The first rule of medicine is to “do no harm.” The same thing is good advice when you are going through emotionally difficult times. At any given moment, as people are struggling with difficult life circumstances, most people actually are giving it their best shot. Sometimes people collapse into complete passivity, but most of the time, human beings are doing the best they can to cope. However, doing your best doesn’t necessarily mean that what you’re doing is effective. People often feel overwhelmed or at least somewhat powerless when life gets really hard. A problem is that people often inadvertently do things during stressful times that make it worse.

A concept in psychology is self-regulation. Self-regulation involves actions that people make (often habitually or unconsciously) that have the immediate impact of reducing stress or tension, at least somewhat. Here are some very common examples. You are sitting watching TV, and after 15 minutes or so, your back feels stiff, so you shift your posture and immediately feel at least a bit more comfortable. Or how about the following examples? Going to the freezer for one more bowl of ice cream, or drinking an extra cup of coffee during a demanding day, or deciding “What the hell” and drinking a third can of beer.

All of this is so common and so natural. However, some forms of self-regulation feel good in the moment, but come back to haunt you. The message in this chapter is to become alert to those largely automatic forms of self-regulation that end up causing more problems down the line. In this chapter, we’ll look at common types of actions that people take that are high risk for increasing negative moods. Once recognized, you can then take steps to reduce or eliminate them.

I’d like to use a metaphor. If you burn yourself on your hand, and it’s a significant burn, one way of responding is to put a bandage on the wound. This may sound logical. The bandage can keep germs out and provide a buffer so that it will not hurt too much if you bump your hand into something. But what if you over-bandage the wound and keep it completely covered up for a month? Well, of course, when you remove the bandage, the burn has not fully healed. In fact, it may be worse. Wounds need protection from bacteria and additional injury, but at some point they need exposure to the air. Lots of distressing emotions are like this, too.

In Chapter 7 we spoke of excessive emotional control and how common it is for people, especially in Western culture, to be very reluctant to open up and share painful, deep, or very personal emotions. At the same time, most mental-health professionals agree that to some extent people need to open up and talk about difficult emotional experiences to facilitate emotional coping and healing. Psychologically gritting your teeth is often a short-term solution that leads to more difficult problems with coping.

Having said this, I must also strongly state that people vary tremendously regarding this issue of “opening up.” Some people are very private; it is not in their nature to openly share strong feelings with others. Many people feel quite uneasy about showing emotions, and this is primarily due to the influence of their past experiences. Lots of people feel embarrassed, ashamed, or too vulnerable to open up with others, even with people they love and trust.

It is, of course, important to be very discriminating in deciding whom to open up to. Some friends or family members may not be able to really listen. Some may be shaken if you express strong emotions (especially if you never have before); they have become accustomed to seeing you in a different light. Some may respond in a judgmental way, showing some form of criticism for the emotions you feel. Some will offer quick remedies, trying to get you over feeling bad as soon as possible. Some will want to rush in with advice about how to “fix” your life problems. Often people say, “I understand,” and although their intentions may be good, often they do not fully understand.

All of these responses may come from those who know you well and love you. But these kinds of responses rarely help, and often hurt. They usually drive emotions back underground.

If you have been prone to keeping a lot of feelings bottled up inside and it feels intuitively right to start opening up with a friend or loved one, it might be very helpful first to have a frank discussion with them. This might include acknowledging that you characteristically don’t get emotional or share more private feelings. However, life has been very difficult lately, and you want to be able to talk with them.

It is also generally helpful to express any reservations or fears that you have, before sharing your distressing emotions. Just stating this out loud can often reduce the anxiety you are feeling about opening up. For example …

These kinds of comments often make a significant difference in reducing distress about opening up. Often the other person will be quite understanding regarding these initial remarks, and will offer reassurances and support.

One of the single-most powerful human experiences is what is commonly referred to as validation. When a person expresses personal feelings, how the other person reacts is critically important. Most of the time when people share personal emotions, confiding in a friend or loved one, they really are not looking for advice about how to resolve their problems. Even if they directly say, “What should I do?” many times this is not actually a question; rather, it is an expression of their sense of powerlessness or exasperation. What they want and need is to truly be heard and understood. What often matters so much more than “advice” is to have the experience of having another human being really care about their suffering.

Validation is acceptance of the truth of another person’s distress. It is acknowledgment and belief. Unfortunately, many of us growing up did express strong feelings to our parents or to others only to have them trivialize our experience (“For God’s sakes … it’s not that big a deal”), criticize us (“You are too sensitive”), or even worse, to be oblivious and unconcerned.

These same experiences can certainly continue into adult life, as well. This once again underscores the need for you to choose wisely whom you will be open with. For many people, a benefit from going into psychotherapy is finding a safe place to be open.

People can experience a lack of genuine validation from others. But perhaps more insidious and damaging is when we do it to ourselves. This is a very common solution that backfires. The person who is overwhelmed with sadness may think to herself, “Don’t be so emotional! What’s wrong with me?!” The aim of such an internal comment might be to help her maintain her emotional composure. That’s the “solution” part. However the backfire is a double whammy: first, she is invalidating her authentic inner feeling, and second, she is scolding herself. She is being harsh toward herself for having an emotion.

This kind of internal “self-talk,” as we have seen, is a major factor increasing unnecessary pain.

How can you deal with this in a helpful way? The first step requires some introspection. You need to look inward to see what you are telling yourself during times when you feel frustrated, sad, nervous, etc. Most people who make a point to start noticing self-talk usually find it simple to spot these inner sources of criticism and self-invalidation. In Chapter 14, we will look more closely at a number of specific approaches designed to help you spot and stop negative self-talk.

Psychologist and researcher Dr. James Pennebaker has conducted extensive studies revealing that pent-up emotions contribute to both physical health problems (such as high blood pressure) and an increased incidence of anxiety, depression, and sleep disorders. Dr. Pennebaker’s breakthrough strategy can facilitate “opening up,” and involves what he calls therapeutic writing. Try the following:

Remarkably, many people who are otherwise cut off from inner feelings or find it hard to confide in others often find therapeutic writing to be a powerful way to access and experience inner, pent-up, or buried emotions.

Pennebaker (in numerous, ingenious studies) has demonstrated that this technique alone can have impressive results. Such outcomes include improved health, decreased blood pressure, an enhanced immune system, better sleep, and reduced emotional suffering.

Like other techniques we’ve explored in this book, therapeutic writing at first glance may seem simplistic. However, do not underestimate the power of this strategy. It’s a direct and effective approach that helps people acknowledge and come to terms with inner “necessary pain.”

Perhaps the most common reason people hold back their feelings (hold back from sharing with others and hold back from really even noticing their own inner feelings) has to do with shame.

At the heart of shame is a fear of rejection or abandonment. When little kids are criticized, scolded, or humiliated by others, it’s easy to see that face of shame … downcast eyes, bowed head. Across cultures, all children are taught to obey certain rules and social customs. One of the most potent and harmful ways to shape a child’s character is to shame them. Of course children must learn to be socialized and to behave. But shaming is something that goes beyond normal “shoulds” and “shouldn’ts.” It is a message that says, “There is something deeply wrong with you.” It is an attack on the basic worth of a child that conveys a powerful message, “Shape up or get out of my sight!”

Shame also gets internalized. People can feel deeply ashamed of themselves even when completely alone. Also, shame operates like an early warning signal. In those moments before shedding a tear or expressing some strong emotion, shame works like a stopper. The person automatically anticipates rejection or some other negative reaction from the person he is with. Shame gets activated and the person swallows his feelings.

Pat Conroy, in his popular novel The Prince of Tides, tells the story of an entire family who feel too scared and too ashamed to speak about terrible events that happened years ago. His main character, Tom Wingo, says, “… in silence we would honor our private shame and make it unspeakable.” This is what shame does … it’s like a black cloud that comes over people and forces them to hide a part of their humanity.

We have all heard, “Confession is good for the soul.” If and when people find the right person to confide in and muster the courage to speak out about inner emotional struggles, often shame begins to evaporate. The primary underlying emotions such as sadness, anger, or what have you, are there; they are expressed, and there is relief. A lot of this relief comes from the experience in the moment of being heard and not rejected.

Although we have spoken a good deal about substance use (e.g. alcohol and caffeine), it is worth mentioning here in the context of solutions that backfire. We already know the negative impact of substance abuse and how most recreational drugs ultimately make anxiety, moodiness, and depression worse. Let’s add to this list that a common consequence of drug abuse is to block feelings.

Josh was a very devoted high school teacher. He worked for an inner-city high school. He met with his kids before school and with children and parents well into the evening.

He went above and beyond the call of duty, trying to help these troubled teenagers. After work he drove home, vigorously worked out by running on his treadmill for an hour, and then poured himself a huge drink of bourbon. He drank his drink and passed out until the next morning.

This has not always been Josh’s lifestyle. It started six months ago when his young wife died from breast cancer. The over-focus on work, the intense exercise, and his substantial alcohol use were distracting him from his intense inner feelings of grief. He kept his anguish at bay, was rarely aware of his internal suffering, and was also heading straight toward an addiction to alcohol.

Again may I say, this is not a moral issue. This is about intense emotional suffering and Josh’s desperate attempt to avoid the enormous pain of his loss. No one wants to suffer this much. But, ultimately, the alcohol use took its toll. His sleep became more and more impaired. And at some point he crashed into a severe depression.

It took involvement in an alcohol recovery program and psychotherapy to resolve his drinking problem and the depression. Once these problems were dealt with, he became more aware of what was eating him up inside. The healing of his broken heart then required opening up to his grief.

Confronted by stressful times, people must think clearly—planning, problem solving, carefully coming to an understanding about what’s happening, formulating strategies for coping, and anticipating what will happen.

Unfortunately, significant stress often takes a toll on clear-headed thinking. When emotions overwhelm people, it is not uncommon to experience some degree of confusion, indecisiveness, and, especially, a loss of perspective. A common experience is also to ruminate and engage in nonproductive worry. In addition, when human beings are severely distressed, they frequently begin to make particular errors in thinking that psychologists refer to as cognitive distortions. In some 12-step programs, they call it stinkin’ thinkin’. These problems in thinking always intensify distress and especially turn up the volume on feelings of powerlessness.

et’s look at five common versions of stinkin’ thinkin’:

Why do these maladaptive ways of thinking occur? Sometimes they are influenced by long-held negative self-concepts (like we discussed in Chapter 6). Thinking “I’m a loser” or “I can’t do anything right” might occur due to the impact of underlying negative core beliefs.

Many times these types of distorted thinking occur because when people are overwhelmed, they lose perspective. For most people, very negative moods are like the tides. They come in for a while and eventually recede. Yet this loss of perspective often leaves people unable to really look at life from a broader point of view. People get swallowed up in the moment, and have trouble seeing beyond their current suffering.

Finally, stinkin’ thinkin’ occurs often when people are depressed. There is a good deal of research to suggest that this is tied to chemical changes occurring in the brain.

You must take stock of these common factors that inadvertently increase stress and misery, and make an all-out effort to stop them. In our next chapter, we’ll take a look at some very effective ways to target distorted thinking.

The Least You Need to Know