8 Emotional Strategies for Depression and Anxiety Relief

This episode was pre recorded as part of a live continuing education webinar on demand. CEUs are still available for this presentation through all CEUs register@allceus.com counselortoolbox you I'd like to welcome everybody to today's presentation. 100 plus practical tips to defeat Depression Today we're going to talk about emotional interventions. Now this is part of a six part series that's based on a book I've got coming out in October named 100 Plus Practical Tips to Defeat Depression. Go figure. So today we're just going to talk about emotional interventions. We're going to define what they are, discuss why it's important to add in happiness, not just eliminate unpleasantness. We'll discuss solution focused methods for helping clients identify emotional interventions, identify mindfulness and how it can help clients tap into happiness and gratitude and develop heartiness. All things that are really helpful for happiness. And we'll explore types of emotional interventions that can be used in individual and group counseling. So a lot of what I'm going to talk about today is not the boilerplate what is grief? What is anger? I'm going to talk about tools and activities that we can do because you know what grief is. I mean, you got that in first year counseling. So emotional interventions, as we're going to talk about them today, help people address emotions that keep them feeling depressed, which means it can help them accept unpleasant emotions. Notice I didn't say eliminate, I said accept them. When you start trying to eliminate them, think about acceptance and commitment therapy. When you start trying to eliminate anger and telling yourself I shouldn't be angry, you just start fighting with it. And it's kind of like being in quicksand. And then you get frustrated that you're still angry. And then you get frustrated that you're frustrated that you're still angry. So we're not eliminating the unpleasant thoughts. We're accepting them and saying, all right, this is I'm not feeling happy right now. How can I improve the next moment? I can't change how I feel right now, but I can improve the next moment. I don't have to stay stuck here. We also want to talk about how to present prevent unnecessary unpleasantness. Because there are things that happen and life hands you lemons and you know, yada yada. But there are also some times where you can avoid unpleasantness. I don't like driving in traffic. You know, driving in heavy traffic stresses me out. So you know what? I typically, unless I absolutely have to, don't drive during rush hour. And that Just helps me feel happier and more relaxed. And finally, we are going to talk about adding pleasant emotions. So like I said, what types of tools do you use to help clients accept their unpleasant emotions and to add happiness to their lives? Okay. Journaling is a great place to go because it helps people become aware of their emotions and start understanding connections. And if you're journaling about, they actually did a study, I don't remember where, but it's in one of our other presentations that they had high school and college Youth Journal for 20 minutes every day about the positive things that happened that day. And by journaling about the positive things, it helped switch their focus, if you will. And they tended to report an improved mood and reduced stress overall after 30 days of practicing this. So by journaling, and especially if you journal consciously trying to identify the positive things that happen that day, it can help you remember that there may have been some hiccups, but the whole day didn't suck. Increased self care is another great thing because if we're sleepy, we are not going to be feeling our uber selves. We may have a higher propensity of getting stressed out. If we're in pain, we're not perfect, probably going to be the happiest we could be. So we want to look for those vulnerabilities, as Linehan calls them, and make sure that we prevent those as much as possible in order to give us the best chance of experiencing happiness whenever it presents itself. So the first activity that we can have clients do is helping them identify their feelings. If they don't know what they're feeling, if they're always fine or okay, you know those garbage terms that we use, you know, I really don't believe they know how they feel. So I want them to use some other word to describe how they're feeling. And you can use emotions charts like this with teenagers, you can use a chart with emoticons on it because that's what they relate to better. That's fine. So if you're working with an individual, you can have them make lists of things that make them feel a certain way, like what types of things do you feel guilty about? What types of things make you happy, Yada yada. They can do collages that answer the same questions and they can do those daily journals. And yes, you could have them experiment with the positivity journal that I talked about a minute ago. Or you can just have them journal about their day and then we can look at the journal together. And if we notice that the journal is largely Negative. We can encourage them to try to balance it out, you know, not eliminate the negative. But what else? You know, tell me about some happy things or some good things that happened that day too, in groups, if you're working on this. Collages is another great art therapy activity that you can do. You can also get a beach ball. And I'm going to talk about beach ball and Jenga a lot today. Get one of those big beach balls and a permanent marker and write down the different feelings all over the beach ball. And then when you have your people sitting in a group, you toss them the ball and whoever catches it looks down and they're probably going to see three or four different words, and they'll choose whichever one they want. But whatever word is facing up most up is the one they're supposed to answer. So if they catch the ball and they look down and it says hysterical, and we're going to think hysterical, happy, you know, I'm going to say, what's one thing that makes you laugh hysterically? And I want them to do that. And we'll pass it around, you know, for as long as we can, and it tends to get some good juices flowing. You can choose to have one ball that has only happy and positive emotions like hopeful and love struck and happy and hysterical and all those things. So you're focusing on happy feelings for that day. Or you can choose to mix it up. Jenga is another one. If you get a Jenga thing game, and on each block you write a different emotion. So whenever somebody pulls out that block, whatever block they pull out, they've got to give an example of what makes them feel the emotion that's written on that block. So it makes it a little bit fun. They're playing a game. It's not quite so. So, you know, we're not just sitting in a circle talking. Gives them something to do in a group. You can also play charades. Somebody will draw a emotion out of a hat, and then they have to act out whatever that emotion is. And people have to guess what they're feeling. Now, angry is easy. How do you demonstrate? How do you act out? Embarrassed or mischievous? So it can get funny and it can get people laughing, but it also can get them to be more in tune. Because remember, when we feel something, there is a emotional response that we label. There is a physiological response. Heart rate goes up, heart rate goes down, whatever it is. And then there are behavioral urges. So this gives us an idea about what are we doing when we get angry? You know, are we tensing our fists and making faces or, you know, when we're anxious. The final thing you can do as a group, if you want to, is do a how would you feel if. And have different scenarios written. Again, I usually use a box and put them on sheets of paper and people draw out a piece of paper. And how would you feel if you got a package that you weren't expecting? You know, how would you feel if your boss called you into his office and gave you a raise? Whatever the situation, you want to have good ones and unpleasant ones in there. But that helps people start identifying the different types of feelings they're feeling and getting used to using those other words besides fine and okay. And Cassandra added that when she has clients journal, a lot of times she'll encourage them to add one thing that they're grateful for at the end of the journal. And that's awesome because at least you're punctuating it. Even if they write this journal, it was a really bad day. But if they punctuate it with something they're grateful for, that increases their sense of hope. And that commitment, control, and challenge that we talk about with hardiness. Fear is one of those feelings that we feel that keeps us from feeling happy. You know, anger and fear are our stress response or our threat response. So when people feel fearful, they can't feel happy. You know, you generally can't have both things coexisting at the exact same moment. And as we've talked about before, there are six basic threats that people either respond with fear or anger, rejection, isolation, failure, loss of control, the unknown, and death. And there are some questions in the book that clients can go through on an individual basis if they want to. But let's talk about group. So if you're in group and you're trying to help clients identify and understand about fear, brainstorm types of situations that make people in the group experience that particular type of fear. So what types of things make you feel rejected? What types of things make you worried that you're going to not be in control? You can have stations around the room if you want that people fill those out. Or you can brainstorm however you want to do that. Discuss as a group why a particular fear is an anxiety provoking. If certain things make you feel like you've been rejected, why does that make you feel or you're afraid you're going to be rejected, why is that fear provoking? Why does that make you feel threatened? What happens if you get rejected there? So we really want to explore what the Meaning of that. Event is to that person. So if they are, you know, they try to ask somebody out on a date and that person says no, and the person's rejected, or they may feel anxious and they may not want to ask somebody else out because they're afraid of rejection. So we want to talk about why is. Why does it make you fearful to put yourself out there and where you might be rejected? What does that say? If somebody rejects you, what does that say about you? And really have them look at the logic behind that. Explore how addressing this fear will impact their depression. So if you've got somebody who has a lot of fears that surround depression, surround rejection and failure, for example, you know, if they could address, eliminate, mitigate, you know, their fear with those situations, if they can start feeling less anxious about rejection, how's that going to impact their depression? Because we remember that depression, when people are depressed, they often feel hopeless and helpless. So if they're exposed to a threat, when we're exposed to a threat, what do we feel? Oftentimes helpless or like we need to get out of it. So if they address some of these fears and, you know, mitigate them a little bit so they're not terrified, they're mildly anxious, will that free up some energy and make them feel more empowered and more self confident? Have them identify strategies that have been effective in the past. So when you have tried to ask somebody out in the past, you know, you've been afraid to do it, but you've mustered up the courage, how did you do that? Or when you've experienced rejection in the past, how did you deal with it? That worked for you, so you didn't feel bad afterwards. And have them put that in their toolbox. You can also have them go through the Challenging questions worksheet. I often have my clients have a Challenging questions emergency card. And basically it has the client ask themselves, you know, what is my thought? If I get rejected, it means I'm a loser, or if I get rejected, it means people are going to laugh at me. Okay, you know, if that's what you think, let's look at that. What is the evidence for and against that? Let's look at objective evidence. Are you making these assumptions based on facts or based on feelings because you're anxious? So you're assuming that, you know, people are going to laugh at you. Those are the two biggest ones. And then we want to have them look and say, you know, in three or four months or three or four weeks, is this really going to matter? Like fear, anger is A natural response to those threats. Rejection, isolation, failure, loss of control, the unknown, and death. But what we fail. And there are many types of fear too, but there's a lot of anger types, if you will, shades of anger that we often overlook as being parts of anger. So anger is, you know, obviously one. Resentment. Well, that's a type of anger, you know, that's anger that you hold on to for a long time and you kind of nurture sometimes irritation and guilt. Guilt is anger at yourself for something you did or something you didn't do that you should have done. So we want to have clients explore each type of anger, what triggers it, how it impacts their mental health, how they could better respond when they do something and they feel guilty about it instead of carrying around this guilt like an albatross around their neck, how else could they respond to, you know, deal with it? So if you're working in individual sessions, have clients keep a journal for one month, and I have them write a page for each emotion. So there's a page for anger, a page for resentment, page for irritation, and a page for guilt. And sometimes they'll fill up a page, sometimes they won't, and that's fine. But I just want them on separate pages so they can start categorizing what's going on so they can identify if there are certain types of anger they feel or how frequently they feel it, and maybe look for solutions. If you're doing this in group, brainstorm the types of things that cause anger, resentment, irritation, and guilt. Or, you know, another way you can do it is create a survey. And I usually when I do surveys, I pass it out at the end of one group and collect it before the next group and then tally it, and we talk about it in the third group. That gives them time to think about it and do it. But if you create a survey that asks clients, what are the top 10 things that. That make you angry? What are the top 10 things that you resent, yada, yada, Then you can start making lists, and you can start having more to talk about in group, and you can pull that out. And instead of having a client be on the spot saying, you know, what's one thing that you resent? You can say, well, it looks like, you know, the majority of you identified this as a common resentment. So let's talk about that. Write it up on the whiteboard, and then process it. Now, remember, guilt is part of that anger. So we want to define guilt for clients and help them see how it is anger turned inwards and explore its impact on mood and self esteem. I mean, when you feel guilty about something, how does that impact your depression? You know, when I feel guilty, I feel, you know, a little bit hopeless. I feel a little bit helpless, and I feel bad about myself. Have clients identify the things they feel guilty for on a sheet of paper and let them share whatever they choose. They may not want to share anything they may be willing to share. You know, I feel guilty that I made this choice. Okay, Explore why the client is angry at themselves. And one of the neat things with this is if you have clients, if it's a closed group and clients are willing to share, it's amazing how many guilts that clients have in common. And they can say, yeah, been there, done that, and burned the T shirt so they can provide social support for one another. One activity I do like to do though, is have clients write down a list of all the things they feel guilty for. They don't have to share it. Just write down a list and then count up how many guilts are on that list. So if they feel guilty for 27 things, all right, you get packs for everybody. And it can be a grocery bag if you want. It can be a backpack, whatever you have access to. If they have 27 gilts, then you put 27 rocks in their pack. And you might need two grocery bags because, you know, those break easy now and they need to carry that around with them during this activity. When we start making the packs, if we don't have a place where we can go out for a little walk, I just have them put the packs on their shoulders and they have to stand there. And when you're holding these packs for a while, they get heavy. So we talk about how guilt weighs them down and zaps their energy. And then we go through the guilts that they have on their list, and I have them look at them. They don't have to share again and identify which ones they can either forgive themselves for. You know, I made a bad choice, I screwed up, but, you know, I've done better. Or which ones they can fix they need to make amends for somehow and which ones they can let go. You know, the ones that are really inconsequential. When they were, you know, in 11th grade, they did something that was unpleasant to a friend of theirs. So, you know, that may be one that they just need to let go because there's really not a need to make amends for it. And there's really nothing to forgive necessarily at this point. So any of those that they think that they can decide to let go. They cross off their list and they can take those stones out of their pack and then they can see how much lighter it is. So this is one of those experiential exercises that can be kind of fun. It's a lot more effective if you can put the stones in packs, either in grocery bags or in backpacks, and you go on a walk, quarter mile, nothing too long, where people are having to move and carry these. If you've ever carried a rucksack with you hiking, you know how much more effort it takes or even carried five bags into the house because you are not going to make a second trip out to the car after the grocery store. You know how exhausting it can be. Another thing that people often feel guilty for not doing things that they feel like they should. And we're just bombarded with shoulds all the time. So a fun activity to do with the group is to make a guilt bill of rights. So we talk about the things that you feel guilty for on a regular basis, like sleeping in on Saturday. You know, I should get up and mow the lawn, I should get up and go to the gym. I should do this and that. But you know, sometimes we need to take care of ourselves. So we want to have this bill of rights that we can say, you know what, I deserve too. So we have them list the guilts and then on the other side, their bill of rights. So sleeping in on Saturday, maybe I feel guilty about that because, you know, I think I should be up doing something else. On the other hand, I work really hard all week, so I do have the right to sleep in and take care of myself. Going to the gym, you know, sometimes I will put off going to the gym because I have so much to do at work. And you know, ultimately I have the right again to take care of myself because my inbox is always going to be full and I'm more effective if I've got a clear head. So you call it justification, call it whatever you want to call it, but the bill of rights is a fun tool that you can use to encourage clients to engage in effective self care, including setting boundaries like not answering the phone and not responding to work emails after a certain hour of the day or something. So how do you help clients identify what they're angry about, understand what's causing the anger, and address that anger? Okay. Delanna suggests to help them identify their thoughts versus their feelings. And you know, understanding where this reaction is coming from is important. And the feeling There. And we're going to talk about that in a second to tell you to pay attention because the thoughts are indicating that there might be a threat. Get them to focus on specifics. What triggered this emotion and has it happened before? Okay. Grief is another one of those feelings that we're going to feel at times. It indicates that you lost something important to you. And, you know, we can have a lot of losses. We can have those tangible losses like a friend or a pet or a family member. We can lose our health, we can lose our self esteem, we can lose our hope, we can lose our dreams. So there's a lot of intangible things we can lose too. And we need to encourage people to recognize that those things deserve to be grieved too. We also want to help them recognize that anger is part of the grief process, as is depression. So if we're talking about depression and we're working with somebody who's depressed, we want to look at, are there things that you're still grieving that you still need to deal with, and how can we help you move toward acceptance? And a lot of times when clients feel depressed, they feel stuck, they feel like they haven't done accomplished things that they should, you know, whatever got them to this point. But there's oftentimes some underlying grief currents that we can help them address. Once they've addressed those, then that particular issue is not serving as a siphon for their energy. So have people identify the types of things that can be grieved and for each type of loss, identify how to deal with it. And there's a bunch of different ways, like radical acceptance, it is what it is. And there, you know, when somebody dies, it is what it is. And radical acceptance means accepting that and focusing on the fact that there are some bad points. But there are also, you know, it's not all necessarily bad. Like when my father died, you know, that was a bad thing. You know, I didn't want to lose him. However, you know, the time I did have with him was so precious and I learned so much and I have so many good memories. And so I'm trying to radically accept that in terms of what happened. With some losses like self esteem, you can work to get it back. You know, you may have done something, you feel bad about yourself, you may have made a whole host of bad choices, but that doesn't mean you have to continue to beat yourself up forever. So explore different permutations of what can you do to deal with this grief situation. All right, so let's Move on to adding the happy. We can't possibly change the past. We can only learn from it and sometimes fix some things that we did wrong. You know, I've worked with people with substance abuse issues for 20 some odd years and a lot of them have, you know, criminal records, convictions that, that, you know, they feel bad about, they feel guilty about, they feel angry about, whatever, but you can't fix it. Those are there, they're on the record, whatever, but you can learn from it so you don't get another dui. And you can possibly, you know, sometimes you can fix things that you did wrong. If when you were in your active addiction, you alienated half your family and if you want them back, you can potentially try to mend those fences. So we want to encourage people to start living in the present moment. What would make now the best now possible? Talk in your groups or with your client about what good it does to hang on to resentment, guilt, jealousy, anger, all of those things there. Holding onto it, it's kind of like holding on to a hot potato. It's going to burn you. You know, you're going to do this and you're going to waste a lot of energy juggling that hot potato so it doesn't actually burn your hands. Don't want to do that. Instead of eliminating anger or anxiety, what about accepting it and choosing to improve the next moment? So if somebody gets angry, you know, think about, they go on Facebook and somebody is gaslighting them and they feel oh so angry, okay? So they could have this whole dialogue with themselves about how they shouldn't get upset about that, yada yada, but they are. So instead of fighting it, acknowledge I'm angry. And this is one of those acceptance and commitment therapy things saying, I'm angry, that's fine. What are my options? I could choose to respond back to this person and potentially get into a posting war with them. I could turn off the computer, I could, you know, and have them start generating lists of options that they have. This helps not only generate options and help them see that they have positive alternatives, but it also gives time for the adrenaline to kind of go away so they can get into that wise mind. And then from that list they can say, which option do I choose to improve the next moment? You can put this up on the board when you're working. I always have a whiteboard when I do groups put different scenarios up there that make people feel angry or whatever. And then you can have them brainstorm their options. And if you look at the act matrix the psychological flexibility matrix. You can see different ways to approach that ride the wave. And we've all heard this when we've talked about dialectical behavior therapy and even mindfulness. Feelings are there to tell you to pay attention. Nothing more, nothing less. And that's one of the things I want to get through to my clients. It doesn't mean that there's necessarily a problem when, you know, the dogs start going eight bananas and it startles me, and I have that initial fear reaction. It doesn't mean that somebody's breaking into the house. I don't think they would with four dogs. But I have that initial feeling. Well, that feeling is just telling me to check the door and see what's going on. It's not telling me necessarily that there's a problem. Just like when a fire alarm goes off, it doesn't necessarily mean there's a problem. Most feelings occur and crest within about five to 10 minutes. And they only continue if people decide to give them power by dwelling on them or nurturing them and thinking about, okay, what could that have been? And thinking about all the past times things have gone bad. You know, you give it more energy. If you give it more of your energy, it's going to stoke that wave. One thing you can do in group is present a video of waves and surfing. Videos are really cool because they show the wave coming in and cresting and then eventually going out. And you can just have them look at that. Point out to them that wind blowing over the water gets it all stirred up, creating the wave. And the more wind, the bigger the wave. So ask them, what is their wind? What types of things feed their wave of negative emotions when they start feeling angry, what feeds that anger? And a lot of times we go. When we get angry, we start trying to figure out how to justify it. So we go down this whole litany of done me wrongs. You know, I'm angry about this and, oh, I'm still angry about this, this and this and this thing that happened two years ago. So we want to have them identify what they do that stokes their wave. When there isn't enough wind to sustain the wave, it dissipates. It crashes into the shore. So asking clients again, what do you do to reduce the wind? So to avoid giving that feeling any more energy, can you check it out to see if there's really a problem? Can you distract yourself? And I refer you to the dialectical behavior therapy acronyms, Improve and accept. Those are great distress tolerance skills that can help people ride that wave until it dissipates. Instead of feeding it. Address feelings. So we're talking about feelings over and over, and this is obviously emotion focused. And I came up with this activity. And if you get a bag of something really stinky, and, you know, I talk about it in the book as dog poop because I so happen to be writing that chapter on a day that my dogs decided to express their displeasure in my dining room. But in any event, if you get a bag of something really stinky, like a baby diaper, those are easy to come by. And if you don't have one of those, if you go to Walmart or something, you can get deer urine that hunters spray on themselves that reeks to high heaven, too. Put it in the center of the therapy room and label it anger and negativity. And it's going to be potent as clients come in, see how they react. If they're looking around to find it and get rid of it, or they're looking at it going, what in the world? Okay, you know, that's cool. We're just going to observe and then process it with them. You know, I usually sit down and I start processing before I take it out of the room, and I say, you know, feelings are like this. What do you want to do with this thing that's sitting in the middle of the room? And they're like, get rid of it. Okay, cool, let's do that. So we'll get rid of it. And then I point out that feelings are kind of like that smelly thing. They're there to tell you to pay attention, to get up and see where the noxious odor is coming from and do something about it. It doesn't necessarily mean there's a problem. And, you know, with dogs, if you have dogs at home or babies too, you know, you never know. You know, you'll smell a smell, and it could be that they've got a soiled diaper, or it could be that they just passed gas, and it's not a big deal. And you don't need to change their diaper. You just have to see how it goes. But if you let that stinky thing sit there, it permeates the whole house or the whole room. And everybody who walks by is like, oh, jiminy. So encourage clients to think about how negative feelings permeate their entire selves when they're angry. How is it like that stinky stuff sitting in the living room or carrying it around with them? You wouldn't bag up something stinky and carry it around with you. All day because it's unpleasant. You know, you don't want to be carrying that around, but it's going to repel other people. Well, again, think about if you're. If you have a client who's in a bad attitude or in a bad mood all day long, how does that affect how other people react to him or her? They probably are like, okay, gonna give John space today. He's, you know, having. He's having a day. So these are the things that we want to have them kind of think about. Why do we carry our stinky feelings around with us then? Because a lot of times clients will say, you know, I was angry all day yesterday or something. Okay, why were you carrying that feeling around with you? And what could you do instead? You know, what triggered that anger? Another kind of hokier one that you can have them do. Hardiness is the combination of commitment, control, and challenge. It means that people understand that even when some things go bad, there are lots of other things in their life that they're committed to that'll make it a worthwhile, rich, and rewarding life. So Raindrops on Roses focuses on commitment. I want to remind people that there are still things in their life that can make them happy, even if something else is going a little bit weird. Bright sunlit mornings blue corner cool breezes blowing Seeing my house clean or going out mowing Amazon packages left at the door Life on the farm who could want any more? When the dogs bark, when the phone rings when I'm feeling sad I simply remember my favorite things and then I don't feel so bad. So you keep that same raindrops on roses rhythm. But people can modify it to what works for them. Because obviously I'm not a big fan of the phone or the dogs barking. It's a fun little activity to have people do either as a group or individually. And then there's adulting. We all have different things we enjoy as well as things we dislike. And part of being happy is not only doing things that make you happy, but also minimizing the things that don't. You can't get rid of them. You know, I can't not pay bills. Yeah. I can't avoid doing laundry forever. You know, there are things that I have to do that are not my favorite thing. So making a list of those things that you dislike doing. Because those things, if we're doing them and we're doing them begrudgingly, how does that affect our mood versus how does it affect you? If you're like, okay, let's knock this out, get it done so we can move on. And encourage clients, they can do a coin toss if they want to, or pretend for a week that whenever something comes up they don't want to do, they just take a breath and they say, alright, we're just going to push through this and get it done so we can move on to something more pleasant and see how they feel differently. But encourage them to know those things that they don't like doing and even the little things like dishes, you know, if they don't like doing dishes, yes, that's 15 minutes. But it's still 15 minutes. So what could you do to make them more bearable? Sometimes doing 15. I didn't want to go running this morning. I just, I wasn't in the mood, but I was like, okay, I'm going to go outside, I'm going to start running. I'm going to do it for 15 minutes. If I'm still miserable, I'll come in. Most of the time when we get started, it's not so bad and we finish it. You compare things that you don't like with things that you do. Like when I wash dishes or fold laundry, I watch television and it keeps my mind occupied while I'm doing the mindless stuff. And you can also give yourself rewards at the end. So once I get the house clean, then I can go to the movies or, you know, whatever it is that's a reward for you. Encourage clients to identify things that they like doing that they compare with those things that they don't like doing because it makes it so much more tolerable when I fly. I hate flying. I'm not afraid of it. I just get bored. I don't like sitting still that long. So I always download a bunch of books onto my mobile device so I can read them while I'm in flight. And I also bring my. On my mobile device, I have little games that I can play offline like checkers. And, you know, it amuses me, whatever it is, but it helps me get through the flight. Serenity is another thing that we talk about and that's one of those happy feelings. The serenity prayer is used a lot in recovery circles, but you can make it more secular and you can just say, grant me the serenity to accept the things I cannot change. So we want to talk about, what does serenity mean? If you think of a serene scene or a serene painting, you're looking at it. What kind of feelings do you have? So really get clients to get into the moment. And understand what serenity is instead of, it's not just a word, you know, when I think of a serene painting, you know, I'm thinking of, you know, maybe a beach scene with still waters and you know, it's quiet and it's, you know, smells good, whatever. Encourage them to ident, really grasp serenity. It means you have the courage to change the things you can. When you're serene, you feel like, okay, I've done everything I can do. The rest is up to the universe or my higher power or whatever you, whatever handles the rest of it. And the wisdom to know the difference. One of the things that helped causes people to feel the most hopeless and helpless is when they're trying to change something that's just not within their power. You can't change the weather. You can't change, you know, at least immediately. You can't change like the local laws. You can't change, change. You know, there's a lot of things we can't change. So we want to have them identify what parts can you change and then whatever's left, how do you deal with it? And that's that wisdom, that wisdom to know what's worth my energy, what's going to be a good use of my energy if my house is 10ft over the property line? Getting upset about it ain't going to do any good. It ain't going to move the house. Pushing it with my shoulder or even get renting A bulldozer well may knock the house down, but it's not going to nicely push the house over. And if I knock it down, then I'm going to be angry about something else. So I don't have the power to change that. So I need to look at, okay, my house is 10ft over the property line. What do I have the power to do? And you know, it may be just accept that, you know, you've got to pay to have the property line moved and buy that section of property from your, from your neighbor or something. I don't, I don't know how they'd handle it. But you want to focus on the things that are realistic that you can change in a short time frame. So have clients identify that list of stressors and irritants, identify which ones of those they have the power to change and what they can do to change them. And this is kind of a fun activity to do in group where you just have them start throwing out stressors and irritants. And it can be traffic, it can be their boss, it can be, you know, their 2 year old who won't potty train. Whatever it is, you just, you know, mind map everything that goes out there, just put it up on the board, keep that pen going until the board is full, and then you go back through and you start talking about which ones can you control, which ones can you change? Encourage people to really talk about that because a lot of times they'll start saying, I can change this, this thing here. And somebody else will say, no, you really can't. And a lot of times that happens when you're trying to change somebody else. You know, I can change the fact that my kid is failing out of school. Not necessarily, not if he doesn't want to study. So we need to look at what do you have the power to do for those things you can't change. Encourage them to brainstorm how they can change the way they feel about the situation. Can they just let it go? You know, if, you know, they break up from a relationship and that person's gone, you know, they got dumped, whatever, that may not be changeable. So how can you change the way you feel about that situation? Instead of feeling, continuing to feel devastated and lost, can you let it go? Can you look at the bright side? You had some good times together, now you get to have good times with somebody else. You know, what are some optimistic ways you can look? How can you view it as a learning experience? Or how can you remove a particular stressor from your life? So again, encouraging them to each type of stressor is going to be a little bit different. Then they have to do it. Talking about it is great. We can have a lot of fun talking about it and coming up with ideas. But if they don't do anything to either change the situation or change the way they feel about the situation, then they're going to stay stuck, which is going to contribute to that hopelessness and helplessness and depression. Encourage clients to make a plan to deal with at least one thing on their list each day. And one of the things we used to do in recovery, one of the steps is to review the mistakes you've made and make amends when possible and yada yada. But we would have people write down an entire list of things that were stressors, guilts, whatever that they needed to deal with. And they would put one on each card and they would put the card in a basket every day they would pick one or two things out of that basket and they would work on that and then that would be it. And then the next day they would work on one or two things more. Because if you spend your entire time that you're awake working on eliminating this litany of done me wrongs, you're not gonna have time for any happiness. So we do want, we want to encourage people to, you know, try to fix things that they can fix or, you know, change things to feel a little bit better about them. But you can have, you can eliminate all these negative feelings. Well, that's great. But if you don't have happiness in there, what do you have left if you're not angry anymore? And my grandfather went through a period like this after he got Parkinson's. And, you know, his eyes were going. And he had Parkinson's and he couldn't make his miniatures anymore. And he wasn't a well educated man, so he didn't like to read. And, you know, like I said, his eyes were going anyway, so there were a lot of compounding factors. And he got very, very frustrated and he started working on, you know, dealing with that anger and frustration. But he wasn't finding anything else that made him happy. So once he started dealing with this stuff and realizing, okay, you know, I have to accept this, yada yada, he was just. There was no happy after it. And it was really hard to see, you know, he didn't have a lot of momentum to keep going forward. So we have to add in that happy. We can do this by finding our inner child. This is one fun way to do it. So have people brainstorm what they like to do as a kid. And this is another fun one that's just awesome to do on a whiteboard because we get to hear about what other people did as a kid that they liked. Heck, even today. But I'm pretty in touch with my inner child. Swing, catch, fireflies, paint slip and slide. And you don't have to have the expensive one. You can get a shower curtain and a garden hose. Board games, hula hoop, roller skate, knock knock jokes. Those are mine. And throw that out there. And when we do this activity in group, I always put mine out there too, because I want clients to recognize that, you know, there's a time to be serious and there's a time to kind of cut loose. Ask them about what their favorite show or cartoon was. If you've ever been sitting in a group with people and talking about, you know, what was your favorite cartoon? Or do you remember Yaqui Doodle? I'm a huge Hanna Barbera fan, so, you know, I'll bring up that or Yogi or something, and people are like, oh, my Gosh, yes, I remember those. You know, I'm like, I have the entire season on dvd. Yes, I do. And it's not for my kids. It's for me. Thank you. What was your favorite food? You know, could have been spaghetti, could have been grilled cheese, whatever. What was one of your favorite songs and what was different when you were little that you miss now? And, you know, it could be getting to sleep in, it could be not having to pay bills, whatever. So I want them to really have a depth of things that help them find that inner child and then encourage them to have a play date with their inner child. You know, whatever day you choose, you're going to do these things. You're going to watch your old favorite cartoons and eat your favorite foods and do those things that you know you miss doing now that you're, now that you're an adult. And you're going to do things that make you happy that day and have them do that for an entire day and then go to sleep. You know, we're not going to process it that day. Why? Because a lot of times when people spend that entire day in touch with their inner child, it can be a little exhausting and it can be exhilarating, but they're going to sleep so much better. So the next day when they start writing their journal about that activity, they're going to hopefully feel more energized, more relaxed, and they're going to be like, hey, this was pretty good. But you have to get all the way through that sleep cycle first. Belly laugh. Laughter relaxes the whole body. A good hearty belly laugh relieves physical tension and stress for up to 45 minutes. Now, that has to be a really good belly laugh, but you can do it. Think about little kids. There's one video of a little baby on YouTube that thinks tearing paper is. The sound of tearing paper is hilarious. And his caregiver is just sitting there tearing paper and he is laughing so hard. And that cute little baby belly laugh. Laughter boosts the immune system. It decreases stress hormones and increases immune cells and infection, fighting antibodies to improve your resistance to disease. So when you're sick, guess what? Now's the time to start bringing out those comedians and anything that makes you laugh, it triggers the release of endorphins, the body's natural feel good chemicals which promote an overall sense of well being and can even temporarily relieve pain. Think about if you broke your leg or you've had pain in the past or toothache or something and you did something and it got you laughing for that period while you were laughing, and maybe a little bit afterwards, you may not have even thought about your pain. You may have been just, you know, focused on whatever was making you laugh. That's those endorphins, and it's helping people feel better. And laughter protects the heart and improves the function of blood vessels, increases blood flow, and protects people against heart attacks and other cardiovascular problems. So belly laugh. It's a good prescription. The other thing we can have people do, and I talked about the DBT acronyms, Improve and accept. We want to help people develop a distraction inventory. Because sometimes they're just things that are unpleasant. Maybe they're waiting to hear back about a job interview or test from the doctor, or maybe somebody passed away and there's just nothing they can do about it. I mean, that person's gone, and it hurts. And that grief is painful. But we need a break. You know, we all need a break from that. Sometimes we don't want to just sit and stew in it. It's kind of like sitting in a bathtub for too long. You start feeling like you're pruning. So we want to encourage people to figure out a way to distract themselves. It doesn't mean they don't hurt anymore. It just means they're giving themselves permission to have a break. So brainstorm some ideas. What can you do? Go outside and look at the clouds and make cloud pictures. Do an art project. Clean. I love cleaning it Usually, you know, I get obsessed with cleaning, exercising, listening to loud music, cooking, reading a book, looking at something online. Whenever my husband gets stressed about something, he goes online and he starts looking at airplane and flying stuff because that's his hobby, and it just completely occupies his brain, and he doesn't think about whatever's bothering him at that moment that he can't change. Encourage people to identify their happy place. Create a group happy place. If you're doing group therapy, you know, we can talk about, what does this look like? And the reason we do it as a group is to help people walk through this fully before they do it on their own. Because a lot of times when people create their happy place, they're like, yeah, it's a beach. No, no, no, no, no, no. We want to get in there with all of our senses. So I'll have them identify. Okay, do you want it to be the beach, the forest? What kind of environment are we in? That's where we start. And then I walk them through the activity, and if they want to close their eyes, great. If they don't that's fine too. They can just focus on something in the room. But I want them to focus on more on my voice and thinking about what I'm saying. So then I'll talk about, okay, you're walking, we'll say the forest. You're walking through the forest. What do you hear? And I encourage everybody in the room to share what's something that they hear? And the birds, the breeze, the leaves blowing. And I want to get multiple sounds because in the forest there are always multiple sounds. What do you smell? Again, I want multiple. Because you're going to smell multiple things. And it could be good, it could be bad, but you're going to smell it. And a lot of times when the breeze comes through, you'll catch a smell of something else on the breeze. Then we talk about, what do you feel? And it can be the sunlight hitting your skin. It can be the dew because it's damp in the forest. On the path you're on, it can be the cool breeze. I want to know what you're feeling. I want to know what it feels like on your feet. If you're walking on this path, is it a rocky path or is it a nice, smooth, cleared path? Really encourage them to keep talking. Keep talking about what it looks like. And you're jotting down notes the whole time that they're saying this. So we did sight, smell, sounds, touch. There's usually not taste, but that gives us a much more. A lot more depth to our happy place. So then we have this great big happy place and I write it down. And the next day when people come in, because we've just done it this time, the next day when people come in, we go through this activity and I will narrate what our group happy place looks like. And so I, you know, I'll start talking and if I can use visual aids, if I've got sounds that I can add to it and stuff, sometimes I'll do that just to enhance the process. But I want them to see what it. How much of a different it makes in their ability to relax and embrace the situation if they use all their senses. And that really helps them get into it and feel like they're there. And then you want to have them go home. And each person writes their own description of their own happy place and using all of their senses. And they can use the model that we created in class so they make sure that to get multiple sounds and multiple smells and those things. And then you can also have people just start a project. What Is something that you could start that would get you distracted. So when people are depressed, they often feel helpless and hopeless, and just nothing makes them happy. By adding in happy things, we can buffer against the depression because it's hard to be depressed and happy at the same time. You can be depressed about something, you know, and that's a specific something. You can feel hopeless and helpless about that. That's true. But it doesn't mean your whole life has to feel hopeless and helpless. So adding in happiness, even if it's just belly laughs, can get some of those neurochemicals that like serotonin going and help people feel a little bit better despite whatever's going on over here. By addressing unpleasant feelings, happy chemicals can be more effective. And, you know, most clients don't care about whether it's dopamine or norepinephrine or serotonin or whatever. They just want to feel better. When we address these unpleasant feelings, when we mitigate the anger, when we mitigate the anxiety, so they're not just completely flooded with adrenaline all the time. They start to get more energy. They start to feel better because they're not exhausted. They're not, you know, fighting a losing battle. Emotional interventions help you address the unpleasant feelings and add pleasant feelings. By developing a better feelings vocabulary, it's easier to identify how you're feeling and to address it. But this is, you know, I really encourage or I discourage in my groups, happy, mad, sad, glad, fine, and okay. I want to know other words. You know, how are you feeling today? I'm feeling elated, I'm feeling giddy, I'm feeling whatever. But I want them to really dig a little bit deeper and try to find something more than a surface emotion. And mindfulness helps people stay in the present moment so they're in touch with their feelings and don't let them fester like a dirty wound or like the smell of dog poop in the living room. We really want them, when they sense something's wrong, to get up and check it out and then choose from there what the best course of action is to improve the next moment. Do they need to do something, or will it just go away? What other emotional interventions do you use with clients? Or another question would be, when you're working with clients and, you know, for a long time, many, many years, I never even considered adding happy as an intervention. But adding happy is something that I regularly do now to encourage clients to, you know, try to find some of that icing. It's important to find emotional release skills that's very, very true. Because if they just have all those emotions tied up in here, you know, it's exhausting to hold on to all that energy and try to keep it contained. So they need to be able to let it go. The happy, the sad, the angry, everything. They need to figure out ways to disperse it and deal with it. One of the fun things about emotional interventions, a lot of the ones that we talked about, is they can be fun and in group, you know, it can get people laughing and sharing and supporting each other. And Cassandra's right. Everything we do does have a purpose. Crying is a great emotional release. Screaming occasionally, as long as it's not at another person, can be a great emotional release. Sometimes when I'm having a really bad day, when I'm angry, well, I used to, before I hurt my shoulder, I would go out and I would hit a tennis ball against a wall, you know, and it was very cathartic for me. Was it solving any problem? No. But it was letting me get out some of that energy for a second so I could get into my wise mind and figure out how to improve the next moment. You can have clients jot down, keep a log, a journal, or a box of things that make them happy. And then when they're having a bad day, refer to that. Or like Pat suggests, when something makes them angry. And in recovery circles, a lot of times we call this a God box, but whatever you want to call it, they put whatever made them angry in that box. You know, they figure out what they need to do to deal with the situation, if anything, and then they put it in the box and that's their way of handing it over to the universe. Okay, so those are all great ideas and we're going to talk more. Like I said, I guess I do more with the with Jenga and the beach balls in the cognitive one on Thursday. There are also games like Family Feud and not Trivial Pursuit, but what's the one with Alex Trebek? Jeopardy. There are lots of different games that people are familiar with that can be fun and a great way to get clients to hone in on concepts without feeling like, oh, we just have to sit here for another lecture. Alrighty, everybody. It is that time. It has been a great class. I really appreciate the fact that you are participatory and I will see you on Thursday and we're going to talk about cognitive interventions. If you enjoy this podcast, please like and subscribe either in your podcast player or on YouTube if you want to attend and participate in our live webinars with Dr. Snipes. You can subscribe at. This episode has been brought to you in part by allce.com, providing 24. 7 multimedia continuing education and pre certification training to counselors, therapists and nurses since 2006. You can use coupon code counselortoolbox to get 20% off of your current order. 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