Managing the emotional challenges: Week 3

These are the requirements of participation. An important requirement is maintaining confidentiality, this allows everyone to feel safe to share and chat if they wish to.

Aim

Please aim to log in 5 to 10 minutes prior to the workshop starting. This can help address any I.T problems.

Try

Please try to ensure your settings are on mute until the end.

Maintain

Please maintain confidentiality, who you see and what is shared here should not be discussed elsewhere.

Please

If you didn’t sign in with your full name, please put your first name and last initial in the chat this ensures you are recorded on the register, and the material is sent to you afterwards.

Support and listening services

Please contact:

• Samaritans is always open to talk about whatever you’re going through. Open 24/7. Call 116 123 (free phone)
• West Yorkshire 24-hour mental health helpline offers support, advice and information for anyone in Leeds. Open 24/7. Call 0800 183 0558 (free phone)
• Connect helpline is a survivor-led service offering emotional support to people in Leeds. Open every night 6pm to 2am. Call 0808 800 1212 (free phone)
• Connect BSL helpline is on Mondays at 7pm to 11pm, facetime, skype or glide with BSL trained staff. Call 07500 870 987
• Shout text service struggling to cope? Text SHOUT to 85258 (free) any time 24/7 for support Messages are anonymous and won’t appear on your phone bill
• Contact 111 (click option 2) to speak with the mental health team

We do encourage you to use these support lines if you feel you need emotional support as they are a useful way to offload and manage distress.

• Information and strategies for managing anxiety and worry
• Different types of worry: Current or real event worries and hypothetical worries
• Worry tree and worry time
• Dealing With uncertainty
• Present moment attention: Benefits and challenges

Transcript

These are the topics that we introduced last week.

We discussed two types of worry, real event, or current and hypothetical worries. We explained how using the worry tree can help you make a plan of action for real event worries.

We also introduced more techniques on refocusing your attention and explained how these can help disrupt the vicious cycle of anxiety and worry.

Finally, we discussed some tips to help you deal with uncertainty.

Hopefully, you will have found something that was helpful.

• Thinking traps: What they are and how to manage them
• Metaphors
• Self-compassion

As we go through the different themes and information listen out for anything that is relevant to you

Ask any questions and share your thoughts at the end

Transcript

This is what we will be covering today.

As we go through the information listen out for anything that you feel applies to you.

You can ask questions, chat, share challenges, your own coping strategies at the end.

• Everyone can have upsetting and unhelpful thoughts
• Usually, people can move on quickly from upsetting thoughts
• However, when people feel low, anxious or have challenging health symptoms
• These thoughts can feel harder to dismiss, they can feel overwhelming and distressing
• Unhelpful thoughts can contribute to thinking traps or unhelpful thinking patterns
• Thoughts affect your mood and actions, making it harder to do beneficial and safe activities

Transcript

Everyone can have unhelpful and upsetting thoughts. Usually, people can move on from upsetting thoughts.

However, when people feel low, anxious or have challenging health symptoms, thoughts can feel harder to dismiss, they can feel overwhelming and distressing.

Unhelpful thoughts can contribute to thinking traps or unhelpful thinking patterns.

Thoughts affect your mood and actions. They contribute to the vicious cycle and make it harder to do beneficial and safe activities.

• People commonly report they worry and ruminate on symptoms such as fatigue and pain
• This then tends to make them more prominent in your attention
• This results in noticing and experiencing even more pain and fatigue
• This can lead to even more anxious and distressing thoughts, thinking traps can start
• Many people report they worry that they may make symptoms worse by doing activities that are beneficial and safe to do
• This can make it harder to break the vicious cycle of thoughts and behaviours

Transcript

People commonly report they worry and ruminate on their symptoms, such as fatigue, pain or any other symptoms more relevant to you.

Worrying and ruminating on the symptoms tends to make them more prominent in your attention. This can increase and maintain the vicious cycle of worry and rumination.

It can lead to experiencing even more anxious and distressing thoughts.

Many people report that they worry that might make their symptoms worse by doing activities that their clinician has advised are beneficial and safe to do.

This worry and anxiety can prevent you engaging in activities that you might find beneficial.

Engaging in safe and beneficial activities could start to bring some vital time away from the internal thoughts and worries about your symptoms.

• Chronic pain and fatigue self-help 

Transcript

Can you see yourself on this vicious cycle of pain and fatigue?

Understandably managing pain and fatigue is challenging and affects your mood.

What can make this even more challenging is falling into a vicious cycle of rumination.

Ruminating and dwelling on your symptoms tends to make them more prominent in your mind which results in feeling lower in mood and then experiencing more challenges with your mental wellbeing.

This results in feeling increasingly stuck.

The refocusing attention technique that we have already discussed can be one way to refocus your attention from your symptoms.

This can bring small amounts of relief however with time and practices you may be able to increase the relief you experience.

• Thinking traps can influence how we perceive a situation or another person’s actions
• Thinking traps can happen automatically without us even realising
• Increasing your awareness of thinking traps means that with time and practise you will start to notice them more quickly
• You can then choose a more supportive encouraging thought that will be more beneficial to your wellbeing
• As we go through examples of common thinking traps see if there’s any you identify with

Transcript

Unhelpful thinking patterns or thinking traps as we sometimes call them happen to everyone from time to time, we all do them.

They can happen automatically without us even realising.

Thinking Traps can disrupt your functioning and can increase the likelihood of you disengaging from helpful activities.

Increasing your awareness of thinking traps means that with time and practise you will start to notice them more quickly.

You can then choose a more supportive, encouraging thought that will be more beneficial to your wellbeing.

We will go through some examples of thinking traps, see there is any you identify with

Learning to manage these thinking traps is one way to manage your wellbeing.

All or nothing thinking

You see a situation in two extreme categories only: all or nothing, rather than in between or the middle ground

I can’t do anything enjoyable anymore, I’ll never be able to work again, this situation will never improve

Compare and despair

Exaggerating other peoples’ strengths and coping abilities whilst discounting your own strengths and coping methods

Example: That person is coping with their condition much better than me; I’m a mess and am not coping at all

Shoulds and musts

A basis for boom and bust: Having unrealistic expectations

Putting unnecessary pressure on yourself to meet unrealistic expectations

Example: I should never ask for help. I should vacuum the house every day.

I should just work harder

Mind reading

Assuming you know what others are thinking:  You fail to consider other possibilities

Example: They are judging me negatively: They think I’m just lazy and can’t be bothered

Self Criticism

Putting yourself down all the time:  Lack of self-compassion, treating yourself differently than how you would treat others

Example: I’m a mess, I can’t keep my house tidy, I’m a rubbish friend, mother, person.

Catastrophising

Going straight to worst case scenarios. Negatively predicting outcomes and not considering other possibilities

Example: I will never get any better, I won’t be able to do anything ever again

Emotional reasoning

Basing your view of situations or yourself on difficult days when you feel worse, physically and emotionally. Thinking you’re never going to get any better

Example: My symptoms have been worse for a few days, I feel low, I’m never going to get any better.

Personalising

Blaming yourself for everything that goes wrong

Taking 100% of responsibility for events that are out of your control

Example: I can’t cook my family the meals I used to.  I can’t walk my child to school, it’s all my fault

Mental filter

Only noticing the negative stuff. Like wearing dark blinkers and filtering out any progress or positives

Example: I’ve ruined a lovely afternoon out with my family by going to bed afterwards.

I could only go to my friend’s celebration for an hour.

Transcript

You will be sent a sheet with thinking traps on.

On this sheet there are questions under each thinking trap, this can help you challenge them.

The aim is to try to recognise when you are falling into a thinking trap, then try to think of an alternative thought that is more helpful.

Doing this can help to reduce the intensity of your emotion even if this is just by a small amount at first.

All or nothing thinking is a common trap where you see a situation in two extreme categories only, all or nothing, rather than in between or middle ground.

Example: “I can’t do anything enjoyable anymore, I’ll never be able to work again, this situation will never improve”

Compare and despair happens when you exaggerate other people’s strengths and coping abilities whilst at the same time playing down your own strengths and methods of coping.

Example: “That person is coping with their condition much better than me. I am a mess and am not coping at all.”

Should’s and musts: This is a common thinking trap and contributes to boom and bust. It is where you have fixed ideas on what you should do. You put unrealistic pressure on yourself and set up unrealistic expectations. You overestimate how bad it is if you did not meet these expectations.

Example: “I should never ask for help. I should vacuum the house every day. I should work harder.”

Mind reading: Assuming you know what others are thinking. You fail to consider other possibilities.

Example: They are judging me for having this condition. They think I am just lazy and cannot be bothered.

Critical self is a common thinking trap. This is like the old saying of putting the boot into yourself when you are already down.

Having a constant internal narrative where you put yourself down, self-criticism, blaming yourself for events or situations, disqualifying the challenges you are facing and your positive qualities.

Example: I am a mess; I am terrible at managing my condition. I am always doing something wrong. It is my fault I am ill. I am a burden on others.

Catastrophizing: This thinking traps is when you go straight to worst case scenarios. Negatively predicting any events and do not consider other outcomes.

Example: I will never get any better, I will not be able to do anything every again.

Emotional reasoning is a thinking trap where you feel bad so you think it must be bad. This thinking trapped can occur when you base your view of situations or yourself on difficult days when your symptoms feel worse physically or emotionally. Thinking you are never going to get any better.

Example: My symptoms have been worse for a few days, I feel low, I am never going to get any better:  I feel anxious, there must be something wrong.

Personalising is a thinking trap where you blame yourself for everything that goes wrong. You take 100% of the responsibility for events that are out of your control.

Example: I cannot cook my family the meals are you., I cannot walk my child to school it is my fault.

Mental filter is a thinking trap when you only notice the negative stuff: It is like wearing blinkers that filter out any progress or any positives.

Example: I have ruined a lovely afternoon now with my family by going to bed afterwards. I could only goes to my friend’s celebration for an hour.

From the thinking traps we have discussed is there any to which you can relate? Can you see how they will contribute to feeling low and anxious.

We will be sending you information sheet that has the Thinking Traps on it. This information she provides questions to challenge each thinking trap. It is a good habit to reflect on these thinking traps to see which ones you particularly identify with.

If you can use the questions to challenge your thinking traps this helps to gradually have a beneficial impact on your mood.

• You will be sent an information sheet on thinking traps
• Pay particular attention to the ones that you identify with
• Thinking traps often include words such as: should, always, why, I’m, never
• Do you find yourself habitually using these words?
• We all use these words, however with thinking traps they become inflexible and habitual
• Using questions to challenge the thinking traps will help you start to break their pattern
• They then start to become less believable
• It takes time and practise
• Small, regular, paced practise will help

Transcript

Thinking traps can be persistent and can seem believable.

Thoughts are not necessarily facts but can be opinions that are heavily influenced by distressing emotions.

Thinking traps often include words such as, should, always, why, I am, and never.

Do you find yourself habitually using these words?

We all use these words from time to time, however with thinking traps they become inflexible and habitual.

Using questions to challenge the thinking traps will help you start to break their pattern.

They then start to become less believable.

It does takes time and practise however regular paced practice will be beneficial for your overall wellbeing.

• Am I using one of the thinking traps?
• How realistic are my expectations: Am I placing myself under unnecessary pressure?
• Is there are a more helpful or realistic way of thinking?
• Am I being self-critical: Am I overlooking my own strengths and positive ways I am coping?
• What would be a more helpful and kinder thought right now?
• Does this thought encourage me or motivate me?
• Even if this thought is true or partially true is brooding on it helpful to me?
• What thoughts might help me to cope with this situation as it is right now?
• If my friend had these thoughts, how would they feel?

Transcript

These are some questions you can use to help you challenge thoughts.

There are others on the thinking traps information sheet.

Am I using one of the thinking traps?

Is there are more helpful or realistic way of thinking?

Even if this thought is true or partially true is brooding on it helpful to me?

Does this thought encourage me or motivate me?

What would be a more helpful and kinder thought right now?

What thoughts might help me to cope with this situation as it is right now?

Can I let any unhelpful and distressing thoughts go by and refocus my attention onto something that I may find more beneficial in this moment?

Therapy metaphors use stories to help us see alternative ways of looking at things

Metaphors provide an objective view which help you see things more clearly

This means you are more likely to spot any thinking traps and choose more helpful, supportive thoughts

Thoughts affect what you do: This helps you decide to take more helpful and beneficial actions

Thought train metaphor

We can sit on the train, watching the scenery (thoughts, images, sensations) go by, or stand on the platform watching the thought train pass by, we don’t have to jump on it

Transcript

Another useful technique is using therapy metaphors. Metaphors use stories or concepts that can help you see alternative ways of looking at something.

Sometimes this can give you space and objectivity which can help to disrupt the vicious cycle of unhelpful thinking. Then you can choose a more beneficial way to react.

We will be sending you an information sheet with more metaphors, you may find a different one that is particularly helpful to you.

This Thought Train Metaphor is to help you recognise that you can recognise unhelpful thoughts or thinking traps and let the thoughts pass by.

You do not have to jump onto the thoughts and going on the distressing journey they take you on.

Imagine you are on a train looking out of the window, the scenery represents your thoughts, images, sensations.

You can sit on the train, watching the scenery (thoughts, images, sensations) go by.

Or you can stand on the station platform watching the trains come in and out. You can watch the thought train pass by, you do not have to jump on it.

When we visit an online store, we tend to know what we are looking for.

We know our budget, the item we want, colour, size, how quickly we need it etc

There may be hundreds of items advertised on the page, but we do not put every item we see into our shopping basket and buy them all. However, we do tend to buy into each thought in our mind’s online shop front

Especially those thoughts that fit with the thinking habits we’ve got into.

I should work harder. I’m always letting everyone down. Everything will go wrong

If only we could treat these thoughts the same way as the online store.

Can you ask yourself:  Do I need to buy this thought, right now?

Can I afford it?

Is it going to be helpful?

Is it really true?

Transcript

Online shopping therapy metaphor

When we visit an online store, we tend to know what we are looking for. We know our budget, the item we want, the colour, the size, how quickly we need it, and so on.

There may be hundreds of items advertised on the page, but we do not put every item we see into our shopping basket and buy them all.

However, we do tend to buy into each thought in our mind’s online shop front, especially those thoughts that fit with the thinking habits we’ve got into. If only we could treat them the same way as the online store!

“Do I need to buy this thought, right now? Can I afford it? Is it going to be helpful? Is it really true?”

We will be sending out the information sheet on metaphors, there are many more on it.

Please do look through as there may be one that you feel you can relate to and that you use when you do recognise yourself getting caught up in distressing thinking.

• Compassion: ‘A sensitivity to the suffering and distress of self and others with a commitment to try to alleviate and prevent it’ as explained by Paul Gilbert
• Self-compassion helps you to make a switch from self-criticism or self-judgment to using words of kindness and encouragement
• Having self-compassion can help you to reduce your distress and give you the space to start to take steps forward to bring more meaning and enjoyment into your daily life

Transcript

Self-criticism or self-judgment are common when people are experiencing a health condition. This also can contribute to feeling distressed.

Self-compassion helps you to make a switch from self-criticism or self-judgment to using words of kindness and encouragement

The statement at the top is by Paul Gilbert who is an experienced teacher and therapist in compassionate focused therapy.

Self-compassion is a recommended technique to help you cope with challenging times.

Self-compassion is a useful approach to adopt when you have a heath condition.

It can help with acceptance and adapting your life to what is possible in the here and now.

Self-compassion is a skill like all the other techniques; it needs small amounts of practise applied regularly.

This is a definition of compassion by Paul Gilbert

Compassion: ‘A sensitivity to the suffering/distress of self and others with a commitment to try to alleviate and prevent it’.

Here he is saying you can be sensitive and caring to your own needs whilst also being committed to taking small steps that may be possible to help you focus on your recovery.

One evening a grandfather was teaching his 2 grandchildren about the internal battles each of us face.

“There are two wolves fighting inside of us“, he said.

“One wolf is vengeful, angry, resentful and scared. The other wolf is compassionate, joyous, generous, kind, faithful, hopeful and caring”

The children thought about this for a moment, and one asked, “Which wolf wins then?”

The grandfather smiled and replied, “the one you feed”

Transcript

This is a useful story to remind yourself that you must feed your internal self-talk in order to have a positive impact on your wellbeing.

The story is:

One evening a grandfather was teaching his 2 grandchildren about the internal battles each of us face

“There are two wolves fighting inside of us” he said. “One wolf is vengeful, angry, resentful and scared. the other wolf is compassionate, joyous, generous, kind, faithful, hopeful and caring”

The children thought about this for a moment, and one asked, ” Which wolf wins then?” The grandfather smiled and replied, “the one you feed”

A useful question to ask yourself is which wolf you are feeding with your internal self-talk.

Supportive, encouraging self-talk can help you to be your own personal coach when you are having bad days

Prepare a few supportive statements, say them to yourself to help you cope with bad days:

• Stop and breathe, I can do this
• This will pass
• I can be anxious/angry/sad and still deal with this
• This won’t last forever
• I can feel bad and still choose to take a new and healthy direction
• I don’t need to rush, I can take things slowly

Transcript

It is common for people’s mood to be affected with a health condition, especially if you are having difficult days or fluctuations with your symptoms.

If you are having a difficult day, then having some pre-prepared supportive statements written down can help you cope and get through these days.

Supportive self-talk acknowledges that you feel upset at experiencing these bad days however it can help you by practising being a supportive friend to yourself and enables you to cope better.

Have a think about creating your own supportive self-talk: Are there any helpful statement that you have used previously or that have been said to you previously by a friend or family member?

• What one thing can you take away from today?
• Was there one thing you felt you could particularly relate to?
• Is there one thing you could do before next week?
• Read the slides again?
• Look at the vicious cycle on fatigue and pain?
• Reflect on the thinking traps that are common to you?
• Pick 1 or 2 questions to help you challenge the thinking traps?
• Reflect on the self compassion story?

Transcript

We are at the end of today’s session.

Just reflecting on the information, we have covered what one thing can you take away from today?

Is there one thing you felt you could particularly relate to?

Is there one thing you would like to try before next week?

We do encourage you to read the slides again when these are sent out.

Look at the vicious cycle on fatigue and pain?

Reflect on the thinking traps that are common to you?

Pick 1 or 2 questions to help you challenge the thinking traps?

Reflect on the self-compassion story?

Everyone here is experiencing a health condition, being with others who have similar experiences has been proven to be beneficial.

Do you have any questions or comments from today?

Do you have a challenge to share with others?

Do you have a coping strategy to share?

Share or listen: It’s your choice

Transcript

Everyone here is experiencing challenges, we have heard many people say listening and chatting with others can be helpful.

There is no pressure to chat but if you do feel able that’s great,

You can chat with your camera on or off or just use the chat function, whatever is your own personal preference.