Therapist: Right. Right. Exactly. Or the worst one is when people tell you just smile, just smile.

Transcription

1 Awareness Transcript Therapist: Ok, group, so there you have it, so there are the three awareness skills, how to accept the moment as it is. Does anybody have any questions? Skyla: So, yeah, when you were talking about this half-smile, this whole like, put on a happy face crap, like that seems really fake and I just feel like why should I--I hate people that smile at me and don t really mean it. Or people that always act happy, but they re really not and they re just smiling. It just seems so fake. Therapist: Right. Right. Exactly. Or the worst one is when people tell you just smile, just smile. Skyla: (sarcastically) Yeah, just smile. It will be ok. La la la la--yeah. PAUSE POINT 1 CHOICE 1: Have the therapist explain that half-smile is using your body to accept. Therapist: So, yeah, people say stop frowning, just smile. Exactly, ok, this is good that you re bringing this up. You re right, it can feel like that because of this smiling thing that we have in our culture. But half-smile is different. You re actually not trying to make anything better, or fake that you re happy, or pretend like everything s great when it s not. In fact, it s really the opposite, so put the I know you hate to smile--so put it on hold for just a second. Here s what it is, you see, you re trying to use your body essentially to help you accept reality as it is in the moment. So, the best way to do it, that s why you want to kind of relax your face and you don t want to grin, you don t want to smile, like, Hey I m happy. Everything s great. It s more like just this tiny lift at the corners of your mouth. And you re trying to use even your physiology, like those little muscles in your mouth, to help bring you into a stance of acceptance. So if you try it, what you want to do is not try to force yourself to be happy, but just this place, just this tiny lifting where it s just like an openness to reality as it is. As painful as it is, but accepting that it is. It s a little bit different than what you re thinking of but this is a really good point because a lot of people have trouble with this. Page 1 of 7

2 CHOICE 2: Have the therapist explain that it is not forcing yourself to be happy. You may get an emotional lift, but the half-smile is not meant to cause a wave of joy. Therapist: So, really, Skyla, a half-smile is just like a movement, not really like forcing your emotion It s more like an acceptance of what is as it is. Some people find that when they do the half-smile that it causes a little emotional lift. It s not like it causes this great happiness. I mean sometimes it is a little less. For some people, it just helps them take an open stance to the moment as it is. Skyla: Ok. Therapist: But no, you re not trying to force yourself to act happy. CONFLUENCE POINT Carol: With all this awareness stuff, I just, you know, I have to say, it just seems kind of weird to me. It s sort of I don t want to say, um, you know, religious, but just kind of weird in that way. I mean, I was wondering what you were going to do next, ask me to paint myself blue and worship a tree or something? Therapist: (laughs) Would that send you running out of this group? No, Carol, this is the good thing about you, that you bring these things up. PAUSE POINT 2 CHOICE 1: Discuss how different can sometimes be a good thing. Therapist: You know, I think it does feel a little strange at first. I mean this is not something that I think that most of us, especially in Western culture, are used to doing. So you know, but it is are you afraid it s going to what are you afraid of, that it s just going to be too weird or we re going to turn into a cult on you or something? Carol: Well, no, but I guess I feel just kind it makes me not feel like myself. It just feels foreign to me. Therapist: Mm-hmm. And that would be good though, right? If you didn t feel like yourself for just a little bit? Page 2 of 7

3 Carol: Yeah. Therapist: Right, so exactly. It is a little bit different, but we need different because your life is hell right now. So, if it feels a little bit weird, it feels a little bit weird. Just observe it and kind of throw yourself in it and we ll see what happens all together. Carol: Ok. CHOICE 2: Have the therapist discuss with the group how this fits with spiritual or non-spiritual beliefs. Therapist: Anyone else feel like this? Is it weird? Does it fit or not fit with your spiritual or non-spiritual beliefs? Lori: Well, let me be honest, you mentioned earlier Zen Buddhism and the connection to that, and I was brought up Christian. I m just not comfortable with the religious part of it. Therapist: Would you be comfortable if it was within the tradition of Christianity? Like if it was in the teachings of Jesus? Would you be comfortable with that? Lori: Maybe. Therapist: Yeah, cause this is a really good point that you re bringing up and we really tried to take the spiritual or religious language out of this so that anyone can apply it. But as a Christian, you can really look at the contemplative prayer movement. We could talk later and I could recommend some books, but it s really in keeping with Christian contemplative prayer. It s not as popular in the mainstream church these days, but you can find these roots in Christianity. Lori: You re saying it s not necessarily religious. Therapist: Yes. I mean the skills that we are teaching are not necessarily religious. You can be religious or not and you can practice these skills. But the thing about them--and one of the reasons that I think there is so much wisdom to them--is that in every major spiritual or religious tradition you ll find these same ideas. So, we could talk about books to look at later. But I think it s important that you feel like what you re doing Page 3 of 7

4 here, the philosophy, that it s not contradicting your spiritual beliefs. And I think you ll find it doesn t. Kyle: Yeah, but I am an atheist, and I don't even believe in a connection or awareness of anything higher... Therapist: Awareness is not about anything higher. It doesn't have to be spiritual... It could be that. If that's what you believe, you could be aware of that connection. But, Kyle, since you don't believe in that, you could just be aware of really practical things. Kyle: Well, what do you mean practical? Therapist: For example, it could be awareness of music. You might--the way your mind gets going on so many things and especially how you get when you're depressed... It could be that when you're listening to music you're being aware of listening to music and breathing while listening to music--but that's it. You just become better able to participate in what's happening rather than having your mind drag you off. Juan: I was just gonna say that in my church, we talk a lot about being aware of the Holy Spirit, being aware of Jesus, and feeling the Holy Spirit and letting it be everywhere in your life, so you don t do it just once a week on Sunday. You have to be constantly aware. Therapist: Juan, you've got it. The essence of all of this stuff, you guys, is that you find ways to be aware that actually stay true to your deep beliefs and don't go against the grain... So, like, if I tell you to sit by a tree and be aware of your connection to nature... I might ask you to go along with it, at least try it. But I also think if you don't want to do it, great. Fine. Let's find something to do that fits with you. So on all of these awareness exercises, bring up these objections. Because it has to be true to your deep beliefs. And I bet we can find some exercises that are. CONFLUENCE POINT Therapist: What else did you guys try? Lori? Lori: Well, I tried. I tried to throw myself into this breathing thing that we did, but when I concentrate on my breath, I feel trapped inside and I start to freak out. Page 4 of 7

5 Therapist: Oh, my god. That is too perfect! Tell me what you mean, it freaks you out. Lori: Well, my heart starts to race and even now my palms were sweating. My throat gets tight. I can t breathe. Therapist: Right, like anxious? Lori: Yeah, definitely like I m going to have a panic attack. PAUSE POINT 3 CHOICE 1: Advise the therapist to tell the client that painful moments are the perfect time to practice awareness. Therapist: Right, so this is perfect. This is absolutely perfect. What we re doing, remember, is essentially practicing accepting reality when it is painful and allowing it to be exactly what it is. So, if you feel a little bit like the sweaty palms and a little bit like that sensation that it s a little bit harder to breathe, that s actually fabulous to practice because this is exactly what happens in life. And what you were just saying that is when life gets hard like this you just want to bolt, but this causes all these problems. So this is like, perfect. This is the practice. Skyla: So you re saying that she should just practice this and then she can pass out, well that s perfect? Therapist: Well, I don t think she s going to pass out is the thing. If I thought she was going to pass out, no. But I don t think she s going to pass out. Lori: But I m really having like a genuine panic attack, like if I focus on my breath, I have a panic attack. Therapist: But do you pass out when you have panic attacks? Lori: No, but I almost do. Therapist: Right. Lori: But I definitely have hyperventilated before and that s what it feels like--- it s setting off, like it s setting off a panic attack. Page 5 of 7

6 Therapist: Right, but you know what the treatment for panic attacks is though, right? Lori: No. Therapist: Oh, tell me you haven t had this treatment, oh! I m so glad you re in this group. The treatment is that you make yourself hyperventilate until your body essentially learns that you re not going to pass out, and it s actually ok. What your brain eventually learns is that it can calm down all on its own and it doesn t need to feel perfectly calm to be perfectly calm. Lori: So you purposely hyperventilate? Therapist: Yeah. CHOICE 2: Advise the therapist to encourage the client to try this exercise before offering another. Lori: I'm not gonna do the breathing exercise... Therapist: So you're... because it's too what? Too scary? Lori: It's too stressful for me. Yeah, too scary... Therapist: Everyone is gonna come to one of these skills, and there'll be one that you say, "This one does not work for me." And that is totally fine. But the trick for you, Lori, especially given that you have panic attacks, is that you can't let it be where you don't move in on it in some way. So my suggestion would be that you try it a little bit. Like, you become aware of your breath and notice the sensation. And you do it for a certain amount of time, and you don't escape. Like, as soon as you notice that the sensation gets uncomfortable, don't leave then. Stay for a little bit. Otherwise your brain is gonna learn there is something to be terrified of. If you're going to do it, you have to do it just a little bit longer and then leave on purpose. Does that make sense? Lori: Will that... Eventually will that help me have fewer panic attacks? Therapist: Yeah, that's my whole point! If you keep doing it your way, you're going to keep having panic attacks. We should get you, so you and your therapist are actually doing treatment for panic attacks. Keep trying the breathing awareness exercises. Even though they're uncomfortable--it's Page 6 of 7

7 worth continuing. It's not like you have to do the breathing exercise. But my guess is that you would benefit from it. Are you at least willing to try it a little? Maybe work with your individual therapist on how you could work this into treatment? Lori: OK, yeah. Therapist: Great. Page 7 of 7