When a client is in emotional distress, their first instinct is often to try to make the pain go away . . .
. . . but by avoiding those feelings, the pain usually just grows.
That’s why helping clients learn to sit with and manage distress is critical.
In the video below, Michael Yapko, PhD, shares a three-step approach to do just that.
Have a look.
And what a difference when the distress comes at you from circumstances that you played no role in. You lose your job because the company goes bankrupt. That’s not your fault, but you still have to now deal with the unpleasantness of unemployment and having to go through looking for a new job.
And then there are the kinds of distresses that are self-generated, the kinds of things that happen to people that are consequences of choices they make, that bring about the distress.
Either way, the person’s going to end up having to learn to cope with distress. But when you realize that some distress is externally generated, it highlights one very important discrimination that needs to be made: Can you distinguish between something that is personal versus something that affects you personally?
I mentioned earlier the company that goes bankrupt and you lose your job as a result – well, that clearly affects you personally. You’re now unemployed. But it isn’t personal. They didn’t go bankrupt in order for you to become unemployed.
It’s one of the things that’s very often fuzzy for people. They can’t distinguish what’s personal from what affects them personally. That’s when a lot of the distress that people experience is self-generated.
But the next part of the process, the next component of the sequence of helping people tolerate distress, is also helping people make a distinction between what’s controllable and what’s not. When people aren’t good at making that discrimination, they will attempt to control things they can’t. Or, vice versa – they don’t try and control things that they could. Again, this is one component of the decision-making process and one pathway into distress.
So, to recognize the futility of always trying to feel good, to understand that what makes distress tolerable is the importance of the goal. Here’s where the work starts to focus on goal-setting.
What allows people to put up with distress is the value of the goal. And so often, what happens for people is they’re in the immediacy of the distress and they lose sight of what the goal is. Or, they never defined what the goal is in the first place.
Change the content. What allows somebody to go through the pain of a divorce? Now, even when somebody is crystal clear this relationship cannot continue, divorce is still painful. What allows someone to suffer the distress of the divorce is the deeply held belief that when it’s all over, they’ll be better off. And if you don’t have that belief, then it’s just pain.
Now, there’s another skill that I just mentioned that goes into tolerance of distress. I’m referring to one more skill that goes into tolerating distress, and the tolerance of distress is based on compartmentalization. The ability to compartmentalize, the ability to separate elements of experience, in the same way that you’ll say to somebody, “Feel the fear and do it anyway.”
That presupposes an ability to compartmentalize, to be able to set aside the trauma, set aside the hurts of the past and do it anyway presupposes a compartmentalization skill. Well, the ability to compartmentalize means separating elements of experience from one another.
So again, if I’m going to focus you on the goal instead of the feelings, I’m highlighting the goal, shining a spotlight on the goal, and letting the feelings diminish and recede into the background. That’s how compartmentalization takes place, and it’s a way of building tolerance for distress.
It means, then, that the person uses the goal as the frame of reference for making decisions instead of the feelings of the moment. I think that’s a really important skillset to be able to build into this, helping people tolerate distress.
For more practical strategies on helping clients tolerate distress, have a look at this short course featuring Peter Levine, PhD, Pat Ogden, PhD, Ron Siegel, PsyD, Janina Fisher, PhD, and Deb Dana, LCSW.
Now we’d like to hear from you. How might you apply Michael’s approach with your clients? Please let us know by leaving a comment below.
If you found this helpful, here are a few more resources you might be interested in:
Working with Emotional Distress – with Janina Fisher, PhD
An Exercise to Decrease Negative Self-Talk, with Michael Yapko, PhD
I was left alone to cry as a baby (no thank you, Dr. Spock) and was told that being held and soothed is how people learn to soothe themselves. No wonder I don’t know how. No wonder I hate harsh feelings – because there is no relief in what feels like forever. Thank you for offering this solution!
Excellent point.. and hence a multifaceted individualized approach is optimal.. no one singular approach can embrace all situations….mindful awareness being an important early facet..determining a goal that supercedes the discomfort..being a rather final facet….in my opinion, Diminishing feelings to reach a goal works in the short term but the stress/trauma remains hidden…. timing is everything….
Yes agreed..hence..my concern and focus would be multifaceted.. 1) acknowledgment of the immediate feelings of the distress.. and 2) creating awareness of a goal that supercedes those feelings and 3) compartmentalizing ie separating elements of experience one from another…but not to diminish the feelings ..but rather to enhance awareness of the origins and the impact of the various experiences.. and 4) finding the common denominator..ie digging deeper to find the common thread/threat that creates the intolerance..and then back to #2) creating awareness and realization of the goal that supercedes our descomfort…
Hi Karen,
Your response was exactly what I had been thinking after seeing the brief video clip. I was not moved by the cognitive response to “distress” as the therapist was suggesting. There are so many layers and facets to humans. I cannot imagine engaging in this strategy ( knowing I do not have the complete picture of the therapist’s method) knowing I may be missing a great deal of one’s trauma history.
Hi Karen T,
What you wrote really makes sense. It’s the best explanation of trauma I’ve read. Can you recommend anything else int his vein or do you have a website / blog?
I’m so glad you said this. I’m a documentary television producer looking for options to refer people to off camera and have been looking for the best course of study to learn as well.
This is a clear and easy follow 3 step strategy to assist people in distress. Loved it.
This is a great idea for a younger person or someone who has not had a history of trauma and coping with life anyway by just what he suggested in compartmentalizing.
When you have had to do this since early childhood, it gains momentum and makes it hard to relax enough to use tools like this due to sheer exhaustion and lack of hope in a better future.
This seems to be where I fall, where I see so many suffering from this lack of hope. I wish someone would address the changes we all have suffered across the globe and not pretend we are not suffering from these worries about a future of common decency or compassion between humans.
I grew having to fair for myself with no parental figure not self-absorbed in their own narcissistic tendency and one suffering from CPTSD from the Korean War and a parent unit who had severe religiosity.
It is easier in treatment to track these longitudinal experiences to solve responses. It was innate in me as a clinician to do that very thing with clients, knowing how repressed childhood makes us if not addressed. That is why I like Schwarz parts writings but these really need to be pieced together just like a jigsaw puzzle.
It is interesting that doing jigsaw puzzles has a therapeutic component for trauma and explains to me how men or women get intrigued with this very thing, especially those men who have avoided their traumas. Feelings are more frowned upon in a man and some woman. I even have to give men a sheet of emotions as it is not part of their vocabulary.
Have a granddaughter who was adopted but not allowed to leave her country for two years as she sat in an orphanage due to problems with that particular country. So many clinicians avoid this type of exploration with warnings of opening up too much. This is true but not for trauma clinicians. Is this not what heals the human psyche and repairs the pains stuck in our nervous system. That is why novels are read, to learn about life of others. I wish I had been encouraged more to read and learn. It takes work but heals the problems that bind our success of healing movement.
Even now I want to read the ideas of those on this forum instead of others interpretation. This takes time but is more worth the general first hearing of information. It is so important to not just listen to a webcast without research of the ideas from that person speaking. Like the glossary is a must to get ultimate paths to investigate.
Keeping your focus on the goal is an effective tools for coping with many types of distress. I am not sure, however, what a goal for me might be as the parent of a daughter suffering from PTSD—aside of my goal to find effective help for her.
Does your daughter have any other support than family and sibblings ? How have those supports been a help for her to cope with her distress ? Being myself a daughter and left with caregivers, than doing very well in life. I know it can be emotionally guarded when intimacy get in the way and overstressing the needs to be in couple of life obligations. Having friends could be difficult since secure attachment has been disrupted. I am hoping those words would be a comfort to you. I am sending my best to your daughter on this path of healing.
1) I didn’t hear Dr. Yapko assigning blame or fault, but rather, making a distinction between internally- and externally-generated phenomena.
2) Interesting/valuable point about the ego wanting to remain in the known state.
3) Yes, attending client’s separating out “monkey mind” from emotions from True Self, are vital. How that is done is the subject of a longer discussion.
Hi Anna
Suffering is all “internal” .
Its an internal phenomena (emotion is energy) generated by thoughts .
Listen again and he does go into the “blame” yes he uses the word distinction , to label suffering that “its not your fault” … its anothers and the ego loves to find people/things to blame( or to self other).
This way of thinking= the blame game ( or trying to validate your suffering)is an ego trap. You dont need to in order to be free from suffering.
Suffering is also caused by resistance to what is.
I do not know if we should set a goal with clients of “tolerating ” suffering, as the ego likes to .For better we seek the goal to create understanding and freedom from suffering.
Our consciousness is inexplicably connected to that of our clients. And this is a tool that is frequently not addressed. The State of the practitioner.
Namaste
Hi Anna
Suffering is all “internal” . Its an internal phenomena (emotion is energy) generated by thoughts .
Listen again and he does go into the “blame” yes he uses the word “distinction” , to label suffering that “its not your fault” … its anothers and the ego loves to find people/things to blame( or to self other).
This way of thinking= the blame game ( or trying to validate your suffering)is an ego trap. You dont need to in order to be free from suffering.
Suffering is also caused by resistance to what is.
I do not know if we should set a goal with clients of “tolerating ” suffering, as the ego likes to .For better we seek the goal to create understanding and freedom from suffering.
Our consciousness is inexplicably connected to that of our clients. And this is a tool that is frequently not addressed. The State of the practitioner.
Namaste
Wonderful!!!
Thank you thank you thank you!!!!
Thank you so very much for your beautiful words. I too find it problematic to attempt to shift the locus of blame within the person who is suffering. While that is one of the goals to be sure that will happen once a person can learn to understand in which of thier bodies the disturbance lies; mental, emotional, spiritual, and physical. So many people are stuck in this conditioned mind, in a state of survival, and it is practically impossible to get on with the business of living, never mind healing from distress when we are stuck in that state. What is really useful is to be able to learn the truth; you are not your ego, you are not your mind, your thoughts, your emotions, these are merely states that you can move into and out of at will. Distress exists for a reason, it is there to let us know that something is not right within us, and it is something to be embraced rather than something to run from. When we can learn to be truly present in our bodies, we can overcome anything, and fault finding becomes irrelevant. Again thank you for your insightful reply.
Was wonderful. Clear, simplified.Focus on how to resolve issues. What a novel concept. Stop kicking the tires and cursing when they went flat on a major freeway. Call triple A and get them fixed😘
Annette LCSW California
I love the frame of reference and the mindset over stress. So useful to overcome stress.