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Borderline Blog

BORDERLINE PERSONALITY disorder IS A BRUTAL DISEASE THAT CAUSES PAIN DIRECTLY TO THOSE who SUFFER AND INDIRECTLY TO THOSE who ARE CLOSE TO THE SUFFERS. tHIS BLOG IS TO PROVIDE A FORUM FOR THOSE WHO SUFFER EITHER DIRECTLY OR INDIRECTLY TO HELP HEAL.

Coping Strategies That Really Work

11/18/2018

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Issue 1: Coping with Frustration
 
This is the first of a series of blogs, each one describing a different coping strategy and its application to real life situations. In order to be most effective, coping mechanisms, or strategies, must be specific enough to improve the outcomes of challenging situations, while at the same time being broad enough to be useful in new situations that present themselves throughout your lifetime. This series of blogs will examine numerous coping strategies that have shown to be effective in very specific situations while at the same time being durable enough to be applied in very different settings and circumstances. Readers are encouraged to add coping mechanisms in the comment section of this blog that they have found to be most helpful.
Utilizing coping strategies effectively requires that you first define what it is that you are coping with. Many of my colleagues refer to coping mechanisms that help individuals cope with their emotions. For example, a vigorous workout, or listening to music or meditation may be suggested as a way to cope with anger or anxiety. These are healthy activities that help to temporarily relieve the discomfort of anxiety or agitation, but do not help with the underlying causes of the emotions. Tranquilizing medications may also be prescribed to help individuals cope with anxiety. When you stop engaging in these activities or taking antidepressant medication the underlying causes quickly restore the emotion. The coping strategies presented in this series of blogs are designed to help cope with the underlying circumstances that are causing emotions of different types. These coping strategies target solutions to the cause of difficulties or discomfort rather than relief of emotions, which is generally temporary.
            This approach to emotions does not treat emotions as symptoms which should be eliminated. In this approach we treat emotions as important signals and we seek to understand what they are signaling. Each emotion conveys information that is associated with survival and adaptation that is unhealthy to ignore. In this blog we will focus on frustration. We will discuss the causes of frustration and the best adapted coping strategy, which will be illustrated in three case examples.
 
FRUSTRATION
 
Individuals experience frustration when they feel blocked in pursuing a goal. The intensity of the feeling is associated with many factors including: the importance of the goal, the magnitude of the obstruction and the amount of time the individual spends in the frustrated state. Each individual has a frustration tolerance. This is the measure of the amount of frustration a person can tolerate without compromising function or sense of wellness. Additional frustration beyond this point, either in intensity or number of sources, is generally first experienced as irritability and short temper. Compromise of function comes as the irritability causes impatience associated with difficulty sustaining attention and sometimes impulsivity. Under conditions of intense frustration destructive behaviors are often reported. In very extreme situations, the destructive behaviors may target animals, such as pets, or even other individuals. The dreaded Shaken Baby Syndrome is most often caused by parents shaking an infant out of frustration.
            The irritability and destructiveness that is often associated with frustration causes it to be confused with anger. For many people, it is subjectively undistinguishable and people are often referred to Anger Management Programs, when they actually are frustrated. Interestingly enough, many of the techniques offered in these programs help with frustration. But anger is not the result of being frustrated in the pursuit of a goal. Anger is caused by pain. We get angry at others who have caused us pain, who are causing us pain, or who we think might cause us pain. Coping with anger requires getting rid of the pain. This will be discussed later in the series.
            One of the most powerful coping strategies for situations that cause you to approach or exceed your tolerance for frustration is called flexibility. Utilization of this coping strategy allows you to adjust the way you approach your goal when the primary method is unsuccessful. It also allows you to adjust your goal when you determine that the goal you initially selected is unattainable.
 
FLEXIBILITY
 
Below are three case examples that demonstrate use of flexibility as a strategy to cope with frustration. These examples are composites of my years of clinical experience that were created to illustrate the applied use of coping strategies.
 
Case 1
 
A professional middle aged man came in seeking “Anger Management”. Although generally a mild mannered man who was well liked by family and peers, he suffered periods of impulsive behaviors around others involving very aggressive verbal battering and occasionally destruction of objects, such as punching holes in the wall. He felt that his behavior had gotten out of hand when he was removed from the counter of an airline for verbally harassing the staff. He described it as follows.
 
“I had to travel down south for business, which I hate to do. I tried to satisfy this customer over the phone, but they insisted that I come down in person or I would lose their business. I spent three days in negotiations and all I wanted to do was to go home, have a nice dinner and read my book. When I got to the airport, don’t you know, it was shut down due to the weather. A three hour delay. That’s when I lost it. I felt like I was going to explode. I went to the airline counter and started yelling uncontrollably that I paid for my ticket and am entitled to get home on time. I was so embarrassed when security showed up but I couldn’t calm down”.
 
We determined that his frustration in the above example was being caused by his not being able to attain his goal of getting home, having a nice meal and reading his book, all on his schedule. He was able to see that the existing strategy was having a negative effect – moving him away from his goal. Using flexibility he was able to see that with some minor changes in methods and goals, he could attain a significant portion of his goal. We found that he could have a nice meal and read his book in or near the airport and then rest on the ride home so that he would get home refreshed instead of exhausted. Learning to see situations that are not going his way as potentially malleable with regard to both method and goal, helped him with other frustrating situations in his life.
 
Case 2
 
A mother argued with her child every morning because he resisted getting up and going to school. The arguments were on occasion so severe that the frustration caused both of them to engage in destructive behaviors. The child eventually became assaultive towards the mother. The mother was looking to cope with the child’s behavior.
 
“The child is ruining my life. I can’t believe that I am thinking this but I don’t think that I can do this anymore. I have run out of ideas and energy, I cannot get him to school on time anymore”.
 
The mother initially stated that her goal was to get the child to school in the morning on time “no matter what it takes”. Based on the mother’s observations we agreed that the child was not well and so we decided to adjust the goal to be the child’s wellness. Rather than forcing the child to go to school and stay in school against the child’s persistent resistance, we agreed to instead find out what is wrong with the child. This ultimately revealed some metabolic problems that were successfully treated, resulting in the child’s being able to get up in the morning and be productive. Conflict between mother and child decreased as the mother was able to incorporate more flexible strategies into her parenting.
 
Case 3
 
An obese middle aged man lost his job in the financial sector due to a code violation. He unsuccessfully fought against litigation against his license and had become immobilized upon the realization that he would never be able to work in the financial industry again. He acknowledged thoughts of suicide. He expressed the following.
 
“I’m done now. There is nothing I can do. I have a family to support and I cannot get a job because I lost my license. I am a total failure. Oh sure I can get a job flipping hamburgers, but my income will plunge. We will lose our house and the children will have to leave school. It’s all over”.
 
The man initially stated that his goal was to get a job that would support his family as close as possible to the way they were accustomed. He had determined that this goal was impossible. Before abandoning the goal of supporting his family well, I encouraged him to examine his methods. He believed that the only way he could support his family at an acceptable level was to work in the financial field, which he was now prohibited from doing. The only alternative he considered was unskilled, minimum wage labor. I encouraged more flexibility in his exploration of his skills, qualities and experience that might be of value in the workforce. Within a year he was successful in replacing his previous income utilizing his skills in a different industry that did not require licensure. He was later able to use a more flexible approach to coping to change his eating and exercise habits resulting in improved health and loss of 100 pounds.
 
 
This blog demonstrates the
 use of flexibility as a strategy for coping with situations that cause significant frustration. Flexibility was applied successfully both to ways in which goals are approached and also to reconceptualizing the goals themselves. We also discussed the need to discern frustration from anger, as the two emotions benefit from different coping strategies. The next blog in this series will discuss coping strategies for anger.
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