Managing difficult emotions - transcript

Hello everyone my name’s Leanne Humphreys and today we’re speaking with Associate Professor Andrea Phelps who’s the deputy director of Phoenix Australia. Andrea has over 20 years of clinical experience and has worked with a wide variety of individuals a wide range of clinical presentations so, welcome Andrea thanks for talking with us today.

Andrea: It’s a pleasure thanks Leanne.

Leanne: Today’s discussions is about the kinds of strategies that disaster-impacted individuals can employ to cope with a whole range of difficult emotions. So, Andrea can you tell us why might people benefit from learning about helpful strategies to cope with those difficult emotions?

Andrea: Yes sure. Look it is very common for people to experience a whole range of different, different and difficult emotions after disaster. Things like anxiety, depression, shame or guilt, anger, grief are all really common for many people. Those feelings will just resolve by themselves in the days, weeks, sometimes months after the disaster.

As the person recovers those emotions will often just disappear. But if they don’t resolve just through the person’s normal coping strategies and supports it might be time to think about getting some additional help. And as a guide, if the person’s distress is severe enough to interfere with just their ability to function in their normal routines whether that be at home socially, at work or school, study, whatever they’re doing. If their distress is severe enough to interfere with that, that’s generally a good indicator that getting off to see the GP for assessment and referral if necessary to see someone in a more ongoing way.

But there are a range of helpful strategies for managing difficult emotions that clients can use on their own, whether or not they’re seeing a practitioner. But can be useful in either case so you know that’s probably worth a little bit of talking about.

Leanne: Yes okay.  So if as health practitioners that we are seeing people having difficulties or, or if individuals themselves are watching this, where do we start? What’s the most helpful place to start?

Andrea: The place that I would normally start is by asking the person to keep a record or a diary of their difficult emotions so just on a day-to-day basis when they’re aware of experiencing an intense, unpleasant emotion making a note about what the emotion is. What the triggers are? How intense the emotion is, and this idea of intensity is really useful. So I often ask clients to rate that intensity on what we call a SUDS or subjective units of distress scale, that’s sort of ranging from 0 to 10 where 0 is completely relaxed and 10 is the most intense distress.

By monitoring emotions and rating them in that way over time, the person will gradually increase their self-awareness and their ability to identify difficult emotions at lower levels of intensity and that’s usually when they’re easier to manage.

Leanne: Yes, okay, okay, so after monitoring and increasing that self-awareness, what are some of the most useful strategies that people can be encouraged to employ?

Andrea: A few simple calming techniques that really help to reduce the intensity of emotions. One of those is controlled breathing.  You know it’s a really simple intervention that just helps the person to restore their level of breathing to a normal rate.

Another is grounding. There are a few different grounding strategies that really just quickly bring levels of arousal down and help to sort of reorient people to focus on the present. But these strategies can also be used in combination with other ways of reducing the person’s general level of distress, so things like making time for regular exercise, relaxation, taking part in activities that are just pleasurable, really just help to relieve the level of stress.

Another sort of notion that I think’s worth flagging, is what we call distress tolerance, and this is the idea that it’s not always possible or even desirable necessarily to get rid of unpleasant emotions, but we can reduce the distress associated with those emotions through simply acknowledging and accepting them. For example, if you get anxious but then you get anxious about feeling anxious, you’re actually compounding the problem or if you get angry every time you have feelings of guilt you’re then having to deal with two difficult emotions and in some cases it’s actually much more helpful to simply acknowledge the feeling and not judge them or try to push push them away. This sort of idea of distress tolerance is really useful as well to when when you’re thinking about when difficult emotions are actually getting in the way of you doing things that you value or your ability to work towards goals so for instance someone says you know ‘I can’t start driving the car again until I get my anxiety under control’ so the the anxiety is a barrier to the person being how to achieve something they want to achieve if you can change that narrative to say ‘okay I need to drive the car in order to achieve my I can I’m going to tolerate it. I need to tolerate in order to get to that goal that I want to get to.

Leanne: That’s fantastic thanks Andrea.  So you’ve really highlighted some really practical in the moment strategies that people can do in terms of changing their behaviors, controlling their breathing, engaging in grounding and you’ve also spoken about ways of kind of reframing or rethinking what it means to be having those intense emotions in the first place, so that’s really helpful. And for people who are interested there’s resources on the webpage to help you understand a little bit more about those techniques. So thanks very much for your time Andrea.

Andrea: that’s a pleasure thank you.