First, I think it’s important to acknowledge that this has been a complex situation. Many of these issues will probably not be resolved quickly as you have noticed and you might recognize that it gets hard to always look at the bright side of these situations. I cannot try to reframe the things you have been through or just tell you to think positively. There are some things in like that really are just bad. An important thing to keep in mind as you go through your struggles in being compassionate with yourself. Do not be harder on yourself than life already is. For example, I ask my patients the question, “Do you think that life is not hard enough? Do you think that you could use some more stress and pain in your life?” Most people respond with no. My response to them is that life is already difficult enough, so you really don’t need to be harder on yourself than life is already going to be. Now, some patients ask how can I work on being more compassionate with myself? I want you to think about times when a close friend feels really bad about him or herself or is really struggling in some way. I want you to think about how would you respond to your friend? How would you respond to this friend who is going through a very similar situation as you? I want you to try to write down what you typically do, what you say, and note the tone in which you typically talk to your friends. The next step is to think about times when you feel bad about yourself or are struggling. How do you typically respond to yourself in these situations? Please write down what you typically do, what you say, and note the tone in which you talk to yourself.
See if you notice any differences. Notice why you may be treating yourself differently from how you may treat others. Please write down how you think things might change if you responded to yourself in the same way you typically respond to a close friend when you’re suffering. Attempt to treat yourself like a good friend and see what happens.
An area to think about is how you are viewing and treating emotions. We established that the situations you have been through and are going through are difficult so naturally there are going to some distress related to these situations. You may ask yourself how much have you been trying to push away emotions or attempting to not feel certain things. Medications are effective and as therapists we do consider them for stabilization. However, we also recommend that therapy in combination with medications is most effective. Typically, when people take the approach of just trying to remove emotions from their lives or to stop thinking, this tends to backfire on them. The emotions seem to reappear again and sometimes negatively. I often recommend patients begin by viewing their emotions differently using some different metaphors. For example, you can imagine using the beach ball metaphor. Resisting reality and ignoring issues is like pushing a beach ball into water, and having it pop up when you let go. This demonstrates that you can only suppress your thoughts and feelings for so long until the beach ball rises again from the water and even sometimes hits us in the face. Also, there is the quicksand metaphor. When you struggle to get out of quicksand you sink in deeper. When you try to stop and resist your thoughts, they often make it worse. Instead, we can become more accepting that we will experience emotions because of life struggles. The less we resist, the less we sink in the quicksand.
Now, we get to the episodes of increased panic or anxiety. Again, continue to remind yourself emotions are normal and it will be important to talk more about these emotions during therapy. There are some steps you can take in order to manage your own emotions during a panic attack. You could start off by trying to add a breathing technique in your routine. The thing about breathing techniques is to practice them even when you are feeling good. The more you practice them the more likely you will be able to do them during a panic attack. Start off by sitting comfortably and place one hand on your abdomen. Breathe in through your nose, deeply enough that the hand on your abdomen rises. Hold the air in your lungs, and then exhale slowly through your mouth, with your lips puckered as if you are blowing through a straw. The secret is to go slow: Time the inhalation (4s), pause (4s), and exhalation (6s). Practice for 3 to 5 minutes.
You could also try the ground techniques using the senses. Try something visual like noticing what is around you. Look for small details you would usually miss. Many people like to focus on texture. My patients usually like to carry around some stress balls or fidget spinners. They focus a lot on how something feels that this helps in brining them back from their panic attack. Lastly, if possible, attempt to change your body temperature. This will lead to a lower pulse and blood pressure. A practical thing to start off with is by wetting your face with cold water for a while.
Ultimately, the situation is complex but this gives some idea of what a therapist may focus on during therapy sessions. I highly encourage you to keep reaching out for help.
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