A stressed out client: her journey to a more peaceful mind
Rachel Sykes | I Work with Stressed Out Professional Women | Licensed in Massachusetts
Rachel C. Sykes, LMHC, LLC
Rachel@rachelcsykes.com
rachelcsykes.com
For those of us who experience chronic stress, it can feel so overwhelming that it prevents us from enjoying much of the good things that life has to offer. Consider Allegra*, a mother of a 5-year old daughter and 2-year old twin boys with her partner Alex. Allegra also works as a lawyer in the investment field, while Alex is the founder of a company that is about to release its first app in the gaming industry. Allegra has assumed primary responsibility for the family and household, and the children are now in school/daycare when she is at work. She also helps to care for her two aunts, one of whom has recently been diagnosed with dementia. While at first she thought she could handle it all, she found herself in the ER over the weekend due to chest pains and difficulty breathing, which ultimately turned out to be a panic attack. The ER doctor referred her for therapy to better understand and cope with her anxiety and panic.
Identify contributing factors
After Allegra started to engage in therapy sessions, she learned to identify the things that create high stress for her, such as feeling unappreciated by her partner, or being afraid that she would be passed over for high-profile assignments at work. Over time, she is able to recognize these stressors before her anxiety and panic become too extreme and result in negative consequences at work or at home. Specifically, Allegra has come to realize that her breathing becomes tight and shallow, and her jaw clenched, and sometimes she feels a little sick to her stomach. Now, when she becomes aware of these sensations in her body, she takes a short break and starts to write down what is going on in the moment that might be making her feel unappreciated or undervalued and practices her coping skills.
“Catch yourself”
Since Allegra became aware of her stressors—she calls them her “triggers”—she now seeks to notice the symptoms earlier in the process. She has gotten in the habit of taking frequent deep breaths and mentally runs through a quick body scan several times throughout the day. When she feels that her stress is too high (for her, it is a 5 or more on a scale of 1-10), she removes herself from the situation, either physically or emotionally and engages in her healthy coping skills. By catching the problem earlier, she has found that she can usually head off major panic attacks and the feeling of being completely overwhelmed and generally suffers less from stress and panic.
“Sit in it” – until you can name it
One thing that Allegra found particularly hard at first was identifying a specific factor that was making her feel so stressed out. In the past, she had always believed that she just had too many responsibilities and that they were all contributing equally to the bad feelings. Her therapist encouraged her to be more patient with herself, and, that when she first becomes aware of a physical symptom, that she engage in a mental exercise where she attempts to focus on identifying the specific issue that caused her stress level to jump higher. Now Allegra can “sit in” the uncomfortable sensation until she is able to figure out what is causing her grief and take action.
Coping devices
Personally, when I am stressed, annoyed, angry or whatever negative feeling is going on, I typically start with breathing exercises. Quick, deep breaths to identify areas of physical tension or deliberate structured breathing exercises, such as box breathing. I can then think more dispassionately about the stressors and, using cognitive behavioral therapy (CBT) interventions, I sort through the issue and either adjust my thinking or decide on a course of action to change my experience. Most of the time, I can do so in a matter of moments and can do so in confidence even if surrounded by others. This can take some time to learn.
Allegra also uses breathing exercises but she finds that using special breathing exercises from her weekly yoga class, especially kapalabhati breath, works to reduce her level of distress but she also has other techniques, such as visualization exercises learned in therapy, brisk walking, and boxing. While she is not often in a situation where she can drop her responsibilities and go alone for a long walk, she can find a private office at work or home to do breathing and visualization exercises for 5 minutes. After she is feeling more settled, she finds it helpful to journal, or write down the thoughts that have been running through her brain.
Listen to your inner monologue
Once the level of stress feels more manageable, one can really start to address those runaway thoughts that are feeding your discomfort. If possible, I suggest journaling or writing down some of the specific thoughts we are having. It can be so easy to forget them after a few days and sometimes those thoughts emerge again later. Somewhat recent research has shown that the actual exercise of writing things down on paper (not typing on your computer or phone) increases your ability to retain important information, so I always try to pitch this old school tool.
Look for thinking errors
Much of the time, when we take the time to write down our negative thoughts, we find that they are either fears or insults, and that they are not supported by facts. For example, Allegra found that she was telling herself that she was a bad mother because she felt so engaged when she was in the office. Allegra was able to prove to herself that she was in fact pretty good at caring for her children and that she was ultimately happier overall when she also got to engage in her professional work and that really benefited her whole family. So, she found the the evidence for her fear that she was a bad mother was not supported by the evidence; rather, that the opposite was more accurate.
Commit to a plan to change
As you can see, Allegra learned to manage her stress and panic in a crisis, and this made her overall functioning noticeably better. However, she also found that by changing her daily routine to include exercise, more vegetables, and more regular workload discussions with her partner Alex, the stress bubbled up less frequently. Allegra now prioritizes her own health, and has made a daily commitment to 5-10 minutes of journaling twice a day, exercising 5 times a week, usually taking a walk or a yoga class, and making small changes in her diet. She has also learned to communicate more effectively with her partner and learned to tolerate the house and family being less than perfect. Ultimately, she has reprioritized her competing pressures and has had to let some of them go. She has also made significant progress with her internal thoughts, which increased her self-confidence and she hasn’t had a panic attack in a long time.
Other blog posts on stress and anxiety:
https://www.rachelcsykes.com/rachel-sykes-weekly-blog/post-covid-anxiety-part-i
https://www.rachelcsykes.com/rachel-sykes-weekly-blog/post-covid-anxiety-part-ii
https://www.rachelcsykes.com/rachel-sykes-weekly-blog/being-in-the-present-moment
https://www.rachelcsykes.com/rachel-sykes-weekly-blog/lettinggo-of-things-you-cant-control
Contact me
Questions? Check out my website, request an appointment or call/email to ask for a free 15-minute consultation.
email: Rachel@rachelcsykes.com
phone: 617.804.6471
I am licensed to work in Massachusetts.
References
Mark Murphy, Senior Contributor at Forbes.com; 2018. https://www.forbes.com/sites/markmurphy/2018/04/15/neuroscience-explains-why-you-need-to-write-down-your-goals-if-you-actually-want-to-achieve-them/?sh=6a7cf5517905
Medically Reviewed by Carmelita Swiner, MD on April 30, 2023, Written by WebMD Editorial Contributors, https://www.webmd.com/balance/what-is-box-breathing
* Allegra is a composite of many individuals and is being used for illustrative purposes, as sharing actual identifiable client examples is generally considered ethically problematic in the field of psychology.