A Therapist's Guide to Navigating the Shit Show

Welcome to the Shit Show!

Life is life-in’ and the world is on fire. How in the heck are you expected to stay regulated AND help your clients stay regulated in a completely emotionally dysregulated environment?!

First of all, let’s get rid of the idea that you’ll *always* be able to achieve happiness or get to baseline. Some seasons in life require us to experience discomfort longer than we would like. When we shift our goals away from perfection, we can meet ourselves, our clients, and our people where they’re at and tend to all our needs as best as we can. I created a post for therapists, as to what has been helpful throughout these wildly political times and basically questioning all the things these days. The two biggest themes that weave our foundational well-being are self regulation and activism/community.

It's common to oscillate between overwhelm & shut down, but nothing gets done in either of those places so, let’s get into it!

Sometimes in therapy, it might be the only time someone will take time to dip into their bodies (or attempt to) and soothe/breathe, so creating space to guide clients through this is crucial. This recalibration for them (& us!!) is so important, even if it feels so basic.

Basic = foundational.

Building community is a huge part of co-regulation. By default, we become part of their community in session. This is an intentional space where they can better access their center (or as close to it as possible), and be a source of grounding within their own systems. A lot of people really struggle with tolerating distress in the first place, so maybe right now, for some, it’s what can they learn about emotional regulation and foundational coping alongside all the ‘shock and awe’ consumption.

At this point, you’re then able to move towards a place of, “Ok, you’ve consumed a lot and have learned a lot, so now what have you done?” This could mean how have they taken care of themselves, others, tended to their bodies, and/or advocated for something they’re passionate about - even if it’s as simple as sending an email. Sometimes we have all the tools, and we just need a reminder of what we do to take care of ourselves. Really, most people just need your hand to grab onto in those moments. When we anchor ourselves, we can better assist our people in anchoring themselves, and THAT’S where we thrive in self regulation and activism/community.

Here are some of my favorite go-to therapy favorites in (and sometimes out of) session! Let me know which ones you gravitate towards or want to try!

Interventions:

Breathwork, Body Scans, Transitions: I always introduce diaphragmatic breathing (a fancy way of saying taking fully belly breaths) or some sort of breath work to see how my clients respond. For many it’s helpful and sets the foundation for other exercises like body scans, or even at the intro/end of a session for people to transition into the next thing for their day. One great thing I’ve learned is if you’re doing a 50 min session, the last 10 mins or so is best spent on helping clients transition out of session and helping them turn the volume down if they’re amped up - very helpful for me to keep in mind when someone is spiraling in session.

Alternatives to Breathwork:

For my clients who experience anxiety doing breathwork, we explore alternative routes and actually a big thing that’s come up that can be soothing are things like soduku puzzles and such! Practicing being in the body is a huge part of my work and for some it’s trying new things and just the repetition of familiar practices that land well with them as they’re working on gradually being able to tolerate difficult emotions. It’s figuring out what helps them feel safe. At home, setting alarms as prompts has been helpful for some to put down the phone outside of session, as a ‘choose something else’ reminder.

Homework:

Some may cringe at homework, but hey, it’s where the lasting changes start to take root! 50 minutes a week or every other week with no intentions in between ain’t gonna cut it y’all! Homework Example: Meeting your own biological needs - How well are you listening to your body - if you need to eat/drink, do you eat/drink? Do you sleep when you’re tired or keep yourself up doom scrolling? Do you go to the bathroom when your body tells you it needs to? —These are daily needs we cannot ignore, but often people do, so it can be a very foundational, basic thing to start with, especially if there’s struggles coping in general. This leads into greater discussions, such as - If someone struggles with sleep, we talk about sleep hygiene, but really we get into how are they supporting themselves throughout the entire day in order to set themselves up for good sleep vs just looking at the hour prior. What your present self does now, your future self will be thanking you for!

Feeling Safe:

If you or your client struggle with breathwork or silence and tend to have extra chattery brains, then the ‘Imagined Safe Place Exercise’ is a goodie! It engages all 5 of the senses and evokes the feeling in your body of being in a safe place, just by imagining and submersing self into the experience. Just like we can get ourselves into a worry spiral just by our wild imaginations, we can also create a sense of calm and safety within our bodies by using that same wild imagination. Even if they don’t revisit the whole practice, by just revisiting the imagery it can create a similar effect. This is a fan favorite among so many of my people!! You can find these online and do a guided one in session, and also offer a YouTube link if someone wants to practice at home, but needs the guided element.

Guided vs Silent Meditations:

Guided (vs more silent) meditations and practices in session tend to land well with most of my clients because the guided element helps their brains stay more focused, to allow attention to what may be going on in the body. If they experience some increased relaxation, but find they were still in their head a bit, that’s just a sign they may benefit from a slower pace of easing into other practices and building trust they can handle difficult emotions before they can access more of their bodies’ experience. Relaxation is a hard feeling for a lot of people!

Pause:

The power of pause! This is life changing for all my clients when they practice that pause to disrupt and gently challenge old ways of coping. It creates just enough of a window for them to be like “Ah, I see what I’m doing and why I’m doing it, so let me reassure/comfort myself and explore trying it differently now.” We talk a lot about the goal not always being happiness or even getting fully to their baseline - but if we can keep them closer to baseline and within that window of tolerance, they can feel more confident to handle hard things. And we also get very realistic about not letting go of old coping skills until new ones are tried and in place. It’s a simultaneous process and understanding that old ways of coping were/are helpful AND how do we explore ways to give them a break and make space for some updated ways to cope that feel less intrusive.

Move Ya Body:

Movement, movement, movement! We all know this is harder for some vs others, but no one can argue about the benefits of moving our bodies. I think when clients can access movement, they have a better ability to take action steps for other things. They release tensions, which organically opens up more space. Learning this and experiencing this for themselves is a game changer. Our bodies do so much for us and it’s a wonderful sign of healing when we treat them with kindness and nourishment.

And finally - I practice what I preach. I share examples about how I self regulate and explore different ways to get involved in my own community and lean on supports. It’s very powerful when we can share our calm and really help our clients co-regulate. Parts work practices tie so nicely into some of these somatic practices and it’s all about catering to each client’s needs, as well as recognizing our own!

I hope these help! I think like many other therapists right now, I keep thinking of all these ways that can be even more helpful, but truly the foundational basics and making sure those are solid have been the most helpful - with myself and clients alike. If the foundation is solid, then moving into action is much easier. Right now, there’s a lot of oscillating between world events and personal events and barriers/grief. For all us navigating the shit show, we need to continue to pull out each other’s strengths. We need to acknowledge how we may be doing things differently than just a year ago, to remind ourselves growth is slow progress, but it exists. We need to experience being capable of tolerating and validating our emotions in order to build confidence, so we can shift the ways we cope, and to realize why it’s worth it to keep going.

In solidarity,

Amber