Therapy makes me feel worse

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SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.
Also visit the online treatment locator.

SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.

The service is open 24/7, 365 days a year.

English and Spanish are available if you select the option to speak with a national representative. Currently, the 435748 (HELP4U) text messaging service is only available in English.

In 2020, the Helpline received 833,598 calls. This is a 27 percent increase from 2019, when the Helpline received a total of 656,953 calls for the year.

The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.

The service is confidential. We will not ask you for any personal information. We may ask for your zip code or other pertinent geographic information in order to track calls being routed to other offices or to accurately identify the local resources appropriate to your needs.

No, we do not provide counseling. Trained information specialists answer calls, transfer callers to state services or other appropriate intake centers in their states, and connect them with local assistance and support.

Suggested Resources
What Is Substance Abuse Treatment? A Booklet for Families
Created for family members of people with alcohol abuse or drug abuse problems. Answers questions about substance abuse, its symptoms, different types of treatment, and recovery. Addresses concerns of children of parents with substance use/abuse problems.
It's Not Your Fault (NACoA) (PDF | 12 KB)
Assures teens with parents who abuse alcohol or drugs that, "It's not your fault!" and that they are not alone. Encourages teens to seek emotional support from other adults, school counselors, and youth support groups such as Alateen, and provides a resource list.

After an Attempt: A Guide for Taking Care of Your Family Member After Treatment in the Emergency Department
Aids family members in coping with the aftermath of a relative's suicide attempt. Describes the emergency department treatment process, lists questions to ask about follow-up treatment, and describes how to reduce risk and ensure safety at home.
Family Therapy Can Help: For People in Recovery From Mental Illness or Addiction
Explores the role of family therapy in recovery from mental illness or substance abuse. Explains how family therapy sessions are run and who conducts them, describes a typical session, and provides information on its effectiveness in recovery.
For additional resources, please visit the SAMHSA Store.

Last Updated: 08/30/2022

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Why we wind ourselves up and how to stop doing it

October 7, 2021 A life

If known methods of coping with intrusive thoughts do not help, try metacognitive therapy.

Pia Callesen

Psychotherapist, specialist in metacognitive therapy.

If you're the kind of person who constantly overthinks himself, you know what it's like. The same problem constantly reminds me of itself. A work dilemma or the question of why you suddenly got a prick in your side this morning - it can be anything, but you can't stop thinking about it. Thoughts swirl in my head, but the solution still does not come. Fortunately, you can get rid of such obsessive thoughts. You just need to understand how they work first. nine0003

Why constant thinking about a problem is bad

Obsession makes us endlessly look for a solution, but surprisingly does not prompt us to act. Constant thinking about the problem only further confuses thoughts and slows down development.

Overworking yourself is a path that can lead to insomnia, trouble concentrating, and loss of energy. Undermined health creates a new cycle of reflection - and now you are already in a vicious circle from which you cannot get out. In especially serious cases, this process can result in chronic anxiety and depression. nine0003

In order to prevent a sad outcome of events, it is necessary to fight the waves of obsession in a timely manner. But first, let's look at common methods that should not be used.

Strategies to deal with obsession do not work

When endless thoughts become unbearable, it is natural to look for any opportunity to calm down and recover. But some methods not only do not work, but also lead to even more winding up of oneself and the situation.

Troubleshooting

There is nothing wrong with him if it is important for you to control the situation. However, this strategy can easily backfire on you.

Take worries about health. If, in the hope of calming down, you begin to look for signs of illness in yourself and loved ones with an addiction, this will lead to even more dangerous thoughts.

This method will not work socially either. Let's say you fanatically monitor your reputation and what others think of you. As a result, you will appear distant and strange, and you will definitely not be able to just be yourself and enjoy someone else's company. nine0003

Self-consolation

The cycle of thoughts often leads to the fact that a person begins to seek solace from loved ones or tries to calm down on his own, having received answers to his questions. This seemingly reasonable strategy does not always work.

You must have searched the Internet for topics of interest to you at least once during one of the periods of obsession. And you must admit that the information found not only does not help to relax, but also makes you wind yourself up with even greater zeal. This is especially true for health. Simple symptoms are associated with the most terrible diseases, and you stop sleeping at night. Thanks Google! nine0003

Too much planning

Smart planning is great. A personal diary helps increase productivity and keep everything in one place. But some go even further and plan their entire lives down to the smallest detail. And here the problems begin.

While you are making plans, you may want to anticipate all possible outcomes of events and factors that could hypothetically interfere with your plan. A cycle of looking for problems starts - you start to wind yourself up because of something that has not yet happened and may never happen. nine0003

Also, if things suddenly start going wrong, it can be alarming. Therefore, planning is certainly worth it, but only in moderation.

How to stop winding yourself up

Many people believe that it is impossible to control your thoughts, because they suddenly appear in your head and instantly attract our attention. And the transformation of these thoughts into obsession all the more cannot be stopped.

If you think the same, catch the good news: you can live without constant worries and winding up. Obsession is not an inborn trait that cannot be eliminated. nine0003

The creator of metacognitive therapy, Adrian Wells, found that self-winding is a learned strategy that we choose ourselves, consciously or subconsciously. This is not part of the personality, but a habit that can be worked on.

The same metacognitive therapy will help to cope with obsessive thoughts. It will teach you to choose thoughts to focus on, no matter what feelings they cause. Here are a few methods you can try.

Identify your triggers and stop paying attention to them

Scientists have proven that the human brain generates thousands of individual thoughts, associations and memories every day. Most of them have no special value - they appear and disappear. Others, on the contrary, attract us - in metacognitive therapy they are called "trigger thoughts." Attention to them can cause a real flurry of feelings, associations and even reactions of our body.

Not all thought triggers are bad. It could be the satisfaction of a cool new project at work, the joy of meeting up with an old friend, or the anticipation of a vacation that's just around the corner. nine0003

But we are interested in other thoughts — those that provoke a chain of experiences beginning with the eternal “What if…”. What if I make a mistake? What if others don't like me? What if I get seriously ill?

A typical loop begins with the questions "What?", "Why?" And How?". What is wrong with me? Why do I feel this way? How can I improve my condition?

These thoughts can be compared to trains at the station. They constantly leave in different directions, and each symbolizes one thought or a chain of them. Suppose a train arrives at the station with the thought “What if no one likes me in a new company?”. You can get on this train, and soon new cars will be added to it - “I won’t be able to survive if they don’t like me” and “Well, then you shouldn’t go to meet them.” nine0003

But there is another way - to skip this train and not pay any attention to it. When you don't energize your thoughts, they either stay on the platform in the hope that you will pay attention to them later, or they pass by.

It's not about the trigger thoughts that pop into your mind, or even about the number of them. Problems arise only when you cling to them and begin to actively analyze them, adding new "cars". Gradually, the train becomes longer and longer, and it becomes more and more difficult to get off it. nine0003

The same thing happens with your condition - you become obsessed and feel worse and worse. Choose the right thoughts and your train will always be light and fast.

Control your reaction

If you obsess over most of your thoughts, you are on the way to a very unhealthy pattern of behavior. By clinging to each thought over and over again, you may not even notice when it starts to happen automatically.

It's true, thought triggers are automatic in nature - you have no effect on the "trains" that come to your station. However, you have the choice of which train to take and which to skip. nine0003

Let's take another example. Imagine that your thoughts are incoming calls on your phone. Let it be a phone that cannot be turned off, which means that you do not control who calls you and when. But you can decide whether you should pick up the phone or leave the phone ringing and do other things.

Yes, a loud ringing phone will surely distract your attention. But what happens if you just don't answer? Someday he will stop calling. This is the main principle of metacognitive therapy - although we cannot control trigger thoughts, only we decide whether to pay attention to them or not. nine0003

Thoughts are actually quite ephemeral. Think about how many thoughts that visited you yesterday, you can remember today. It is unlikely that you will name at least ten. Thoughts come and go, you just need to learn how to work with them.

Postpone worries for later

Try to take time for your reflections. For example, set an alarm for 19:30 and 20:00 - now you have half an hour to not restrain yourself and worry as much as you want.

Gradually it will become a habit - every time in the middle of the day you have anxious thoughts about health or whether a new colleague likes you or not, you can say to yourself: "I'll deal with this later" and postpone the worries until you need to time. The main thing is not to do this an hour or two before bedtime, especially if you suffer from insomnia. nine0003

Postponing experiences for later has a positive effect in several directions at once. First, it shatters the idea that feelings and thoughts cannot be controlled. You already do this every day, even though you don't know it.

Think about the last time you saw scary news on the Internet on your way to work. At first she worries you, and then you remember that you need to hurry, and again turn your attention to your affairs. This is the control of your thoughts. nine0003

The second, no less important function of this method is the realization of the very ephemerality and variability of thoughts. Usually, thoughts that seem vital to us in the morning are practically forgotten by the evening. Some of them you will never remember at all.

And finally, when you put off worrying for later, you reduce the total time of worry. You feel in control of the situation and you stop giving in to anxiety so easily.

Train your attention

If you constantly overthink yourself, you may become afraid of trigger thoughts. This is not surprising - they are bad for the emotional state, and it would be much better if they could be easily avoided. In reality, this is completely unproductive - without proper processing, these thoughts will accumulate, and you will feel even worse.

Try to set aside your trigger thoughts daily until evening time for reflection. It's like learning to ride a bike - you won't succeed right away, and you will often fall. But with regular practice, you will understand how this process works, and it will become automatic for you. nine0003

Metacognitive Therapy offers a simple 10-minute exercise to switch and train attention. Focus on three or more ambient sounds. For example, on the busy movement of cars outside the window, the singing of birds, the radio working in the distance, or the cheerful cries of children in the yard. It is best to choose sounds of different range and volume so that some of them are closer and louder, while others are further and quieter.

Now try to focus on each of the sounds for 10 seconds and let the others blend into the background. Use a timer for accuracy. Repeat the exercise after two minutes. But this time focus on each sound for 2-3 seconds. With practice, you can add one of your trigger thoughts to the list of sounds. Quickly focus on it, and then shift the focus back to something completely different. nine0003

There is another suitable exercise called "Window". Write one or two of your trigger thoughts on the glass with a washable marker. For example, “What if I fail my driving test?” or “What if she thinks I’m boring?” Then try to look at the landscape outside the window as usual, without paying attention to the words written on the glass. Switch between words and scenery, holding your attention for a few seconds. This exercise will help you realize how easy it is to move trigger thoughts into the background. nine0003

What to do if you don't want to get rid of obsession

So far, we have discussed winding only from the point of view of a problem that interferes with life. However, you can look at it quite differently.

Perhaps you think that constant thinking and experiencing has its merits. If this is the case, it will be especially difficult for you to get rid of the obsession, because it has already become a defense mechanism that helps you through life. Rolling up is your comfort and safety zone, a familiar strategy you turn to when times are tough. nine0003

This attachment to thoughts and experiences shows that you have a lot of false assumptions about the benefits of obsession. Here, for example, is one of the most common myths: “If I worry about what might go wrong, I better prepare for it.” Or another example: "If I analyze all my mistakes in detail and emotionally, I will not make them next time." These thoughts make it difficult to let go of the situation and stop winding yourself up.

Ask yourself: Has your experience ever helped you make the right decision or take control of a situation? Most people answer it rather vaguely. nine0003

On the one hand, obsession gives a sense of security. But if you look at the situation in a different way, winding up becomes the main cause of tension, anxiety and anxiety. If you're not sure whether to get rid of the obsession, make a list of pros and cons. You will understand a lot.

If you want to leave your habit of thinking, but "smooth out" its negative emotional effect a little, make time for your experiences. But before you make a final decision, try to live without winding yourself up. nine0003

Let this be a little experiment. Watch what happens if you give up constant thinking. If you succeed, you will feel great relief, as if a stone has finally been lifted from your shoulders. Well, in case everything does not go the way you wanted, you can always return to the old strategies.

“The trauma of rejection: how I got rid of it”

135 132

Know yourselfRelationship crisis

A chronic feeling of rejection accompanied me for many years. I could not even think that it and love almost always go together. Inside me, these feelings were changing at such a speed that it seemed that I was about to be thrown overboard. Rejection found me in a variety of life situations, and the only thing left was to flee from myself, my emotions. What was it expressed in? nine0003

When I was a child, my mother willingly shared her life experience and notorious female wisdom with me. By her example, she showed how to live, and I absorbed the example with every cell of my skin. I had to be wise, understanding, not pay attention to problems, turn a blind eye to the unpleasant truth, pretend that everything is in order.

It doesn't matter what's inside you seems to be torn to pieces. After all, if you show it, voice your feelings, a terrible thing can happen: a man can leave you, and then you will be left alone. nine0003

This approach was found in all of the mother's stories. Of course, she did not use such language, because it is shameful and painful to admit the fear of being abandoned or even to admit the thought that you might be abandoned.

Why? Because this rejection in the mother's life already happened some time ago in childhood

This is a paradox of the psyche - we are afraid of what has already happened. Therefore, psychic defense mechanisms try to keep us from re-experiencing pain. In order for the inner monsters not to break out, colossal energy, maximum tension is required. nine0003

To minimize the pain, my mother unconsciously shared it with me through her stories, and she experienced temporary relief. At the same time, of course, she did not realize that she was writing the script for the life of a child.

What about me? I adopted my mother's attitude and was also a "wise woman." Obvious facts pointing to her husband's infidelity, I did not seem to notice. Why? To avoid the terrible feeling of being abandoned. Denial allows you to deceive yourself, providing a stay in the world of illusions. The truth is so heavy that it seems impossible to bear it. nine0003

Recognition is what really makes you take a deep breath. It was the first thing I started working on myself. She admitted that it really hurts me, that this pain is inside me and it needs a place.

This step was hard for me. It's like stepping into cold water - you have to want it fiercely, gather all your will into a fist and dive in

Terrible, unpleasant. Water from all sides burns an unprepared body. But when the crisis of the first step is overcome, amazing things begin to happen: awareness of oneself in a new space. nine0003

This, too, is a painful process, and one must also go through it. Crisis and temporary discomfort make development possible, and this is the positive side of overcoming.

What can be done at this stage? Allow yourself to be with this experience, to feel it. You can describe in detail your feelings on paper - in which part of the body this pain lives, how it looks, what size and color, how old it is. You can draw her and get to know her.

Detailing transforms our internal state from something incomprehensible into something quite concrete, having certain boundaries - size, shape, name. This technique allows not to displace the pain, not to hide it, but on the contrary, to make it visible and understandable, to bring it out. And with this external image it is already possible to work further. nine0003

The method of free association has been very effective for me. Exercise is best done in silence and a relaxed state. Take a sheet of paper and a pen, formulate your painful topic.

In my case, "I feel lonely." Write down 16 associations to your key phrase in a column. Associations must be expressed in one word and may be in the form of a noun, adjective or verb.

Write immediately, spontaneously, whatever comes to mind. It is superfluous to think, since it is spontaneity that will be the answer of the unconscious. Even if you think the thought is shameful, immoral, or something else, write it. Don't rate. Words cannot be repeated, they must be different. nine0003

Pair the 16 received interpretations - the first with the second, the third with the fourth. This will give you 8 pairs. For each pair, write down one more image, which you also group into twos. For each pair, select one more combining value.

And so on until we get one single word - one deep thought related to your problem

What is it about for you? What thoughts, images, feelings arise? Perhaps you have already experienced similar conditions? Consider when and with whom? Under what circumstances? nine0003

Reflecting on this, you release the deep experience, make it understandable, clothe it in concrete forms. It may take several weeks or months to understand the meaning of the keyword.

It is not worth forcing the process. Just stay with this thought, and after a while the subconscious mind will issue a solution. This will definitely happen, because our psyche is designed in such a way that through naming and pronunciation, the healing mechanism is launched.

When the associations are brought to the surface, you can proceed to the next step - creating a new idea of yourself

Think about how you would like to live if you did not have such a problem? Just imagine, allow yourself to imagine it. Feel your feelings in a new type. Remember what thoughts, feelings, images, sensations in the body arise at this moment.

By such actions you write down a new positive experience, a different reality into your subconscious. This is the process of healing - bringing out the hidden emotions, recognizing their existence. Allowing yourself a new life scenario, you create an internal resource. nine0003

When inner integrity sets in, you are no longer tormented by previously incomprehensible emotions and experiences, because you have already lived them, accepted and transformed them. And this gives a huge resource for achieving any result, including in order to be happy.

About the author

Elena Lyunina — analytical psychologist.

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