As a student of self-care, I’ve learned the importance of identifying what works and integrating it into my daily schedule. After three weeks of isolation, I’ve discovered that experiencing my emotions, following a schedule with set breaks, walking and connecting with others is what works-for now.
I learned from Una McClusky, author of Transference and Countertransference from an Attachment Perspective, how important it is for care providers to be in connection with others and I’ve taken that to heart, integrating as many moments of connection possible with my colleagues into my week. In the past, I might have shied away from the ringing phone, hoping to hold onto some silence in my busy days, but now I’m encouraging myself to move forward, pick up the phone, and connect.
Since my 2-day virtual conference that was supposed to take place in Los Angeles, I’ve had the privilege of working with psychiatry residents, psychotherapists, nurses, physicians and students from Canada, Denmark, England, Ireland, Italy, Norway, Sweden and the US. On March 26, I taught the basics of Affect Phobia Therapy to psychiatry residents at UC-San Diego online. I felt it was essential not only to demonstrate how these principles can be used with their patients, but also with themselves so they could experience less anxiety and more connection. On March 30th, The Stockholm Certified APT™-Core Training met with trainees from Sweden, Norway, Denmark and Italy to ‘check in’ about how they are doing both professionally and personally. On April 3rd, I met with students from SAPU in Stockholm remotely and we discussed the importance of processing feelings of loss throughout the course of treatment, not just at the end.
In addition, I hosted our 2nd Therapist Affect Phobia Community Hour with guest, Dr. Michael Alpert of NYC. He explained why it can be difficult seeing our images online and demonstrated a technique anyone can use at home by themselves or with another person. To practice this exercise, you’ll need to look at your reflection in the mirror, or through your phone/ computer screen. As you look at your image, pay close attention to your eyes and begin to ask yourself questions like:
What do you see?
What are you noticing as you see yourself?
Can you accept what you are seeing?
What does it feel like to accept yourself?
What’s getting in the way of you accepting yourself?
What feelings are you experiencing toward yourself?
When did you feel like this in the past?
I volunteered to help him demonstrate this technique and followed his directions to look at my image on the Zoom platform. Immediately upon looking at my image I noted the tiredness in my eyes, I felt I as though I looked older, wiser and concerned.
When he asked me to pay attention to my tiredness, I felt tears come to the surface and I experienced sadness. He asked me if I was feeling more compassionate toward myself, but my sadness deepened instead. I realized that I was experiencing loss, I was missing what was familiar to me, my offices, my clients, my friends, my colleagues and then I noticed that I was feeling worried too, I was worried about finances, my well-being and not knowing what life will look like when the pandemic ends. My feelings went deep during his demonstration and at a certain point, I became self-conscious and retreated from the demonstration to resume my role as host. I shifted my gaze from my own reflection and looked at the square boxes in front of me with the names and faces of mental health clinicians and researchers from all over the world.
After our Therapist Affect Phobia Community Hour ended, I noticed that I was teary at times, experiencing discomfort and becoming more aware of my losses. The next morning, I experienced separation anxiety with my trainees while having to meet them online and felt deeply sad for only seeing them through a computer because of our loss in ability to be with each other in person. However, it’s important to note we all noticed that while we were personally connecting with one another, we were feeling more alive, less tired.
After our meeting, I joined a live stream yoga class and felt a deep longing for the comfort and warmth of my local studio, reluctantly adjusting to doing yoga at home. When my instructor asked us to name an intention for the class, I became acutely aware and distracted by an overwhelming sense of loss that settled inside of me as I realized I was far away from many meaningful people in my life and worried that I may never see some of them again.
Tears come to my eyes and I remembered the last time I felt this way was in August 2010 when I visited Leigh McCullough in San Diego before she completely lost her capacity to talk due to ALS. I remembered her weeping in my arms, deeply in touch with her sense of loss, loss of what was and loss of what was coming. Her capacity to experience the depths of her emotions was profoundly touching and I witnessed a ‘letting go’ happen inside of her followed by a sense of relief as she experienced her feelings with me.
As I remembered these memories of Leigh, I felt an old sadness rise to the surface and I grieved for that time long ago. I realized that once again, I was explicitly aware of change in motion, not only experiencing it, but also witnessing the end of what was once before. A long time ago, I learned that the only option in these moments is to master a level of acceptance, acceptance of what is now.
Structure helps me show up and accept what is happening right now. It’s my answer to any problem, it keeps me accountable and enables me to work toward the goals that are important to me. What is difficult about the pandemic is that all of us are in a free fall together and we have to adapt to our circumstances as they arrive. When you create a structure of self care, it will eventually turn into a system. So it is important that you select behaviors that will address the issues that have risen to the surface in our changing times, like:
Discomfort seeing our images online
Tiredness, exhaustion
Guilt for focusing on our families over others
Anxiety
Panic Attacks
Depression
Hypochondria
Fear
Isolation
To start developing your self care routine, you need a daily schedule that includes a variety of breaks. Due to my domestic and international commitments, my work days begin early and end late, but I try to insert a 15 minute break for each hour that I work, a two hour break for lunch that may include a yoga class, cooking or relaxing, and an hour break for a quick walk and a snack. Once you commit to a structure that works for you, insert only the behaviors that you’ll find rewarding, enjoyable or fun. Some examples of self care activities that people have shared with me over the past few weeks include:
Drinking lots of water and herbal teas
Playing musical instruments
Playing games online or with family members
Having an exercise mat nearby
Listening to music
Reading a novel
Doing puzzles
Drawing/painting
Creating a theme to follow for the day
Experiencing your emotions
Taking longer breaks
Spending time with pets
Spending time with children
Starting your day with yoga or meditation
Trying an online exercise class like ballet
Waking in the woods, on the beach, in your neighborhood
Hosting dinner on zoom with friends and family
Talking on the phone
Creating a sanctuary at home
Taking baths and showers
Reaching out to others when feeling isolated and out of control
I had some misses this week. I missed two online meetings, I was an hour late for another, and on one day I worked through one of my breaks and didn’t get to my walk. It was no surprise to me that on that night, I woke up to an ‘acting out’ dream where I threw a party in a big house full of people coughing and sneezing. I woke up in a panic, engulfed in free floating anxiety and I remembered the guidance of Dr. Patricia Coughlin, author of Maximizing Effectiveness in Dynamic Psychotherapy, “What can you do to feel more in control?”
I’m experiencing daily tiredness that momentarily lifts and then settles back down, gently arriving and receding like the fog in San Diego. It’s unsettling, this sudden shift in my life, and I’m using everything I have learned about self-care to help myself adapt to what is my new normal-working from home, online appointments and virtual teaching.
What I learned from this week is that if I feel my feelings and connect with others, my tiredness retreats for a while and I’m able to access a healthy sense of activity and joy for being. I better understand that feelings of loss today are intermingled with feelings of loss from my past. Structure helps me do the things that are necessary so I can feel more balanced and connected, it allows me to get my walks in, do some yoga, get organized and experience things I enjoy with others.
On August 13, 2010, I wrote an email to Leigh McCullough, days before I was to meet her in San Diego so I could hear her voice for the last time. I wrote, “All I can do is get out of my way, leave my ego on the shore, float downstream and be still until more is revealed.” It strikes me that those were such wise words at the time, little did I know of the complex challenges facing me as she slowly, but surely became ‘locked in’ before her death in June 2012. That period of my life wasn’t my hardest period, that was yet to come, but it was my most constructive. I learned what I was capable of becoming- myself.
As we face this pandemic together, I trust that one day, we’ll remember the lessons we’ve learned, the feelings we’ve shared, the bonds we’ve built and experience a sense of letting go and accepting what is our new normal.
In parting, I want to share the wise words of my Swedish colleague, Jenny Svebeck- sometimes it helps to remember that “Everything is Now!”
Warmly,
Kristin
Feelings give energy and color to our lives. They help us make wise choices, be close to others and set limits. However feelings can also be frightening. If we are afraid of what we feel we can develop an affect phobia. We retreat, no longer dare to be vulnerable and suffer from stress, anxiety or vague physical complaints.
Dr. Quin Dam is a clinical psychologist, psychoanalyst, supervisor NVP, NPaV and NVPP, and works in private practice in Leiden. He has over 20 years lecturer at RINO Amsterdam and supervises the peer of GPs with the Balint.
This is the first Swedish book about the affective-focused psychodynamic therapy. Our affect theory guides our attention and prepares us for action. They tell us what is important and helps us communicate it to others.
The mechanism of emotional change is central to the field of mental health. Emotional change is necessary for healing the long-standing pain of character pathology, yet is the least studied and most misunderstood area in psychotherapy and pharmacotherapy.
This hands-on manual from Leigh McCullough and associates teaches the nuts and bolts of practicing short-term dynamic psychotherapy, the research-supported model first presented in Changing Character, McCullough’s foundational text.