supports.
Above all, the best overarching form of self-care is to practice self-compassion. “Always remember to love”. Embodying this mantra is easier said than done, but everything you do with the awareness and drive that it will improve and maintain your mental health is remembering to love. When you read articles to improve your mental health, it is remembering to love. When you give yourself a break after a long day, it is remembering to love. When you advocate for yourself, it is remembering to love. The road of life is filled with upheavals, but it is your malleability and flexibility to conquer these events that make you strong.
Always remember to love (ARTL),