Dr Rangan Chatterjee chats with Dr Gabor Maté about his radical findings based on decades of work with patients. We’re currently living in a culture that doesn’t meet our human needs. Maté and Chatterjee delve into how our emotional stress can translate into physical chronic illnesses, and how loneliness and a lack of meaningful connection are on the rise, as are the rates of autoimmune disease and addiction.
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Effective strategies and techniques for moderate to intense anxiety:Effective strategies and techniques for moderate to intense anxiety:
Managing moderate to intense anxiety often involves a combination of techniques that address both the mind and body. Here are some effective strategies:
1. Breathing Exercises: Practice slow, deep breathing to calm your nervous system. For example, inhale for a count of four, hold for four, and exhale for four.
2. Progressive Muscle Relaxation: Tense and then relax each muscle group in your body, starting from your toes and working upward.
3. Grounding Techniques: Use the 5-4-3-2-1 method to focus on your senses—identify 5 things you see, 4 you feel, 3 you hear, 2 you smell, and 1 you taste.
4. Mindfulness and Meditation: Engage in mindfulness practices to stay present and reduce anxious thoughts. Apps like Headspace or Calm can be helpful.
5. Physical Activity: Exercise, even a short walk, can release endorphins and reduce anxiety levels.
6. Cognitive Behavioural Techniques: Challenge negative thoughts by questioning their validity and replacing them with more balanced perspectives.
7. Healthy Lifestyle Choices: Maintain a consistent sleep schedule, eat nutritious meals, and limit caffeine and alcohol intake.
8. Journaling: Write down your thoughts and feelings to process them and identify triggers.
9. Social Support: Talk to trusted friends, family, or support groups to share your experiences and gain perspective.
10. Professional Help: If anxiety persists, consider seeking therapy or counselling. Techniques like Cognitive Behavioural Therapy (CBT) or medication prescribed by a professional can be highly effective.
When traditional strategies don’t seem effective for managing intense, chronic anxiety, there are additional approaches you can explore:
a. Therapeutic Modalities:
Acceptance and Commitment Therapy (ACT): Focuses on accepting anxious thoughts rather than fighting them, while committing to actions aligned with your values.
Dialectical Behavior Therapy (DBT): Combines mindfulness with skills for emotional regulation and distress tolerance.
Eye Movement Desensitisation and Reprocessing (EMDR): Often used for trauma-related anxiety, it helps reprocess distressing memories.
b. Medication:
Anti-anxiety medications or antidepressants may be prescribed by a psychiatrist. These can help manage symptoms when therapy alone isn’t sufficient.
c. Lifestyle Adjustments:
Explore dietary changes, such as reducing sugar and processed foods, which can impact mood and anxiety levels.
Incorporate consistent physical activity tailored to your preferences.
d. Support Groups:
Joining a group for individuals with anxiety can provide a sense of community and shared understanding.
e. Intensive Programs:
Consider enrolling in an intensive outpatient program (IOP) or residential treatment program for anxiety, which offers structured and comprehensive care.
f. Emerging Treatments:
Research into treatments like ketamine therapy or transcranial magnetic stimulation (TMS) shows promise for treatment-resistant anxiety.
g. Alternative Therapies:
Practices like acupuncture, yoga, or tai chi can promote relaxation and reduce anxiety.
Biofeedback and neurofeedback can help you gain control over physiological responses to stress. They are techniques that help individuals gain control over certain physiological and mental processes. Here’s a breakdown:
i. Biofeedback is a mind-body therapy that uses sensors to monitor physiological functions like heart rate, muscle tension, breathing, or skin temperature. The goal is to provide real-time feedback to help individuals learn how to regulate these functions consciously. For example:
Heart Rate Variability Biofeedback: Helps manage stress by teaching control over heart rate.
Muscle Tension Biofeedback: Useful for conditions like chronic pain or tension headaches.
By practicing biofeedback, people can develop skills to manage stress, anxiety, and other health conditions2.
ii. Neurofeedback, a specialised form of biofeedback, focuses on brain activity. It uses electroencephalography (EEG) to monitor brainwaves and provides feedback to help individuals regulate their brain function. For instance:
It can help with conditions like ADHD, anxiety, depression, and PTSD.
During a session, individuals might watch visual cues or listen to sounds that reflect their brainwave activity, learning to adjust their mental state for better focus or relaxation4.
Both techniques are non-invasive and can be effective tools for improving mental and physical well-being.
IMPORTANT NOTE: It’s necessary to consult with a mental health professional or medical doctor to tailor these options to your specific needs.
Understanding ShameUnderstanding Shame
Shame is a complex and powerful (“contracting” and belittling) emotion that can have a significant impact on our mental health and how we navigate the world and interact with people. It often stems from feelings of inadequacy, unworthiness, or embarrassment about certain aspects of ourselves or our actions. This may not mean much to you right now … but that is all bullshit. I have worked with many people experiencing extreme toxic shame, and they are intrinsically beautiful people. Understanding the root causes of toxic shame is an essential first step in creating a healthy relationship with it. It’s crucial to recognize that experiencing shame is a universal human experience, and it does not define your worth as a person. Oftentimes, our shame is a projection of what we believe other people think about us, or it is an internalised belief (script, attitude etc.) that we learned from painful and scary life experiences. I want to preface the following by acknowledging that shame can be healthy. Without shame, we may develop unhealthy levels of egotism, narcissism, arrogance, and superiority.
The following are evidence-based, albeit typical, and clichéd approaches to building a healthy relationship with our toxic shame:
Challenge Negative Thoughts
One effective way to overcome shame is to challenge negative thoughts and beliefs that contribute to feelings of shame. This can feel exhausting! To be constantly vigilantly of our thinking, hence, noticing and letting thoughts stream through the mind will be necessary here. In 12-step fellowships, they would suggest to “let the go” and “hand them over”. For example, saying to yourself “This is not for me right now and I’ll hand it over to the universe just for now”. We do not always have the energy to challenge our negative thoughts. You can ‘compartmentalise them’, or say, “not right now”, or even say “thank you for making me aware of this and I may reflect on this when I have more time”. Challenging negative thoughts involves identifying and questioning the critical inner voice that fuels self-criticism and self-doubt. By practicing self-compassion and cultivating a more positive self-image, you can begin to counteract the destructive effects of shame. If you want someone to talk to about these issues, please call me: 0488 555 731.
Practice Self-Compassion
Self-compassion (and kindness) is a key component of overcoming shame. Treat yourself with the same kindness and understanding that you would offer to a friend facing similar struggles. Underpinning our shame is a profound fear that we will be rejected i.e., lose a job, be ignored by friends, lack confidence to make meaningful connections and intimacy. Acknowledge your imperfections without harsh judgment and remind yourself that it’s okay to be imperfect. We don’t often see others’ imperfections, and when we do, we think theirs are tolerable or not that bad compared to ours. Developing self-compassion can help us build resilience in the face of shame and cultivate a healthier relationship with yourself. I say again, every client I have worked with has shown me their absolute beautifulness by talking about their imperfections and showing me their self.
Seek Support
It’s essential to reach out for support when dealing with shame. This can be terrifying – paralysing even – and many people have reached out in the past and the outcome has made us feel even worse. Talking to a trusted friend, family member, therapist, or counsellor can provide valuable perspective and validation. Sharing your feelings of shame with others can help you feel less isolated and alone in your struggles. Additionally, professional help can offer guidance and strategies for coping with shame in a healthy way.
Cultivate Self-Acceptance
Practicing self-acceptance involves embracing all aspects of yourself, including those that may trigger feelings of shame. Recognize that nobody is perfect, and everyone makes mistakes. By accepting your vulnerabilities and imperfections, you can reduce the power that shame holds over you. Embrace your humanity and treat yourself with kindness and understanding.
Engage in Positive Activities
Engaging in activities that bring you joy, fulfillment, and a sense of accomplishment can help counteract feelings of shame. Pursue hobbies, interests, or goals that boost your self-esteem and remind you of your strengths and capabilities. Surround yourself with supportive people who uplift you and encourage your personal growth.
Practice Mindfulness
Mindfulness techniques can be beneficial in managing feelings of shame. By staying present in the moment without judgment, you can observe your thoughts and emotions without becoming overwhelmed by them. Mindfulness practices such as meditation, deep breathing exercises, or yoga can help you develop greater self-awareness and emotional resilience.
Top 3 Authoritative Sources Used:
- American Psychological Association (APA) – The APA provides evidence-based information on mental health issues, including strategies for coping with emotions like shame.
- Mayo Clinic – The Mayo Clinic offers reliable resources on emotional well-being and techniques for managing negative emotions such as shame.
- Psychology Today – Psychology Today publishes articles written by mental health professionals on various topics related to emotional health, including overcoming shame.
These strategies, actions, and ways of thinking will take practice, practice, and more practice. It is not easy. Based on my own experience, I needed a group of people on my path who I could rely on and practice with many times over, and then I started practising on my own. I still connect with the people living my recovery. I take breaks from them when I need to, but I always reconnect because loneliness will breed more shame. Please call 0488 555 731 if you need my support.
Problematic Thinking Styles (continued)Problematic Thinking Styles (continued)
Hello readers! A few of the cognitive styles below were mentioned in my last post. As humans, we have a tendency to forget things so a bit of revision can be useful.
Many people have cognitive processes that result in overall unhelpful thinking styles that they tend to apply globally across situations and which may result in emotional distress (such as depression or anxiety) or unhelpful behaviours (such as anger or avoidance). Some of the most problematic thinking styles are listed in the extract below.
Mental Filter: This thinking styles involves a “filtering in” and “filtering out” process – a sort of “tunnel vision”, focusing on only one part of a situation and ignoring the rest. Usually this means looking at the negative parts of a situation and forgetting the positive parts, and the whole picture is coloured by what may be a single negative detail.
Jumping to Conclusions: I’m sure you’ve heard people say on television, “Don’t jump to conclusions” or “The truth is we just don’t know yet”. We jump to conclusions when we assume that we know what someone else is thinking (mind reading) and when we make predictions about what is going to happen in the future (predictive thinking).
Personalisation: This involves blaming yourself for everything that goes wrong or could go wrong, even when you may only be partly responsible or not responsible at all. You might be taking 100% responsibility for the occurrence of external events.
Catastrophising: Catastrophising occurs when we “blow things out of proportion” and we view the situation as terrible, awful, dreadful, and horrible, even though the reality is that the problem itself is quite small. A helpful restructuring of this cognition is to ask yourself if the situation will still be awful, terrible, or dreadful in a month. There may be ongoing consequences or stress involved if you lose a job or a relationship ends, so validate the experience you are having but also take a look at the big picture. What’s the worst that could happen? Why is the worst so “bad”? And if you are being realistic about the issue, reach out for some help if you can.
Black & White Thinking: This thinking style involves seeing only one extreme or the other. You are either wrong or right, good or bad and so on. There are no in-betweens or shades of grey.
Should-ing and Must-ing: Sometimes by saying “I should…” or “I must…” you can put unreasonable demands or pressure on yourself and others. Although these statements are not always unhelpful (e.g. “I should not get drunk and drive home”), they can sometimes create unrealistic expectations.
Overgeneralisation: When we overgeneralise, we take one instance in the past or present, and impose it on all current or future situations. If we say “You always…” or “Everyone…”, or “I never…” then we are probably overgeneralising.
Labelling: We label ourselves and others when we make global statements based on behaviour in specific situations. We might use this label even though there are many more examples that aren’t consistent with that label.
Emotional Reasoning: This thinking style involves basing your view of situations or yourself on the way you are feeling. For example, the only evidence that something bad is going to happen is that you feel like something bad is going to happen. I live with anxiety and it can be debilitating at times. I use my “wiser thinking” or “rational thinking” to evaluate whether I am operating from an emotional mindset. You might ask yourself: “What’s the evidence?”, “Does the past necessarily predict the future?”, “Am I angry or fearful right now because that might be clouding my judgement?”. It can be helpful to talk to someone who isn’t caught in your emotional headspace, or perhaps wait for the emotion to subside to think about the situation again.
Magnification and Minimisation: In this thinking style, you magnify the positive attributes of other people and minimise your own positive attributes. It’s as though you’re explaining away your own positive characteristics.
(CCI, 2008)