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Anthony Quintiliani, Ph.D, LADC

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July 25, 2016 By Admin

Helping Professions and Emotional Balance

Helping Professions and Emotional Balance

Helping professions must practice to achieve emotional balance.  Working conditions for the helping professions have become more and more difficult over time, especially with the advent of so called “helpful technologies” and ever-increasing governmental/funding requirements for documentation.  When I started in the (behavioral mindful-happiness-emotional -balancehealth) field of clinical psychology and addictions in 1985, the entire medical record was a total of 6 pages.  The assessment report, treatment plan, progress notes, releases, communications, and termination report were added as expected.  The for-profit attack on health care has only made matters worse.  And even large non-profits with $1,000,000 plus CEOs and CFOs, again, cut into salary and benefits for staff as well as placed additional pressure to produce, produce, produce and produce. The very organizations dedicated to helping people with serious medical and psychological needs have, themselves, become little more than stress-mills – burning out otherwise dedicated and professional personnel. Staff dissatisfaction and rampant staff turnover have added yet more stress to the “helping environments.”  The preponderance of novice inexperienced counselors fresh out of graduate school adds more stress. For an eye-opener, examine closely how some emergency rooms and in-patient psychiatric facilities deal with seriously mentally ill consumers.  Restraints, restraints, restraints appears to be the treatment of choice, or perhaps the treatment that can be delivered by tired, frustrated, perhaps burned out staff.  It appears in the age of technological advances and concerns about money in health care (even

Medicaid will shift to values-based reimbursement), have resulted in a work environment NOT AT ALL conducive to good mental health.  Personally, I am in favor of outcomes-based reimbursement so long as the designated outcomes are set by informed, experienced clinicians and NOT some government bureaucrat who may never have had professional experience sitting with a client or patient. In such a hostile environment, even clinical supervision (if existing) has become a review of utilization and case audit discrepancies rather than helpful clinical  inputs and emotional maintenance activities.  So, what is the helper who remains in such an environment to do?  The American Psychological Association has presented some sound advice on this matter.  Under the heading of “Research-based strategies for better balance” here is what the association recommends for helper self-care.

  1. Practice Mindfulness on a Regular Basis – Even the most critical meta-analyses have documented beneficial effects of mindfulness, meditation, and yoga on stress, anxiety, depression, physical pain, and emotion regulation (i.e., addictions). Some support exists for improved sleep quality and even greater happiness. Check in with yourself during the day and take a  brief mindfulness break with or without your client/patient. Practice regularly on your own for the best results. Some studies have documented that regular mindfulness practices improved executive brain functioning, reduce limbic power, and buffers stress reactivity.
  2. Reframe, reframe, reframe – What are the pay-offs from your work?  Pay more attention to positive in the workplace than to negatives. Even neutral (or even better, positive) reappraisal may be helpful. It is a good idea to take a brief mental break to note what good things have happened at work. What is your emotional status at the time of the check-in?
  3. Seek support from positive psychology – Strive to be in charge of you emotions. Positive emotional experiences support resilience, self-esteem, satisfaction and even gratitude. Practice simple gratitude (another mindfulness tool) about what you do have rather than what you want.
  4. Use social and emotional support – Connect emotionally with your colleagues, and use the time for mutual support rather than moaning and groaning about “how bad” things are at work. Remember in eye-to-eye/face-to-face communications your mirror neurons are always “on;” so be aware of the impact your facial, behavioral and verbal emotions have on co-workers.  Keep it positive and supportive!
  5. Use supervision well – If you have acceptable supervisions at work, be aware that the pressure on supervisory staff is even more serious. An effective supervisor should know more than you know, and a good supervisors should be able to support you keeping things in balance. If you do not have adequate supervision at work, consider purchasing better supervision on your own – even if it is once a month it can be helpful.
  6. Move your body and get outside if possible – Mindful movement is an under-utilized mindfulness ractice in health care settings. Yoga stretches, exercise, qi gong, and tai chi movements can be very helpful in transforming your negative energy into positive energy. If possible enjoy nature as much as possible WHERE you work. Get some fresh air and sunlight into your body.
  7. Use more self-compassion – Self-compassion is another under-utilized mindfulness practice in health care systems. Life is made up of suffering, joy/happiness, and neutrality/boredom. When you suffer, practice self-compassion; when you are happy, practice gratitude; and, when you are bored, wait for impermanence to change everything. Then start allover again.  Self-compassion will assist you in showing compassion for the suffering people you are helping, rather than viewing them as part of your work problem. This is simply projection at it’s worst.
  8. Practice spirituality or religion – If you are involved deeply here, these practices may be highly effective in helping you cope better with work and other demands, and be more fulfilled in life.
  9. Lastly, reflect on personal meaning – Reflect on your personal meaning in life and how work makes up part of that aspect of yourself. The rewards you obtain from helping others may be greater than you think, so long as you are not totally stressed out doing it. Take time to be with your personal meaningfulness.

Refer to Weir, K. (July/August, 2016). Monitor on Psychology.Washington, DC: The American Psychological Association, 42-46.  Go to this blog (Mindfulhappiness.org) to review other posts on self-care, self-compassion, etc. Note: Some items noted here come from my blog not the APA article.

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By Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, VermontChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

CLICK HERE  or any image below to Order 

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Filed Under: Emotional Regulation, Featured, Happiness, Meditation, MIndfulness, MIndfulness Activities, Mindfulness Training, Practices Tagged With: EMOTIONAL BALANCE, MINDFUL HAPPINESS, MINDFULNESS TRAINING, PROFESSIONALS EXERCISE

April 12, 2015 By Admin

Mindfulness Training

Mindfulness-Based Emotion Regulation

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The following emotional regulation practices (also called emotional balance skills) have been supported by over 2500 years of mindfulness training and current psychological research on human emotions.  These practices/skills are to be practiced before they are needed, and directly applied when they are needed.  Here is the list.

1) Practice noticing and expanding the gap (time/space/energy) between internal emotional impulse and external behavioral activation.

2) Focus on calm, slow, deep breathing when overly aroused emotionally.

3) Be mindfully aware of what (people, places, things, memories, etc.) causes your emotional dysregulation, and experiment with ways to alter your reactions to such triggers.  Note that these conditions are impermanent – they arise and that fall away.

4) Maintain a personal journal about regrettable emotional reactions and behaviors.  When things improve, also write about that in the journal.

5) In the vipassana tradition, work on recognizing (acute awareness) the initial arising of an emotional reactions in your body (sensations), and experiment with ways to alter or stop the parade of madness.

6) Use compassion to become aware of the other person’s increasing emotional suffering, and act accordingly to reduce it.

7) Use the proprioception of facial nerves to alter emotion in your brain by smiling at fear and anger in you.  If the fear is something serious, do what you need to protect yourself.

8) Practice interception skills by becoming more and more aware of sensations in your body that signal emotional reactivity and dysregulation. Take advantage of this early warning system to change your reaction to a more productive response.

9) When you fail to control emotional reactions, do your best to shorten the behavior and verbal activation period.  Apologize quickly and sincerely.

10) Understand the cognitive-behavioral model so you can use such information to improve the moment and your reaction.

11) Practice labelling your emotional content via thoughts, words and actions so you may be able to extend cognitive (pre-frontal) control over reactivity.

12) Increase your desire to be free from emotional suffering, which anger and other afflictive emotions simply increase.

13) Read about the Four Noble Truths, and practice daily meditation, yoga, or exercise to be in touch with your brain, mind, and body.

14) Do not willingly invite anger or emotional reactivity into your human space.  Find a more productive alternative to practice.

15) Do the 4-Ds: drink water, distract, do something different, and delay your response (thoughts, words, actions).

16) Investigate themes in your emotional reactivity.  Isolate the BIG ones, and get help to transform them and your reactions.

17) When experiencing afflictive emotional states, practice opposite action (DBT skill). Try your best to do something in the opposite direction.

18) When feeling emotionally hurt or angry, do your best to LET GO of your hurt ego and self-cherishing and apply a practice or skill immediately.

19) When feeling sorry for yourself or angry about something that is impermanent, practice gratitude review. Thinks of things you have gratitude about.  Really concentrate on them.

20) Follow the wise advice of Thich Nhat Hanh, Chogyam Trungpa, and Pema Chodron by holding your anger as if it was a newborn baby.  Since it is part of your experience, allow your mind to transform it into something that needs to be taken care of with loving kindness and unconditional love.  Know you are suffering!  Be kind to yourself and your emotional reaction.  Do not act on it.

21) Practice loving kindness meditation for yourself and others on a regular basis.

22) If you are very skilled, practice smiling at your fears and inhaling the pain and suffering from others as you exhale your own loving kindness to others.

For more information refer to The 14th Dalai Lama (Tenzin Gyatso) and Ekman, P. (2008). Emotional Awareness: Overcoming the Obstacles to Psychological Balance and Compassion. New York: MacMillan Audio Books, CD 6.  See also Chodron, P. (2010). Smile at Fear: A Retreat with Pema Chodron. Boston: Shambhala Audio, CDs.

By Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, VermontChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness

CLICK HERE to Order!

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Filed Under: Breathing, Featured, MIndfulness, MIndfulness Activities, Training Tagged With: DR ANTHONY QUINTILIANI, EMOTIONAL BALANCE, EMOTIONAL REGULATION, MINDFUL HAPPINESS, MINDFULNESS TRAINING

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