The Mindfulness Response: Emotions

Participants who experienced trauma in their past talked about triggers. The group discussed triggers from the five senses, where a strong sensation could start the memory. Mindfulness practice helped connect the strong emotion to the trigger by examining sight, sound, touch, taste, and smell.  A participant experiencing PTSD and psychosis described negative thoughts about their current situation and feeling unsafe.

Triggering Situation:­__________________________________________________________ 

A friend says, “Let’s go to the mall and the grocery store.”

Emotions and Feelings                                 Negative Thought__________________________

Uneasy, anxious                                              I will have a panic attack if I go to the mall.

Discomfort, fear                                              People in the grocery store will insult and harm me.

Identify your feelings: ___________________________________________________________

Identify the triggering situation:  The mall, large spaces, crowds …

_____________________________________________________________

Take ten deep breaths and focus on the present moment.

Use Affirmations

I am safe.

I am ok.

I am here at home.

I can do this.

Ground yourself and focus on your deep breaths.

            Name things in your environment.

            Count backward from 100 by fives.

            Describe colors or shapes that you see in the room that are the same.

            Do calisthenics or stretches

            Deep breathe

Distraction: Talk with a supportive person about your anxiety levels and fears.

            Call a friend or support person to get your mind off your distress. Talk about what you have done lately.  Ask them about their day and what they did.

Opposite to Emotion (O2E)

            This is a skill from DBT, Dialectical Behavior Therapy. Acting the opposite is trying to do the opposite of what your emotions say. This confronts the bad mood and challenge yourself to do something different. Sometimes this feels like riding down a raft, over rapids and churning, splashing water. It can be refreshing, exciting, and exhilarating. It calls for a drastic change in our usual routine.

            I used the opposite emotion to overcome my fear of being in public and went to the grocery store. I told myself that other people didn’t have time to watch me, because they had to get their food, and were too busy to notice me.

            A bad mood is when our thoughts turn into negative, distorted thoughts, our images and sensations become negative, our actions or behaviors create more trouble, and our feelings go downhill. Participants described it as falling into a deep hole and couldn’t crawl out of it. Sometimes we need help to get out of the deep, dark hole. When we have inner thoughts and feelings that describe our inner turmoil, it is time to change.

Reality Checks for Strong Emotions, PTSD, and Psychosis Triggers

Do a Reality Check around the strong feelings and negative thoughts from the emotion. Describe the situation to a supportive friend. Describe the thoughts and feelings. _____________________________________________________________

_____________________________________________________________

Fear

            There is nothing wrong with the feeling of fear unless everything starts to become fearful.

Fear as a feeling is important and protects us from danger and uncertainty. It is ok to question the level of fear and determine if you need to be vigilant about your immediate situation. If you do not feel comfortable, try considering alternatives.

Other strong feelings and thoughts that create delusions are:

Grandiosity:    Increased self-worth. I am a super-model.

Jealousy:         Believing that a partner is unfaithful, without evidence of it being so.

Persecutory:    Believing that a person is unworthy and deserves to be punished.

Somatic:          There is something wrong with my body. I have cancer.

Erotomaniac:  Belief that someone of high status is in love with them.

Find a supportive person. This could be a friend, a family member, or an individual therapist.

Explain the situation and the symptoms. Use the facts only.

A trusted support person who will listen to my fears is _____________________________________________________________

Situation _____________________________________________________________

_____________________________________________________________

The place or a person that is a trigger: _____________________________________________________________

My thoughts: _____________________________________________________________

My actions: _____________________________________________________________

What is the reason for my feelings and thoughts? _____________________________________________________________

Is this my paranoia talking to me or an actual fear? _____________________________________________________________

Evidence for Fear	Evidence Against Fear
Two people walked by and looked at me.	They didn’t glare or stare at me. They looked away after a second. They don’t know me.
The neighbors are watching me.	The neighbors are doing their laundry, washing dishes, or taking a shower. They don’t have time to watch me, and they don’t care what I do.

Is there evidence that my feelings or thoughts are real? __________________________________________________________________________________________________________________________

What is the evidence against this? _____________________________________________________________

If there is paranoia or social anxiety, can you go to a place or event with someone and observe if other people insult you? ____________________________________________________________

If agoraphobia comes with panic attacks, would it be helpful to go into the community with someone else, and not alone? ____________________________________________________________

            Fear is a normal feeling to have for everyone. It can be beneficial, and it can keep us safe. Excessive fear can hold us prisoner in our own homes. It gets to be a problem when a person won’t leave home for small errands, to go to work, college, or school, or to do activities with family or friends.

Fear Levels

            Fear levels may vary depending on your neighborhood, or whether you live in a busy city or a quieter rural area. Participants talked about feeling comfortable where they lived and not locking their doors. Neighborhood watch programs help neighbors watch out for each other and deter crime. In a city, people might be told to lock their doors to the house, close and lock windows, lock their car doors, and close and lock the garage door. There are different levels of fear.

Lower Levels of Fear and Ongoing Anxiety

            Lower levels of fear can be seen in those with anxiety. This phrase usually starts with

What if ….

            This statement may not be a bad thing. It alerts us to be aware of our surroundings. It reminds us to stay safe. When it comes all the time, it can interfere with our usual routines.

            Stress is a common daily symptom for these people. The ongoing anxiety can be seen in people who are jittery or nervous. Worry and anxiety take energy from us and interrupt our concentration. We can use this energy to try to get tasks done. We can tell ourselves to focus on a task for a certain amount of time, and then take a break. This helps lower anxiety and worry.

Medium Levels of Fear

            Being “street smart” is another level of fear, where a person is aware of the environment in a busy metropolitan area. Be aware of who is around you, whether you are in a crowd or in a deserted business area of a city. Being street smart uses your ability to sense danger on the street and this comes from experience living in an environment with a known crime rate.

Heightened Fear/Hyper-vigilance: 

            Checking over my shoulder to see if I am being followed is one sign of heightened fear.

Being wary of every tall male, who looks like they are in their twenties, with a beard, of (any race, height, or weight…)

These types of fear can be from PTSD or past trauma. Sometimes we are reminded of things that happened years ago, and they bother us again, even when we discuss it in therapy.

            Group therapy participants who have been involved in gangs, gang violence, or drug dealing talked about heightened fear levels. Reality can be mixed into it since their chosen lifestyle is not safe. These traumatic memories can come back to haunt us years later. This can involve PTSD flashbacks and nightmares.

Paranoia is a fear level “right now”

I am certain that others will insult or harm me or rob my apartment. _____________________________________________________________

I cannot disobey the voice that tells me that other people are watching me, or that I am unsafe. _____________________________________________________________

            If a person was assaulted or robbed, the memory of this will linger and return as a flashback. Flashbacks from trauma memories come from people who have experienced abuse, verbal, physical, emotional, sexual assault, or bullying. Participants talked about situations where they were at an inpatient mental health unit and could not manage symptoms. One participant said it was so frustrating to have symptoms out of control and could not stop them.

Self-Persecutory Delusions

            These thoughts are strong and intense. People believe they did something wrong and should turn themselves into the police. When these types of thought appear, the person needs to include psychiatry in the conversation, because their symptoms are unmanageable.

I know that I did something wrong, and the police will come and arrest me.

I deserve to be punished.

I did many bad things in the past and need to go to prison.

Psychosis

I feel like I am in a movie and all these PTSD flashbacks occur all the time, and all day long.

I see monsters and demons in the corner of the room.

Other examples:

            Getting fired from a job, divorce, deaths of friends or family, national disasters, weather disasters, abusive situations in relationships, combat or war, refugees escaping war and conflict from their country _____________________________________________________________