Coping Strategies That Really Work

Issue 2: Acceptance – A Foundation of Coping

 
We all experience circumstances, thoughts and feelings that are uncomfortable and unwanted. For many the natural tendency is to either avoid them or to deny them. These strategies only serve to delay dealing with the unwanted conditions, which usually results in them getting worse. This often causes symptoms, most notably anxiety. Obsessive Compulsive Disorder, Panic Disorder, Phobia and even PTSD all have foundation in circumstances that are not being addressed. This blog will present an alternative coping strategy that is based on learning how to accept unwanted circumstances, so that they can be addressed most effectively.
            Avoidance and denial of circumstances, thoughts and feelings can take many different forms. Physical avoidance of circumstances that cause fear is called Phobia. Sometimes individuals avoid circumstances, thoughts or feelings by ignoring them. Some mask them with alcohol or other substances. Denial can take a direct form where a circumstance, thought or feeling is simply denied. Anxiety and other forms of discomfort come from lying to oneself. This is because lying to oneself undermines the ability to trust oneself resulting in self-doubt and feelings of vulnerability. Sometimes it is the significance of an event that is denied rather than the event itself. In such a case justifications might be offered such as “I didn’t really mean it”, “I was only joking”, “I had too much to drink”, “it only happened once”, etc. Avoidance and denial do not address the source of the discomfort. They are a form of procrastination, not effective problem solving or coping strategies.
       Some treatments focus on eliminating anxiety and other symptoms. This might include medications for subjective anxiety, insomnia, headache, etc. which are reactions to unwanted events in the patient’s life. These medications may relieve these symptoms, but they will not address the underlying causes. Similarly, some forms of psychotherapy endorse diversions, such as physical exercise, meditation, yoga, etc. to cope with anxiety or other symptoms. Some therapies focus on changing thought patterns to reduce unpleasant feelings. Once again, temporary symptom relief can be achieved this way but the discomfort quickly returns because the source of the discomfort has not been addressed. The following approach is not an approach to palliative relief of personal discomfort. Rather it is a strategy that involves directly addressing unwanted situations tactically.
 
Consider the following example that is a composite of my work with many individuals over the years.
 
Mr. X. is a management level employee of a large financial firm. He manages a lot of money and a lot of people and he makes a lot of money. He also spends a lot of money living an extravagant lifestyle. The first couple of weak earnings reports he ignored. Some variation in his industry is to be expected. He started to have difficulty falling asleep because he was worried about his business. He also began drinking more alcohol because it “helps me relax”. He visited with his family doctor, who prescribed medications for sleep and anxiety. He began massage therapy, which was also helpful in reducing muscle tension. Due to some irritability that Mr. X. expressed towards his family during this time, he was asked to go to “anger management”. There he learned how to suppress angry outbursts through mindfulness and self-control. This was successful in reducing the frequency of his angry outbursts.
            These interventions had no tangible effect on the cause of the problem: his work situation was changing. His increasing awareness that something unusual was occurring was increasing his stress and anxiety, which he was attempting to manage with the above palliative treatments. Once he accepted that things were changing for the worse at work, this empowered him to take actions to cope with the changing work situation. For example, he used flexibility, the coping strategy introduced in the previous blog, to change the way he approached his work. Accepting that there was a shift from cooperation to competition among his coworkers changed his focus from team success to individual success. He also became more defensive as he recognized that his superiors were becoming more critical. He also began to consider back-up options if the quality of his work experience continued to deteriorate.
 
Mr. Xs failure to accept the changes at work while pursuing palliative treatments for his discomfort prevented him from addressing what was happening at work. The necessary adjustments could only be made once he accepted that his work situation was changing and that he needed to adapt. The discomfort he was feeling is meant to compel him to address a situation that requires his attention. Suppressing these feelings prevented him from making the necessary changes at work. Another example where the failure to accept circumstances as they are prevents adaptation is described below.
 
Ms. Y is a single mother who lives with her 10 year old daughter and works full time. Each morning the mother tried to get her daughter off to school on time so that she could get to work on time. This was rarely the way it actually happened. Most mornings the mother and child would end up arguing about being late and their relationship deteriorated over time. Both the mother and the child suffered symptoms of stress. The child’s grades began slipping and she reported an increase in physical symptoms, such as stomachache and headache that made it harder for her to be in school on time, or some days to go at all,. The mother started to have difficulty sleeping as she often worried about the argument coming in the morning and then her having to get to work late. She often skipped breakfast which combined with the loss of sleep compromised her performance at work. The mother was offered sleep medication, but was reluctant to take it for fear that she would not be able to get up in the morning.
            In order to improve this situation, the mother and the child had to accept that the situation they had set up for school mornings was not working and had to be changed. Once again, the acceptance that situation is not working stops the frustrating behavior of trying the same routine each morning and failing, and creates the opportunity for the use of flexibility to change the routine to one that might work. For example, the mother might change her hours at work slightly so that she is not late. Another option might be for mother and child to go to bed earlier and begin their routine earlier, etc.
            In this issue of Coping Strategies That Really Work, I described the use of the coping mechanism, acceptance. The key role of acceptance as a first step in coping was illustrated in two different environments. In those examples, acceptance of the situation facilitated the use of flexibility, which was introduced in the first issue. In the next issue, I will introduce another coping strategy, utilization of resources and show how both flexibility and acceptance work cooperatively to support effective coping strategies that target improved outcomes in situations that cause discomfort and dysfunction.