HALT relapse Prevention

In this presentation, hopefully we're going to have a lot of fun. This is a lighter presentation than some of the others that we've done. We're going to define what HALT actually is. And believe it or not, you know, hungry doesn't just mean I need food in my tummy. And we're going to explore how this biopsychosocial approach can be helpful for preventing relapse and enhancing mental health halt. If you have worked in dual diagnosis facilities or co occurring disorder facilities, whatever your place calls it now, you're probably familiar with this acronym and it stands for hungry, angry, lonely and tired. It reminds you of, it's there to remind people of the dangers of being any of those things. And I include an angry, also anxious. Because remember, fight or flee their part of that stress response. Some people react to a threat by getting scared. Some people react to a threat by getting angry. Some people react to a threat by getting scared and then protecting themselves by getting angry. But either way it's a reaction to a threat stress, either emotional or physical stress. So whether you're sick, you're in pain, you're nutritionally deprived, you are emotionally stressed about something. Those things trigger the HPA axis. We've talked about that, your threat response system. When that happens, your body secretes cortisol and glutamate and norepinephrine to prepare you to fight against or defend against the perceived threat. And that's when we start having, having symptoms of anger or anxiety or if it goes on for too long, sometimes it's depression because our body just is done. It says I can't do it anymore. When these feelings, which are very normal, are left unchecked, they can lead to addictive behaviors and mental illness. In recovery, you're not going to go through life not having any dysphoric emotions. One of the things we talk about in recovery from addiction is that one of the blessings things of recovery is the ability to feel feelings. And one of the worst things about the recovery, about recovery is the being able to feel feelings. So it is, can be sort of bittersweet. Sometimes emotions are normal. Emotions are your body's way of telling you hey, remember there might emphasis on might be a threat here. It's dumping energy to prepare you in case you need to fight or flee. The first thing you need to do is use that energy to survey and evaluate is there a threat to me in this context at this time? And then decide how to use your energy. Let's start with hungry. A lot of times people think of hungry when they hear this acronym as making sure you eat a good diet. Well, that's true. We need to provide the body the building blocks it needs in order to build the neurotransmitters and keep everything operating smoothly in our body factory. No doubt. However, hunger is actually defined as having a strong desire or craving. Oh. So when we start using the word craving, that brings up a whole bunch of other things, not just food. So hungry actually is a much more global term when you think about it that way. When people start feeling hungry, they're having cravings for something. They're feeling like they need something, they're lacking something. So what types of things? And this is actually a question, you can answer it in the chat window if you want to. What types of things can you hunger for? And how does each impact your physical and mental health? So to give you a few prompts, obviously, we'll start with the easy one. Food. If you are not eating a healthy diet, you may crave certain foods. Healthy diets help make sure that we have all the necessary raw materials that are that our body needs in order to function and run smoothly. When we don't have those, we experience cravings. When I am dehydrated, for example, I crave iceberg lettuce. Well, guess what? Iceberg lettuce is like 90% water a lot of times, and there's very few actual nutrients in it. So in reality, a lot of times when I'm craving iceberg lettuce, it tells me that I'm dehydrated. Sometimes we crave comfort foods, foods that are high in fat and processed carbohydrates, because our dopamine or our serotonin is low. And when we eat those, it does prompt a rush of those endorphins and dopamine and serotonin. So it's important to recognize, are you eating because you are hungry, because you are lacking nutrients, or are you eating to soothe a mood state? And it's important to recognize that when we eat crappy, we feel crappy. I mean, you have go on a cruise or something, and maybe you don't eat great for a couple of days, that's one thing. But when you're eating poorly for weeks or months on end, it starts to have an effect on your physiology, on your mood, because your neurotransmitters and your gut microbiome kind of get impaired in terms of mental health. When we are eating a healthy diet, it helps support those neurotransmitters. Our brain is one of the Biggest consumers of blood glucose. So if we have, we don't have enough food, if we don't have enough blood glucose, we can start to feel very irritable, very foggy, have difficulty making decisions. When we are dehydrated, even 1% dehydration, which is well below the threshold of even saying, oh, I'm parched, 1% of dehydration starts impacting our ability to focus on, to remember and to solve cognitive problems. Interesting little fun fact there. So it's important to carry that water bottle with you and pay attention to what you eat. You can hunger for knowledge, and I know that's one of those kind of warm, fuzzy concepts, but sometimes we want to understand and hungry can be hungering for knowledge, for example, about techniques and tools that can help me be my happiest, healthiest self. When we hunger for knowledge, sometimes we go kind of willy nilly and we're just so desperate to find information we don't fact check it. And that can be detrimental to our physical and mental health if we are using information that is not reliable. So it's important when we hunger for knowledge that we find reliable sources. If you want knowledge about physical health, you know, going to sites like Hartford Health or there are some others that, that are out there, or asking your doctor, what are some good books, what are some good authors that you would recommend or your counselor, you know, or if you're a counselor, asking other counselors what are some books that, or podcasts or videos that you would recommend to your clients to make sure that if it's you, you're getting the information that is accurate, reliable, helpful, if you're recommending it to somebody else, obviously you want to pass on to them useful, helpful and accurate information. We can hunger for hope. And that is an issue that plagues a lot of people a lot of the time because things happen. And nothing, virtually nothing, maybe there is something out there, but virtually nothing is going to make everybody happy all of the time. There's almost always some people who are happy and hopeful and ecstatic about something and people who wanted it a different way, and they lose hope and they feel hopeless and helpless and powerless. And it's important when we are craving hope, when we are hungering for hope, that we find ways. And this is where hardiness comes in, that we find things in our life that are able to provide that hope. You know, maybe you don't like your job, okay, you know, maybe that is not going great right now, and maybe there's no hope for it improving in the, in the short term. All right, so what are some ways, alternate ways that you could address that so you could have hope that you would eventually be in a job that you enjoyed? Also, what are other things in your life that are going on that give you hope, that give you inspiration? You know, everything in our life is usually not going to be going great at the same time. So helping people find hope, find that little glimmer of light in the darkness that they can hold on to and go, okay, I can see, see a way out of this. When things don't go their way, helping them step back and say, okay, how can I make this work for me? In what ways can this help me be the person I want to be, live the life I want to live, given the current circumstances? And, and with hope. That means sometimes, you know, changing your cognitions, changing your way of thinking and going, okay, well, this is the way I wanted to do it, but we're going to have to scrap that. Best laid plans, as they say. How can I, what things can I do? What do I have control over that I can use my energy for in order to help me work towards that rich and meaningful life that can help me work towards hope. Sometimes we hunger for escape or relief. We just, we can't take it anymore, anything just to make it stop. And this, all of these things are true. Whether we're talking about addiction or mental health issues and being aware of these feelings of escape or desire for escape and relief are really important because that tells us that somewhere we are feeling really disempowered, really unsafe, really scared, really hopeless, you know, really something that we want to stop feeling. When we realize that, when we recognize that, then we can identify what we're feeling, the need to escape from, and then make more wise mind choices about how to address that situation in a way that's meaningful. And sometimes we hunger for power and control. We want things to be our own way and an addiction. This is really very true very often. But there are a lot of other people who don't have addictions who really struggle with power and control issues. Maybe it's because they have a history of trauma, maybe it's because that's how they're wired, whatever it is. But recognizing when you don't, when you feel like you're disempowered, when you don't feel safe, recognizing that and then being able to step back and saying, why do I feel this way? Why am I craving so desperately power and control right now? What in this context, at this Point in time. Do I have power and control over, you know, helping them see that? Okay, some things, you know, embracing the good with the bad, radical acceptance and all that. Some things I do have control over, some things I don't. But the things I don't have control over, I do have control over, whether I invest my energy in it, whether I dwell on it. So encouraging people to identify the things they have power and control over, how can each one be addressed to prevent mental illness, addiction or relapse? Well, and actually, well, that comes later. That's right. Food educating clients about healthy eating we cannot, unless you are licensed to do so. We cannot make food prescriptions, we cannot make menus for people. But we can educate them about the importance of antioxidants that come from our colorful fruits and vegetables that can help with keeping the brain healthy and clearing out that oxidative stress. There are a lot of things that we can do to educate. We can educate people about why they may crave things like chocolate and highly processed foods and help them identify that as a potential relapse, warning sign, as a potential sign of distress and actual neurochemical imbalance instead of just seeing it as a bad habit or whatever they see it as. In terms of knowledge, I talked about that a little bit already. We need to make sure that if we are craving knowledge, if we are hungry for knowledge, that we make sure that we get accurate information. For clinicians and people who enjoy reading peer reviewed journals, you can go to pubmed and it has a really long URL. If you just go into your search engine and type PubMed, it'll come up. But it is part of the National Library of Medicine and it does link you to articles and peer reviewed journals. So that can be one way to get knowledge that is theoretically accurate. You can also find websites that seem to be accurate. If you read an article on, you know, drjimbob.com and it sounds really good. Well, look to see if Dr. Jim Bob actually has references cited at the bottom of the article. A lot of the more reputable websites like Harvard Health and WebMD, and I can't even think of all of them right now, actually do link to the scientific studies. They do link to the experts who provided the raw information that was used to inform the article. And that is one way to tell if it is something that is definitely useful. Well, definitely accurate. Whether it's useful or not depends on the person. And it's important to recognize that that's not always going to be the case. You know, there are Some people out there who may have very accurate, very helpful websites that they don't see anything. But you know, if you're, when you're starting to develop your library of helpful resources, it's good to start out with the most stringent peer review criteria you can. And then, you know, maybe get a little bit more loosey goosey as you go along and develop more knowledge and you can read for yourself and go, yeah, that makes sense. Or that's hogwash. When we crave hope. You know, I talked about making sure that we help people identify what they do, what they can control, what they can do with their energy at this particular time, in this particular circumstance to improve the next moment. That in and of itself brings hope. I can see a light at the end of the tunnel. I can see that I don't have to sit here in my misery and, you know, get all pruning and stew in it. I can see that there are options. That's what hope is about. We can help people recognize alternatives. And when people are seeking escape and relief, it is so important that they don't wait until that point to create a list of things they can do, ways they can address those issues. You know, it may be in recovery, it may be calling their sponsor, calling their coach, calling their counselor, calling a trusted friend, going out on a walk, going to the gym, whatever it is that works for them. They need to have a list of at least five things that they can do when they are feeling the need to escape that can help them, if nothing else, tolerate the distress. Remember, not everything can be changed. You know, you're having feelings of a need to escape, a need for relief at 2:00am you know, you don't have a whole lot of options. Whatever it is that you need to address or you think you need to address may not be able to be addressed until business hours the next day. So what can you do in order to tolerate that distress until which time you can address it? Power and control. A lot of times we thirst for this or hunger, sorry, hunger for this. And helping people recognize what they do have power over. Too often people who are depressed, angry and anxious feel unsafe, helpless, hopeless, disempowered, and they focus on that. When you're in that mindset, that's generally what you're going to see. So it's important to help people acknowledge that, but also acknowledge the things that they do have control over, the areas where they do have power and the strengths that they do have that can help them survive the current distress. Angry and dysphoric you know, obviously dysphoric doesn't meet the acronym, but angry, anxious, depressed. Anger is half of the fight or flight response. When we feel or perceive that there might be a threat, that HPA axis is activated and we feel angry, generally feel angry or anxious. Or if we're in a state of burnout and we're just completely worn down, we may feel depressed. Anger and anxiety go by many different names though. And this is where again, it's more broad than what it looks like on the surface of that acronym. Anger can be called rage. Anger can be called anger, frustration or irritation. Guilt. Guilt is angry at yourself. And I forgot to put resentment on here. I knew I was forgetting one when I made this. Resentment is another thing we talk about a lot in recovery. And it's a form of anger. It's holding on to anger that's in the past. Guilt is anger at ourself for stuff in the past. Resources. Resentment is anger at other people or other things that happened in the past. Grief. Part of the grief response is anger. Remember denial, anger, bargaining, depression and acceptance. So when we're grieving, we may feel angry. We will likely go through a period where we feel angry that we couldn't control that situation or we can't get back what it is we lost. And envy and jealousy are also forms of anger when we're envious. Stay with me with this. When we're envious, we're angry at other people for having something that we want or we feel we should have. Envy and jealousy are a permutation of anger. Anxiety is a little bit more straightforward. Anxiety, stress, worry, fear. And as I said, when these things go on for too long, when we start to feel helpless and hopeless about something, that is when we have this feeling of depression. Anxiety and anger are our body's response, our ramp up response to fear. Our body's giving us energy, it's giving us focus, it's giving us what we need to fight or flee. If we're feeling angry and anxious, angry or anxious, a lot of times we don't feel completely disempowered and helpless yet. So depression comes along the way. Thinking about the impact of these feelings, anger, anxiety, depression on your whole self physically, we know it triggers the HPA axis. It alters the levels of serotonin and gaba. Those go down. It increases glutamate and cortisol, creating a neurotoxic environment in our brain. If it goes on for too long, it reduces our sex hormones that are, well, our gonadal. Hormones that are very neuroprotective. So not only are we creating a more toxic environment, we're removing the protections. You know, it has a whole host of impacts. Oh, and it impacts the thyroid, it makes the Cortisol, makes the T4 less able to convert to T3. So we start having hypothyroid symptoms. So physical health, when we have a high level of anger and anxiety and then eventually dysphoria and depression, it impacts our neurotransmitters, it impacts our hormones, it impacts our sleep, it impacts our appetite and our circadian rhythms. It impacts our pain level and our systemic inflammation. It even impacts our gut microbiome. So there are a lot of downsides to nurturing anger, anxiety and depression. Now, remember, and I know I'm saying this a lot, but, you know, a lot of people get. Don't hear it when I say it the first time. So I'm going to say it multiple times. Feelings are normal. Feelings are great. That's your body trying to protect you. It's when you hold on to these feelings for hours, days, weeks, months, years, and nurture them that it can start causing negative or unhealthy repercussions. Affectively, when you're angry and dysphoric, it's going to be harder to be happy. Now, you can be angry, you know, for a few minutes or an hour or whatever it is, and then be happy a couple hours later. That's true. But when you hold on to anger, when you're nurturing that anger and really focusing on doesn't allow a lot of time to develop. Take energy from that. A lot of times people are not willing to take energy from that to turn their mind and say, okay, I'm going to put this anger over here for right now, and I'm going to focus on this thing that makes me happy. Cognitively, we become more cognitively inflexible, become more negative and pessimistic when we are angry and dysphoric, which tends to have a negative impact on our environment and our productivity and our relationships. Encouraging clients. And I have them make a five columns on a piece of legal paper, or sometimes we do it on the whiteboard. Physical health, affect, cognition, environment and relationships. And we go through these things and talk about how, nurturing them, how instead of dealing with them, holding on to them and nurturing them, or trying to ignore and suppress them can really come back to bite them in the butt, basically. We also, however, talk about the benefits, if any, of holding on to these things. And remember A lot of times we do things because we perceive there's a benefit. Anger and anxiety can be beneficial to us if they are accurate because their purpose is to protect us from harm. So we don't want to get rid of them completely. We just want to be able to use them like fire alarms to tell us when there's a problem and motivate us to do something. Instead of being a state of being. Feelings are natural reactions. It's important to be aware of them. And they're early warning signs and triggers for each feeling. You can have clients, you know, make lists. This. It's kind of boring to do in group if you do it this way. You can also have them draw cards out of a hat and describe what their early warning signs are. For particular feelings. You can do Pictionary and try to have them act out a particular emotion. There are a variety of things that you can do. You can also do the game taboo and try to have them guess the different emotions. Get creative when you're trying to think about this. But early warning signs. What are your early warning signs for anger or even for. Since anger is along a continuum, start out with frustration and irritation. What are your early warning signs that you're getting irritable? You know, for me, my, my foot may start to tap and, you know, I may start to get physically sort of agitated, shifting in my seat, back and forth, or, you know, pacing around. That is my sign that I'm. I know that's one of my early warning signs of irritability. And it's important for people to recognize what their personal early warning signs are and recognize triggers for each of these things. And that can be a fun one to do with the beach ball activity. Put each word on an aspect of the beach ball and toss it around when people grab it. Whatever feeling is facing up, they need to identify one to three, depending on your. Your group triggers for that feeling. Write those up on the board. And then as you go through, you're going to have people say the same thing triggers their guilt, for example. So you can just put, put hash marks by it. If somebody else says, you know, forgetting somebody's birthday cause causes me to feel guilty. All right, you write that up there. And then if somebody else gets guilt later and they identify that as one of theirs, put a hash mark. The goal is to help people feel like they're not the only one. The goal is to help normalize people's feelings and then figure out how to address them. Part of addressing anger, anxiety, threats. First part is get safe. Help people figure out how to get safe and make sure that they're safe, emotionally, physically, financially, whatever. Help them make sure that they're safe. The next step is to help them identify where that threat, you know, what cognitions are supporting their fear, their anger, and then identify whether that is based in fact in the present context, what are the facts to support their feeling of threat in the present context, and then how likely fcp? What is the probability that that's going to happen? Loneliness is an interesting one, and I have talked with a multitude of clients and I've experienced it myself, that you can feel lonely when you are in a room full of people and you can feel loved and connected even when you're all alone. I mean, you can also feel loved and connected in a room full of people and lonely when you're all alone. But the point being that it's not just the presence of people that addresses loneliness. It's important to recognize and help people recognize that loneliness in part is related to self esteem. When you're disconnected from yourself, when you are rejecting of yourself, then you're seeking validation from other people. And when you don't get that, it can make you feel disconnected, unlovable, unconnected. So self esteem is really an important part of addressing loneliness. When we are lonely, when we are needing that external validation or even just that oxytocin boost, we can be less discriminative in the company we keep and what we do to get that feeling of loneliness quelled, even for just a few minutes. And that is a really big relapse trap for a lot of people, getting back into a unhealthy relationship or doing things that they later regret for that momentary respite from their feelings of loneliness. So we want to talk about self esteem with them. We want to talk about reconnecting with themselves and loving themselves. Now, that's not going to make them feel completely better or completely unlonely, but it's a step encouraging them to recognize the impact of loneliness on their physical health. When they're feeling lonely, how does that impact them physiologically? And when they're feeling lonely, their oxytocin is low, their, their stress is up, they're feeling isolated, A lot of times they're feeling depressed and maybe angry, anxious. You know, there's a lot of times there's some dirty discomfort there. As Hayes would say, there's a lot of different dysphoric feelings that are existing when people are lonely. Envy, jealousy at other people who may have seemingly connect, healthy relationships. You Know, there are a lot of things so helping people recognize what's going on with them affectively when they're feeling lonely and how that's impacting their, their physical health, their ability to see all of the options versus being, having cognitive inflexibility and how does it impact their environment and their relationships? You know, when people are lonely, sometimes they will glob on to other people. They will become in, try to become enmeshed and that can be exhausting for the other person. So it's important for people to be able to provide their own element of self validation and set boundaries in order to address some of that loneliness, but also to recognize what they have when you, when people are lonely, you know, and they start to develop a relationship instead of spending that whole relationship time together with that person complaining about how lonely they are, enjoying embracing and you know, sucking up the feeling of being connected to somebody, even if it's just for an hour or two hours or however, you know, if you go to lunch or something, instead of focusing on how lonely you are, most of the time focusing on how blessed you are in the moment. Loneliness is often described as a feeling of isolation, lack of connectedness, or not being loved and accepted. People need to figure out what does it mean for them. So they need to define what, what it means when they feel lonely, because that's one of those kind of amorphous terms there. What are the facts for and against their current beliefs that are making them feel lonely? Some of the ones that are common. Nobody understands my situation or nobody could understand my situation. I have nobody to rely on. I am not lovable or likable. And it's important to help people go back and identify their cognitive distortions, their unhelpful thinking styles that are contributing to this and again, evaluate the facts. What are the facts supporting your notion that there's nobody in the world who understands what's going on with you or could understand what's going on with you. And thankfully to date, I don't think I've ever found a situation, not one that I can remember where that has been completely true. Now there are some people who have unique circumstances, but most of the time there are also other people who are experiencing or have experienced similar unique circumstances. What could you do to address the loneliness? Is this another activity or step for them to ask themselves? What things can you do to reconnect with yourself? You know, we tend to feel less lonely if we are able to self validate, if we are able to feel like we are good people. If we are able to connect and enjoy spending time with ourselves. And that sounds really weird to some people, but. But it is an important skill because we don't always have others, like, at our beck and call to help us prevent loneliness. So what can they do? Hiking, journaling, picking up a hobby, you know, cooking. I enjoy. You know, I enjoy cooking and gardening. When I am out there, I'm not really thinking about being around other people. I am one with what I'm doing and myself at that point in time. And in that moment, I'm not lonely at all. I'm alone, but I'm not lonely. And helping people explore times in their past, preferably their recent past, so it's more tangible when they have been immersed in something, when they've been doing something and they've been so focused on it that they have felt a connection with that and with themselves and not focused on feeling lonely. What could you do to address the loneliness, but that will help you connect with others? Unfortunately, over the past, you know, year, a lot of families have been torn apart. A lot of friendships have been lost. There's been a lot of discord. And so there are a lot of people that are feeling very lonely and somewhat isolated right now. And it's important to help them step back and regroup and say, okay, what can I do to connect with others who might understand me? Where can I find this? And there are outlets for that. There are outlets for people who have just about any belief system. It's just a matter of figuring out where they are and how can I connect with the universe, God, higher power, whatever you want to call it, how can I commune with that so I feel a part of something? Remember, when we do anything that's positive for someone else, or even, you know, critters or even the universe, if you feel a connection to that, it increases oxytocin. So when you pick up a piece of litter and put it in the garbage can, if you are doing that because, you know, it helps the environment and it keeps a little squirrel from accidentally suffocating himself or whatever, that actually does increase oxytocin and makes you feel more connected to what's going on, Mindfulness can also help a lot of people address their loneliness because they start becoming more aware of how they actually do impact other people, which makes them notice that they are connected. It helps them pay attention to the fact that there are other people that are actually impacted and care about them. A lot of times when people are lonely, they are focused inside and they are somewhat unaware of what's going on outside. That's not always true, but sometimes. And finally, tired. Tired can obviously mean sleep deprived. And sleep is so incredibly important. And you all know that because I've done like half a dozen videos on sleep improvement, and those are on the YouTube channel if you want to go into the deep detail on those. But sleep is essential to HPA axis and circadian rhythm, neurotransmitter and hormone regulation. It's essential for cognitive clarity. So there are a lot of reasons that sleep is important in recovery and in maintaining mental health. So whether you're talking about recovery from depression, anxiety, addiction, or you're just trying to prevent those things, sleep is one of the most important things. It doesn't really cost a lot. You know, maybe at the front end it does when you're getting a good mattress and stuff. But it's one of those things that people generally overlook because in our culture, we are plagued, in many cases, not everybody, by FOMO or fear of missing out. So we stay up because we want to watch one more episode on whatever show we're binge watching on tv or we don't want to miss out on something when our friends are going to go out in the evening and stay out late, even though we know it's going to take us way past our bedtime and we have to be up at O Dark 30 for work. Making more informed choices and recognizing the impact of sleep deprivation on our mental health and our physical health is really important. And then figuring out how to improve sleep by scheduling it in, creating a sleep routine, paying attention to ergonomics, addressing things that keep you awake, you know, the list goes on. There's probably, I think last time I checked, There were like 17 different things on the checklist for sleep hygiene that I hand out to my clients when they. When they go through their intake. But tired can also mean done. Burned out over it, helpless. You know, maybe you call it depressed, apathetic, tired. I'm just, I'm done. Burnout is a reaction to prolonged or chronic stress and is characterized by emotional and physical exhaustion, cynicism, less ability to identify with other people or your purpose. It's just that people start to develop this attitude of what's the point? I just. I don't know what will make me happy anymore. I don't know what I can do. What's the point of doing anything? And feelings of disempowerment, even if I do try to do something is not going to make a difference anyway. I think we've all Been there a time or two. So what do we do about it? Encouraging people to recognize the impact of tiredness and, and being burned out on their whole self, their pacer self, physical health, their neurotransmitters and their hormones. You know, we talked about how sleep is important to that, but also preventing burnout, preventing getting emotionally and physically drained and exhausted. When you are drained, you can't be helpful, you can't be engaged, responsive to those people in your life because you just don't have anything left to give. So making sure that you prevent, do what you need to do to prevent burnout and exhaustion is essential to helping people move towards that rich and meaningful life. You know, I'd love to say that sleep is optional, but it ain't. Affectively tiredness actually has been shown to increase anger, anxiety, depression and apathy. Partly because it screws with the circadian rhythms and the HPA axis, partly because when we are tired, burned out, exhausted, we don't have the energy to deal with one more thing. So when things happen that normally we may be able to cope with with no problem. When things happen and we're already tired, it's like the straw that broke the camel's back. Cognition. Now this was an interesting study. I found our perception of effectiveness is actually impaired. We start to feel when we're tired or burned out, but even when we're just sleep deprived, we tend to have greater feelings of helplessness and defeat. We tend to give up more easily. And they found that people who were sleep deprived had impaired decision making and schema updating based on feedback, which translates to learning. So people, when they're tired, they go through a situation and they get new feedback that might alter, you know, their perceptions of things. But because they are tired, something happens in their brain and they actually can't make use of that new information to update their schema. So their ability to adjust and adapt becomes almost non existent. And people tend to have a more cynical outlook when they are tired and especially if they're burned out. Environmentally, people who are tired and or burned out tend to be less productive. And think about it, even if you're talking about sleep deprived, are you as productive as when you've had a really good night's sleep? When you are burned out, are you as productive as when you're not? And I've never met anybody not saying that I won't ever, but I have yet to meet anybody who is as productive when they are burned out as they are when they are not. And a lot of times it might filters down because we are tired over it. Lacking the norepinephrine and the dopamine that we need to have that get up and go and keep at it. We quit engaging in things that are meaningful, things that actually could bring us happiness. It's like, yeah, go bowling with my friends. No, that would mean like taking a shower and stuff. And I just, I ain't got it in me. So it becomes a problem. In relationships, there's a perception of inadequacy, loss of self esteem, and personal failure. This is especially true with burnout. But if somebody is chronically tired, they're not getting good quality sleep for a period of time, they can also start to have these experiences because everything else kind of happens, they feel less efficacious, they aren't able to remember things, they're having more difficulty cognitively. They have more. Less energy. So they start feeling guilty that they can't do and the things they used to do and be who they want to be because they just ain't got it in them anymore. So again, this goes with physically tired as well as emotionally tired. Causes of burnout. Let's think about this for a second. And we often talk about burnout in terms of work environments, but we can get burned out on life. Let's just put it out there. We can get burned out, we can get over it. Burned out on news, burned out on what we're doing, just burned out on life sometimes. And it's important to take a look at that. And yes, I agree with you, Anne. This past year especially. And let's talk about why that is. Now, these two hyperlinks up here go to two different articles that I thought were particularly interesting about burnout. But basically, burnout occurs when we feel like we have a lack of control or say about what's going on. And in the past year, we, whether it be lockdowns, whether it be working from home, whether it be wearing a mask, where it. Whether it be getting other people to follow the rules, whether it be. Politics, you know, there are a variety of things where there are a lot of people right now who are feeling very stifled. They feel like they have no power, no ability to assert their thoughts, wants and needs, which contributes to a sense of helplessness. Nothing I do seems to matter. You know, you can try, you know, maybe you try to fix things in your relationship, and nothing you do seems to matter. Chaotic environments. Well, the past year for most of us has been chaotic. And for people whose children were in public school or, you know, schooled outside of the home. And then all of a sudden, they started having to homeschool in addition to maybe even working from home. Oh, my gosh. Oh, my gosh. How incredibly chaotic. Any change, whether it's a positive one or not, throws your world into chaos. It disrupts the homeostasis. And in a. In the short period that may not be so bad, you know, you can usually deal with it, but when it goes on for months and, you know, with some of these things, it's like, yes, you're going back to work. No, you're not going back to work. Yes, you're going back to work. No, you're not going back to work. So people don't feel like they can plan what's going on. And, you know, this can happen even outside of the past year. You know, people's lives, even before all of the stuff of 2020, people's lives sometimes had situations or times in which they felt a lack of control or, say, a sense of helplessness and powerlessness. Their environment was chaotic for one reason or another. They felt a lack of support, encouragement, and acceptance. And this is so important right now. And, well, even before. Right now, even before 2020, that was one of the reasons that I really detest a lot of social media, because there is a concept of disinhibition. And when people are online, a lot of times they will type comments and say things that they wouldn't say to people in person. But there is a lot of criticism and lack of acceptance and discouragement online. And even in person, you know, this can happen too, in the news, wherever you're looking for, a sense of acceptance, encouragement, a place you belong, a place of connection. If you can't find that or if it disappears, then it can feel very chaotic. And you can feel like you're kind of flailing around in a tornado. People feel a sense of burnout, especially when they focus on only one dimension of their life. Work, for example. If that's all they're focused on and it overshadows everything, all of their energy is put into their job, then they may start feeling burned out because. Especially if work starts to become chaotic, too. But they're trying to put all their energy in here, but then they have 17 other things that need to be done, and they're trying to juggle those with whatever little energy they can squeak out instead of evenly dispersing their energy over the things that are important. And perfectionism. When we are perfectionistic, it really leads to burnout, because we are a lot of times our worst Critics. So we are not accepting of ourselves. We are not encouraging of ourselves or supportive of ourselves. We're saying, well, I should be able to do this better. Well, no, not necessarily so. Struggling for perfection can also contribute to a sense of helplessness and chaos and lack of support. Encouraging people to evaluate how these things are present in their life and what they can do about them. What do you have control or say over? You may not have control or say over, you know, whether you get thrown into Facebook jail or not, but you do have control or say over whether you go on Facebook or what you post, you know, you do have control or say over that you may not have control or say over how somebody in your family reacts to you, but you do have control or say over how you react to, to them. And recognizing, you know what where your control lies, recognizing where your safe zones are. Because remember, a lot of anxiety and anger originates from a feeling of threat, a feeling of unsafeness when we're in a sense of chaos. If you remember the, the wizard of Oz, when Dorothy hits her head and she sees the tornado swirling around and there's the Wicked Witch and everything else, that's kind of how we feel when we're in chaotic environments. No wonder it is exhausting. So how can you disperse that tornado? How can you create a sense of calm even in the midst of chaos? You may not be able to change the world, you may not be able to get calm in the world, but how can you get some semblance of calm in your corner, in your little packet of the world? Using the FCP method. Again, evaluating the facts for and against your beliefs, really addressing those cognitive distortions like all or none, thinking I have no control or say over anything, well, that's not true. So using the facts to support or refute people's beliefs that are keeping them feeling helpless and out of control, helping them evaluate the things that they do have control over and the probability that their worst fears are going to happen or that their belief will actually come true, that the probability that you will soon have no control or say over anything. Could it happen? Well, anything's possible. But is it likely in the next, you know, foreseeable future that, you know, the United States, for example, would become a communist country? Pretty non probable hardiness. How can these things be addressed? Focusing on what things are going well in your life, focusing on all the things that are important in your rich and meaningful life that you're committed to, and viewing hardships, viewing chaos instead of as a problem, as a challenge to say okay, well, that didn't go as planned. Let me drop back and figure out how I might do it differently. And sometimes it just all comes down to being willing to drop back and punt and creating mastery experiences, focusing on progress, not perfection. You know, what things, you know, focusing on progress instead of saying, I am totally hopeless over everything and nothing I do seems to matter. Focusing on setting small goals that help you have a sense of personal power. Helping you set small goals that show you that, hey, I did this, and there was a positive result. Mastery experiences, especially micro mastery experiences, should only be, especially if somebody is burned out. Maximum of daily goals. You don't want to have weekly or monthly goals because they're too exhausted to think that far out. They need to see personal power almost immediately and be able to say, okay, I did have some control today. There was some calm today. We did make some progress today. Even if I wasn't perfect, we did make some progress. I remember, and I'll share this with you, it's kind of sort of related. When my son was in preschool, he would come home and I would try my hardest to play with them and to interact with him. And he just, you know, wasn't really interested in it and. But he would with his teacher. I mean, he was completely different at preschool. So I had Ms. Jessica come over and I'm like, what am I doing wrong here? And she came over and watched us play for a little while, observed. And after about 15 minutes, she's like, I've seen enough. And I'm like, okay, so why is it that he's not engaging with me the same way? And she looks at me and very flatly says, you're boring. Excuse me? I was, from a five year old standpoint, I was extraordinarily boring. I was trying to make everything into a lesson instead of being creative. And so I had to work on that. You know, it was distressful to me at first that, oh my gosh, I'm not the perfect parent. But then I started learning more and setting small mastery experiences to become better at being less analytical and more creative and more, you know, childlike in some ways. So working towards that, recognizing that, you know, we all have different talents and I was never going to be a Miss Jessica, but working towards that was something that I was able to do. HALT on his face seems very overly specific, but actually encompasses a myriad of biopsychosocial triggers, warning signs for distress and and relapse. Regular mindful awareness of the triggers for warning signs of and strategies to address HALT can help people take proactive steps to prevent distress and relapse. Are there any questions? This is one of those acronyms that we use a lot in addiction recovery. I wish we used it more or I wish it was used more in all recovery and prevention circles because it really is very succinct and it can help people remember to be mindful and to check in with themselves. I hope everybody has an absolutely amazing weekend. I hope it is beautiful wherever you you are at and you can embrace the awe and wonder that this universe can provide. Have a wonderful day and I will see you on Tuesday.