8

Help People to Exhale Emotionally and Mentally

Sometimes the most important thing in a whole day is the rest we take between two deep breaths.

—ETTY HILLESUM, IN HER POSTHUMOUSLY PUBLISHED DIARY, ETTY

“Shh! Listen!” I said firmly to Alex, the stressed-out forty-something executive who’d been venting nonstop for 15 minutes about all the things he had to do and all the deadlines facing him and on and on.

He was startled, “Listen to what?”

“Listen to the quiet,” I replied.

“The what?” he responded.

“To the quiet,” I continued. “It’s located between the noise in your head and the noise in your life, and right now it’s screaming out to me and you to be heard.”

“Huh?” he said, still confused.

“Close your eyes,” I instructed, “and breathe slowly through your nose and in a little while you’ll begin to hear it.”

After several moments Alex began to tear up and then cry. This went on for five minutes, after which he slowly opened his bloodshot eyes. He had a smile on his face.

“What was that about?” I asked.

Alex chuckled wryly, “That is what I’ve been looking for all my life. And everything … and I mean everything … I do to get me there, takes me further away. That’s a lot to think about.”

He did go on to think about it—about the peace he’d felt in that moment, and what he needed to do to find more of it in his life. That’s because he got the chance to exhale rather than merely vent.

image MOVING A PERSON AWAY FROM DISTRESS

Stress isn’t bad. It causes us to focus, become determined, and test our mettle. It’s when stress crosses over into distress that we lose sight of our important long-term goals and instead look for what will relieve us now. At that point, we’re too busy looking for an emergency exit from our pain to be either rational or reachable.

Earlier, I talked about making people “feel felt.” That’s easier said than done, however, if you’re dealing with people in distress. In these situations, the first step is to move people out of this state and into a state where their brains are capable of listening to you.

If you’re trying to reach people in a state of distress, adding to their stress can be disastrous. This is the mistake that makes many hostage situations turn fatal—and it can also destroy a business deal or a relationship. Take the wrong step, and people on the brink of distress (or already over the edge) will respond in one of these ways:

image   Shooting from the hip (“Oh yeah! Well, then, take that!”—maybe along with a stapler or even a punch getting thrown). That’s the result of the amygdala hijack I talked about in Chapter 2, when the amygdala pulls the plug on the reasoning part of the brain and pushes the person to react in a hostile way.

image   Venting (“You don’t have a frickin clue about me”). You can’t reach a person who’s venting, because you wind up defending yourself or counterattacking.

image   Suppressing (“Nothing’s wrong,” through gritted teeth). A person who chooses this route will close you out rather than letting you in.

But there’s another option that people in distress can choose, if you show them the way: exhaling. Only exhaling enables people to experience and express their feelings—like draining a wound—in a way that doesn’t attack others or themselves. It’s the only response that relaxes stressed-out individuals and opens their minds to solutions from other people. That, in turn, offers an opportunity to resolve the source of the stress and prevent it from recurring.

When you give a distressed person breathing room—a place and a space to exhale—you don’t just get the situation back to normal. You actually improve on it. That’s because in addition to getting a person to calm down, you build a mental bridge between the person and yourself. And when you build that bridge, you can communicate across it.

Mr. Williams, a patient I encountered early in my career, had recently been diagnosed with lung cancer and had thrown out the last two psychiatric consultants who had tried to speak to him about his illness.

“You’re going to love this guy,” the oncology doctor told me sarcastically as we walked to his patient’s room. I peeked in Mr. Williams’s room and saw him sitting there steaming, seething, and ready to rip the head off of any shrink type who tried to talk to him about his illness. He wasn’t handling his disease all that well—who could blame him?—and he clearly needed some kind of psychological assistance. He just didn’t want any.

Envisioning him ripping me apart if I walked into his room and introduced myself as a psychiatrist, I came up with a different solution. I immediately went to Westwood Stationers and ordered a different name tag, replacing the one that said, “Mark Goulston, M.D., Psychiatry” with one that read, “Mark Goulston, M.D., Oncology.” None of that soft-sounding specialty for me: I was going to act like a “real” doctor. I swear, when I put on that new name tag I even walked taller.

I entered Mr. Williams’s room, trying to act like an oncologist instead of a psychiatrist, and said: “Hello, Mr. Williams, I’m Dr. Goulston, one of the new doctors on the oncology team.” Then I began asking him questions about how he was doing and what his concerns were. However, I could see him sniffing as if he smelled a rat. I continued to talk, but it was clear he was on to me.

At one point our eyes locked and I knew he was going to tell me to get the hell out of the room. I realized that if I looked down or away I was lost, so instead, I continued to look into his eyes. As I did, I could see there was a lot going on underneath his baleful gaze. I don’t know what possessed me, but I fired at him: “How bad does it get in there?”

He took my challenge head-on and fired back: “You don’t want to know!”

I was temporarily at a loss for words, but then I somehow found these: “You’re probably right—I probably don’t want to know. But unless someone other than you knows and knows soon, you’re going to go crazy!”

Surprised by my own audacity, especially with such a seriously ill man, I kept looking into his eyes, not knowing what he would say. He stared back at me with great intensity and then his face suddenly broke into a wide grin and he said: “Hey, I’m already there, pull up a chair.”

He started to talk about how angry and afraid he was, and as he did, he exhaled even more. As a result of our talks, he began cooperating with the medical staff. His doctors told me he even required less pain medication. And I went from being the enemy to being a person Mr. Williams actively sought out as a sounding board for his fears and feelings.

image GUIDING A PERSON TO EXHALE

When I first saw Mr. Williams, I didn’t need to ask if he was in distress and heading toward meltdown. Even without his chart, I would have known. It was written all over him in body language: angry expression, rigid shoulders, crossed arms that said “get lost.”

If you spot the same body language in someone you’re trying to reach, don’t try to get through with facts or reason. It won’t work, because you’re not going to get anywhere until the person exhales. Understand that you can’t make the person do this—but you can make him or her want to do it.

Let’s say, for instance, that you’re confronting Dean, your boss, who’s glaring at you across his desk with crossed arms and a thunderous brow. One of the best ways to get Dean to exhale is to get him to uncross his arms—both the real ones and the ones in his mind. Keep this in mind: Just as the hip bone’s connected to the thigh bone, the crossed arms in a person’s mind are connected to physically crossed arms. Get a person to uncross his arms physically, and you can get him to uncross his arms mentally.

To do this, ask Dean a question that creates tremendous emotion or passion in him. (That’s why I goaded Mr. Williams, which seems counterintuitive with a very sick patient.) Words won’t be sufficient to communicate what he feels, and he’ll need to use his arms to emphasize what he says. That’s why you often see people using their arms and hands to make a point even when they’re talking on the phone.

When Dean uncrosses his arms and uses them to communicate, it will open a door in his mind. The problem is that when that door first opens, there’s no room (yet) for you to get through it, because of the barrage that’s coming out of the door at you. So here’s what you do:

1.   Give Dean plenty of time to express whatever he’s saying. When people vent, whine, or complain, they’re trying to prevent an amygdala hijack that could make them act out in some fight-or-flight way that could be far more destructive. Once they pick up speed, they don’t want to be interrupted. (It’s like finally having the opportunity to use the rest room after you’ve been stuck on the highway and not wanting to have to stop before you’ve relieved yourself!) The best thing to do when someone is venting, whining, or complaining is to avoid interrupting.

2.   Don’t take issue with anything Dean says, become defensive, or get into a debate.

3.   After he vents, you’ll both be exhausted. This is not to be confused with a relaxed state. The difference between exhausted and relaxed is that when you’re exhausted, you feel empty and tired and you’re not open to input. At this point, it may appear that it’s your turn to talk—but it’s not. Talking right now is the rookie mistake that most people make. If you start to talk now, Dean will close down because he’s too exhausted to listen.

Instead, pause after he’s unloaded on you, and then simply say, “Tell me more.” Doing this has several positive effects:

image   When it turns out you’re not going to get into a debate with Dean, it disarms him. There’s no need for him to fight you, if you don’t engage in a fight.

image   “Tell me more” shows that you were listening and heard what really bothered him. It also lowers his paranoia that you’re now going to come back at him for, in essence, dumping on you.

image   When you don’t take issue with Dean venting at you, he will finally begin to exhale. You’ll see it in his posture, in his face, and even in his breathing as he relaxes and lets go of his distress.

If you can allow Dean to exhale and then empathize with the upset he’s feeling, he’ll feel relieved, grateful to you, and in many cases willing to reciprocate. Why? Think back to the mirror neurons I talked about in Chapter 2. When you take a heavy burden off a person’s shoulders, the person often wants to mirror your action by doing something similar for you.

Sometimes you can help a person who’s venting to exhale by saying at some point, “Close your eyes, and just breathe.” (I used this approach with Alex.) This triggers what Herbert Benson, a pioneer in the field of mind/body medicine, described as the relaxation response—the same response you’re invoking if you practice meditation. In this physiological state, a person’s heart rate, metabolism, breathing rate, and brainwaves all slow—the exact opposite of the fight-or-flight response. This triggers a calming chemical cascade that allows the person to exhale and “listen to the quiet.” (I recommend this approach if you’re dealing with a child or teen who’s venting uncontrollably).

The biggest key to helping a person vent and then exhale, however, is to let it happen. Most people short circuit this process during the venting stage by becoming defensive (“I’m not the only one who’s to blame here”), trying to offer solutions (“Well, maybe you should look for another job if you hate yours so much”), or getting nervous and trying to make things better (“Okay, I know it’s been rough, but let’s forget about all this for a few hours and go out to lunch”). Do not make any of these mistakes, because, like draining an infected wound, the job of getting a person to exhale isn’t done until it’s done. When it is, you’ll earn your reward, in the form of a strong connection—one based on the powerful emotions of relief and gratitude—that you can use to get your own message across.

Here’s a closing word for parents … especially those of you with teenagers. I offer it because getting your teen to exhale can save the sanity of everyone in your house.

If you’ve raised teens, you know that they often seem like alien beings—and in a sense, that’s true. Compared to grown-ups, teens have a far stronger biological response to upsets and release more stress hormones. They also have different levels of the neurotransmitters dopamine and serotonin, making them more impulsive. Their neurons are still developing insulation and pruning excess connections—two processes that will eventually lead to mature thinking—and their decision-making circuits aren’t fully developed yet. As a result, they’re quick to move from stress into distress, they don’t make judgments well, they can’t communicate their feelings in a mature way, and they’re quick to blow up, get moody, or say, “I hate you.”

That explains them—but what about you? All of us make mistakes as parents—we’re too overbearing, too protective, too anxious, too much of a doormat—and those mistakes can make our kids, who are already wired to be impulsive and quick to distress, respond in crazy ways that we call defiance, oppositional behavior, or just “being a jerk.”

To see if this is happening in your household, give your sullen teenager a chance to tell you—and a chance to exhale. Wait until you’re going for a drive and your child is captive in the car (since kids hate unsolicited heart-to-heart talks, which always feel like a lecture) and then ask these questions:

image   “What’s the most frustrated you have ever felt with your mom/dad or me?”

image   “How bad was it for you?”

image   “What did it make you want to do?”

image   “What did you do?”

Then, if you get your child to answer these questions honestly, say (and mean it): “I’m sorry, I didn’t know it was so bad.”

Don’t be surprised if you see tears of relief when you let your child exhale in this way. Better yet, those tears may be followed by the first nonantagonistic, nonconfrontational talk the two of you have had in a very long time. That’s because exhaling will help your teen bring that strange, impulsive, moody brain under control—at least for a few blessed hours.

image  Usable Insight

Forget about music. If you want to soothe the savage beast, get the beast to exhale.

image  Action Step

If you’re trying to reach someone who’s suppressing his or her feelings, ask, “Have I ever made you feel that I don’t respect you?” or “Have I ever made you feel that you weren’t worth listening to?”

Be prepared for an emotional response to these questions, and don’t interrupt the person or get defensive. Let the person vent and exhale. At that point, positive emotions will fill the hole left behind by the negative ones.

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