Thursday, August 27, 2020

Helping our patients to shift gears from ruminating about the past and fears

Have you ever had patients who are continually living inside their heads, and ruminating about the past, or worrying about the future?

How can you help them to shift gears?  This is a metaphor I often use to help these folks. 

When we are ruminating about the past, or anticipating a negative future event in an unhelpful way, we are living inside our heads. This is what we would call the “inside head experience”.  Introversion is another term, if you like that term better. We are now “stuck in that gear”. 

To shift from that gear, we must first use our “clutch” to detach from that gear.  Defusing, detaching, distancing or unhooking from thoughts/feelings is just like that clutch in the car. But this is not enough. If one purely focuses on defusing and unhooking from thoughts/feelings, then it’s like pressing on the clutch and releasing it again back to the original gear. 

Once the clutch is pressed, one must then go into neutral, be present and grounded in our body and the five sense experience rather than the “inside head” experience, and at the same time observe our thoughts and feelings without judgement and urge to act. Observe and notice it with curiosity. Perceive to gain more clarity rather than judge and act impulsively. 

Then we can shift gears to value based actions especially when we have more clarity. What’s the quality of life that we want to create?  Where do we want to go despite the challenges. How can we live life true to who we are and our values?

One must coordinate all the elements above in order to “shift gears” more effectively. 

The challenge is that many folks may not know how to operate the clutch and gears properly. Many may have a poor functioning automatic gear box, or may not know how to drive manual. 

The wonderful thing is, this is a learnable skill just like learning how to drive a car, albeit probably much more difficult perhaps. 

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