Blog from psychotherapist and author Chris Warren-Dickins

How to be comfortable with the uncomfortable

1/22/2022

I can't get enough of Stanford Neuroscientist Dr Andrew Huberman's research. It really supports many of the strategies I use with clients to help with their anxiety and panic attacks.

For example, meditation and breathing exercises can help people to teach their nervous systems "to be comfortable in uncomfortable states" (Dr Andrew Huberman), putting their brain in an optimal state to function.

The trouble is, so many say they don't have time to do this. However, research shows that the recommended 'dose' for meditation/breathing exercises is just 5 minutes a day.

Check out Dr Huberman's fascinating video here.

If you need some breathing exercises, I have plenty here.

I hope you find this useful, and I hope you manage to carve out that all-important 5 minutes each day. But if you sometimes don't manage to, be kind to yourself and try to understand rather than judge.

Chris Warren-Dickins LLB MA LPC
Psychotherapist, author of Beyond the Blue, and LGBTQ+ advocate
#beyondtheblue #beyondthebluebook

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The neuroscience behind EMDR

1/21/2022

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My book Beyond the Blue mentions Eye Movement Desensitization and Reprocessing (EMDR) as a type of therapy that can help people with anxiety, depression, relationship conflict, and trauma. As a psychotherapist, I use EMDR on a daily basis, and I am often asked why we focus on eye movements.

Here is a quick explanation to explain why EMDR works. This explanation is based on the research carried out by Stanford Neuroscientist Dr Andrew Huberman, and if you ever get a chance to watch any of his videos, he is fascinating to watch. I will include a link to one of his videos at the end of this blog post.

When you attend an EMDR therapy session, eventually (after preliminary work) we will identify target memories that relate to your current difficulties. For example, from a young age you might have formed the belief that you are ‘unsafe’ or ‘unlovable’, or you might carry around an overwhelming sense of shame or abandonment.

Focusing on a target memory, we will guide your eyes laterally (left and right, rather than vertically, up and down). This process helps to quieten your amygdala (your brain’s alarm system) in relation to that target memory, and the triggering belief or emotion.

Why do we know this works? Because research shows that when we walk or otherwise move forward, and things move past us, this causes our eyes to move laterally, and thus quietens our amygdala. So the lateral eye movements in EMDR replicates the brain’s natural ability to quieten the amygdala.

But that is not all…

When you are triggered, or experience a threat (whether that is in the present, or a distressing memory of a past event), you might fight, flee, or freeze. In 2018 Dr Andrew Huberman carried out research into the part of the brain that is responsible for the fight response, or “forward confrontation”, and Dr Huberman explains that this part of the brain is linked to the dopamine reward pathway (and this plays a big part in us experiencing pleasure).

Faced with a threat, when we move forward in a safe way, we suppress the amygdala, and we send signals to the dopamine reward centres of our brain “to reward us for forward effort” (Dr Huberman).

So in the face of a threat, a sense of forward action will help, and that can be replicated through the use of the lateral eye movements in EMDR - the brain thinks you are moving forward, and this suppresses the fear/alarm system of the amygdala, and it also rewards you through the production of dopamine.

I hope you found this as interesting as I did! If you have any questions, get in touch. As promised, here is a link to just one of Dr Andrew Huberman's many interesting videos explaining about EMDR and the brain.

Chris Warren-Dickins LLB MA LPC
Psychotherapist, author of Beyond the Blue, and LGBTQ+ advocate
#beyondtheblue #beyondthebluebook

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Panic attacks

1/16/2022

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Panic attacks are terrifying and debilitating. You cannot breathe, your head spins, your limbs are buzzing with energy, and you are sweating like a pig. At the time you believe that you are going to die, but you don’t. You are sure that you have something physically wrong with you (perhaps your heart or lungs), but the doctors can find no cause for all of this.

Without any explanation for this, you start to do some of the following things -

You avoid things because you are terrified that the panic attacks could come on at any moment,
You become overly dependent on someone for things that you once could do alone,
You become isolated, physically, and emotionally.

Each time you look back and realize that this is your mind playing tricks with you, rather than a serious physical health concern.

But there is hope for change. With a bit of guidance, we can help you to -

Feel the panic less intensely,
Experience panic attacks less frequently,
Regain a sense of control over your life,
Stop avoiding things that you fear might trigger a panic attack, and
Accept the occasional panic attack.

To plan for the next panic attack, here are some things to consider -

Physical health? - Are there any physical reasons why you experienced the symptoms of shortness of breath, a spinning head, or sweatiness. It is worth ruling out any physical health issues, and it is worth reflecting on any substances or stimulants that may contribute to this (caffeine, excess sugar, nicotine, etc).

Psycho-education - After you have ruled out any physical health issues, it can help to understand why you experience a panic attack. Your brain has an alarm system to alert you when things go wrong. You need that alarm system, so your blood can pump faster and get the heck out of there if there is an actual threat. So, in a way, we should be thankful for this alarm system, because without it we would be in trouble. We just need to find ways to reset the alarm, so that it doesn’t keep going off for no reason.

Simple as ABC. Knowledge is power, so you need to track when the panic attacks occur, and why. A simple log called the ABC log can help you record the following -
- A is for Activating Event - For example, you were at the supermarket and you started to panic because you thought people were staring at you, and that made your heart race because you feared you might trip and fall and embarrass yourself, and then your mind started to think about getting COVID because you noticed some people not wearing their masks properly, and then you feared that you were going to pass out in front of everyone, which would be mortifying.
- B is for Beliefs and assumptions - In this example, you assume people are staring at you, and even noticing you in the first place. You are probably also assuming that they are thinking negatively of you. You are also assuming that you are at high risk of COVID, and you are assuming that people will judge you for tripping or passing out.
- C is for Consequences. This is where you would record the behavioral and emotional consequences. For example, you may end up leaving the supermarket and returning home without any of the groceries, and along with the panic and anxiety, you are frustrated at yourself for letting your fear of the supermarket get to you.

I challenge you to a duel. Once you have recorded the when, where and whys of your panic attacks (in the form of your ABC log), I can help you to identify unhelpful thought patterns and challenge your assumptions. For example, I could help you to develop a more compassionate voice instead of that harsh critic who assumes that everyone is judging you. I could also challenge your tendency to catastrophize, and I would do this in two ways -
- Firstly, how likely is it that the ‘catastrophe’ is going to happen? Give it a percentage: Is it ten percent likely, fifty, seventy, or one hundred percent likely?
- Secondly, how bad is that supposed ‘catastrophe’? On a scale of 0-100, how distressing would it be to trip over? It may initially feel like an 80 or 90, but when you compare it with other things that could go wrong (for example, a loved one dying), you may realize that the fear of tripping over is actually a 10 out of 100.
- Only when you stop and realize that this is something that is not very likely to occur, and/or even if it did, isn’t as distressing as other things, you can start to gain perspective. You can then train your body to react more proportionately (and save the heart pumping and sweating for the stuff that is almost certainly happening, and likely to cause a 90 or 100 level of distress).

Calm your body, ease your mind. In previous blogs I have outlined the various ways to calm your body, which in turn will ease your mind, and help you to assess a situation more rationally. Here is a link to just a few examples.

Exposure and positive coping statements. Panic and anxiety are made worse when we avoid what makes us anxious. Gradually, slowly, stop avoiding the things that are triggering your anxiety. For example, if you get anxious around people in a supermarket, you could start by imagining each stage of going to the supermarket. You can develop positive coping statements such as ‘I am strong enough to handle this’, and you can use the above-mentioned body-calming exercises to prepare yourself. Once you have imagined each stage of the event, and you have kept your anxiety levels within a reasonable range, try one stage of the exposure. For example, drive to the supermarket parking lot. Try the next stage and the next, continuing to use your body-calming exercises and positive coping statements, until you have conducted a successful trip to the supermarket with only moderate anxiety.
Stop, Look, and Listen. One of the most helpful things about panic and anxiety is to focus outwards, away from your own bodily sensations. Panic is often fueled when we feel a racing heart or sweaty palms, and then our mind starts to race, and then we focus even more on our thoughts and bodily sensations. Try and take a moment to focus outwards, and even describe everything and everyone you see.
Mind your Mindfulness. In my book Beyond the Blue I set out the basic principles of Mindfulness but, in brief, these include -
- Using present-moment awareness to anchor yourself in the present, not fearing a future unknown. Usually, you would use your breathing, but if you have found that this makes your panic attacks worse, focus on the texture of your clothes or skin as you gently touch your arms and legs. Or focus on the colors and textures of objects around you.
- Non-judgmental acceptance of whatever anxious emotions and thoughts may be arising. Don’t give them fuel by following them; just let them drift away like bubbles.
The Past is Present. Sometimes things that have happened in your past can have an impact on your panic attacks in the present. For example, I once worked with someone who grew up in a household where anger was not tolerated. As a result, this client worked hard to repress their anger at every opportunity. The trouble was that all this repressed energy had to go somewhere, and they ended up having panic attacks instead of assertively communicating their anger. We had to slowly work through this conditioning and they eventually learned that feeling angry was an acceptable emotion.
Plan for relapse. You aren’t going to manage this perfectly the very first time, so this means you might experience another panic attack. Make plans for this, and reflect on what you learned, rather than making it into a catastrophe. Some people find it helpful to make a list of the above-mentioned strategies and carry that list around with them (either on their phone or on a small card in their pocket). This will be a personalized list of strategies that you have found helpful - there is no one-size fits all. For example, the list might include:
- Positive coping statement: ‘Solid feet set apart, solid mind and solid heart’
- Focus on the colors and textures of your surroundings
- Square breathing (and remembering to pause between sets, and notice that pause)

Panic attacks are scary at the time, but they do not have to rule your life. There are simple tools for you to use and regain control of your life, and if these do not help, there are treatments such as EMDR (Eye Movement Desensitization and Reprocessing therapy) that can help. Either way, you do not have to continue to struggle.

Chris Warren-Dickins LLB MA LPC
www.chriswarrendickins.com
Psychotherapist, author of Beyond the Blue, and LGBTQ+ advocate
#beyondtheblue #beyondthebluebook

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How to set boundaries... with love

1/15/2022

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In a relationship you bring your own baggage. You may feel more easily triggered, or scared, or angry, in certain situations that are beyond the control of your loved one(s).

When it comes to your emotions, there are no rights or wrongs. You feel how you feel, but it is how you act on it, and how you communicate those emotions, that counts. This is where boundary-setting comes in. Boundaries help you to establish the space within which you can –

Feel your emotions
Communicate those emotions
Work out how your emotions might be causing conflict within your relationship
Negotiate with your loved one(s) what you are going to do about that

One approach to all of this is to use DEAR skills to set boundaries with love. DEAR skills were developed by Marsha Linehan, who created Dialectical Behavior Therapy (DBT). Here is a quick three-minute run-down on using DEAR skills to set boundaries with love -

Describe your perspective fully, without making assumptions about the other person’s perspective. Simply describe what you see.
- This is an example of using your Describe skill - You saying to your loved one(s) "I see your shaking fist and I hear your raised voice, and this seems to me an expression of anger"
- This is not using your 'Describe' skill - Saying to your loved one(s) "You are angry and I know why"
Express your feelings clearly and in a non-accusatory way
- This is an example of using your Express skill - Saying to your loved one "Although I still love you, I feel scared when you raise your voice and shake your fist near me. You can express your anger around me, but I wonder whether there is another way for you to do that and still feel heard"
- This is not using your Express skill - "You wanted to intimidate me so you are doing everything you can to harass me"
Assert your boundaries without apology and without dilution.
- This is an example of using your Assert skill - "I hear that you may not see it my way, but I wanted to share how scared I felt, and this is the way I view it"
- This is not using your Assert skill - "Perhaps I am wrong, and perhaps it is silly to get scared when you don’t mean to do that"
Reinforce - Engage with the other person so they see the benefits of the boundaries you are trying to set, and the potential cost of continuing without these boundaries. For example, ‘I love you enough to be willing to share how I feel when you do that, and I am concerned if we continue like this, I might retreat even further from you’. There are no threats and no value-compromising promises.
- This is an example of using your Reinforce skill - "When I feel scared, I am unable to show you my full self, and I am unable to show you the full amount of love I have for you"
- This is not an example of using your Reinforce skill - "If you don’t change, I will leave"

If DEAR skills are new to you, start slowly. Try one or two parts of it the next time you need to set your boundaries with love.

If you would like more tools to tackle relationship conflict, get Beyond the Blue, available from most good book retailers.

Chris Warren-Dickins LLB MA LPC
www.chriswarrendickins.com
Psychotherapist, author of Beyond the Blue, and LGBTQ+ advocate
#beyondtheblue #beyondthebluebook

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How to find better ways to cope

1/15/2022

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Emotions can really get in the way of things. If we are overwhelmed with anger because we are stuck working from home and teaching our kids at the same time, the pressure might get to us so we say or do something we might regret. We might attempt to dampen these emotions with distraction or food or substances.

But our emotions are are also important sources of information. Sometimes we need to heed the warning signs; like the fuel light on a car, we can only ignore it for so long before that ‘running on empty’ turns into a grinding halt, where we cannot concentrate on work, we are unable to respond kindly and calmly to our kids, and our better half is packing a suitcase to go live with the in-laws.

There are better ways to cope, and this is where we turn to emotion regulation. This is a big area, and you probably don’t have time to read a whole book about it, so here are just six aspects of emotion regulation. Emotion regulation can involve -

1.    Increasing present-focused emotion awareness – For example, rather than regretting the past or fearing the future, you are mindfully identifying those one-word emotions that are arising within: Anger, sadness, loneliness, or rejection, for example.

2.    Developing flexibility in your thoughts and assumptions – For example, are you assuming that your partner knows that you need some space to breathe, and that it would be great if they could take the kids for a run around the park? Do you then generalize this present frustration, and overlook other times, when they have been able to check in with you and find out what you need, and respond lovingly to this?

3.    Identify patterns of emotion avoidance – For example, you might have been raised in a household where tears were unwelcome, and so you quickly try and throw yourself into work, or a petty dispute with a friend, instead of allowing those tears to come.

4.    Develop awareness and tolerance of bodily sensations - Mindfully noticing and describing your bodily sensations can often serve as a bridge to emotional awareness. We may say that we are “fine”, and yet when we think of our partner, we get a tightness in our throat or our stomach.

5.    Gentle, gradual exposure to the things you avoid – How many times have you heard someone say “I don’t want to cry because I fear I will never stop”, or “If I let myself really feel this, I will become overwhelmed and never get out of this slump”? This is a fear-driven approach to emotions, and yet there is another way. I like to think of emotions as a wave – there is a build-up, peak, and then subside of an emotion. If we avoid that emotion when it is building up, we do not benefit from experiencing the subside of the emotion, and this experience can teach our brain that these emotions are not to be feared, and they are temporary.

Emotion regulation is hard if we listen to some of the myths that surround our emotions. As a psychotherapist I frequently hear these myths -

“It is wrong to feel these emotions, especially anger”
“Your emotions contain no useful information”
“Emotions prevail over thoughts”
“You are a hostage to your emotions, so they cannot change”
“If you succumb to your emotions, you will be overwhelmed”
“We need to regulate all emotions”

The truth is that there is no right or wrong about your emotions, they just exist. It is what you do with them that dictates the right or wrong of emotions, including anger.

It is important to pay attention to your emotions because they contain important information about what needs to change. But you need to balance this information with your rational mind.

You don’t have to be a hostage to your emotions; they can change by learning about emotion regulation. Part of this includes an awareness that emotions (given the right conditions) peak and then subside. You don't have to become overwhelmed by them.

You can change your emotions by developing skills in emotion regulation (as set out above), but you only need to regulate the ones that are unhelpful. This is a useful guide to what emotions are helpful and unhelpful -

You should regulate emotions that cause more problems than benefits (you can carry out a pros and cons exercise to assess this)
You should regulate emotions that lead you to act against your values
You should regulate emotions that are in conflict with your goals

I hope you find this useful.

Chris Warren-Dickins LLB MA LPC
Psychotherapist and author of Beyond the Blue
chriswarrrendickins.com

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Help for anxiety

1/1/2022

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If you are feeling triggered by rising COVID numbers, these simple tips might help with your anxiety.

Chris Warren-Dickins LLB MA LPC
www.chriswarrendickins.com
Psychotherapist, author of Beyond the Blue, and LGBTQ+ advocate
#beyondtheblue #beyondthebluebook

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Podcast to preserve your mental health

12/29/2021

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Earlier this month I was interviewed by radio DJ Graeme Smith. We chatted about strategies to preserve one's mental health during the holidays. Below is a link to the full podcast.

Have a listen, and let me know what you think!

Chris Warren-Dickins LLB MA LPC
www.chriswarrendickins.com
Psychotherapist, author of Beyond the Blue, and LGBTQ+ advocate
#beyondtheblue #beyondthebluebook

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How to manage opposing political views

12/22/2021

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As we come together for the holidays, we may encounter family members who hold political views that oppose our own. Even worse, there may be some who are intent on hurting us, not least because they are homophobic, biphobic, transphobic, or racist.

Here is another extract of my interview with radio DJ @mrgraemesmith for @playoutcastuk where I discuss how to manage this sort of personal conflict.

I hope you find this useful, and if you need to listen to the full interview, it is available here.

Stay grounded during the holidays, and stay safe.

Chris Warren-Dickins LLB MA LPC
www.chriswarrendickins.com
Psychotherapist, author of Beyond the Blue, and LGBTQ+ advocate
#beyondtheblue #beyondthebluebook

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Podcast interview - Radio DJ Graeme Smith

12/18/2021

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It was great to catch up with radio DJ Graeme Smith in his new podcast Outcast. Graeme asked to speak to me as the guest mental health expert, and I outlined some strategies for you to look after your mental health over the holidays. Below you will find an extract of the podcast, and here is full episode.

All the strategies are available in my new book Beyond the Blue, helping you get beyond depression, anxiety, relationship conflict, and trauma. Get your copy of Beyond the Blue here.

Stay safe during the holidays, folks!

Chris Warren-Dickins LLB MA LPC
www.chriswarrendickins.com
Psychotherapist, author of Beyond the Blue, and LGBTQ+ advocate
#beyondtheblue #beyondthebluebook

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Unicorns need not apply

12/9/2021

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In my previous post I identified some of things you want to avoid when seeking a mental health professional.

Here are some of the good things that mental health professionals can do for you.
There are some wonderful professionals out there.

You just need to know how to spot them.

Chris Warren-Dickins LLB MA LPC
www.chriswarrendickins.com
Psychotherapist, author of Beyond the Blue, and LGBTQ+ advocate
#beyondtheblue #beyondthebluebook