Psychologist Melbourne "Dr Kate Cain" "Sleep tips"

Are you beating yourself up? Over something you said or did?

What happened? Did you do something you wished you hadn’t? Did you say something you wished you could take back? Is it causing you a lot of distress thinking about it? Some perspective can usually help in these circumstances.

So what did you do? Did you harm someone? Was it on purpose? The chances are likely not. Perhaps you did something embarrassing. That’s happened to all of us. But it can help to realise that you will have spent a lot more time focusing on it (perhaps even obsessing over it) than anyone else involved. They saw it, they heard it, they may or may not have thought anything of it at the time and now they are getting on with their lives. It may loom large in your current thinking but in the scheme of things, it was very probably no big deal.

In some cases, we can say things we really wish we hadn’t. Words can come out of our mouth before we have time to stop them. Dealing with the aftermath is not easy. We can agonise over things we have said and spend a lot of time wishing we could undo them.

If we are sorry, apologising can be very helpful. Letting the other person know you are aware you caused them pain and are sorry for having done so, can be an important first step in mending a bridge.

If we become aware that this seems to be happening a lot, it may be helpful to reflect on why we said what we did. Was stress involved? When our body is trying to cope with stress it uses up neurobiological resources., or ‘brain power’. These are the resources we need to help us regulate our emotions and keep them in check so we can ensure we respond and don’t react. For it’s the reacting that can get us into trouble - when we are stressed we don’t have the time (or more relevantly, the capacity) to think rationally. So if you are feeling stressed (and you will come to know the signs, but a key one is recognising when you are quickly getting irritated quickly or easily agitated), create some space for yourself to think. Be kind to yourself (and possibly others!) and take a few deep slow breaths, maybe excuse yourself from the situation and go for a walk, or grab a glass of water. Just take some time out. No-one needs to know.

And if you have said or done something, remember, we are human and humans make mistakes. Most people acknowledge we can all get stressed at times and can act out of character. People usually forgive bad behaviour or hurtful remarks, especially if they hear an apology. Then let it go.

Longer term, there are lots of things we can do to help manage stress as it is not good for our bodies, let alone for our relationships! If you have noticed this is a bit of pattern for you, see my other blogs for tips on managing stress. And if you do want to understand it a bit more and find out what’s going on, it may be helpful to talk to someone - because although stress is often a factor, there may be some underlying beliefs and thinking styles that are contributing to the problem. It may be for example, that you are being triggered by something that happened in the past with someone else but that is still echoing in your life today. An issue for another blog…

Perfectionism... a blessing and a curse

Do you want something done? And done extremely well? Give it to a perfectionist. They will turn themselves inside out making sure it’s not only done on time, it’s done flawlessly. And they will never let you down - they are incredibly reliable. Looking for someone to join your team? Recruit a perfectionist. Win-win.

Actually, not quite. It’s often a one-way win because the perfectionist usually has to turn up their stress levels quite a lot in order to achieve a result. And I mean the result they will be happy with. Because their goals are inevitably that little bit (read a lot) higher than anyone else’s. The perfectionist can’t take the risk with bringing in a “normal” result. Better to do that little bit more and make sure. They can’t afford to get it wrong. And getting it wrong usually means less than 110%. And therein lies the dilemma for the perfectionist. The stress level required to get something done “properly” (read flawlessly) can be exhausting.

Some elements of perfectionism are very positive. Having high standards and being very organised are two very adaptive attributes. Excellent skills that serve us well across different areas of our life. However, on the downside perfectionism comes with maladaptive attributes which are the fear of making mistakes and doubting what’s been done. These attributes can result in procrastination and second-guessing, the incessant worrying before and after the event. What if I mess it up? What if I make the wrong decision? Have I done it properly? What if I could have done it differently (read better)? What if I missed something? And so on and so on….

It’s when these two different parts of perfectionism get out of balance that the person trying to juggle them begins to suffer. Because in order to achieve their goals they need to pump up the adrenalin and cortisol. Sound familiar? Yes - those neurochemicals that are part and parcel of anxiety. And that’s no accident as there is a very high co-morbidity rate between perfectionism and anxiety. Getting things done flawlessly often comes at a cost.

If this reminds you of someone (you?) and you have decided you have had enough of operating like this, the first step is to start to recognise when you are putting pressure on yourself. Your stress triggers will be familiar (stomach clenching? tight throat? muscle tension? etc., etc.). Learn to recognise these when they first kick in and ask yourself - does it need to be absolutely perfect? Maybe not. Maybe a bit less than perfect is OK… and a lot less stressful.

Who's in charge? You or your anxiety?

The anxious part of our brain can often be in full flight. It thinks it’s being helpful, keeping us alert to potential dangers. What might that person be thinking of me? What if I make a fool of myself? Am I boring everyone? Best I keep quiet. Best I not go. Better to stay home. Fly under the radar. I’m much safer that way.

Well yes, you might be safer. You certainly can’t make a fool of yourself if you keep quiet, stay away, don’t get involved. But then what about that other part of you? The part that wants to connect with people? The part that is aching to join in, be involved, be recognised, and be part of something. Unfortunately, the anxious part of our brain can stop us doing just that.

For that’s the ultimate dilemma facing some people who have to manage this beast called anxiety. They are torn in two, having to choose between keeping themselves safe by not engaging with people, and taking the plunge and doing just that so that they can connect - something they truly want to do.

Don’t get me wrong - anxiety or stress has its role. If we are in true danger we might need that sudden rush of adrenalin or cortisol. Even that rush of pro-inflammatory chemicals we produce when we get anxious in case we are injured and our body needs to repair itself. We might need those chemicals to help us to run like hell, or prepare to fight (or yes, even “freeze”) to get out of danger. However, when you think about the possibility of real danger, and needing to react like that, it seems like the number of times we might need to do that is pretty slim and way out of proportion to the anxiety we can experience.

Unfortunately, when our anxious brain has been in “full flight” mode for a while, it can’t tell the difference between a real threat and an imagined one. So our body is being pumped with that adrenalin and cortisol, and even pro-inflammatory chemicals, even if we are just worrying about the possible consequences of speaking up in a group, or going out with friends. It’s a bit of an overkill wouldn’t you say? Definitely.

So, for now, it might help to become aware of that anxious part of your brain and how it may be controlling your life. How it is stopping you from joining in, from speaking up, from doing what you really want to do. Connect with people.

When you feel those familiar signs of anxiety, stop and realise that those chemicals have just fired up. Stop and ask yourself - how much danger am I truly in? Odds are, not that much. So, you can stop and thank your anxious brain for trying to protect you, but remind yourself - it is a bit over the top. Take a few deep, slow breaths and wrestle back control. The other part of your self will thank you.

Anger feels good in the moment... but then what?

Anger is one of those emotions that can feel uncontrollable. We can go from being calm one minute to being in a full blown rage the next. And then we can be left wondering what just happened. And so is the other person who “copped it” courtesy of your outburst. Does this happen to you? Is it something you want to change? If so, read on…

First, not all anger is bad. If someone is treating us badly then anger is understandable. In fact, it can serve us well. It’s OK to let the other person know we are angry at what they are doing. To let them know they have stepped over a boundary and that it is not acceptable. Of course, it needs to be expressed in a way that doesn’t cause harm to anyone, but that is possible to do.

On the other hand, not all anger is helpful or indeed justified. It may be that sometimes your anger is out of control, and (on reflection) not entirely justified. Part of the problem is that expressing anger can feel good in the moment. It’s a form of release and sometimes can give you a sense of power. Unfortunately, that’s usually a fleeting feeling and what we are left with can be shame and embarrassment, as well as having to deal with the fallout of having upset someone else. From a big picture perspective, it’s not good. So, let’s look at some practical strategies to help you manage it.

First, let’s do a brief review of what happens to you physically when you start to get angry. This will differ by person. My clients usually don’t have trouble identifying these as they are quite familiar to them and indeed spring to mind with very little prompting. What are yours? A tightening of the throat? A clenching of the stomach? An increased heart rate and quicker breathing? Maybe you get a tightening in the head - like an almighty headache is about to descend. Just sit for a minute and think through your physical responses that signal anger is about to descend.

Once you’ve identified these you can use them as your personal “canary in the coal mine”. They are your warning signs that things are about to go “pear-shaped”. That emotion-driven part of your brain is about to take over and is probably going to take you down a path that doesn’t lead to a good place - one where you lose your temper.

If you can recognise these physical warning signs early enough you will be able to implement an intervention (yes - on your own behalf). What you will be doing is creating some space so you have time to think - in fact you will be giving your rational brain (in your pre-frontal cortex) time to take back control. You know that expression “I need to collect my thoughts”? Well that is exactly what you are doing in these moments. You will be creating some space so you can to start to engage your rational part of your brain so that you can respond, and not react.

One way to do this, is by focusing on breathing slowly and purposefully. Take a deep breath in through the nose, on a slow count of four, hold it for a slow count of two, then let it out through the mouth to a slow count of six. Do that a few times and it will help reduce the physical symptoms. Once they have reduced and you are feeling calmer (i.e., you are no longer in “fight” mode), your rational part of your brain can start to think clearly. And that includes thinking about what the consequences will be if you do get angry and “let rip”.

Another approach, is to simply walk away from the situation until your physical symptoms subside. If you feel the need to say something at the point that’s OK. You could say “I don’t feel well, I just need to get some air” or “I need some water” or “I can feel a headache coming on. I need a headache tablet”. Whatever works for you is OK. Then walk away and do the breathing exercise above. Once you feel calmer, you can come and continue the conversation - but this time you will be in control of your response, and not your anger.

This will take practice, but give it a go. Because you’re worth it…

So you have to go to that function. Now what?

Are you dreading the thought? Are your old familiar anxiety symptoms starting up again? Stomach clenching, heart racing, throat tightening (or whatever your symptoms are) - every time you even think about it? You’ve promised your partner you will go. Maybe it’s your work function. Or perhaps it’s a family function (yes they’re not fun for everyone!). And now you are feeling trapped.

It’s OK - you can get through it. Let’s look at some strategies that might help.

First, a safety net. If things really do start to get overwhelming when you are talking to someone, you can always excuse yourself and say you don’t feel very well and need to go and get some water, or some fresh air. You could say you can feel a headache coming on and just need to step outside for a few moments. Buy yourself some time to collect your thoughts. Go somewhere quiet and practice the 4/2/6 breathing technique I talked about in a previous post (a quick reminder: breathe in through the nose to a slow count of 4, hold it for a slow count of two, then breathe out through the mouth to a slow count of 6. Do that for a few minutes until you feel your anxiety symptoms subside.)

Are you worried about what to talk about? Some safe topics include asking your ‘conversation partner’ whether they have seen any good movies or read any good books lately. Whether they have been on any holidays recently, or if they are planning any in the next year. What destinations are on their bucket list longer term? What do they do in their spare time? Do they have any hobbies?

And don’t forget, you don’t have keep asking questions - you can use their answers to build on the conversation and tell them what you’ve seen or read, or places you’ve been or would like to go to etc. Engaging in a two way conversation makes for a much more lively interchange with someone.

If it’s a function where there are new people, you can always ask what they do for a job and whether they like it. Perhaps what they most like about it or indeed if there is anything they don’t like it or that they find challenging. Or ask where they live, and what they like about that area. Or how they came to be at this particular function. Did they know someone connected to it? Have they been to something like this before?

If it’s a family function and you are starting to feel overwhelmed by someone, you could try changing the topic. You could say “I’d like to think this is a day for relaxation, let’s talk about something else.” If they continue to ‘push’, you could say “Actually it’s not a topic I want to address in this setting. Let’s just enjoy the day.” If they challenge that, you could say you are starting to feel a little uncomfortable discussing this at the moment, so can we please change the topic?

What if it gets too bad and those anxiety symptoms really do start taking over? It’s perfectly OK to excuse yourself, say you feel unwell, and leave.

Hopefully though, you can try some of the ideas mentioned above because the more you can “expose yourself” to this type of anxiety and survive it, the better off you will be in the long run.

But it can be done in small steps. Looking after yourself is important so whatever you decide is right for you is OK.

Early warning stress signs - use them!

Sometimes we have been running on high stress levels for such a long time we’re not even aware of it. So how can we pick up on this? One way is to look for early warning stress signs.

So what might one of those early warning stress signs look like? Let’s call a spade a spade. It can look like one of those moments when we “lose it” or “blow a fuse”. And that usually happens when we get really irritated with someone and let them know it. The words are out of our mouth before we can stop them. Ouch.

When this happens the result can be upsetting not only for the poor person bearing the brunt of your irritation (or worse, your anger) but also for yourself. So you’ve become upset, said or done something and now wish you hadn’t. And surprisingly, the target of this outburst can often be a loved one. Yes, I know it’s a contradiction. The ones we care about the most are often more likely to bear the brunt of our negative emotions. Why? Probably because it’s safer for us to “let loose” on them over someone we don’t know very well. Still, it’s not good, right?

One way to look at these incidents is to consider them an early warning sign. A sign that you are a bit stressed or that your anxiety is escalating. So flip it around. When you start to feel yourself getting irritated over something, stop. Is it really that important? Or is something else going on? Do you have too much to do? Is there pressure somewhere else in your life that is bubbling over into other areas? If so, it may be time for some time out.

We can’t always make our problems go away, but we can affect the impact they have on us. So activities like meditation or exercise can help reduce stress levels. Also, doing something that you find soothing can also be very helpful. Think of it as giving yourself a hug.

It might be a hot bath, a massage, listening to music, or even sitting quietly petting your dog or cat. Struggling to think of something? Just take a couple of minutes to stop and think about it. There must be something that you enjoy that feels like a balm for the soul and body.

And if that voice starts up, the one that tries to tell you this is a waste of time? Tell it to be quiet. It is NOT a waste of time. You need to do this to try and decrease your stress levels. Because really, it’s not much fun for everyone else if you ‘share your stress around’. So, take charge and try and reduce your stress. Don’t let it run (or ruin) your life.

It will be better for those around you, and importantly, much better for you.

Social anxiety

Someone has invited you out. You said yes and now you’re asking yourself - why? Why on earth did you say yes? You know you hate socialising. It’s agony. You will feel so stressed beforehand that enjoying yourself there will be almost impossible. In fact, you feel quite ill at the thought of it, right now. Your heart is racing, your stomach feels as though it’s in a knot, your legs are shaking and you’re starting to sweat.

Stop! Breathe….

You have started down a pathway you don’t need to continue. We know from previous posts that these distressing physical symptoms are preceded by thoughts. So what might those thoughts be? Let me help…

That you will make a fool of yourself? That no-one will want to talk to you? That if you do talk to someone you will say something ridiculous and they will never want anything to do with you again? That you won’t fit in? That you will stick out like a sore thumb?

Again - Stop! This time ask yourself how true are these thoughts? What is the likelihood that you will make a fool of yourself? Pretty slim. How many times have you been out and NOT made a fool of yourself. Probably plenty of times. In fact, it’s so rare you can’t count the number of times on one hand. And why won’t you fit in? Why would you stand out? Keep challenging those thoughts - they are your anxious brain talking, trying to protect you from some imagined disaster. Actually trying (most unhelpfully) to stop you going.

Using self-talk can be really helpful here. So ask yourself - how true are those thoughts? Use your rational brain to get back control and make a decision based on likelihoods, not imagined catastrophes. It will take practice but in the end you will feel much better for it.

Because you’re worth it…

Catastrophising - a familiar 'friend'

Anxious thoughts can take us on a journey. The problem is, we often don’t realise we’ve even started the journey, let alone arrived at a rather frightening place.

One of the more helpful things you can learn to do is start to take control of that ‘thought journey’. How do we do that?

In my last post, I suggested you learn to recognise your physical symptoms when you are triggered by an anxious thought. So let’s use that strategy again, except this time, stop and ask yourself what you just thought. It will have been almost unconscious (it’s an old habit!) so you might have to stop and focus for a minute. What you will more often than not find is that that thought has triggered a sequence of possible events flowing on from it. If you pursue that thought to the end you will find you have catastrophised an outcome.

So, an initial thought, based on a (usually flawed) interpretation of something that just happened has just spiralled out of control. For example, your partner may have said something offhand that you have immediately assumed was a criticism. You jump from feeling criticised, to thinking your partner isn’t happy with you, to thinking they don’t want anything to do with you any more and that they are going to leave you. Now, that’s one hell of a journey.

Stop and ask yourself - how likely is this outcome? Retrace the thought journey your anxious brain has just taken you on and realise it’s very likely to have taken off in the wrong direction and has just careered out of control. It’s actually very unlikely your partner is going leave you, they may just have been distracted or been having a bad day.

So - take back control and put the brakes on. Take some time out. Challenge the thought and you will often find your anxious brain has just taken you down that old familiar catastrophising path. Rethink the likely outcome, and you will realise it’s very likely you have no cause for alarm.

Practice this technique (it will take time) and you will find it eventually gets easier to stop those catastrophising thoughts taking over your life and making you feel anxious.

It will make for a much calmer life.

Super anxious? Help in the moment

Learning how to control anxiety in the longer term requires some new daily practices. I’ve talked about a couple of these strategies in my earlier posts - good sleep practices and meditation are a great place to start.

However, what can you do when you suddenly feel overwhelmed in the moment? When your heart starts racing, you start to feel hot, your stomach starts churning? Maybe your palms start sweating or your legs feel shaky.

The physical symptoms associated with a sudden surge in anxiety will be very familiar to you. Indeed, they will be individual to you because, although there are similarities among people, the exact combination will differ by person. You will know them - have a think now about what would be on your list of symptoms. Familiar, huh?

To help manage these symptoms in the moment - the trick is to recognise them when they start so you can hopefully ‘get in early’. What do I mean by that? The earlier you become aware that your anxiety symptoms have been triggered, the quicker you can start to try and control them.

So - as soon as you recognise those old familiar (unwelcome) symptoms I want you to focus on your breathing. Breathe in very slowly through your nose to the count of four. Hold that breath for a slow count of two, then slowly breathe out through your mouth to a count of six. Do that a number of times - it may take a few minutes, it may take a little longer. Keep focusing on your breathing in this way until your symptoms feel a little more under control.

No-one has to know what your doing - this can be done very quietly without drawing any attention to yourself. No need to sit in a darkened room with a candle burning. No headstands, no active wear. Just quiet focused breathing. In the office, around the dinner table, on the train.

You might also like to practice this when you are not in the middle of a highly anxious state as another way of getting your brain in training for a new, calmer way of being.

Because it’s a much better way to be…

Meditation - time out for the brain

Do you ever feel like you’re endlessly worrying? As though your brain never seems to switch off? If so, you might like to try meditation.

I like to think of meditation as a mini break for the brain. Just some time out for your brain to be reminded what it’s like to be still, quiet, calm.

It is something that takes practice though, because it’s not always easy. In fact, don’t be surprised if you find it a struggle. That’s your brain being resistant. If your brain had a voice you could almost hear it say “What is going on? I can’t sit here doing nothing, I have to worry!”. So persevere. It will get easier.

It might help to think of it as being similar to starting a training program to improve your physical fitness. If you haven’t been exercising much you can’t suddenly get up one morning and decide to run 10km in 30min. Meditation is similar - when you first start meditating you will be putting your brain into training. Technically, you are actually rewiring your brain into a new way of being. A calmer, quieter, more relaxed way of being. The beauty of that is not only do you give your brain a break while you are meditating, you are helping to bring down your baseline stress levels throughout the day.

When you’ve been exercising more you feel better throughout the day, right? You feel like you have a bit more of a spring in your step. It’s the same with meditation - not only is your brain getting some much needed time out for the time you meditate but it can eventually help quieten that never ending worrying that has become your constant companion throughout the day.

There are lots of apps available. Smiling Minds and Calm are free but do your own searching and find one that suits. You can start with 5-10 minutes a day if you like and build it up over time. Do what works for you. But keep at it. That brain might eventually learn to stop all the constant chattering and give you a break.

And that would be good…

Sleep - the great elixir

Do you have trouble sleeping or feel like you are not getting enough sleep? Do you find it hard to get up in the morning? Do you feel like it’s an effort to get through the day? Perhaps you crave a mid afternoon nap or you are having trouble concentrating or making decisions. It could all be due to not enough sleep.

So let’s start with the basics. How many hours sleep do you think you need? What time do you have to get up? Then use this to work backwards to the ideal ‘going to sleep’ time. And note, the ‘going to sleep’ time may not currently be your ‘going to bed’ time. To help align them it may help to begin a ‘wind-down’ practice before you go to bed. The idea is to eliminate activities that activate the brain as well as conditioning the brain to be ready for sleep. That way, by the time you go to bed, falling asleep becomes a lot easier.

This means no electronic devices in bed - no social media, podcasts, movies, or TV shows (reduce temptation and leave your electronic devices in another room.) Meditation before bed time can also be helpful. And no coffee or caffeinated tea in the evening, or for some, even later in the day (listen to your body).

If you tend to wake up during the night and toss and turn, worrying endlessly, you could begin an evening practice (before bed) of writing down a list of things you might be worrying about, including tasks you would like to get done tomorrow. “Purging” the brain this way can help contain the worries.

If all else fails and you are struggling with the tossing and turning, get up, perhaps have a cup of herbal tea, sitting somewhere quietly, and ideally in dimmed lighting, then go back to bed when you feel in a calmer state.

If you can include some or all of these strategies as part of your nightly routine you will hopefully start to sleep a little better and feel more rested.

Because you’re worth it…