How to Help Clients Manage Uncertainty

37 Comments

When clients are feeling out of control, a common coping strategy is to focus on the things that they still can control.

But according to Kelly McGonigal, PhD, what people want more than a sense of control is a sense of hope and positive influence.

So how can we help our clients change their focus? In the video below, Kelly will share her 3-step strategy for helping people manage uncertainty. She’ll also get into the one key shift that can help clients find a wiser, more compassionate perspective on their situation.

Click here for full transcript

Dr. Buczynski: The COVID-19 virus confronts us all with an enormous amount of uncertainty and unpredictability. And uncertainty makes us nervous. We like to solve problems and feel like we’re competent and that we’ve got things under control. But if you are a psychologist, psychotherapist, social worker, a nurse, or a physician, I’ll bet you are working with patients who are dealing with many factors that are out of their control. So I took a look back at our archives to see what we had that might be useful Dr. Kelly McGonigal addressed a similar situation. In this video, she’s talking about parents whose child is in crisis. They desperately want to fix the problem, and it’s so painful to see their child suffer. She shared a 3-step approach for working with uncertainty, that I think you will find helpful no matter what the crisis. Dr. McGonigal: I find that it’s very common that the people who show up in my classes/workshops are at the stage of their lives where they are parents of teenagers or young adults who are struggling. It’s so common. I can’t think of anyone I know professionally, students or friends who haven’t experienced some kind of major crisis when their child is in that stage – whether it’s recovery for addiction or an eating disorder, being treated for depression or anxiety, having to leave college after the first semester because of unfulfilled requirements…and the list goes on. There’s a lot of crisis happening for people at this stage, and a lot of parents are trying to control the situation – they desperately want to be able to do something that’s going to take away their child’s suffering. They so want to believe that it’s going to turn out OK and they want to be comfortable with that version of OK. They want to feel that: my child will beat this and never suffer in the same way again. Or my child will achieve this – they’ll graduate – they’ll get through high school – they’ll go to a good college – they’ll have a successful career. Whatever it is, the parents I see have this idea that there should be a way to do something that guarantees a certain outcome. I find myself talking to a lot of parents who are living in that particular version of uncertainty – where there is real suffering or a real crisis or real uncertainty about what the outcome is going to be – an overall sense of paralysis about being out of control. I’ll give you a sense of what I often talk about with them. First, I try to affirm their identity – the identity that feels like it is being challenged or threatened by the experience of uncertainty. For them, their identity is about being a caring parent and what they’re experiencing in this moment of uncertainty is a challenge to their value and their strengths as a parent. They’re feeling: If I were a good parent, this would not have happened. I would have been able to control my child’s life in some way so that they wouldn’t be suffering, or they wouldn’t have fallen down this hole, or they wouldn’t have ended up experiencing this failure… whatever the situation might be. It’s really important to affirm the identity being challenged by whatever the experience is. This goes not just for parenting, as in this example, but for any situation where you start to feel out of control, and yet you still deeply care. So, we want to affirm the identity by saying: Yes, one of the reasons this is so difficult for you is that you care so much – you are such a caring parent – you are so committed and devoted – it’s not evidence of the opposite. We want to take time to acknowledge what’s difficult about their situation. Again, what causes people to seek control or certainty is their wanting to avoid having to feel whatever the disappointment or the shame or the anger or the fear is. We want to give people permission to articulate, to be with, and to acknowledge what the pain is that is making them reach for: I should be able to control this – there must be something I can do to fix this. Instead, we want to get them into a compassionate space. And then the third step: to shift people’s focus from control to choice. I mentioned that when people are dealing with wanting things to be certain, they will tell you they want to be able to control what is happening – and that’s the problem they feel out of control. It’s very common for people to suggest something like: Let’s think about what you can control – what do you have control over? And that step is somewhat in the right direction – it’s somewhat useful, but it’s much more important to ask questions like: What can you choose in this situation? What do you want to bring to this situation? Who do you want to be in this situation?” Then, people are more likely to identify positive actions like: What I want to choose in this situation is courage. What I want to choose in this situation is putting my child first. What I want to choose in this situation is reaching out for support and finding resources… as opposed to what they want to control. If you ask people: What can you control? Their minds are going to go in other directions which take them away from the idea of choice, which is so important. Choice brings to view a wise, compassionate perspective on what you can’t control, and there’s a phrase I like to use I alone am not the cause of this suffering, and I alone cannot resolve or cure this suffering. This type of perspective is important for people who are clinging to certainty or clinging to control. With this perspective, there’s a freedom that comes and allows you to re-engage with the situation and make choices that are consistent with your goals and your values and the relationships that matter to you. It’s important to have a sense of surrender and a sense that you can do your best but you can’t do it all. The situations that most often trigger this desire for certainty and control are the very ones that are bigger than the self – it’s important to be able to recognize that this is bigger than me – that’s critical!

We are facing challenging times. The work that we do feels more important than ever, especially as we help people not only cope with uncertainty, but also make choices consistent with who they want to be.

How will you use what you just heard in your practice? Please let us know in the comments below.

You might also like to see:

When the COVID-19 Pandemic Leaves Us Feeling Helpless

An IFS Approach to Fear and Anxiety During the COVID-19 Pandemic

[Infographic] Four Core Strategies for Managing Stress and Anxiety

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37 Comments

Julia S, Other, USA says

I am a “rejected” parent in a Parent Alienation situation and this helps me so much! It’s the extreme where after 22 years of devoted engaged and super fun parenting my children don’t feel “safe” enough to receive a phone call from me. The loss of my relationship with my children is only outpaced by my worry about the destructive impact on my kids. So grateful to receive your message this morning Affirm your identity: What can I choose: Acting within my character. Al Anons 3 c’s I alone didn’t cause, I can not control and i alone can not cure this situation… Thank you for giving me inspiration to help anchor the pain.

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Kim White, Social Work, Princeton Jct., NJ, USA says

Yes, very timely and very helpful. Thanks for sharing this with us Ruth.

Take good care all.

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Irene Valdes, Psychotherapy, MX says

Maybe it’s your fault!

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Terri Reuvers, Social Work, Faribault, MN, USA says

Patients who may benefit from factual can be directed to the CDC website
for up to date facts and, if they choose, a short survey to screen symptoms that will lead to recommendations.

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Annette Brehm, Social Work, W Lafayette, IN, USA says

I really like the concept of asking “What can you choose?” This increases the awareness of our internal resources. Even if a person is choosing “surrender” or “acceptance” it highlights the self-efficacy involved in that process and a sort of ‘team work’ with something that’s outside of themselves. Thank you.

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Elizabeth Russell, Another Field, Greenwich, CT, USA says

I listened to this three times, and took notes….very profound and meaningful and spot on good advice for these times. After I contemplated these points, I realized how many implications they have in so many situations!!

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Vonne Solis, Another Field, CA says

Thanks to Kelly and NICABM for sharing. As a mom who lost a young adult daughter to suicide in 2005, these are issues I’ve struggled with for years.

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Saira Birley, Counseling, GB says

So very useful to think about choice rather than control.

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Wilma Grobbelaar, Coach, AU says

Thank you for sharing. I will be able to bring the awareness to some of my clients that are having difficulties in uncertainty in their life.
Wilma

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sarah barbee, Another Field, GB says

Thank you this is so helpful, clear and concise information and guidance that makes me feel more supported to go and run the staff reflections groups for nursing staff with older adults and end of life care in the NHS who are under enormous stress, and give me some tools and reduces my anxiety that this is greater than us all.

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Cherolee Trembath, Medicine, South Lyon, MI, USA says

The statement ” I alone am not the cause… I alone cannot resolve…” is so powerful. It allows us to be free from frantic efforts to ensure the safety of those we love, and lets us plan to do the best we can with whatever presents.

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Jane Arthur, Psychotherapy, LAND O LAKES, FL, USA says

Nice reframing Kelley, seems like a gentle stroll from the threat center to the soothing center through self acceptance and compassion.

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sian peer, Another Field, GB says

Love how complexity is always mediated by simplicity. I found the reframing of the question of what can I control – to what can I choose so inciteful. Many thanks for sharing.

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Maggie Keary, Counseling, GB says

So helpful to be reminded that what is so often the cause of pain is the need to try and avoid it.

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Tim Payne, Other, GB says

Hi – I love it – it’s really useful – thank you – to look at it all + not block areas of it is useful – ?✨

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Michelle R. Kobayashi, Marriage/Family Therapy, Los Angeles, CA, USA says

Wonderful! Thank you so much. I will share this with my clients – and try myself. People really need this information now.

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Diane, Counseling, Enumclaw, WA, USA says

Thank you, Ruth, for taking time to find this video and the wonderful advice Kelly has to share! I found it to be a great reminder, and it will be incredibly helpful in interacting with clients during this challenging time.

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Colleen Allison, Psychology, CA says

THIS IS SUCH A HELPFUL WAY TO FRAME THINGS IN OUR CURRENT CLIMATE OF FEAR. AND GIVEN THAT IT’S A TWO STEP PROCESS: 1) WHAT DO I CHOOSE, AND 2) “I ALONE DID NOT CAUSE THIS” IT CAN BE EASILY CALLED TO MIND. THOUGH IT IS NOT AN EASY OR SUPERFICIAL PROCESS

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Erin Kelly, Psychology, AU says

This is so helpful! Thank you. These are useful perspectives for mental health professionals too – we can’t control this situation, but we can choose who we want I be in this crisis, and we can bring compassion both to our clients and to ourselves. We’re all in this together. Take care everyone

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Lynette McCormack, Dietetics, AU says

Thanks so much for sharing that post. I found it extremely helpful. I also really appreciate the spirit in which it was shared. It’s true, many things are bigger than we are ( and we may not realise this) and it’s a great feeling to be supported by a community that is devoted to helping clients resolve what they are unable to resolve on their own…….And to help clinicians become aware of those things that they need to ask others for help to resolve! A nice piece of clarity to start the day with!

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Heather Mawla, Marriage/Family Therapy, Pacifica, CA, USA says

Great timing to put this out there. Great way to simplify what can be overwhelming. Many thanks

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Sangita Biswas, Marriage/Family Therapy, Pleasanton, CA, USA says

In these times of isolation when we clinicians are scrambling to help our clients I am grateful for this amazing tool. Thank you.

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Michele Bachman, Counseling, Orlando, FL, USA says

Thank you for this timely and wise perspective. Very helpful and centering in these uneasy, vulnerable days.

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Francesca Waddington, Psychotherapy, GB says

A great 3 step strategy, to use in a session, that could even be extended. It’s interesting the illusion of control we have, when most of the time lots of things are uncertain and in constant flux. Currently this is on a global scale – unprecedented !
Choosing how to view this and what to do/bring to the table is a neat fix.
Right now in the present we can choose lots of things:
To actually feel more of a sense of freedom in this turmoil to be able to:
Pause, slow down, breath, relax, reflect
Ring someone and actually speak to them, write a letter/postcard
Create a sense of community
Help another/be compassionate
Catch up on reading that book, music, movies, mindful colouring
Re-visit your goals for life in different areas
Tidy that cupboard out – sense of accomplishment

There is so much more – embrace the uncertainty and connect with others.

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Kati Morrison, Medicine, CA says

Many thanks for offering help and support during this uncertain time.
I would like to add a few more strategies as I had much worse life experiences then pandemic.It was surviving genocide.Pandemic is was,pandemic hatred.
1.I suggest people to think of times they survived that was terrible but they made it.
2.How can you help others and use your strength to do it?You are better off then many others.
Right now,for example,contact is important when people are isolated.
3.How can you make use of this situation for yourself?
You have time and you are well.
Thanks for the inspiration.

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Katinka Keith, Counseling, Waterloo, IA, USA says

Excellent and SO timely. Thank you for the replay.

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Karen Macke, Counseling, Waynesville, NC, USA says

A nice perspective which has compassion.

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Marilyn Earle, Psychotherapy, Bluffton, SC, USA says

Thank you for this informative, brief but clear information regarding the current situation we all face in this time of uncertainty. I found the third stage of taking control by making clear choices about what you want to accomplish when you are feeling out of control to be very helpful. It is a great way to reframe and think about what you can do during these difficult times. Thank you so much for bringing this to my attention.

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Cynthia Garrett, Psychotherapy, Duxbury, MA, USA says

Very helpful thank you
Cynthia Garrett LMHC

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Rhenda Sheedy, Psychology, IE says

Thanks for this – very timely. Especially Kelly’s advice about acknowledging that this situation is bigger than me and reframing the focus from control to choice. Stay well

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Tania Py, Psychotherapy, GB says

Thanks for sharing this helpful advice

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Julianne Freeman, Counseling, AU says

Thank you Ruth and Kelly,
I work in an Australian school and students have never felt more uncertain than with the events caused by COVID-19.
I will work towards:
-affirming their identities as students and what they can bring to the situations around them, and perhaps too, exploring what they are learning about themselves in the wake of such challenges
-encouraging them to explore and express their feelings in creative new ways
-inviting students to identify choices they can make to reaffirm their identities (as students) and the steps they can take to reinforce their choices: asking for help, finding resources, learning how to learn differently (ie remote access learning)
-bringing to awareness a philosophical perspective about how much can be controlled and how we can exercise control over ourselves even when our circumstances are uncertain.
“When we are no longer able to change a situation, we are challenged to change ourselves.” Viktor Frankl.

Jules Freeman

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Evangelia Andritsanou, Psychotherapy, GR says

Thank you for this clear strategy and compact presentation. What I found especially helpful and will use with parents in times of crisis was the first point : “Affirm their identity”. Wishing health and resilience to all from Athens, Greece!

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Marsha Marino, Psychotherapy, Massapequa , NY, USA says

Thanks Ruth!! A welcome piece of insight I can use and share with my clients and myself under current circumstances.

Marsha

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Marsha Marino, Social Work, Massapequa , NY, USA says

Thank you for that insight during this time of uncertainty. A welcome video as I try and get through my day. It was helpful personally and professionally.

Marsha

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Cathy Cheshire, Coach, Westlake, OH, USA says

Thank you for sharing

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Dee Daly, Psychotherapy, IE says

Excellent, I will use this by putting a frame on the key points and will modify appropriately with each individual client in mind. I think working with choice as a word as opposed to control is a good idea, to muster up empowerment.

thanks for this piece.

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