I write this blog post from personal and professional experience. What works for each person is different and you will have to find your own way. Think of this as improvising on a recipe so that it works for you. Many of the ingredients will be the same from recipe to recipe, but they are combined in different ways to make completely different dishes. With eggs you can make a broccoli quiche or a chocolate cake or corned beef hash, depending on what you mix them with and how you prepare them.
What follows is a list of ingredients to start with. There are three main sections: how to look at it (the philosophical part), medication, and coping skills.
Philosophy of tests
I’m writing this in America, where the cultural expectation is to put on a show of happiness, because being happy means you’ve succeeded at life and being unhappy means you’ve failed and you’re a burden to others. That is so stupid! Stop thinking like that right now. Here’s the truth: life is painful for everyone. Everyone’s tests are personal based on their strengths and deficits. Actually, I think our strengths and deficits are often the same qualities. For instance, I have an abundance of compassion for other people, but a deficit of compassion for myself. This causes all kinds of problems for me. Another person might be strong in perseverance in meeting work goals but weak in persevering through interpersonal conflict. A narcissist will look at me and think I caused my own problems. I might look at someone who thinks that you trip over love in the street and don’t have to work at it as dumb enough to get what they deserve. Enough of the judgment of others—we don’t understand each other’s tests, and we think other people don’t have tests as bad as ours because their tests wouldn’t be tests for us. Everyone has tests. And we get the same tests over and over until we learn whatever it is that makes us not vulnerable to that test anymore. And then we get a different test. And then the old test comes back in a more subtle way just to make sure we really did develop that virtue that we needed.
There is nothing you can do to make the ocean calm. Nothing. Ever. Sometimes the waves are small and the winds are favorable, and you succeed or fail by how you adjust your sails and your rudder, and other times you have to ride out the hurricane, which takes a whole different set of skills.
Here’s another truth: all people are interdependent. The saying, “No man is an island” is really true. Self-sufficiency is another myth that Americans are particularly fond of, and it makes us not want to be a burden on others and therefore to suffer through our tests alone. This is inefficient to the point that it sometimes makes getting through the test impossible, and it deprives others of feeling useful and helpful. I know this and I still don’t like asking for help. Feeling vulnerable is a really uncomfortable feeling. But honestly, if you can’t manage vulnerability, I swear the universe will send you test after test until you can. Who wants that?
“God (or Life) will never give you more than you can handle.” BALONEY! God/Life will never give you more than you can handle by relying on God/Life, which means any test is fair game. If you look at life as a school, your challenges are what develop your abilities, and you have to be pushed beyond your current capabilities in order to develop new strengths. I have the body of a reader, not a runner, much to my disappointment (but not so much disappointment that I’m interested in taking up running). Let’s say I want to run a six-minute mile, or more accurately, let’s say my life requires that I run a six-minute mile. I can’t run a thirty-minute mile, for heaven's sake! I’m going to have to push myself past the painful edge of my ability over and over before I ever I ever get to a six-minute mile. And even if I never get there, I’ll be in better shape just for working on it.
Okay, on to coping skills, in no particular order.
Breathe. Seriously. People suffering the panic of a devastating personal crisis hold their breath. Make yourself breathe. And then focus on your breathing as an easy way to meditate. There’s a type of Buddhist mediation called Tong-Len. You breathe in, imagining yourself breathing in the suffering of everyone who is going through the same thing you are, and then breathing out comfort to all of them, including yourself. Sounds woo-woo but it actually helps you get centered because you realize that your suffering is not unique or special, which is oddly comforting, and you realize that there is comfort to be had, eventually if not immediately. Also, measured breathing slows down your autonomic nervous system, which helps you calm down. Some people think that breathing into a paper bag helps because you re-breathe your own exhaled carbon dioxide and this is supposed to help you calm down. It doesn’t hurt and it might help. If you don’t have a paper bag handy, just breathe into your own cupped hands around your mouth.
Pray. I’m a Baha’i but I’m willing to accept the good ideas of any religion, and the early Christian monks (known as the Desert Fathers and Mothers) had lots of good ideas. One of them is “ceaseless prayer.” It comes from the Bible: ”Pray without ceasing.” (I Thessalonians 5:17). I have my own recipe for this and you will have yours. Mine has two components: (1) Saying prayers over and over in my head, all day and night, kind of as a background to what I’m doing. I say two Baha’i prayers a lot (“Is there any Remover of Difficulties save God? Say: Praised be God. He is God. All are His servants and all abide by his bidding,” and “God is sufficient unto me. He is the All-Sufficing. Let the trusting trust Him”) but you can say any prayer. I usually sing my prayers because it’s a little more meditative but you can say or sing them according to your preference. I also like the 23rd Psalm a lot for crisis-praying. Muslims might pray, “Allah-u-Akbar” (God is Great) in these situations. Hindus have chants that I don’t know off-hand. . You can repeat anything that comforts you. One possibility might be reminding yourself that, “The only constant is change,” knowing that nothing, even your horrible, searing pain, lasts forever. (2) The second component to my version of ceaseless prayer is doing my best work as an offering to God. It can be professional work, mopping the floor, gardening, parenting—anything that you do that contributes to the betterment of the world in large or small—even tiny—ways.
If you can’t focus enough to pray the way you want, pray for the ability to pray better, and in the meantime, keep saying the words. I find that my attention drifts in and out of the words. This goes the same for secular affirmations.
Guided Imagery. I like the guided imagery by Belleruth Naparstek. Audible has five of them for $5 each, and the one for Healing Trauma is quite good. Some people find the guided meditation too intense, but the affirmations, in and of themselves, are helpful. I like the way she words her affirmations in an “I can feel myself getting better” kind of way. They’re not stupidly unbelievable, like Stuart Smalley affirmations. This author also has a book out called Invisible Heroes, about using guided imagery for PTSD, that has several scripts that really could be used to anyone’s advantage.
Nature. Walking, fishing, hiking, sitting at the beach, sitting in a forest, gardening, looking at the sky, petting an animal or seeing an animal in the wild—Nature is always calming and always giving insights. I mean, you know, within limits—seeing a bear is only calming if it’s not chasing you. Leaning up against a tree is only calming if you don’t get pitch in your hair. My favorite places to walk on the island (and everyone else’s) are the Bloedel Reserve and the Grand Forest, but people walk everywhere around here. I also find going to the ocean helpful. I think to myself, “There are some things that are bigger than my problems, like the biggest ocean in the world, for instance.” And the ocean is life-giving, beautiful, dangerous, and terrifying all at once—like life. Watching and listening to the waves is soothing and meditative. I really like First Beach, up at La Push, (I haven’t been to Second or Third Beach). Here on Bainbridge, if you can’t drive to the ocean, just walk to the nearest beach; it’s the same thing on a smaller scale. Hurricane Ridge is a great place to hike. Mountains are so solid and huge that they feel comforting. The whole Olympic Peninsula is an inexhaustible source of lovely places to hike that are not touristy, as far as hiking goes. Closer to home, I like Foulweather Bluff. If you drive to Brinnon you’re very likely to see a herd of elk.
Lower your expectations. Don’t try to build an empire during a hurricane. After you ride it out, you can go back to empire-building. Just try to get through this hour, this day.
Work. Sometimes work helps because it gives you a feeling of accomplishment or competency, and either of those can give you strength when you’re feeling weak. Also, it can be a distraction from your problems. It’s definitely harder to do a good job when you’re having a crisis, but working during a crisis has it’s benefits, too. Most of us don’t have a choice, anyway, so we might as well get what we can out of it. When I have a crisis, I take more breaks. I don’t push myself as hard. I socialize less and hunker down on projects more.
Read. You can watch TV, too, but I think reading is better because your own imagination symbolizes the content to your life in a way that someone else’s imagination can’t do. Read what you’re drawn to. During a particularly hard time in my life, all I read was survival memoirs. My crisis wasn’t physical, like being lost at sea or having fallen into a canyon, but the mental skills it took to survive were surprisingly similar. I had to work through a lot of why me crap and figure out how to problem-solve and put one foot in front of the other despite being limited by trauma. The most helpful books for me were Deep Survival and Surviving Survival, by Laurence Gonzales, and Adrift, by Steven Callahan.
Or read to escape into someone else’s life for awhile, or to another world entirely. Harry Potter is great on a million different levels: good vs. evil, love vs. power, community vs. acting alone, loyalty vs. selfishness, managing your fears, doing the next right thing, trusting your intuition. The list goes on. Plus, there’s magic. If you can't have magic, you can at least fantasize about having it.
Learn and/or engage in a skill that has organized, patterned activities. This comes from Laurence Gonzales. You can learn to knit, learn a new language, learn any number of things—but there’s something about learning that pushes your stress hormones back down (it activates the frontal lobe, which competes with the parts of the brain that produce stress hormones). There’s also something about methodical activities that competes with your brain’s ability to freak out, so knitting is particularly good because it’s methodical. You need to focus enough to do your stitches but not so much that it takes much energy.
Lean on your sturdy friends. My friends have cooked dinners for me, watched my children, given me rides when I was too sick to drive, helped me with my housework, and listened to me complain. I have done the same for them. A crisis is when you learn who you can depend on in a crisis. Some of your friends will be better to have fun with, some will be better to have deep talks with, and some will be better to lean on—or some combination. In a crisis, the people who listen to your deepest feelings may or may not be the people who help you the most, because during a crisis it's hard to do the laundry. Your most practical friends might actually be who you need the most. Some people are good at building the house (practical stuff) and some people are good at building the home (feeling stuff). We all have our strengths and weaknesses and some people aren’t sturdy enough to lean on but they’re still worthy of being your friends. So hang out with them when you’re not in a crisis. Don’t expect a birch tree to have the strength of an oak nor an oak tree to have the flexibility of a birch.
Work it out through your body. The best way to work out anger is through your body. Run, dance, chop wood, throw rocks as far as possible into the water at the beach—just do something physical.
The best anxiety and depression medications, according to research, are not medication at all, but exercise. You might be too depressed or wound up to feel like exercising. Force yourself to do whatever small thing you can and work up to bigger things—just do something physical.
Travel. I think we’re always inventing ourselves for other people, and new places means no one knows you, so you have to invent yourself from scratch for them, and in so doing you re-invent yourself for yourself. It helps to re-write your internal narrative. My family always thought of me as an absent-minded professor type and with them I couldn’t escape the stereotype, but when I spent a few months in Belarus, no one had any preconceived ideas about me, so I didn’t feel limited by it. Even if you can only travel to the mountains or Port Townsend for an afternoon, I think getting out of your daily routine is helpful in a crisis. And if you can go to Madagascar (the furthest populated land mass from here, in case you want to know, which I may or may not have looked up when I wished to be as far away as possible), so much the better.
You do have to distinguish between travel and "geographic escape." If you're trying to outrun your own self-loathing, travel won't work because wherever you go, your brain goes with you. If you're trying to examine your mind in full light for the purpose of growth, then it's a great idea.
Re-write your narrative, at least in your own mind. Your self-talk can have an impressive effect on your emotional health. You can’t just say, “I’m not a victim. I’m a survivor.” You have to know what you did to become a survivor. Think it through, chipping away all the self-blame and other-blame until you find the healthy and true story.
Help someone else. It’s pretty hard to feel like a helpless, vulnerable, miserable failure when you’re helping someone else.
Complain. Speak your truth, just be careful who you speak it to. Don’t tell it some someone that you know is going to tell you to buck up, or tell you that the person who hurt you didn’t actually hurt you, or tell you to count your blessings because lots of people have it worse. If someone else has had their leg amputated, it doesn’t make my broken leg hurt any less. Those people (the ones who tell you to buck up, not the amputees) choose denial as their favorite coping mechanism. Be nice to them and find someone else to talk to. It’s good to acknowledge that you’re in the middle of a challenging time for you. It’s helpful if your purpose is to learn, and learning can take awhile, so you don’t have to be done complaining in ten minutes. You can complain intermittently throughout your whole life as long as you’re actively engaged in your growth.
Feel your feelings. Just lay in your bed and close your eyes and let your sadness or your despair or your hopelessness, or your fear, or whatever horrible, unbearable feeling you have wash over you in full force. It will be awful, but it won’t last long, and you will feel a little bit lighter afterwards. It probably won’t last longer than about two excruciatingly painful minutes. And it won’t kill you. When you are in really desperate straights and you need relief, this can help.
It’s useful to learn that your emotions won’t kill you, because sometimes it feels like they will.
Cry. Cry the great big ugly cry. If you have to hide to do this, go ahead. Crying helps relieve the pressure. Go ahead and feel sorry for yourself, because the truth is that life stinks sometimes, but don’t let yourself get stuck there. Half an hour of self-pity is long enough.
Grieve. Grief never goes away. It washes over you in waves forever. The waves vary from knocking you over to just soaking you to just getting your feet a little wet, but they never go away completely. So get used to rolling with the grief waves. Sometimes you see them coming, sometimes you don’t. When they hit, step back a bit and do what you have to do to express that grief: cry, write, dance it out, talk it over, paint it, sing or listen to heartbreaking songs, pray. Whatever you find helps you, make a mental note of it so you can remember it on demand when you need it. If you express it, it will go away until next time. If you stuff it with denial or alcohol or busywork or judging others or anything else, it will nag at you constantly.
Sleep more. For some reason, we need more sleep in a crisis. Or at least I do, and I’ve read that other people do, too. Even if the crisis is not physical. Stress and grief make us tired. Sleep heals.
Laugh at yourself. If you’re wishing a slow, painful death on someone who hurt you, it doesn’t mean you actually want that person to die a slow, painful death (hopefully) but rather that you wish they understood what pain felt like so they’d stop hurting you. Or maybe you’re wishing a swift death on them, like a plane crash, so they’ll be gone quickly and permanently and leave you alone. I’m telling you as a counselor and as a human being that this is so common it’s almost universal, and you are not the worst human in the world. See it for the ridiculous fantasy that it is. Take it one step further and make up a delicious but totally unrealistic curse (for instance, "May you be abducted by aliens and then tossed out of the spaceship into the vastness of space for being a substandard human specimen"). Be creative, and then have a good laugh.
Also, laugh at how stupid we humans can be in general. Laugh at the existential human predicament. I find that old Monty Python skits help.
Acupuncture. Acupuncture is good for both emotional and physical pain. I found it to be effective for fear at one time in my life, and one acupuncturist told me that he thinks it is more effective with emotional pain than physical pain. However, I have also found it effective with back pain.
Counseling. Duh. Get recommendations from your friends. Try a few counselors until you find the right fit.
Do the next right thing, even if you can't see your destination. Especially then.
Lastly, medication. Effective medications are of two kinds: addictive and non-addictive. Each medication has its pros and cons, even if it’s not addictive.
There are a couple SSRI antidepressants that are also helpful for anxiety. Some people respond to them better than others. Sometimes you have to try a few in order to find the one that works best for you, or that works at all. You can’t stop taking them all at once or you’ll get withdrawal symptoms; you have to taper down. But otherwise they don’t have addictive symptoms like cravings for more, messing up your life, and so on. For some people they don’t work, for some people they cause weight gain or loss, for some people they cause severe apathy, and for some people, more often young people, they make the depression worse. There are some other medications that help for anxiety that are not SSRI’s, that might be more helpful for those who don’t respond well to the SSRI mechanism. Find a good psychiatrist and work with him or her on finding the right medication for you if you want medication to be part of your crisis- (or ongoing pain-) management plan. It’s a perfectly valid choice as long as you don't make it the only thing you rely on; then it would be a crutch.
Benzodiazepines are often prescribed for anxiety. They are highly addictive and they cause nasty withdrawal symptoms. You should not use them if you have any reason to think you're at high risk for addiction (which will very likely be most of the people reading this blog). They are also dangerous in combination with other things that slow your central nervous system, such as alcohol and pain killers. I’ve seen some clients with prescriptions for both benzodiazepines and pain killers at the same time. Sometimes their doctors were being responsible and other times not. Also, because drug abusers like benzodiazepines, they might steal yours, so be careful about that. All that said, they can take the edge off anxiety in about 15 minutes. Sometimes anxiety feeds on itself and if your coping skills are not enough, this kind of medication can lower your anxiety level enough that you can then take over from there. They can be helpful, but only in very small and infrequent doses. Find a responsible psychiatrist and take his or her advice. Don't be your own doctor, deciding your own dose and frequency; that's what addicts do. It's not self-medicating if it's overseen by a competent physician/psychiatrist whose advice is followed.
I am a believer in natural medicine. Sometimes a naturopath or an herbalist can prescribe supplements or herbs that are very effective for mental health conditions. As with all doctors, they have to be responsible, smart, and well-educated, and you have to consider the known side effects of whatever you take.
Being the addiction counselor that I am, I don’t think self-medicating with any intoxicating substance is effective. You need your coping strategies to work in both the short run and the long run, and addictive substances only work in the short run and in the long run they make things worse. This includes legal addictive substances like alcohol and marijuana and tobacco. Just because things are legal and/or natural doesn’t make them safe.
Finally, if you're struggling with addiction, you need to add other, very specific tools to your tool chest. Among them: how to deal with cravings, how to deal with stigma and self-loathing, how to set up road blocks for drinking/using and scaffolding for recovery. Addiction counselors help with figuring out what you need to get started in recovery and teaching you the necessary tools for long-term recovery.