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Tuesday, August 22, 2017
COPING WITH STRONG, SUDDEN EMOTIONS: An excerpt from MASTERING THE ADDICTED BRAIN by Walter Ling, MD
 
Walter Ling MD

As most drug and alcohol addicts eventually realize, good intentions alone aren’t enough to break destructive habits. However, addiction can be managed once its true nature is understood. Mastering the Addicted Brain: Building a Sane and Meaningful Life to Stay Clean is a simple yet profound guidebook that takes readers step-by-step through the process of building a life after addiction by adopting new behaviors that create lasting change. An internationally renowned psychiatrist, neurologist, and addiction specialist, author Dr. Walter Ling has worked with thousands of addicts, their loved ones, and fellow clinicians. His no-nonsense, no-judgment approach, which he calls the “neuroscience of common sense,” advocates holistic methods to prevent relapse and establish new patterns to create a sustainable, meaningful life.

We hope you’ll find this excerpt helpful as Dr. Ling offers advice on what to do when strong emotions crop up for those in recovery. 

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Meditation and journaling are ideal for calm moments of reflection. However, what do you do in heated moments? Sometimes, strong emotions arise suddenly and we don’t know how to handle them. We can get swept up in our emotions and react and behave inappropriately. Or we may deny our emotions entirely; try to suppress an emotion we fear, such as anger; or mislabel our feelings. For example, we may say we are “a little upset” when in fact we are very angry or depressed. All these things can prevent us from understanding and dealing appropriately with our emotions. Moreover, our emotions often manifest themselves through physical symptoms and outward expressions. You might experience a stomachache or a headache when you are nervous, bite your nails when you are stressed, or yell when you are angry. It is important to recognize these outward signs of emotion so they do not continue to build up inside. 

On the other hand, physical symptoms can also be the cause of your feelings. You may feel down in the dumps because of a genuine physiological depression, because of the fatigue that persists beyond the immediate withdrawal (known as protracted abstinence syndrome), or simply because you’re hungry. Clinical depression may require specific medical management, but sometimes you just need to eat better. In other words, so that we react in appropriate ways, and avoid harming others, we must correctly identify the cause of our emotions while also learning to identify and face our true feelings as they arise.

The problem is that, when strong emotions arise suddenly, we tend to react too quickly. The connections between our emotional brain and our survival brain are fast and autonomous. They usually happen before we’ve had time to think. This is not surprising since we acquired our survival and emotional brains long before we got our slow-and-deliberate thinking brain. Our emotional-survival brain unit is our first responder to any crisis. Any sudden emotion will cause it to jump into action before we have time to take in the whole picture, which is how we get into trouble. To avoid that, we must practice slowing down in the moment so we can engage our thinking, cortical brain before we act. We can do this with the following exercise, which I learned from Dr. Rudolph Tanzi, Professor of Neurology at Harvard University Medical School.

STOP and HALT: Understanding Our Vulnerability and Exercising Control

STOP is an acronym that stands for “Stop, Take a few deep breaths, Observe, and Proceed.”

When you notice a strong physical or emotional reaction, practice these four steps:

  1. Stop whatever you are doing. Restrain the urge to act immediately on whatever you are feeling. Say to yourself, “Hold on a minute, wait.”

  2. Take three deep breaths to calm yourself down, and smile — I mean really smile. This interrupts the emotion itself and releases the bonding hormone that makes people like you.

  3. Observe what is going on inside you and around you: What in this situation is affecting you? How are you affecting those around you?

  4. Proceed with consideration of others. That is, make sure you act in ways that don’t hurt or harm others.

When we get upset and “lose control of our emotions,” our emotional brain calls on our reptilian brain, its old partner, which is devoted to our survival. If we are upset and feel threatened, this part of our brain kicks in to protect us, usually by urging us to fight (to end the threat) or flee (to escape it). But in many situations, these reactions are overreactions. They are inappropriate to what’s going on and hurtful to others. We think we’re protecting ourselves, but we are only making things worse.

By learning to STOP when we feel emotions taking over, we give ourselves time to evaluate what’s really going on and act appropriately.

We are most likely to act without thinking, and fail to engage our thinking brain, when we are run-down, exhausted, or feeling bummed out. Counselors use the acronym HALT to remind people in recovery that they are especially vulnerable to relapse in four situations: when they feel Hungry, Angry, Lonely, or Tired. These feelings keep us from engaging our thinking brain. When we feel our emotions getting the best of us, we should use STOP to give ourselves a chance to see what is really going on and engage our uniquely human cortical, thinking brain.

In the same way that our emotional brain is linked to our physical, survival-oriented brain, so our emotional brain is linked to our thinking brain. Yet as I mention above, the connection between our feeling brain and our survival brain has been around much longer. It is powerful and easily activated, and communication is fast and automatic, mostly out of our consciousness. Our thinking brain, which exercises control over our unconscious emotional-survival brain, arrived on the scene much later. It is also powerful, but it needs to be actively engaged. It operates in our consciousness. Our cortical brain is what makes us uniquely human, since it provides control over our largely subconscious emotional and survival brains, but the bad news is that it is slower to respond, and we have to actively engage it to make it work.

The good news is that this effort has big payoffs. By engaging our cortical brain, we can change our thinking, or consider a different point of view, and this helps us change how we feel. Since feelings lead to actions, right thinking leads to right feelings, which lead to right actions.

For example, we may feel sad, mad, or worried, and we believe we can’t control or change these feelings. Perhaps we blame others for causing us to feel this way, or we blame ourselves for our weakness. By engaging our thinking brain, we can see that these feelings have nothing to do with weakness and that they aren’t being caused by others, and by changing our perspective, we can start to feel different. For instance, perhaps a recovering person says, “All my friends have abandoned me. They never call. I might as well do drugs.” By being mindful of HALT and using STOP, the person might change their thinking to: “I feel lonely. Drugs won’t fix that. I need to call my friends.” Changing our thinking can help to diminish negative feelings and lead to better solutions. In another example, perhaps someone says, “I am so angry she doesn’t agree with me that I feel like using drugs.” They could revise this to: “It is all right for her to disagree with me. I don’t need to be angry, and using drugs won’t make it any better.”

When we think differently, we act differently, and when we act differently, things turn out differently, usually for the better — and that helps us cope with bad feelings and keeps them from driving us back to using drugs. It is important to realize that we do have control over our emotions. We can change the way we feel by changing the way we think.

You might ask, if we have so much power over how we feel and how we act, how come we still get into so much trouble? The answer is that we don’t think as much as we think we do. It takes conscious effort to avoid our automatic survival responses and to engage our thinking brain. That is why we need to keep reminding ourselves of HALT and practicing STOP. That is also why journaling and practicing mindfulness are so helpful, particularly for those in recovery. They create a calm space for our thinking brain to understand what’s going on and execute the right command. They slow down our emotions so we can increase our self-awareness. Putting the thinking brain in charge is hard enough under normal circumstances, and it’s extraordinarily difficult when we are distracted by the powerful HALT emotions. We just have to keep practicing until we make self-awareness a habit.

# # #

Walter Ling MD

Walter Ling, MD, author of Mastering the Addicted Brain, is Professor Emeritus of Psychiatry and the founding director of the Integrated Substance Abuse Programs (ISAP) at the University of California, Los Angeles. With board certifications in neurology and psychiatry, Ling has conducted clinical trials of psychiatric medications, acted as a consultant to the World Health Organization, and run a private practice listed in the “Best Doctors in America” directory.

Excerpted from the book Mastering the Addicted Brain. Copyright © 2017 by Walter Ling, MD.



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