Stress Disorders and Better Well Being
Happiness is not a goal; it is a state of mind, whereby you are comfortable with yourself, others and the world around you. When we have this comfort we are kinder, more forgiving, and also more able to deal with challenges. We take more of these on. We are more flexible and optimistic. We do more of the things we love. We are more creative. Our relationships grow. When we are like this we find meaning in our lives.
Suffering through anxiety, depression or bouts of anger, what might we be like when we are experiencing these emotions? We may fixate on ourselves or become obsessed and enraged with the actions of others. We may feel like we cannot cope at all. Our thinking can become so repetitive and rigid that we can only perform the most menial tasks. Our relationships can deteriorate. We avoid doing the things that we like to do. Or we do things that we later feel ashamed of. Living like this makes life a chore.
The only difference between those two states is how we manage our thoughts, emotions and actions. We can acquire and use a specific set of tools that over time will allow us to not be controlled so much by what happens inside or outside our heads. This is what will give you comfort with yourself, others and the world around you. This is what will enable you to react better to all of life’s difficulties.
We All Know These
Let’s define what it means to feel bad and then learn what we can do about it.
The emotions that we associate with causing us to feel bad/suffering/stressed are complex. But are also very familiar to us:
Anxiety is the fear of something that we think is happening or about to happen to us. This is the feeling that we get when we are worried. It is also the feeling that can make us panic and become nauseous.
Anger is a hostile response to a perceived provocation. It can be passive or active. In other words, we can respond to people who we think have provoked us by lashing out at them. Or we can ignore them, send them mixed messages, and attack them in a more indirect (passive aggression) manner. Either way, we always feel uncomfortable.
Depression/sadness is probably the most profound, in so far as that we can experience a diverse range of feelings. We can feel hopeless, sorrow, disappointment, helplessness. We can feel being at a disadvantage in life compared to others.
We Make It
While there is some unavoidable suffering like the death of a loved one, most of the suffering and stress we feel is self-created. It is triggered by our irrational thinking habits. These kinds of thoughts that accompany stress come from the part of the brain responsible for emotional functions. They are often extreme, negatively biased, and have no basis in reality. Psychologists call these thoughts cognitive distortions or thinking errors (1). Do you remember the last time that you were in a bad mood, what kind of predictions and opinions did you make? After your stress subsided did they prove to be true?
We all have these thinking errors, rather than fight them, be non-judgmental and try to understand them. Recognise them for what they are. When we do this we can then look for less extreme opinions and predictions.
To break the habit of extreme emotional thinking and to let you engage your higher-order brain functions. The next time you feel worried, angry or sad, take a pen and paper and answer these five questions: (write them down, as it is much more effective, you can throw the paper away when finished)
1. How do you feel and why?
E.g. I feel very nervous, I have to give a presentation tomorrow.
2. What are your thoughts?
E.g. I am thinking that I will be too nervous to do a good job, that I will mess it up and get fired.
3. What kind of thinking errors are your thoughts? (see below)
E.g. Filtering out the positive, catastrophizing
4. Could there be there any alternatives to your thinking?
E.g. Yes, the last time I did a presentation I forgot to include some things, but it was fine. I remembered to mention them in the review at the end. I was nervous, but I carried on. I coped.
5. Can you do anything now that will make it easier for you to cope?
E.g. I can read my notes and look at some possible questions and ways to elaborate my key points.
Thinking Error Types
We think we know for sure how another person views us. In reality, we do not know what is going with others. How people act and communicate is so complex, we cannot know for sure why others say or do the things they do.
All or Nothing Thinking
We see things as being black or white: That person is good or that person is bad. If only people were as simple as this. The reality is that we are so complex and our motivations change over time.
Filtering Out the Positive
We think only about the bad things from the past, the present or the future. (This is known also as negative biasing. News media feeds this way of thinking and the next one too, actually all of them).
We think things are much worse than they actually are. If we fall short of meeting our financial goals one month we may think, “I’m going to end up bankrupt.” If our loved ones are not returning our messages it is because they had an accident…
We personalise everything! If a friend doesn’t call us back, we assume, “She must be mad at me,” or if a co-worker is grumpy, we might conclude, “He doesn’t like me.”
Our emotions are not always based on reality or any kind of rational analysis, but we assume that our feelings are the best judge for thinking or acting a certain way.
When our emotions are strong we feel 100% sure that everything will happen exactly like we are thinking it will.
We take one particular event and make it a rule for all other similar events that follow.
We measure our life against someone else’s material success without recognising our own achievements. A more toxic habit could be; becoming satisfied with yourself when you see someone down on their luck or feeling depressed when you consider someone is doing well.
Emily is trying to meet a deadline at work so she asks her colleague Hannah for help. She has helped Hannah in the past and she thinks Hannah will return the favour. Instead, Hannah tells Emily that she is busy and cannot help her. This interaction is overheard by a supervisor who tells Emily that she should; “try to finish the work by yourself”. Emily does not know what to say. She is consumed by her thoughts and emotions and finds it difficult to focus. She spends so much time thinking about what happened that it ruins her ability to perform well. When Hannah says hi to her later in the day she ignores her. She stays late. She works late every day, but each day she gets less and less done. She does not meet the deadline. She is exhausted. She no longer has any interest in her work and thinks about quitting. She thinks that her colleagues will probably be glad if she does.
Steve is walking home from work down a busy street during rush hour. A flood of people is walking in the opposite direction to him. Nobody is getting out of his way. He has to squeeze through and dodge the crowd. Occasionally he makes contact with someone’s shoulders. With each step he finds himself getting angrier and angrier. A man walking out of a shop accidentally bumps into him. Steve confronts this man and shouts lots of different things at him. When he arrives home his partner is watching a show on T.V that he thinks is stupid. She always watches it, and normally he would be able to tolerate it, but tonight the noise is too much for him and he tells her to: “turn that #$%& off”. An argument develops and before he knows it they are shouting at each other.
Jackie is sitting at her desk and she feels a very familiar emotion. She knows this feeling. It has been there ever since she was asked to give that presentation. Sometimes she feels it strongly, other times it is not so bad. Now it is almost show time and it is with her again. She starts to imagine all the worst-case scenarios: What if I go red, what if I make a mistake explaining something, what if my mind goes blank, what if I cannot answer their questions…Each imagined situation makes Jackie feel more and more nervous. She decides she cannot do it and walks out. She messages her boss that she is sick and is going home. They message her back, but she does not think that she can deal with their message. So she tries to ignore it. It is then, that a different kind of suffering starts: She berates herself; she tells herself she is not able to do anything. Her inner voice becomes more negative and repetitive…
In those scenarios, you can see how suffering begins and grows. There are four parts:
I. Events: something happens to us: It could be an internal event, like a memory or it could be external: Using the example of Steve above, the event is walking against the flow of people.
2. Thoughts: Our thoughts are triggered by the event, from the example of Steve this could be: “these idiots are so rude” or “they must think I’m weak”. He thinks this despite the fact they are just doing what he is doing; trying to go home. These thoughts could be considered as being over generalising, and mind-reading.
3. Suffering: When Steve thinks the thoughts he does, he feels angry.
4. Behaviours: This feeling of being angry leads him to certain actions, he shouts at a stranger and later at his partner. This behaviour will then lead to a new cycle of thoughts and feelings.
What We Can and can’t do
Everyone wishes they could control their stresses, but this can often be futile. There are parts you can control and there are parts you cannot. It is important to understand which is which so you don’t waste your time trying to change something that you have no power over.
We cannot control our life events, but we can influence our thoughts, emotions and our behaviours.
Life is chaotic, we can never know with certainty what is going to happen to us. Tomorrow we could become ill or we could win the lottery. Think about it, some of the greatest things that have happened to you in your life were unplanned. You created friendships, fell in love, you became curious about something and started to learn. This is life. It is full of serendipity, you would not want it any other way. I am not saying all events are beyond our control. It is a good idea to make plans for the future, but more important than that is being able to respond to the here and now. We are free agents, even though we cannot control what happens to us, we can control how we react and how we live.
Outside the moment for the moment
The following are what are we will conduct exercises on when you join a Buteykohead class. These are the pieces we can change. The key is to practise these exercises when you are not very stressed so that when a situation arises, you can deal with it as best you can. Over time the more you practise the greater your ability will become. You will build neuroplasticity and your reactions will become healthier by default.
The phrases, messages, and images that run through your head when you are calm or when you are stressed are known as your inner monologue. They are always running in your mind. They are automatic. This is why, if we fight them or tell ourselves to stop thinking it does not work. However, if we step back, accept our thoughts, and take on the role of a passive observer. We can find out what we are thinking about ourselves, others and the world around us. We can then offer alternatives to these views if they are causing us to feel and react in extreme ways. The exercises that you will learn in a Buteyko class when practised will change your thinking habits and that will in turn change how you feel and how you act.
Mindfulness-Based Cognitive Therapy (MBCT)
Learn to use cognitive methods and mindfulness meditation as a way of recognising in the moment when negative thoughts are creeping up. The purpose is not to stop these thoughts from occurring, but to stop us from running with them. It is our spiralling thoughts which often triggers our anxiety, depression and anger.
To do this you can separate your thoughts and emotions from you and treat them as entities that can be observed without placing importance on them. The reasoning behind this practice is that when we are fearful or treat our thoughts and emotions as being heavy burdens, they tend to become magnified. Conversely, when we treat them passively, -when we are at peace with them- allowing them to come and go, they lose their power of us, our day does not become consumed by our heads.
When you continuously apply MBCT techniques you build a life-changing habit of being at peace with yourself and being able to carry on despite your thoughts.
What does your experience tell you about when you try to make yourself calm down? Probably that when you try to calm down your mood actually becomes worse.
Did you ever:
- Tell an angry person to calm down?
- Tell an embarrassed person to stop being so nervous?
- Tell someone who was sad to cheer up?
- Tell someone experiencing an anxiety or panic attack to not be afraid?
If so you will know that it did not work. Yet this is what a lot of us do to ourselves when we have extreme emotions. We beat ourselves up for feeling a particular way. We tell ourselves not to be sad, angry afraid, or embarrassed. This extra pressure that we are putting on ourselves to change makes our feelings more intense.
Instead of telling ourselves not to feel a particular way, it is better for us to be non-judgemental with our feelings, and bring our attention to how our body is physically. What does your stomach feel like? How hot or cold are you? Are you tensing up? Is your heart beating faster?
I don’t have to ask you what your breathing is like. You are breathing faster using your upper chest, rather than using your diaphragm to move air in and out of your lungs. This kind of breathing is known as hyperventilation, it disrupts the balance of gases in your body. It prolongs the feelings of anxiety and makes the physical symptoms of stress worse. Stopping this hyperventilation is the solution.
The exercises related to better emotional control lie at the heart of what the Buteyko method is about. This is where you have control. The central tenet of the Buteyko method is: when you reduce your breathing volume at rest you are able to control hyperventilation when stressed. This will lessen the intensity and duration of your suffering. Again the key here is that you practice frequently, and with time you will be able to tame your emotional response.
Reduce Hyperventilation → Reduce Intensity
Evidence shows that the practice of reduced breathing exercises which modifies carbon dioxide tolerance are therapeutic to those who suffer from anxiety, panic attacks and depression (2). The technique of observing and slowing down the breath has been shown to calm the mind and improve resilience in stressful situations (3). Practising breathing exercises that create a slight accumulation of carbon dioxide conditions the brain to tolerate higher concentrations of the gas. Gently subjecting the body to the feeling of air hunger for short periods of time will also reduce the body’s fear response, reducing the risk of panic and hyperventilation.
In addition to addressing hyperventilation over the long term, it is also important to learn to control breathing during the early stages of heightened stress. A central feature of anxiety and anger is that the symptoms are cyclical, feeding back in on themselves and perpetuating the feeling. If symptoms continue, the increase in breathing volume serves to disturb blood gases further, reducing the delivery of oxygen to the brain and causing emotions to become even more intense (4,5).
While the long term goal is to reset the respiratory centre towards normal breathing volume, we expect improvements in people who suffer regularly from panic disorders and poor anger management in the short term. Noticeable breathing, frequent sighing, and breathing from the upper chest are all habits that can be easily addressed by re-education of the breath and reducing breathing volume to a healthier amount.
While many breathing techniques aim to slow down breathing, the Buteyko method is the only breathing system that intentionally reduces breathing volume in order to create a tolerable need for air. In essence, the theory works like a vaccine – reducing breathing to create an air hunger is similar to giving the body a very small, controlled dose of symptoms, which can be a useful strategy to overcome moments of extreme stress and build resilience, which is key to being able to change the final piece of the puzzle.
Behaviour: The Last Piece
What kind of situations do you avoid when you are anxious or sad? What do you find yourself doing when you are angry? If you explore these avoidances and actions and plan for times when you might be triggered you can break the cycle of how you react.
Trying Your Best: This is what you aim for when planning. It is not about telling yourself you will do this or you won’t do that. The exercises or coping skills that you will learn are about planning to try your best to respond to the situation. With practice. You will find:
- Your reactions to situations decrease in extremity
- That previously learned associations between situations, thoughts and emotions weaken
- Your confidence or self-efficacy in you feeling able to deal with stress improves
- That you become less of a slave to thoughts and feelings
- You will feel more empowered, more in control, more free
3. Int J Psychophysiol. 2005 Nov-Dec;58(2-3):190-8. Epub 2005 Aug 30.Physiological markers for anxiety: panic disorder and phobias. Roth WT1. Meuret A , Wilhelm F, Ritz T, Roth W. (2008). “Feedback of end-tidal pCO2 as a therapeutic approach for panic disorder.” J Psychiatric Research 42(7): 560-568. J Psychiatr Res. 2008 Jun;42(7):560-8. Epub 2007 Aug 3.