Tag Archives: Resilience

What discomfort can teach you

By Shari Gootter and Tejpal June 16, 2021

Comfort is something we all seek. The notion of “being comfortable” is highly prized (and promoted) in our society. It is considered a major selling point if you are in the market to buy a bed, clothes, a car, a pair of shoes — almost anything. But the overvaluing of comfort in our lives can come at great cost.

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Our relationship with comfort and discomfort is influenced by our culture, our personal history and our personality. If we are born in a tradition in which failure is not an option and social success is the norm, we may challenge ourselves with long hours of work or study to avoid the discomfort of failure. If we are born into a family where depression or anger was part of the daily landscape, we may want to avoid these emotions at any price and dissociate when these feelings arise. Taking a deeper look at our relationship with comfort and discomfort provides us insight on our path toward acceptance and happiness.

Discomfort exists at many levels:

  • At the physical level, it may manifest as a headache, a digestive issue or a skin irritation.
  • At the emotional level, it may manifest as anxiety, worry or depression.
  • At the mental level, it may manifest as constant agitation, an inability to focus or ambivalence in decision-making.
  • At the heart level, it may manifest while experiencing loss, change or separation.
  • At the spiritual level, it may manifest as existential angst, lack of purpose or a feeling of disconnection.

Certain life events can be challenging and unfamiliar. If we are clinging to any form of comfort, we will limit our ability to adapt and grow. Through the years, the overpromotion of comfort, happiness and pleasure has created tremendous distortions. There is no tolerance for any amount of discomfort and tremendous impatience for any kind of pain. When comfort is the only choice, resilience and the ability to overcome adversity are lost.

Running from discomfort

If you want to stay centered and at peace, you need to stop running away from discomfort (or always running toward pleasure). Running from discomfort prevents us from being able to see and feel what is present. It holds us in a false state of reality and never allows us to know our true selves. On the other hand, being uncomfortable teaches us to transcend pain and pleasure, thus allowing us to be true to ourselves. It also allows us to see clearly when challenges occur.

The constant promotion of pleasure and comfort has contributed to the emergence of addictive behaviors. For example, many individuals use food, medication or gaming as a way to soothe their pain or “escape” their stress. This starts with a tremendous obsession of the mind that makes us believe there is only one way. When our mind gets frantic about one thing, there is no room for anything else and our behavior becomes extremely reactive. As soon as we grasp for more comfort, we become intoxicated. Intoxication does not necessarily have to involve a substance such as alcohol. We can be intoxicated with power or greed. As soon as we are intoxicated, we lose our intelligence and our ability to be present.

When you experience discomfort, we suggest that you stay away from labeling it, contracting and wondering when the pain will go away. None of us came to Earth to suffer, but none of us came to earth to run away from suffering either. Every time that you hit your limitations, you have the opportunity to unfold and open.

Mara, one of our clients, was struggling with tremendous discomfort. She was never satisfied with herself and experienced ongoing anxiety about her future. She dealt with her pain by consuming alcohol. After several years of doing this, Mara was no longer able to follow through with much of anything, and she ended up getting fired from her job. This was a much-needed wake-up call for Mara to realize that she needed help. When she first came to see us, she had a strong motivation to rid herself of her discomfort. But as she learned to develop a sense of compassion for herself, she grew more able to embrace her discomfort. Mara came to understand that when she was trying to cover up her discomfort, she was actually opening the door to self-destruction.

Accepting discomfort

Accepting our discomfort is led not only by bravery but by our heart center. At that moment, we choose to accept who we are. Our will does not help to heal our pain; our heart does. For Mara, getting fired was the saving grace. Others may go deeper into negative coping mechanisms that further enhance patterns of self-sabotage before determining to change their relationship with discomfort.

Often, when we experience discomfort, we perceive it as a threat. We want to separate from our discomfort to protect ourselves. When we do this, we create the opposite of what we are looking for. The more we separate from our discomfort, the more we separate from ourselves, and the more pain we experience as a result.

Underneath any discomfort, there is a fear. For some it could be the fear of missing out. For others it may be the fear of not being in control, or the fear of being overwhelmed and losing sense of self.

The longer we numb our discomfort, the more stuck we may feel. The longer we reject our discomfort, the louder our ego becomes. The practice of allowing discomfort is the practice of integration. Integration occurs when we allow our behavioral patterns, traits, emotional states and experiences to come together in a more unified and organized state. Without integration there is separation, and with separation there is distortion.

The purpose of pain is to awaken the heart, not trigger the mind. It is not about overcoming pain; it is about recognizing and being willing to learn from it.

Some spiritual traditions will bring discomfort to the core of their practice. The intent is to teach the practitioner to stay whole while in pain and to prevent the mind, led by the ego, from directing the experience. The focus is not on overcoming pain but rather on surrendering and allowing the experience of pain to expand where it wants to be. It teaches the mind not to separate but to allow. It teaches the mind to go beyond subject-object relationship. At that moment, there is an alchemy happening in the body, and one may shift from pain to bliss because the mind is not locked into form.

The practice of being uncomfortable

Regardless of your spiritual tradition and belief system, meditation is a great way to learn to be still with discomfort. Many people express difficulties when trying to learn to meditate and often give up, believing they are not good at it. The purpose of meditation is not to add pleasure or pain but rather to develop a neutral mind that allows whatever arises. Consistency in a meditation practice paves the way for acceptance and humility, which are two beautiful qualities of the heart.

If you are able to stay still during pain, without hoping for pleasure to come, you are free. If instead of fighting against the pain, you welcome it fully, you will shift and heal. When this happens, you will realize that pain and pleasure are not opposites, but simply sensations; you are now living beyond polarities.

Being uncomfortable does not always relate to pain or pleasure; our own fears and limitations can create great discomfort. To avoid discomfort, we may prevent ourselves from taking risks and put our self-development on hold. Some may feel stuck and have pushed the pause button, whereas others might operate on autopilot by staying with their to-do list. For example, some people may stay in a relationship or job even though they know it is no longer serving them. Both are forms of avoidance.

As we learn to allow pain to be part of our experience, we need to notice other possible scenarios that prevent us from learning about our discomfort. The first scenario is to be attached to our pain, allowing it to become our identity. At that moment, our life revolves around our pain, and this limits our ability to heal and make positive changes. The second scenario is to be uncomfortable with others’ discomfort. This steers us toward being “people pleasers,” constantly focusing on others’ well-being and avoiding being in touch with ourselves. Related to this second scenario, it can also be challenging to be around someone we deeply care for who is experiencing a great deal of discomfort. We may want to “fix it” or change it as a sign of love.

The practice of being uncomfortable teaches us to stay connected with ourselves, to be curious and open. It teaches us to be relaxed and surrender into the discomfort. The more we want to control our discomfort, the more stuck we become.

Allow discomfort to be part of your experience. Welcome it fully from the heart center. At the core of your pain or fear, you will grow and you will learn.

Practices

To become comfortable with the uncomfortable, we invite you to try the following practices. As with every practice, consistency and repetition are key to gaining insights and creating change.

Practicing in itself can create discomfort. It is when you are the least inclined to practice that it may be the most beneficial. Practice teaches you to go beyond your emotional reactivity. As you keep showing up for yourself, it will get easier.

Meditation Tonglen

Tonglen is a meditation practice found in Tibetan Buddhism and used to awaken compassion. Through acknowledging our own and others’ suffering, we open our hearts.

  • Sit in a comfortable position. Lengthen your spine and draw your shoulders down your back. Soften your face and jaw. Close your eyes.
  • Connect to one part of you that is in pain at a physical, emotional, mental, heart or spiritual level.
  • Notice the quality of your pain.
  • Imagine all of the people with a similar experience and inhale their pain. Do not be afraid to “inhale” others’ pain. You will not get more pain. In fact, you may feel some relief.
  • Exhale; send relief.
  • Repeat the process for at least three minutes.

Journaling

Some of you may be really reluctant to start this practice and others may simply love it. The benefits of journaling are priceless. It helps you process emotions or situations with more awareness and clarity. It is a safe container to express your voice. Research on journal writing therapy indicates positive outcomes related to identifying emotions and feelings and reducing stress. It can be a catalyst for change and healing.

  • Think of something that makes you uncomfortable. Is this new or old? What are the main emotions you are experiencing? What behaviors or strategies have you implemented? What did you learn about yourself?

Take action

Taking action is where the true learning takes place. You get an opportunity to truly assess your relationship with discomfort and stretch yourself.

  • Do something outside of your comfort zone.

 

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This article is based on a chapter from our book WAY TO BE – 40 Insights and Transformative Practices in The Heart of Being. For more information, go to www.40waystobe.com.

 

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Shari Gootter is a licensed professional counselor and certified rehabilitation counselor with decades of experience in designing and leading workshops for diverse populations. Her focus has been on helping people shift while going through losses or adjustments. She has also created programs for counselors that assist them in developing a framework that supports lasting transformation. Shari is a therapist in private practice and has taught yoga for decades. Contact her at sharigootter@comcast.net.

Tejpal has over 30 years of experience supporting individuals on their journey toward healing, life purpose and real joy. Tejpal blends her intuition, energy healing, creative processes, life coaching and yoga into her work. Tejpal was born in France and moved to the U.S. 25 years ago. She has worked with people from many cultures and traditions.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Reformulating client well-being during an economic crisis

By Scott Gleeson July 13, 2020

Various forms of the same headline say it all: “The worst unemployment rate since the Great Depression.”

The U.S. Labor Department declared back in early May that 20.5 million people had abruptly lost their jobs as many businesses shut down or significantly altered their workforce operations during the coronavirus pandemic.

For mental health counselors, the COVID-19 crisis has prompted a plethora of alterations in conjunction with health-risk anxiety — from a major uptick in telehealth services to exacerbated symptoms for clients working from home extensively for the first time in their lives.

But what about adding the loss of a job or reduced wages on top of everything else? Quarantining takes on new meaning when a career is significantly throttled. The current unemployment rate is nearly double what it was during the Great Recession of 2007-2009.

“If you think about the college graduates of 2008, they’ve been in the workforce for a decade now, and they’re experiencing another major recession,” says Clewiston Challenger, a professor of educational psychology at the University of Connecticut. “This time, there could be a longer lasting effect on the job market. Your job is a major source of identity, so therapists can play a serious role in [helping clients find] that temporary identity without work.”

Clients also may have to adjust their mental health treatments based on changing insurance coverage from a lost job, and clinicians could find themselves adjusting their rates to accommodate financial burdens.

Of course, working clients have felt emotionally compromised too.

Ingrid Erickson, a licensed professional counselor and member of the American Counseling Association, works as a career counselor for Heritage Professional Associates in Chicago and as a leadership coach for BetterUp, a training firm that helps employees and companies bolster their work fulfillment and culture. She has noticed a common trend in which still-employed clients have felt an extra emotional weight over the past several months. As such, her therapeutic approach has been adjusted into “a mini treatment plan in the context of a larger one” — a compartmentalized plan with a sharpened focus on how the coronavirus pandemic is affecting each client, and then a broader scope that contains the client’s overriding goals pre-COVID.

“A common theme is that people have been running [over] capacity,” Erickson says. “Work provides a rhythm to our lives, and for some that normalcy was taken away amidst all the uncertainty of COVID. It’s created a situation where a lot of people who are working are pretty maxed out. There’s a lot of fear, and it can be difficult constantly trying to figure out what the new normal looks like. Emotionally, cognitively, it can be really draining.

“With a lot of clients, we’ve had a mini reassessment because COVID is uniquely impacting each person in different ways, whether it’s job insecurity, high-risk loved ones, interpersonal by living in tighter quarters … It’s important to take a step back and see how the added stress is playing a role in maybe bringing a lot of things to the [emotional] surface that normal life doesn’t. I find it helpful to acknowledge how the stress affects our work life. There’s this expectation of doing our lives as normal. Well, it’s not normal right now. We’re needing patience and compassion for ourselves.”

One way that normalcy can be hindered is in clients’ bank accounts. Gideon Litherland, a licensed clinical professional counselor at Veduta Consulting in Chicago and a Ph.D. candidate at Oregon State University researching supervision effectiveness, says broaching financial concerns with clients can become necessary, even if they are avoidant of such topics.

“This is the worst economic recession since the Great Depression,” Litherland says. “We can’t ignore or not talk about what clients may very well want to ignore. If the client does not want to tend to them, what are the fears in attending to those feelings? It becomes appropriate to say, ‘Hey, things are going on economically. How is this affecting you financially?’ It is clinically relevant to check in with a client about financial stress for their mental well-being. The experiences can be ‘Where’s my next paycheck coming from? Where could I live if I get kicked out of my apartment? What happens if I declare for bankruptcy?’ It’s entirely within our role and purview as clinicians to tend to a client’s basic needs, and [financial concerns] fall under that.”

Erickson says mindsets are different for every individual based on where their career trajectory was at before the coronavirus pandemic. She adds that the past several months have greatly influenced quarter-life and midlife assessments in reverse directions based on where clients were at in their identity development.

“The market is not great right now and very unpredictable, so a lot of people who were going through a job search put actively looking on the shelf for now,” she says. “Then there might be others who almost see this breaking period, whether furloughed or laid off or working from home, as an opportunity to rethink what they want their careers to look like. There’s a freedom to really reassess with creative thinking and problem-solving. When we do career thinking on a shot clock, we don’t do our best.”

A recent Wall Street Journal report found that the worst of the coronavirus shutdowns may be over. The uptick of air travel, hotel bookings and mortgage applications could signal a turn for the better economically in the U.S. However, those improvements could be tied to temporary factors, with emergency spending from Congress among key reasons for more temporary spending.

Erickson says that looking ahead to brighter days, while necessary, can be a double-edged sword. One thing she is coaching her clients with is the premise of separating short-term goals and emotions from long-term goals and emotions.

“Long-term hope and optimism with a vision for the future can be an anchor during times of stress,” she says. “Planning for the future has a value, but at the same time, fear and anxiety for the future can paralyze, so we run the risk of getting stuck worrying and rehashing over and over to where we’re emotionally suffering based on something that hasn’t actually even happened.

“I’ve found it can be helpful to shorten the time frames to avoid the emotional flooding and just … focus on making it through the next day and week. If you’re a small business owner, instead of asking, ‘How do I help my business survive?’ then focusing on immediate issues, what’s within your immediate control and then coming back later to focus on the months ahead.”

The gradual reopening of states also means that people who were working from home will be thrust back into their old routines and structures, albeit with a renewed outlook.

“There have been a lot of positives that have come from being away from the day-to-day,” Challenger says. “For many people who see their job as their identity, perhaps this crisis gave them a chance to focus on other facets of their life and look outside of their identities as employees. And now more than ever, companies are more comfortable with distance communication, so we might see some of these industries morphing into more Zoom meetings and working from home.”

Even as some people appear set for a return to normalcy in the short term, others are likely to experience lingering impacts from the economic crisis. For instance, college graduates who were poised to enter their respective professions after earning their degrees have instead been greeted by closed doors and blocked opportunities because of the coronavirus.

“COVID happened so abruptly,” Challenger says, “and now all of the sudden companies aren’t in a position to spend money anymore. So, that job a college graduate might’ve wanted is gone.”

In the long run though, Challenger adds, “The class of 2020 will be built on resilience.”

That notion of resiliency and a bounce-back effect is where Erickson sees the silver lining.

“Resiliency isn’t built in times where it’s easy,” she says. “We’ve been forced to live our lives without resources in ways we never had before. If anything, hopefully these times can show that we can make it and shows us what we can do.”

 

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Related reading

See Counseling Today‘s August magazine for an in-depth feature on helping 2020 graduates navigate life after college amid the COVID-19 pandemic.

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Scott Gleeson is a licensed professional counselor at DG Counseling in Downers Grove, Illinois, and Chicago. Contact him at scottmgleeson@gmail.com.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

For such a time as this: A plan of action for moving forward

By Esther Scott June 30, 2020

[Editor’s note: This is the fourth article in a series on action plans for different areas of life during the COVID-19 pandemic.]

During this period of physical distancing, a new norm of limiting touch was created. Although touches are often few and brief in American culture compared with other cultures, these brief touches contribute greatly to our emotional well-being. Many have missed the small touches of friends and family that connected them at a deeper level, or the social courtesy of a handshake during introductions.

Social distancing, although necessary, has been a big challenge. But after a period of quarantine and isolation from friends and family, perhaps a bigger challenge will be returning to normal interactions of touching one another without fear and anxiety. There are mixed emotions involved. Some people are feeling relief and gratitude as restrictions are gradually loosened, while others are experiencing frustration with the “new norm” or are fearful that others could still infect them with the virus.

Whichever side you come out on, it is important to remember that touch creates a human bond that is particularly necessary for building a healthy, more connected community. Studies show that we need to touch and be touched. Human touch is vital for well-being. It leads to the release of oxytocin, also called the “love hormone,” which helps regulate your fight-or-flight system and calms your body in times of stress.

Studies also show that lack of touch can be harmful to health. In experiments with monkeys, researcher Harry Harlow demonstrated that young monkeys deprived of touch did not grow and develop normally. We must now work at getting back to where we can touch each other without anxiety or doubt.

In the meantime, learning to express warmth and affection through words will help us move forward. Here is a plan of action for that.

Images from the United Nations COVID-19 Response page at unsplash.com

1) Focus on the future.

Every storm passes. And this too shall pass. After a period of quarantine or isolation, you may feel emotions that include relief and gratitude, or even feelings of personal growth and increased spirituality. Just as fear was once spread, hope and security can be transmitted socially too.

Looking at crises as opportunities to rethink and reorganize our priorities will prove beneficial. Crises bring opportunities for improvements that are not always possible in other conditions. The analogy of a diamond may apply here. The beauty of the diamond comes about from the extreme experience of pressure and heat. The same is true for us. We will emerge stronger from this situation and the complex challenges we have faced and are still facing. Let’s focus on a future that is filled with hope.

2) Prioritize your mental health and be flexible.

Things may get worse before they get better, but we are still here. Human beings have great capacity for adapting in times of suffering.

Prioritizing your mental health can be one of the best steps you can take at this time. For many, this will mean continuing to see their therapists or booking online sessions to talk through things and being intentional about practicing self-care.

Feeling anxious as we reintegrate as a society will be normal, but if you experience symptoms of extreme stress such as constant sleep problems or an increase in alcohol or drug use, a visit to your health care provider or mental health professional can make a positive difference. Mental health is essential to everyone’s overall health and well-being, especially during difficult times. Focus your attention on your strengths and abilities, and imagine yourself coping and adapting successfully.

Flexibility is adaptive. It is imperative that we build a foundation of healthy coping and stay connected to our values and to one another. Gratitude is a good first step toward opening the door to flexibility. In fact, the more you practice gratitude, the better your brain gets at recognizing positive things.

Start by thinking about one thing or person for which you are grateful. Focus on the feelings that arise, and hold them in your heart. Know that you can return to that thought of appreciation anytime as you move forward.

3) Be optimistic and resilient.

Optimism is the tendency to see and judge things in their most positive or favorable outcome. Resilience is our ability to overcome difficult circumstances and grow in the face of adversity. These qualities will be key in our efforts to recover. When we are anxious, we tend to overestimate and exaggerate the impact of a negative event and underestimate our chances of recovery. Resiliency gives us a realistic balance.

The ability to handle adversity will be another critical component to our success moving forward. Even if you or someone you love has been diagnosed with the coronavirus, maintaining an optimistic attitude is essential to supporting recovery. Being optimistic will help you make your thoughts and emotions much more positive, which in turn gives your immune system a boost.

The experience of the coronavirus does not have to become a traumatic and overwhelming experience that marks us for life. On the contrary, it can be an excellent opportunity to exercise our resilience — that is, to grow in the face of adversity.

Religious individuals involved in tragic circumstances often report finding peace, hope and even increased faith in the midst of the experience. Consequently, they tend to report high satisfaction in their lives. “We are hard pressed on every side, but not crushed … Struck down, but not destroyed” (2 Corinthians 4:9).

We can all benefit from this kind of optimism. Therefore, let us start filling our world with music and songs of hope in preparation for the great celebration that awaits us. We will meet again. We will celebrate again. Let’s get started.

 

 

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Esther Scott, LPC

Esther Scott is a licensed professional counselor in Arlington, Texas. She is a solution-focused therapist. Her specialties include grief, depression, teaching coping skills and couples counseling. Contact her through her website at positiveactionsinternational.com.

 

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Coping with the (ongoing) stress of COVID-19

By Lindsey Phillips May 21, 2020

The COVID-19 pandemic is affecting everyone differently. Some are coping with the loss of a job. Some are risking their lives caring for those who are sick. And others find themselves deeply contemplating existential questions of mortality and the meaning of life.

The pandemic could also be compounding underlying mental health issues for some clients, notes Robert Haynes, a member of the American Counseling Association. For instance, clients who were already battling depression or obsessive-compulsive disorder may now be dealing with a significant amount of anxiety and stress on top of that related to COVID-19. Those confronted with social injustices because of their race, ethnicity, sexual orientation or disability may also be more affected, he adds.

“People are going to be all over the spectrum as far as how they’re doing, what they’re doing and how it’s affecting them,” Haynes says. “Don’t assume anything, even if you’ve been working with a client for some time. This [pandemic] may be a huge setback for them.”

Many people have not dealt with this level of stress before, and some are having newfound anxieties, which can be jarring, says Shainna Ali, a licensed mental health counselor (LMHC) in Orlando, Florida. The pandemic may also uncover an unaddressed mental health concern that could benefit from counseling, she adds.

Coping with uncertainty

People’s ability to cope with stressful events has been and will continue to be tested by the COVID-19 pandemic. During this time when mental health is moving to the forefront of the public’s consciousness, professional clinical counselors are in a prime position to help clients cope with uncertainty and loss, build resilience, adjust their coping strategies and self-care routines, and identify their individual and community strengths. And counselors, of course, can best help their clients by remembering to also take care of themselves during this challenging time.

Uncertainty surrounds this global crisis. No one is quite sure what to expect or what the next day will hold. The uncertainty, fear and unknown with COVID-19 creates the perfect formula for anxiety, says Haynes, co-author, with Michelle Muratori, of the recently published ACA book Coping Skills for a Stressful World: A Workbook for Counselors and Clients.

A common response to this uncertainty is trying to seek control, Ali says. Throughout this pandemic, Ali, owner of Integrated Counseling Solutions, has constantly been reminding clients, “Manage what you can. Release what you can’t.” Fixating on what you can’t control leads only to rumination, but focusing on what you can manage is one way of coping with a stressful situation, she says.

For example, an adult client might worry about their parents and how well they are isolating during the pandemic. The client may want to visit their parents but also fear making them sick. Ali would advise this client to find another way to check on them (one that aligns with the Centers for Disease Control and Prevention guidelines) such as calling or doing a video chat.

“Focusing on what we can control might help us to feel more grounded,” says Muratori, a senior counselor at the Center for Talented Youth and a faculty associate in the school of education at Johns Hopkins University in Baltimore. Counselors can help clients set small, achievable goals and take time to reflect on what they have accomplished each day. For example, clients can ask themselves, “What is one thing I can do today to move toward accomplishing my goals?”

People can also control the type and amount of information they consume. As Stephanie Dailey, an assistant professor of counseling at George Mason University, points out, overexposure to media tends to increase people’s levels of distress, fear and anxiety during disaster situations, regardless of whether they were involved in the crisis.

“Accurate and timely information is important,” says Dailey, a licensed professional counselor in Virginia. “But if a client is constantly on social media and is accessing sensationalized or erroneous information, it’s going to undermine their mental health.” She advises counselors to inquire about how much access (or overaccess) to information clients might have.

Coping with loss

Not all loss is obvious. A couple mourn the cancellation of their vacation plans. A high school senior is upset because he won’t be able to experience graduation with his friends. A young child misses her first Broadway show. Neighbors are no longer able to relax and celebrate the end of a workweek by having dinner with one another in their homes on Friday night. Baseball fans lament the start of the season being postponed.

Loss is upsetting because it highlights what we no longer have or what we could have had, explains Ali, a member of ACA. She helps clients more fully understand what they are truly mourning and validates their appropriate emotional responses to the loss, such as sadness, anger and frustration. But she also helps clients see possibilities for experiencing gratitude even in the midst of loss.

For example, if a client is upset about not being able to get married when originally planned, Ali first reassures the client that feeling that way is OK. She may then ask the client to think about something for which they are grateful. The client may respond, “I still have my partner.”

Ali, author of The Self-Love Workbook and the blog A Modern Mentality (hosted by Psychology Today), finds gratitude a particularly valuable coping skill currently because “right now, it’s really easy to get distracted by the negative.” Encouraging clients to be grateful and to look for the positive isn’t meant to undermine or minimize negative emotions, she asserts. Rather, it deters clients from ruminating on the negative. 

Ali might also ask the client upset about their postponed wedding, “How can you still honor what you have?” This question would help the client refocus their energy on what can be managed (such as revising their wedding plans or planning an at-home date night) rather than wrestling with what is beyond their control, she explains.

Building resilience

Haynes and Muratori say that resilience is one of the key components of being able to cope with stressful events. Some people incorrectly assume that resilience is innate, but it can be learned, asserts Haynes, a clinical psychologist and producer of psychology video programs for Borderline Productions. “Resilience is more what you do than it is who you are,” he explains. And like any other skill, it grows stronger with practice.

Counseling techniques that help clients connect with others, adjust their thinking and beliefs, become more optimistic and flexible, practice self-care, attend to the spiritual dimension of life or promote self-compassion can bolster resilience, Haynes says.

In Coping Skills for a Stressful World, Haynes and Muratori share an exercise for strengthening client resilience. It involves clients tracking their reactions to stressful events for a period of two weeks and asking themselves some questions: What did they feel and think about the situation? What actions did they take to resolve the crisis? How effective were those actions? What did they learn? The exercise encourages clients to consider their own strengths and the ways they already cope with stressors. Clients come to the realization that they can use these same tools that they already possess when facing future crises, Haynes and Muratori explain. (The use of out-of-session exercises and activities such as this one is a major focus of their workbook.)

Ali works with clients to create their own toolkits of general self-care and coping skills that may be helpful during difficult times. It is important that people establish a general self-care practice rather than waiting to focus on coping skills during a crisis, Ali notes. She says that everyone’s coping skills during a stressful event will look different, but she advises clients (and counselors) to break into their “emergency coping kit” and find activities that help them manage stress.

Dailey, an ACA member who specializes in disaster mental health, finds ways to tap into her clients’ strengths to promote resilience and coping. If a client enjoys art, for example, Dailey may recommend painting or drawing as a possible coping tool. If a client is a natural helper, Dailey might have them brainstorm ways they could support others during the COVID-19 crisis, such as making masks or volunteering virtually. Spiritual or religious practices also provide an enormous amount of strength for some clients, she adds.

“Communities and individuals are innately resilient,” says Dailey, co-author of the 2014 article “Shelter-in-place and mental health: An analogue study of well-being and distress” for the Journal of Emergency Management. “Everyone has strengths, and this crisis can be an opportunity to find those strengths.”

As Muratori, an ACA member, points out, learning coping skills and resilience is not just something that will help clients get through the current COVID-19 crisis. It will also prepare them for future crises, large or small.

Adjusting coping and self-care strategies

“One of the skills in being resilient is also having some flexibility,” Muratori says. That is particularly relevant now because the COVID-19 pandemic has forced people to constantly shift and reshift their schedules while also creating new routines.

It is natural for people going through challenging times to engage in rigid thinking such as “I can’t stand this,” Muratori says. She advises counselors to remind clients that they are standing this; they are adapting and adjusting.

Many of Ali’s clients thrive with routine, but those routines have repeatedly been disrupted by physical distancing, quarantine and gradual reentry. Some of her clients were used to having a clear distinction between their home lives and work lives, so being forced to work from home has created new challenges for them around establishing and maintaining boundaries.

Ali works with these clients to recognize their personal boundaries and to establish some sort of new routine for themselves. She encourages clients to use a semistructured routine, in which they set their intentions for the day but also remain flexible to accommodate new circumstances as they arise.

Dailey also advises clients to maintain a regular routine as much as possible. She encourages them to focus on the basics, such as waking up, showering, eating and going to bed at the usual times.

Ali says that social connectivity remains an important coping strategy during the COVID-19 pandemic. “Social distancing and social isolation are not the same,” she emphasizes. Ali advises clients to think of creative ways to continue meeting their social needs. For example, if clients previously coped with a stressful workweek by going out to dinner with friends, perhaps they could consider hosting a virtual dinner party.

Likewise, clients may need to adjust their self-care regimens right now. After first defining self-care, Ali says, counselors can help clients brainstorm self-care techniques that have worked for them in the past and then look at how they can adapt those strategies (if necessary) to work in an environment of physical distancing or gradual reentry. For example, if a client previously coped with stress by going to the gym, how could they still fulfill that need while gyms are closed? Could they take a remote fitness class or go for a run instead? (For more on this topic, read Ali’s ACA blog post “Self-care & social distancing: Helping clients adjust during COVID-19” at tinyurl.com/ACAMemberBlogAli.)

“Any tools that will support relaxation are really critical at this time,” Dailey emphasizes. She finds mindfulness an effective technique for helping clients regulate their emotions because it encourages them to pause for a moment and let their bodies catch up with their brains. In turn, emotion regulation helps clients successfully manage their symptoms, maintain focus for day-to-day problem-solving and attend to physical needs such as eating, sleeping and taking the proper medications, Dailey says. Clients can journal, go for walks, spend time outside, exercise, meditate, do breathing exercises or do grounding exercises to manage their anxiety, she adds.

Counselors can also play a role in making self-care fun. To help boost self-care, Ali challenges clients (and herself) to combine various coping strategies. For example, a client could livestream a fitness class with a friend, or a family could do a gratitude reflection together at dinner.

Coping as a community

Muratori says that the COVID-19 pandemic exemplifies communal shared trauma — a traumatic event that affects an entire community directly, indirectly or vicariously. The good news is that community members are finding ways to support one another.

In Dailey’s community, neighbors stood on their porches one night and clapped into empty space to show their support for health care workers. They also placed stuffed bears with hearts on the chests in their windows to show their love for one another. Members of Haynes’ neighborhood also placed stuffed bears in their windows so children could go on a “bear hunt.”

Counselors can encourage clients to look around their communities and notice these resilient acts, Dailey says.

Ali specializes in individual mental health counseling, so her clients typically come to her to work on their own individual concerns. But since the COVID-19 crisis began, Ali has noticed that her clients are also showing more concern for the mental health of those around them, including family members, friends and neighbors.

Ali’s clients are also passing along their coping skills to others. One client noticed a roommate was anxious and suggested that they color together because coloring had previously helped the client manage stress.

Some of Ali’s other clients have been modeling the coping and communication skills they learned in counseling for their children at home. This includes using “I” statements, taking breaks and practicing self-care.

Ali also found a way to use her expertise to serve her community. Ali noticed a pattern of heightened stress among people in her life (herself included) because of the pandemic, but as a counselor, she also knew that this reaction was normal. She realized, however, that others in her community might not understand the emotions they were experiencing or know how to cope with the increased stress.

“This [pandemic] is not just exacerbating mental health concerns for people who are in counseling. This is also highlighting mental health problems for people who are not in counseling,” she says.

Of course, Ali couldn’t provide counseling to her entire community, so she and two other LMHCs, Candice Conroy and Sanya Matani, started offering a free virtual lesson to help people better understand and cope with the stress they might be experiencing because of COVID-19. The three LMHCs made it clear that the lesson wasn’t a substitute for counseling and provided resources for people to seek professional help.

Coping as a counselor

Haynes and Muratori express concerns about the stress levels counselors might experience throughout the pandemic and even after the initial threat subsides. “They need to take care of themselves better than they ever have before,” insists Haynes, author of Take Control of Life’s Crises Today! A Practical Guide.

Counselors need to apply the same coping strategies and tools to themselves that they give to clients, Haynes says. These include getting proper sleep, exercising, connecting with others, taking breaks, processing their emotions, turning off the news and getting outside.

Ali acknowledges that she has been feeling the stress of handling her own anxieties and concerns about the pandemic while also maintaining her current caseload. At first, the pandemic was the main topic for all of her clients, but this is evolving, she says. Now that most of her clients have adjusted to a new routine, they are again discussing their primary concerns that originally brought them to counseling. Still, Ali thinks it is important to do a quick check-in with her clients about how they are coping with the ongoing stress of COVID-19.

Self-care becomes even more important for counselors when sessions all deal with the same topic, giving clinicians few breaks to escape from it, Ali says. She has been coping with her stress by journaling, doing yoga, dancing, walking her dog, practicing mindfulness, reading, doing video chats and exercising.

Counselors need to remember that they are affected (whether directly or indirectly) by this pandemic too. Before the pandemic, most of Ali’s clients used traditional counseling, but with physical distancing rules in place, they now mainly use telebehavioral health. Ali acknowledges that staring at a screen for long periods of time has been taxing for her.

Taking breaks from the screen and using a semistructured schedule for both her personal and work schedules have been helpful coping strategies for her. When she feels particularly overwhelmed, she also practices a “digital detox,” putting her digital devices away for a day and focusing on her self-care to find her equilibrium. If a complete digital detox seems intimidating to counselors or clients, she encourages them to create small, manageable digital boundaries such as stepping away from their devices for a few hours or setting a timer to minimize their use of electronics.

For counselors in private practice, isolation can be another pronounced risk during the pandemic, Haynes points out. He highly recommends that counselors seek out colleagues for consultation, support and supervision during this stressful time.

Much like counselors advise their clients to look for individual and community strengths, clinicians can listen for examples of clients’ resilience, Dailey says. This may result in vicarious resilience, a concept developed by Pilar Hernandez-Wolfe, David Gangsei and David Engstrom in which therapists experience their own personal growth by witnessing and recognizing the growth of their clients.

Adjusting to a new normal

Even after the number of COVID-19 cases subsides, life won’t just go back to normal. The reentry process is going to upset people’s routines all over again, Haynes predicts. For that reason, he and Muratori advise that counselors prepare to take a more directive stance with some clients and focus on their life skills during the transition back toward a “new normal.”

Counselors may need to provide clients with guidelines, instructions or demonstrations, or they may have to model or teach clients new skills, Haynes and Muratori say. For instance, some clients who have been laid off may need help filing for unemployment, conducting a job search or applying for new jobs. Others may need guidance on how to safely reenter their workplace or physically interact with family, friends and community members for the first time in months.

Counselors will also have to help clients manage expectations, Dailey says. For example, many clients may now be dreaming of returning to work, but when that finally happens, they could very well find themselves stuck in meetings again and wondering what their kids are doing at home. Likewise, parents feeling impatient about their children returning to school may have forgotten what the old morning struggle was like to get everyone off to school and work on time.

Adjusting back to something resembling the previously normal routine as stay-at-home orders are lifted will take time. Dailey thinks the adjustment will come in phases. People returning to work will be one round of adjustments. Then there will be another adjustment period as schools attempt to reopen in the fall. 

It is also important to note that clients won’t just be going back to “work as normal,” Dailey says. Even if they return to the same job and the same physical work location, things promise to be different in the wake of COVID-19. These differences may cause some clients to feel relief, whereas others will experience a new round of anxiety and fear.

Dailey compares these adjustment phases to a flipbook. Everybody has their own unique story with the pandemic, and every page of the flipbook represents a new experience, a new adjustment. Counselors can help clients process and cope with these adjustments by “flipping” through their stories, stopping at certain points, and assessing how the clients reacted and coped with that part of their story. The tools they used to cope — making art, meditating, sewing, exercising — are ones they can use again in the future as they adjust to a new phase, Dailey says.

The COVID-19 pandemic possesses the potential to change the counseling field and how professional counselors work with clients now and in the future, Haynes says. Since the turn of the century, it’s true that the United States has experienced major crises such as 9/11, large-scale natural disasters and the Great Recession, but, as Haynes points out, there hadn’t been a crisis on a global scale like a world war until COVID-19. This experience could shift the focus more toward prevention and preparation (both for individuals and for systems on a national level) for future crises, he says.

Adjusting to this new normal doesn’t have to be all negative. Once we reenter society after the threat of COVID-19 subsides, we will be able to celebrate regaining some of our old coping strategies as well as the acquisition or discovery of new strengths along the way.

Counselors are in position to help clients gain greater perspective and self-awareness while coping with the stress and loss that the pandemic has introduced, Ali says. To aid in that process, she sometimes asks clients who have already adjusted and are successfully coping with this stress and loss, “What are you learning during this time?”

In asking that question, Ali has found that several of her clients now understand how the coping skills they previously learned in counseling have helped them handle this stressful moment in history.

How we cope with the stressors of COVID-19 can tell us a lot about ourselves, Ali says. While it may be unpleasant, we can use these times as learned lessons that will help us continue to adapt and manage stressors in the future.

But for now, just take a deep breath.

 

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Lindsey Phillips is a contributing writer to Counseling Today and a UX content strategist. Contact her at hello@lindseynphillips.com or through her website at lindseynphillips.com.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Helping clients grow from loss

By Sherry Cormier February 4, 2020

Loss is a universal experience and an underpinning of many therapeutic issues. The client who has just lost a job, the parents whose son is addicted to opioids, the client whose long-term relationship unraveled, and the client who received a devastating health diagnosis all have loss in common.

As a professional counselor and bereavement trauma specialist, I am sensitized to the ways that loss informs clients’ worldviews and emotional struggles. And as a grief survivor, I am aware of the unique ways in which loss can serve as a catalyst for growth. An African proverb captures this sentiment when it says, “Smooth seas do not make for skillful sailors.” But this raises questions: Is growth possible for everyone, and how do counselors help clients grow after a traumatic loss?

Posttraumatic growth: What is it?

Posttraumatic growth (PTG) is an approach that informs our practice as professional counselors. Richard Tedeschi and Lawrence Calhoun, who pioneered much of the research and theory on PTG, define it as positive change that follows the struggle after some kind of traumatic event. PTG represents change that occurs after a life crisis rather than during it. It usually involves longer-term change that occurs over an extended period of months to years as individuals cope with crisis by developing ways of thinking, feeling and behaving that are different from what they relied on prior to the life-changing event.

PTG is not the same as personal development or maturity. It may be thought of as something that occurs somewhat spontaneously as the result of trying to cope with a challenging life experience of seismic impact. Evidence of PTG does not imply that the loss or traumatic event was somehow desired.

Approximately 10% of loss survivors stay mired in grief, guilt and despair for an extended period of time following their loss. Clients who experience these emotions, coupled with an intense yearning for who or what was lost, might be suffering from complicated grief, which requires a particular kind of professional treatment (see complicatedgrief.columbia.edu). The majority of loss survivors do not get stuck in acute grief, however, and report some measure of growth during recovery from loss. For many of these survivors, growth may coexist with distress.

Research summary: What do we know?

In 1996, Tedeschi and Calhoun’s research resulted in the Posttraumatic Growth Inventory, a 21-item self-report measure that yielded five empirically derived markers of PTG:

1) Improved relationships with others

2) Greater appreciation for life

3) New possibilities for one’s life

4) Greater awareness of personal strengths

5) Changes in spirituality

These five markers of growth have been reported by a variety of survivors, including prisoners of war, veterans with posttraumatic stress disorder, people diagnosed with cancer or other life-threatening illnesses, people who became paralyzed from accidents, and those who have lost spouses or life partners. Although much of the research has been conducted with people living in the United States, other studies have explored PTG with individuals in other countries.

Among current findings on PTG, Tedeschi and his co-authors cited the following in their 2018 book Posttraumatic Growth: Theory, Research, and Applications:

  • About 30% to 60% of survivors report some experience of PTG following a difficult life event.
  • PTG is both a process and an outcome.
  • PTG is generally a stable phenomenon over time.
  • PTG is more evident in those individuals who score higher on measures of extraversion and openness to experience and is also related to optimism.
  • There are both universal aspects and culturally specific characteristics of PTG.

Critics of PTG point out that self-reported or perceived growth is not necessarily the same as actual growth. Some of the conflicting findings on PTG seem to be the result of differences in how growth is defined and measured across studies.

Growth-promoting practices with loss survivors

There has been less research about specific interventions and techniques that might facilitate PTG in survivors, although a predominant feature of a growth-oriented therapeutic approach involves working with client stories or narratives. The following practical strategies can be used to help facilitate growth with loss survivors.

Create a safe therapeutic environment. Traumatic loss erodes a sense of security and thrusts survivors into the middle of unfamiliar circumstances. Social support is crucial, yet many people in survivors’ social networks may be uncomfortable with grief or may offer well-intentioned comments that feel offensive to the survivor. Counselors’ first task is to provide a safe container that is comforting and companionable for loss survivors. Creating a therapeutic environment in which we listen closely and hold up a mirror to reflect these clients’ experiences will help loss survivors feel known.

Use self-care practices. Traumatic loss may disrupt the rhythm of survivors’ connections. One way to help loss survivors reestablish bonds with others is to encourage them to grow a new relationship with themselves. We can help clients do this by recommending effective self-care practices such as movement and exercise, adequate sleep, and the intake of nourishing food. In the 2012 book The Emotional Life of Your Brain, Richard Davidson points out that a lack of consistent self-care practices sabotages our ability to regulate our bodies and emotions. Mindfulness and self-compassion are additional self-care practices that can be used by loss survivors who feel emotionally flooded with anger, guilt or anxiety. Teaching self-compassion and mindful meditation to these clients can help them reestablish a connection with themselves and, ultimately, with others. These tools also enhance clients’ equilibrium, making further work toward growth possible.

Explore client narratives. An important part of therapy with loss survivors involves exploring their narratives or stories. PTG occurs most often with clients who create an adaptive narrative in which they are able to see themselves as survivors rather than victims. The following items play integral roles in exploring client narratives.

Timelines: Initially, clients can construct a timeline of their lives with significant events marked at various ages. Timelines provide critical clues about pre- and post-loss stressors as well as the loss event itself. Clients who have been subjected to many pre-loss stressors often have more difficulty discovering growth. Using strength-oriented queries when asking clients to review their timelines is useful. For example, “Juanita, I noticed you had a miscarriage when you were 20. How did you cope with that? What tools did you find that helped you through that loss?”

Clues of growth: Many clients are so affixed to the trauma of the event that it’s hard for them to detect anything positive about their story. Counselors can be most helpful by noting clues of growth and healing in clients.

For example, James, an African American in his mid-20s, is discouraged because he has been through multiple losses. The house he once lived in with his grandmother was recently obliterated by a tornado, and now she is in the hospital with multiple injuries. In addition, the business he started just folded. In recounting his narrative, James mentions that a local church has offered to help rebuild the home, and a nearby car dealership just offered him a job. He says having others reach out to him with offers of assistance feels so unfamiliar that it’s starting to change his opinions about the world and other people. Although he doesn’t identify this as an indicator of growth, his counselor does by pointing out ways in which James’ views of himself, other people and the world are shifting in a new direction.

Cultural context: Exploring client narratives within a cultural context is also crucial. Some clients may present narratives of cultural losses rather than individual losses in instances in which they have faced significant discrimination based on their race, ethnicity, gender, age, ability status or sexual orientation. It is important for counselors to be aware of the ways that clients’ cultural affiliations affect their lives and their views of traumatic loss and healing.

For example, James reveals that he has been working odd jobs since he was 14 to support himself and his grandmother, whose only source of income is a small Social Security check. James confides that this elevated level of financial stress and the recent losses he has experienced make him feel more vulnerable as a black man living in a predominantly white rural community.

Journaling: Counselors can also facilitate client narratives by encouraging the use of journaling as an adjunctive therapeutic intervention. Therapeutic journaling is a tool developed by James Pennebaker, who says that writing about traumatic events reduces stress and strengthens immune cells. Consistent journaling is most effective, but 15 to 30 minutes of journaling several days a week can be more productive than daily journaling, which may produce more rumination than growth, according to Pennebaker. When working with survivors of loss, counselors typically instruct these clients to write about their deepest thoughts and feelings regarding their loss.

Case example: Sharon

Sharon is a 62-year-old woman whose live-in partner of 40 years died of a sudden heart attack. Sharon resides in rural Appalachia, where she had lived with her now-deceased partner for many years. She has no children, and her one brother lives hundreds of miles away. Sharon stopped working in a dental office seven years ago to help take of her partner, who had uncontrolled diabetes. She has no real friends and reports that she has rarely been out of the house in the past seven years. She says that she has no neighborhood acquaintances or memberships in any social groups.

In the first several counseling sessions, Sharon sobs and indicates that she has no idea how she will go on after losing her partner. She has limited income but no real expenses other than rent and utilities. She insists that she does not want to return to work and has sufficient income to meet her monthly obligations. She presents herself as something of a loner and describes herself as isolated.

Sharon came to the community counseling center at the urging of her brother, but she is unsure that grief counseling can be helpful to her. Short of bringing her partner back to life, she doesn’t know how talking and crying about her loss will accomplish anything. She is not having trouble sleeping but feels compelled to get out of the house during the day. She drives around randomly and visits local discount stores just to have someplace to go.

Sharon becomes more interested in counseling when a grief support group is offered, and she attends several sessions. She returns to individual counseling in a much more animated state and is even able to laugh. Having made several friends in the grief support group, Sharon reports that the group has helped her feel less alone. She is able to construct a grief timeline in counseling and is amenable to doing occasional journaling when she has bursts of grief. Over time, she pursues recommendations for joining a local gym and a book club at the public library.

Four months into individual counseling, Sharon becomes interested in volunteering at a local animal shelter and starts doing so on a weekly basis. Several months later, she feels like a different person. She says she is ready to stop coming to individual counseling sessions but will continue attending the grief support group.

Not all grief survivors experience the kind of growth that Sharon experienced — or so quickly. Even though she continued to miss her partner terribly, her life as a caregiver for the past seven years had precluded her from developing much life satisfaction for herself. Her ability to make friends and develop social connections and her volunteering activities with the animal shelter gave her a great deal of self-efficacy and provided positive ways to deal with the absence of her partner.

Some people will not cope with loss as effectively as Sharon did. Those who experience losses associated with violence or who have coexisting diagnoses such as depression, anxiety or substance disorders are more likely to go through an extended recovery period for healing. In addition, many grief survivors feel guilty for experiencing any kind of satisfaction, as if it amounts to some kind of betrayal of the person who is no longer here.

At the same time, it is not uncommon for grief survivors to reevaluate and shift their priorities in life, in part because their life circumstances have changed. For example, Emilee lost her spouse Roberto, who was a retired military officer and active in veterans’ affairs. Roberto had spent his retirement years traveling internationally in support of this cause. Emilee had rarely accompanied him because of her fears of terrorism and plane crashes. After Roberto’s death, however, Emilee decided to engage with the same veterans’ foundation that Roberto had been active in and found herself traveling all over the globe. Emilee wanted to preserve her spouse’s legacy and share her own gifts with a larger number of people. Loss survivors such as Emilee and Sharon who find ways to give back or volunteer are more likely to report narratives of growth.

Being attuned to growth

Potential for growth exists when clients uncover meaning from their loss and construct narratives that fit into their worldview and sense of self. Skilled counselors can serve as guides to help survivors make sense of what has happened. No survivor should ever be pushed to grow, but having a counselor attuned to growth may be the missing piece that helps clients become more resilient in the face of traumatic loss.

In my own experience as a grief survivor following a series of personally devastating losses, awareness of my growth sneaked up on me. It was as if a dimmer switch got turned up again as my outlook and mood shifted in a positive direction. I include this because being attuned to indices of growth may be one of the best ways that we can help clients recognize growth possibilities and emerge from the darkness of a traumatic loss to find light again. As Jon Kabat-Zinn, founder of mindfulness-based stress reduction, has said, “You can’t stop the waves, but you can learn to surf.”

 

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Sherry Cormier is a licensed therapist, certified bereavement trauma specialist, and former faculty member at the University of Tennessee and West Virginia University, as well as being a public speaker, trainer and consultant. She is the author of Counseling Strategies and Interventions for Professional Helpers (ninth edition), senior author of Interviewing and Change Strategies for Helpers (eighth edition), and co-producer (with Cynthia J. Osborn) of more than 100 training videos for Cengage. Her newest book is Sweet Sorrow: Finding Enduring Wholeness After Loss and Grief. Contact her through her website, sherrycormierauthor.com.

 

Letters to the editor:  ct@counseling.org

Counseling Today reviews unsolicited articles written by American Counseling Association members. To access writing guidelines and tips for having an article accepted for publication, go to ct.counseling.org/feedback.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.