Most people in the population self-medicate in some way. Headache? Take a couple of paracetamol. Had a bad night’s sleep? Make it a double shot flat white the next morning. Rough week at work? Hello happy hour!
When does it cease to be socially acceptable, this treating of our own minor ailments? Drowning your sorrows to the point of mild tipsiness is almost encouraged, but end up weeping and drunk on the floor and we cringe. Perhaps when the line of normality is passed and we not only relieve our pain, but become altered in some way, it is viewed in a similar way to the use of performance enhancing drugs.
There are good over the counter options for aches and pains, sore throats and dry eyes. There aren’t so many options for psychological pain. I am not referring to the type of ongoing or recurrent pain due to mental illness, but the kind of distress we all experience from time to time in our everyday lives.
The common responses to these intense feelings are maladaptive, such as the stereotype of the girl who has been dumped by her boyfriend sitting in bed scoffing chocolates then getting trashed with her friends, followed by a drunk-dial of the well-known number to berate him for leaving or to beg for another chance. We can all predict that the following day she is likely to feel worse, not better!
Think of a young girl, trying her best to cope with emotions that feel out of control, aims for short term relief, distraction or other catharsis through cutting herself, or the middle aged man unable to cope with day to day life without a bottle or two of wine. These are familiar stories.
What are some better, kind-to-yourself ways to relieve psychological pain? There are plenty of behavioural techniques and cognitive strategies that can help. Here are some suggestions (and I would love to hear yours):
-Exercise. This can be a mindful, refreshing walk with or without company. It can also be a good heart starting workout that releases endorphins. There is plenty of evidence that intense exercise is beneficial for anxiety and depression, with an effect comparable to medication.
-Distraction, ideally with a pleasant sensation (how about a massage?) or spending time with a friend doing something fun.
-Write it down. Design a haiku that exactly sums up your mind state.Write a journal entry. Write a letter (don’t send it yet but let it sit until the intensity has passed, then re-read it).
-‘Self-soothing’. Run yourself a sweet smelling bath, or brew a loose leaf tea. Sit in the garden and stroke a pet. Listen to some relaxing music. Think of what calmed you as a child and try to recreate it. Wrap yourself in a soft blanket. Have some warm milk.
-Mindfulness can help with the sense of being out of control and can also be very soothing. Use your senses to bring yourself back to here and now. Feel the ground under your feet. Feel the breath flow in and out of your chest. Can you feel the warm sun on your skin? Smell the spring blossoms on the breeze?
-Debrief. After a traumatic event, basic event debriefing (that is, talking about what exactly happened, who, where and when) can be helpful. It is less helpful and can be damaging to do a deep psychological debrief in the early stages following the event.
-Talk to a friend who is in need themselves- not about your problem but about theirs. Providing someone else with support gives you a sense of usefulness and competence, improving your self-image.
-Acceptance. Remember it is normal to feel emotions and react to them. Try to identify the emotion you are feeling and how you are responding to it. For example ‘I feel anxious about going to this party and so I am very frustrated with myself because I wish I was more comfortable socially’. Accepting the primary emotion and not punishing yourself for it through guilt or shame can make the first emotion easier to bear.
-Remember that emotions cannot remain at that intense peak for long. Use a safe technique that helps you cope in the moment, knowing that the wave will subside. Ride that wave.
-Finally, congratulate yourself for being a thinking, feeling human being who is sensitive, alive and expressive and thus makes this world more beautiful. It is good to feel things and you can cope. It may feel like almost too much to bear but you, my friend, can bear it. Feel your feelings, only detaching from them for the purposes of distraction. Do the best you can in the state you are in and look after yourself.
Resources: Psychiatric Times (various articles)
The Dialectical Behavior Therapy Primer, B. Brodsky and B. Stanley, Wiley-Blackwell 2013