Learning to hold uncomfortable feelings with love, hope, care, kindness and compassion

If one holds a crying child with feelings of worry, fear, helplessness, anger, and frustration, it’s an awful experience. 

If one can hold a crying child with feelings of love, care, and compassion, it may lead us to a very different place.

So what’s my point?

The “feelings” with which we use to solve our problems matter. It matters deeply. It can make all the difference between a terrible or a wonderful outcome.

So next time we have an uncomfortable thought or feeling, consider holding it like a crying child, but with hope, care, love, kindness and compassion, and let that guide us, rather than the anger or helplessness.

How to be aware and shift our dialogue to improve our relationships

In couple counseling and conflict resolution, it’s often to see the following dialogue examples between person A with “Filter A”, and person B with “Filter B”. “Filters” represent our values, beliefs, and past experiences in the diagram above. 

Person A says, “It’s a square”.

Person B says, “It’s a rectangle”.

Person A says, “I don’t know why you keep saying it’s a rectangle when it’s a clearly a square.”

Person A says, “I can see why you say it’s a rectangle, but you are wrong. It’s a square.”

In couple counseling and conflict resolution, we try to shift the above dialogue to....

“Okay, so you see it as a rectangle. Can you tell me more so that I can understand?”

“I can see why it seems like a rectangle to you, AND at the same time, I see it as a square. I wonder how we can move forward with that?”

“Ahh, it’s a prism, and we are both correct in our own way.”

“Okay, so in this context, which way of seeing is the most helpful?”

Coaching couples to be more defuse, present, and more acknowledging of the other person’s perspective, rather than being critical/defensive/avoidant, is key in conflict resolution. It’s not easy of course, with our strong fight or flight response. It’s only human. Awareness, patience, and practice, will help our relationships move towards positive change.

Are you an inner compass person or an outer compass person?

Part of counseling is to help folks to understand self, and to fully accept self, the good and the bad. 

Are you an “inner compass” person or an “outer compass” person?

In other words....

1. Do you tend to make decisions or take actions based on your own inner feelings, principles/values (inner compass) OR

2. Do you tend to make decisions or take actions based on the feelings, principles/values of others (outer compass)?

Each has its pros and cons.

The “outer compass” folks are great at trying to create outer harmony by pleasing others, making them happy, being pragmatic, trying to fit in, but if excessive, they can “lose themselves” in the process. This can create a lot of inner disharmony and unhappiness. Some may refer to this as “moral injury” in some context. 

The “inner compass” folks are very good at knowing who they are, and living life true to who they are. However, if one is not careful, it can create a lot of friction for themselves if the outer compass is too different to the inner compass, leading to maladaptation.

In counseling, we often see the “extreme outer compass” folks, and the “extreme inner compass” folks. Outer compass folks have to learn to be a bit more inner compass, and the inner compass folks have to learn to be a bit more outer compass perhaps, in order to adapt better.

Which one are you bias towards? The inner compass or the outer compass?

Have you ever gone from one extreme to the other? Have you ever been able to find that elusive sweet spot, in order to balance your inner and outer compass? How can you learn to be more of one or the other?

I often view it like left handedness and right handedness. The reality is that we all use both “inner and outer compasses”, but there may be a bias towards one over the other.

School and parenting expect us to be more outer compass as a general rule. So I often see those children with “extreme inner compass” struggle here, leading to adjustment issues with fight/flight stress responses, which then may lead to a number of diagnoses, including ASD, ODD etc. “Extreme outer compass” kids are vulnerable at school too, especially with peer pressure, and if they find themselves in the “wrong crowd”. They are also more vulnerable to the judgement of others. 

For those with a partner, your partner will tend to be the opposite. So naturally, you will learn the opposite, although it can be quite annoying, as this may not be your natural tendency. Inner compass folks will be perplexed at why the outer compass folks worry about what other thinks, and outer compass folks are perplexed at why the inner compass folks are so stubborn.

Furthermore, when one is experiencing a negative outcome from following the outer compass, one can make a “sharp switch” to the inner compass in a more reactive way. This may cause problems. Of course, this can also be done in a more healthy, intentional way, through skills in Acceptance Commitment Therapy (ACT). 

One can use inner compass effectively, or ineffectively. The same as the outer compass. If one use the outer compass in the wrong way, it can seem “out of context” or unauthentic. If one uses the inner compass in the wrong way, it can come across entitled or selfish.

Acceptance Commitment Therapy (ACT) focuses more on the inner compass. What’s our values, and how can we take committed actions towards these values. Empathy training and social skill training are a little more about the “outer compass” perhaps. To do well in life, we need both don’t we? Having said that, life is a team sport. As long as we have those elements in our team, we don’t have to do or be everything, although there needs to be awareness and appreciation.

Simple psychoeducation can be fundamental and critical for solving our emotional problems

I think that sometimes we can underestimate the value of simple psychoeducation as part of the counseling process. Examples are:

• We can learn about the simple fight, flight or freeze as a response to stress. 
• We can learn that anger may be a simple manifestation of stress.
• We can learn that stress may be a response to maladjustments in our lives, and to sort out these maladjustments, we need to look at the external locus of control (our external factors), and the internal locus of control (our internal factors). 
• We can learn that when a child is showing aggressive behaviors, it may represent the simple fight response to stress, and stress can be due to disconnection, shame, or loneliness. 

I often use the following metaphor to explain to my patients about the importance of simple psychoeducation and emotional literacy.

To solve maths we need to know what numbers are i.e. simple numeracy.

To solve communication, we need to know the alphabet i.e. literacy.

To solve finance, we need to know financial literacy.

So to solve emotional problems, we need simple emotional literacy first through simple psychoeducation.

It’s simple, but fundamental and absolutely critical. 

Feelings are not just for perceiving. It is also important for driving value based actions

When using feelings to drive action rather than simply to perceive, feelings are like your set of clothes in your wardrobe. You have a diverse set of clothes for different weather, seasons and events. 

Proficient users of feelings know what clothes they have, where to find it, and when to use it correctly for different situations. 

Non proficient users of feelings use it reactively or try not to use it at all. 

Counseling is like being someone’s stylist. We help people to recognize the items of clothing in their wardrobe (feelings), where to find them, and recognize which one to use in any particular context or event.

We learn to use feelings to drive value based actions more intentionally rather than reactively. 

Counseling is a balance between validation and challenge of your current thoughts, beliefs and behaviors to impact change

Counseling is a balance between validation and challenge. It’s important to have a safe, compassionate, nonjudging space for the acknowledgement and validation of our current thoughts, thinking, feelings and behaviours. Validation is safe and supportive and at the same time, over-validate and things may be a bit slow to change. 

Challenge is an important vehicle for change, but if we are unprepared and over-challenged, our unwanted defensiveness and resistance may be triggered and hinder change. It’s a bit of a dance as one of my colleagues might say.

In practice, I often ask my patients which way do they prefer?  Towards the validation, towards the challenge, or somewhere in the middle, and use that as a rough guide. When in doubt, we would use validation as a default as it’s more foundational in counseling.  

No one size fits all. 

Shame is the granddaddy of all uncomfortable feelings

The emotion of shame (I am bad/not good enough) is the granddaddy of all uncomfortable feelings. 

The unhelpful feeling of shame amongst the patients we see is very common, but nobody really presents to us with....

“Hi Doc. I have unhelpful feelings of shame.”

Often the presenting complaint are, “I am stressed out, burnt out, anxious, frustrated or I am angry all the time”. 

Folks with the primary emotion of shame, invariably have associated sense of disconnection leading to fear/anxiety, leading to the fight/flight/freeze responses OR distractions like emotional eating and drinking, which then create more shame/disconnection. 

First thing is to step back and see that at the primary level, and create a safe and compassionate space to talk about that in order to defuse or “zoom out” from that. Not easy because shame IS a really “yukky” feeling!

So how else can your Doctor or Mental Health Professional help you?

1. Provides you with supportive counseling and unconditional positive regard.
2. Provides compassionate reflection.
3. Helps you to cultivate self compassion.
4. Helps you to improve your emotional literacy and self awareness.
5. Helps you with psychological flexibility skills like mindfulness, acceptance, defusion and “unhooking” from thoughts associated with shame.
6. Encourage you to take more value based actions.
7. And ultimately, breaking the cycle above!

The difference between punishments vs consequences

I think understanding the difference between punishments and consequences is very important not only in parenting but also in management and leadership in your work/business.

Punishments and consequences can be seen as very similar logically but have very different “flavours” and outcomes. One has anger and frustration attached to it. The other one doesn’t. 

So the key point is in the delivery. Punishment is delivered with anger or frustration.  Consequence is delivered in a more neutral or compassionate manner. 

Do you have a more zoomed-in or zoomed-out perspective to life?

 

What do you see in this photo?

The point is, when we are too zoomed in, it’s hard to see the bigger picture. 

In counseling/Acceptance Commitment Therapy, one of the most important thing is to educate our patients around the concept of fusion and defusion or in other words, zoomed-in (+hook onto thoughts) or zoomed-out (+unhook from thoughts) perspectives. 

It’s like when you zoom into a forest, you can see a dead tree, but when you zoom out, you may see a beautiful lushed tropical forest. Nothing has changed but your perspective has. 

Many folks we see have a very zoomed-in or “fused” perspective to life eg folks with depression, anxiety, or personality disorders. 

Some folks we see have a very zoomed-out or “detached” perspective to life and so zoomed-out, that it is out of focus. Think ASD or even Dissociative Disorders when in “extreme”. 

Of course, life is very dynamic and requires us to zoom in and zoom out all the time depending on context. The problem is when this zoom function malfunctions.  Imagine having a camera without the ability to zoom in and zoom out in order for us to focus.  It would be quite frustrating. 

Part of counseling is to help folks to zoom in and zoom out in various context through active listening, reflection, validation, and “gentle” challenge. 

Using metaphors like these can help us explain abstract concepts to our patients in more digestible ways.

The more zoomed-in folks may have to learn how to zoom out more through meditation, mindfulness etc, and the zoomed-out folks may have to zoom in more to gain more empathy, passion, and connection in life perhaps. 

The inner harmony vs outer harmony in decision making

Have you ever experienced the inner conflict of doing something that would make others happy but at the expense of your own happiness?

If yes, then how can we process that emotion and make a decision that we can be at peace with?

Decision making can depend on whether we want outer harmony or inner harmony. 

It would be great if we can have both, but at times, we may have to choose one over the other and then be at peace with that. This will require self awareness, acceptance, emotional literacy and emotional processing. 

To achieve outer harmony, follow the values and thinking of others. 

To achieve inner harmony, follow your inner principles and values. 

Perfectionism, self criticism, and fear of failure

In counseling, it’s very common for us to see folks with these 3 traits and often together. 

1 Have “unrelenting standards” 

2 Self critical and self punitive

3 Fear of failure. 

This is of course a perfect “storm” for stress.  This is the triad for perfectionism.  We have such high standards that we cannot reach.  We then criticize self, blame self, and avoid failures due to our fear of failure. Hence, we cannot achieve. It’s a vicious cycle. 

If we can change self criticism to self reflection/self compassion, along with defusing/changing our beliefs around failures, then we can still have our high standards and succeed. 

The good news is, these skills of self compassion and changing our perception around failures, can be learnt. 

Primary emotions vs secondary and tertiary emotions

I often try to educate my patients about primary emotions, secondary emotions, and tertiary emotions.

What’s that?

Here is an example. If someone has a primary emotion of disconnectedness and loneliness, this can lead to a secondary emotion of fear/anxiety, which then can lead to a tertiary emotion of anger/frustration/avoidance/withdrawal, or distraction through food, smoke, alcohol, drugs, gambling etc. 

People tend to fix the problem at the tertiary and secondary level because these are what people can see, but it’s much more effective if one can fix it at the primary level. There is much leverage in that.

The main message is try to fix the problem at the core rather than on the surface. 

Balancing the inner compass with the outer compass

Many folks I see don’t tend to make decisions based on their own values and principles but more on the values and principles of others. I would call this following the “outer compass”.

When others know what they are doing, then following the values and principles of others are great. But if others don’t know what they are doing, then big problems.  

Moral of the story.  Don’t simply follow the crowd. One has to assess the quality of that crowd. It’s important at times to stay committed to your own principles and values. This is your “inner compass”. 

Is emotional pain important for us to thrive and survive?

Emotional pain is like physical pain and of course, it's uncomfortable. We don't like it and at the same time, it does serve a very important feedback mechanism for us to process in order to help us thrive and survive. Emotional pain can be an indication for us that our needs are not being met. This is one of a few frameworks with which we can use to process our emotional pain. It is an important framework to assist us in regulating our emotions. We can summarise it into 3 human needs: 1 The need for stability, security and control 2 The need for love and connection with our "tribe" 3 The need for growth, newness, fun, and novelty Knowing which needs are deficient will assist us with addressing those issues more effectively. Reference: Maslow Hierarchy of needs Rogerian Psychotherapy

Short video on fixing anger at the core rather than on the surface

As a family Doctor, it is not uncommon for me to see folks with anger issues, and this can have a significant impact on their relationship with their families, partner, spouse, children, friends, and the people they work with. It is important to understand that underlying anger, we may find fear and anxiety, and underlying anxiety, we may find loneliness and disconnection. Loneliness or disconnection is the primary emotion. Anger is on the surface. Once we can address the disconnection at the primary level, then it may lead to less fear and anxiety, and then less anger.
So the main message here is to acknowledge and fix the problem of anger at the core rather on the surface level. Understanding primary, secondary and tertiary emotion is a very important part of emotional literacy, which will help one to process emotion, and to better manage one's relationship with others.

Short video on my incidental YouTubing journey to improve people's mental health

As a family Doctor, I teach a lot of my patients about incidental exercise and incidental mindfulness. Incidental exercise is where we incorporate what we do everyday including chores as a form of exercise. When we park our cars, we can park the car further away so that we can increase our walking as exercise. When we perform house chores or working in the garden, we frame it as a form of exercise. It is practical and pragmatic. It reduces barriers to take action. As I love to share ideas around emotional literacy and emotional processing to improve people's mental health and wellbeing, I have decided to trial incidental YouTubing and incorporate it into my work life. It will make it more practical and achievable. Let's see how that goes........

If numeracy is critical for solving maths, then emotional literacy is critical for solving emotional problems

Why is emotional literacy so important explained in less than 45secs? 

To solve maths we need to know what numbers are ie numeracy.

To solve communication, we need to know the alphabet ie literacy. 

To solve finance, we need to know financial literacy. 

So to solve emotional problems, we need to have emotional literacy first. Counseling helps us by improving our emotional literacy and emotional processing.