Mind and Emotions (4 page)

Decide which one you’d like to start with, then visualize the scene. Notice everything about the physical environment. If things are being said, listen to the tone of voice as well as the words. Notice any feelings in your body, and try to remember what you actually did (emotion-driven behaviors) in response to the situation. Now carefully watch the emotion that builds inside of you. Stay with your image of the scene until the emotion is strong and clear and you begin to have words for it. Record this experience on your Emotional Response Worksheet, including the thoughts, sensations, and emotion-driven urges. After you’ve finished writing about the first scene, set time aside to tackle the next two images.

This exercise and the previous two have given you a lot of practice in observing and naming aspects of your emotional life and the parts of your emotional responses. This practice is essential in learning to recognize how emotions affect you and drive your behavior.

How Emotional Problems Arise

Emotional problems are often blamed on stress, trauma, early upbringing, interpersonal conflicts, hormones, and genetics. But surprisingly, research shows that another factor is much more responsible for emotional disorders: our coping behaviors (Hayes 2005). We each learn to deal with the stress of life using a repertoire of coping strategies designed to reduce pain. The trouble is, some coping strategies work better than others, and some are absolutely catastrophic in terms of their long-term impact on well-being.

There are seven maladaptive coping strategies that drive most of our emotional distress and turn painful moments into chronic disorders. These coping strategies are called transdiagnostic factors because they are the underlying cause of symptoms across many diagnostic categories: anxiety, depression, chronic anger, borderline personality disorder, and post-traumatic stress disorder, to name a few. Let’s take a look at the transdiagnostic factors, or maladaptive coping strategies, that lie at the root of chronic emotional pain.

Experiential avoidance.
People who use this strategy automatically try to avoid painful emotions and thoughts. As soon as they feel something uncomfortable, they try to suppress, numb, or push away the experience. They attempt to put a lid on things so the pain is somehow muted. This coping strategy often backfires because avoidance not only fails to suppress painful feelings, it also makes the pain worse. An example is Harold, who withdrew socially and began drinking in an effort to avoid the sadness of losing his job. But his sadness just turned to depression as he sank into alcoholism and isolation.

Rumination.
In this strategy, people use obsessive thoughts to blunt the fear of uncertainty, and use judgments in the hope of forcing themselves or others to do better. In the form of worry, rumination tries to prepare you for every bad thing that might happen. In the form of good-bad evaluations, it tries to perfect a flawed self and a flawed world. But these efforts never work. Ultimately, rumination keeps you focused on what’s bothering you, so its net effect is that you feel more anxious, more angry, or a greater sense of loss and disappointment.

Emotional masking.
The aim of this coping strategy is to make sure no one ever sees your pain. It arises from a fear that if others saw your emotions, they might be contemptuous or judge you as weak, foolish, or crazy. So the mask must stay on and the feelings that burn in you must stay hidden. The price for this maladaptive strategy is that the real you remains invisible, lost in the effort to look good. You can’t show what you need or feel, so you remain helpless and possibly unfulfilled in your relationships. No one knows what hurts or what needs to change.

Short-term focus.
The motto of this coping strategy is “Why do it right when I can do it now?” When faced with emotional pain, many people focus on what can give them relief in the moment. They want to stop or suppress the emotion and will do whatever it will take to build a wall between themselves and their feelings. But while short-term focus may provide a brief moment when the pain diminishes, in an hour or a day or a week it’s back—and it’s worse than ever. That’s because short-term relief strategies often harm people in the long run. For example, drugs or alcohol can numb the pain in the moment but create long-term job, relationship, and health problems that eclipse the original distress. Another example is avoiding an upcoming social event because it makes you anxious. The short-term solution of avoidance temporarily reduces anxiety, but in the long term each choice to avoid increases the level of social fear, while also leading to isolation and risk of depression.

Response persistence.
In this transdiagnostic factor, you continue responding to similar situations in the same way, even when it doesn’t work. Sometimes this happens because you’re afraid to try other responses. Or maybe you have inner rules that prevent you from seeking a new solution. Either way, the result is that you become inflexible and always cope with problems the same old way. You’ve heard the adage that every problem looks like a nail when all you have is a hammer. Likewise, every conflict turns into a fight when all you know how to do is get angry, and every little mistake turns into a catastrophe when all you know how to do is brood and castigate yourself about it.

Hostility or aggression.
This coping solution helps mask stress, fear, loss, guilt, shame, confusion, a sense that you’re wrong or bad, the feeling of being engulfed or overwhelmed, and a host of other painful emotions. Anger is a big lid that covers a lot of pain and keeps it out of your awareness. This solution is often effective in the short term, but research shows that the more you use anger to cope, the angrier you get (Tavris 1989). Hostility begets even more hostility in a vicious circle that poisons lives.

Negative appraisal.
This coping response uses negative evaluations or judgments to help you prepare for failure and bad outcomes, control others, or beat yourself into being a better person. If you use this strategy habitually, you’ll tend to expect things to go wrong and to focus on things that actually are wrong. This attention to the negative may seem to protect you from painful surprises, but you’ll end up feeling more angry, anxious, and depressed because you filter out most positive experiences. An example is a man who stumbled in a speech at his daughter’s wedding and could hardly think about anything else for the rest of the night. Meanwhile, he was missing the joy he could have been feeling.

Assessing Your Problematic Coping Strategies

The seven transdiagnostic factors listed above drive most of the emotional struggles people experience. But which maladaptive coping strategies affect you the most? It’s worthwhile to figure this out because it has a bearing on which treatment approaches will be most effective for you. The following inventory will provide answers, giving you a score for each of the transdiagnostic factors.

The items in this inventory are different ways of dealing with problems. As you complete this inventory, think about difficult or stressful events in your life, including work challenges, family problems, conflicts, and frustrations. Do your best to rate each item in terms of how frequently you use it. There are no right or wrong answers, so choose the most accurate answer for you, not what you think is most acceptable or what most people would say or do. Rate each item on a scale of 1 to 4, where 1 means you don’t use that strategy at all, and 4 means you use it a great deal.

To score the inventory, add the scores for items 1.1, 2.1, 3.1, 4.1, 5.1, 6.1, 7.1, and 8.1. This is your score for experiential avoidance; record it on line 1 below. Then add your scores for items 1.2 through 8.2. This is your score for rumination; record it on line 2 below. Continue in the same way to determine your scores for all seven transdiagnostic factors.

1. Experiential avoidance (1.1-8.1) _______
   
2. Rumination (1.2-8.2) _______
   
3. Emotional masking (1.3-8.3) _______
   
4. Short-term focus (1.4-8.4) _______
   
5. Response persistence (1.5-8.5) _______
   
6. Hostility or aggression (1.6-8.6) _______
   
7. Negative appraisal (1.7-8.7) _______
   

The higher your score for any of the seven transdiagnostic factors, the greater your tendency to use that coping strategy in response to problems or stress. A score above 16 for any of the factors suggests that this coping strategy is affecting you emotionally. A score above 24 indicates that this factor has a strong influence on your emotional life.

How the Universal Protocol Can Help You

Each of the ten treatment chapters in this book teaches a specific skill, and each of these skills is designed to target and change one or more of the transdiagnostic factors. The table below indicates which transdiagnostic factors are targeted by each chapter, to help you choose where to focus your efforts.

A high score for a particular transdiagnostic factor indicates that you should make a strong commitment to learning the corresponding skills. On the other hand, a low score suggests that you might skip learning a particular skill (as long as you don’t have another transdiagnostic factor that would benefit from developing that skill). So a low score on negative appraisal suggests that you might skip chapter 7, Cognitive Flexibility Training, and a low score on both response persistence and hostility or aggression indicates that you might skip chapter 10, Interpersonal Effectiveness. If you don’t have the time or energy to work your way through the whole program, it’s fine to skip skills you don’t need as much. But if you do have the time and energy, we encourage you to work your way through all of the skills in this book. Each will strengthen you in your struggle with emotions. And the truth is, anyone can benefit from learning all of these skills.

Chapter 3

The Cost of Avoiding Emotions

This chapter describes the most common ways of avoiding unpleasant emotions and discusses why avoidance results in major long-term problems, even if it does offer short-term relief. We’ve also provided exercises to help you identify, assess, and analyze your own avoidance strategies.

Types of Avoidance

The ways people typically avoid painful feelings can be grouped into five basic categories: situational avoidance, cognitive avoidance, protective avoidance, somatic avoidance, and substitution avoidance. For clarity, each type of avoidance is explained separately below. In real life, however, people often attempt to reduce painful emotions using two or three types of avoidance simultaneously.

Situational avoidance.
This is the most common type of avoidance. With situational avoidance, you stay away from people, places, things, or activities that tend to trigger emotional distress. For instance, you might avoid crowds or large parties. Or you may try not to make eye contact with people or avoid situations in which you have to interact socially with strangers. Perhaps you steer clear of certain people, such as your brother-in-law or police officers, who make you nervous, or particular places that trigger a panicky feeling, like theaters, elevators, or subways. Or maybe you avoid certain animals, such as snakes or spiders, or certain activities, like public speaking or changing clothes in a locker room.