What is a self-rescue kit for when you’re freaking out?
A self-rescue kit is a box or bag where you keep items that can help you when you’re not doing well or just need help shifting your physiological and/or emotional state. This is where science also comes in–applying what we know about how emotions work, what trauma does to the body, and more—to get us out of tight spots.
What the container looks like, what gets kept inside, and what the items help with is entirely customizable and personal. Though this is not my original idea (check out “comfort boxes,” “cozy corners,” “safety boxes,” “grounding boxes,” and so on), this is my take on them and I hope it’s useful to you!
You can share what this kit looks like with other people, but you do not have to. This is for *you*. Top 3 tips to get started?
Put it somewhere that is easily accessible to you: Think of a first aid kit—you don’t want it on an unreachable shelf you forget about! If you deal with ADHD / issue with object permanence, consider using a see-through box/bag clear so you can easily see the insides. Consider labeling it too, especially with a neon color or something that stands out.
2. Start ASAP: don’t wait until you have “everything perfect.” Just grab a box or bag and start putting stuff in it. You can always change it up later.
3. Practice using it outside of emergencies: Sit with your box a few minutes a day for a week or two even when you’re not freaking out so you build the habit and muscle memory of actually using the box. Then, when you’re freaking out, your body is already primed to reach for it versus having to think about it too hard.
The specific items you put inside will vary widely depending on what “brain hacks” you most often need, what you most often struggle with. Do you most often need support calming down? To change your body temperature? To hype yourself up? To stop ruminating? To destress? Think of objects that could help with those and put them in there. Shifting temperature, breath, and focus are 3 big strategies to calm a body in distress. There’s also science around the uses of scent and memory, the importance of nutrients/food (hello protein bars!),
Just no perishables, please, unless you make sure to check it frequently and toss things out so it’s not gross. If there is a perishable item (an ice pack, a banana, etc) that is key to your self-rescue kit, you can instead include a post-it note that says “EAT A BANANA ASAP”, or something like that.
There are two “types” of items that I personally recommend having at least two or three of: sensory aids, and cognitive aids.
Sensory aids are things that are about addressing your body (not your thinking mind) and you experience with your available senses—whatever those are for you. Here are some examples:
Smell: a scented salve you can rub on your temples or wrists, a candle, a favorite cologne/perfume spritzed in the air, an essential oil and cotton balls to put it on, sachet of herbs, coffee beans, Vicks vaporub
Taste: gum, water bottle, mints, lozenges, favored snacks, water-flavoring drops (the idea here is that you’ll have something that is soothing and familiar, or perhaps something where the temperature, texture, and/or flavor can be nicely distracting to experience and try to describe out loud—or if you have issues with skipping meals or blood sugar, perhaps small snacks that offer some good protein and nutrition)
Look: paper-clips you can focus on bending or linking, meaningful photos, a note with names of videos or films you like, coloring books and pencils, bubbles you can blow (super helpful for regulating breathing!), and even shades/eyemasks if what you need to do is REDUCE the things you’re looking at or take a nap!
Hear: a bell, small plastic maracas, a CD / link to a playlist, small sound-machine, beads and shells on a string
(Pssst, this can also be where you keep emergency stashes of your herbs/medicines/tinctures/etc.)
Cognitive aids are things that can help in a “brain reboot” of sorts and address your thinking mind. Things like post-it reminders or mantras, how-to manuals (for panic attacks, rage fits, grounding techniques for when you disassociate, etc), therapy notes, emotion flashcards, your support system’s contact info, a list of crisis hotlines with their numbers, “gratitude lists,” distraction items (sudoku, crossword puzzles, etc), nice poems or passages from books you like, etc.
Remember: I call it a self-rescue kit, but that does not mean you should not need anybody else to support you in rescuing yourself. One item in your kit can be a note that reads in big, glittery letters: “CALL YOUR FRIENDS, YOU GRUMP” and their numbers, or a note from a loved one that reminds you that they are there for you.
What if I made my kit but then I did not use it when I needed it?
That’s okay! This is a new thing you are trying. When the distress has passed, try examining why you didn’t use it. Perhaps the location of the kit made it so that you were physically or mentally blocked from accessing it.
OR perhaps what you put inside is not what you actually want or need when you’re unwell. My friend and assistant, Lui, insists that what can help them feel better is exercise but they never do it, which makes us both think that it is not something that can actually help them in their current life. It is just what they think should help them, or what they’ve been told to do. What actually helps them temporarily calm down or get distracted enough to move is having a smoke outside and laying on the floor making broken-machine sounds. So, y’know, your mileage may vary.
As an example, the list of things that my box contains or has contained:
A fat bird sculpture two of my sweeties sent me when I had COVID. I love fat birds and their existence got me through graduate school so it was both a preexisting symbol of hope and resilience AND it gathered renewed meaning in this care package.
Fidget toys (the rainbow pop toys? Love those!)
A few small samples of fun fragrances (here is Waffles which smells like actual waffles with maple syrup and Salt Air which makes me think of home en Puerto Rico)
Slimes. I love slimes. The end.
A jar of soil from the home where my parents and abuela live.
Minty gum.
A bone found in the woods of The Rêve that I then decorated while crafting with my chosen family. It reads “Planting seeds for a regenerative future” and “love” with stickers and rhinestones and glitter.
Herbal blends from the boricua transfeminist media collective Espicy Nipplez.
A small glass vial of water from an intention-setting ritual I led at the Sex Down South conference in 2021, which includes dissolved paper with messages of love and abundance for our future.
This is not my first kit. Some items have stayed, some have been replaced by others when the older version no longer worked for me. It will probably change in the future, as my needs and tools evolve.
There is no wrong way or right way to make a self-rescue kit for yourself, and there is no limit to how many things you put in there! Whatever and however many things can help you in a time of need is okay. Perhaps you prefer a smaller kit, if many options overwhelm you, for example. Or maybe you prefer a wider variety, if you have changing sensory needs and boundaries.
And if you need inspiration, here’s a poem you can print out / write down and keep inside your own box—
Are you hydrated? When did you last glut your thirst with a handful of spring?
Have you eaten anything besides emails or your fingernails in the last three hours? Have you pulled the protein out of an oak tree or palmed an avocado pit this month? Are your forlorn probiotics
languishing on your butter shelf? Are you dressed? If so, does your skirt strike matches alight as you walk by? Can you melt it a little around your waist and ribcage? Are you resisting
a dream? Wrestling a dreamless night? Let yourself take a bath in your bed clothes for fifteen minutes, no pressure to fall asleep. But make sure to turn off all your beehives first. At least take them out of your bedroom.
Have you uncoiled the ropes of your legs and strung them along the length of the city today? Have you let a lake or a snow bank sketch silent letters on your back? When did you last give away
your unworn clothes, your well-fitting metaphors? Tell a neighbour or a person across the coffee shop counter how well they catch the light.
Have you snugged into a seedpod in the past couple days? Do you need a massage? Complete something
smaller than a lichen: return a library book, or a letter, or a look, or a relationship you regret. Sew a button on that’s come loose. Crack a window. Crack an egg.
Do you feel unattractive? Rub your skin with smooth stones or strong magnets. Wear sunglasses. Take your reflection in on the surface of a puddle.
Give yourself ten minutes. Give yourself ten years. Give yourself an orgasm. Give yourself a change of seasons. Give yourself a new lover. Give yourself a to-do list written with sidewalk chalk and hopscotch across it.
Have you been working really hard shovelling all the sidewalks of your friendships? Remember it takes time to recover from exertion, especially when you are a seedling.
Know that your friends want to send help. They want to send daffodils and their extra hands to braid your hair. They all want to be deciduous trees and long semi-coloned sentences for you. They want to.
Remember: you are a comma, one beloved earring, a house circled on a traveller’s map, sometimes misplaced, but never an imposition.
Everyone feels like a hallway at some point or another. But you are a room that people enter to stay.
You’re cozy in your bed, drifting off to sleep when a voice calls out: “I’m scared! I need you!” You leap out of bed, heart pounding, and rush into the child’s room. He is sitting up in bed, his face stained with tears, cuddling a stuffed walrus. “Sweetie,” you say in the kindest voice you can muster, “it’s time to sleep now. I was asleep. You need to sleep too.” You give him a hug, he lies down and you go back to bed. Fifteen minutes later: “I’m awake! I need you!” Back into the child’s room, less patience now. “Baby it’s time to go to sleep.” “But I NEED you.” “We all need to sleep. Our bodies need sleep. Lie down now and I’ll sing you a song.” You sing a lullaby and tiptoe back to bed. Begin to close your eyes, and the child calls again.
A friend told one of us this story recently. At her wit’s end, she talked to his teacher who said, “he just wants to feel heard.” Instead of reminding kids of the rules, rationalizing, or focusing on soothing, you’ve got to home in on what they feel in the moment. You have to take them very seriously and ensure they believe you. “Use a lot of ‘really’,” the teacher said. “I really, really hear that you are scared.” Or “I can see that you are really, really sad right now.” When children hear this, they know you have connected their meaning to their behavior, they feel heard, and they can let go.
If you’re wondering whether you accidentally clicked on a parenting article, here is the connection you may be waiting for: Our feelings can be just like small children. They have a deep need to be heard, to be held, without judgment or rejection. To be held with compassionate curiosity. How can you be with yourself in a way that says “I am here. This is okay. Whatever comes up right now is okay,” especially if you’ve been taught the opposite?
In this article, we’ll go over what can happen to buried and inconvenient feelings, the science of emotion and survival, and how you can manage and process all these things differently and/or with new awareness.
Feelings Gone Underground or in Disguise
The tricky part here is that kids (and feelings) don’t always make “rational” sense (and sometimes they do, but you don’t have the tools to understand them or are speaking different languages). When you ignore feelings, they don’t go away; they go underground. When they’re buried, they don’t stay buried forever. Once they’ve gone under, they often come back in even more confusing, less recognizable ways.
Feelings don’t always have the language to tell you what is happening or why. They only have the crude tools to make themselves heard. They manifest in adjacent feelings and other behaviors that may be hard to connect to the “originating” event or situation.
Explosiveness and irritability: You’re filled with rage in certain situations – maybe your boss didn’t reply to your email, or your mom cut your toast in half when you wanted to “eat it big.” Maybe you snap at someone when they interrupt you while you’re working at your computer, or respond curtly when they ask how you’re doing. Either way, when explosive anger and irritability are disproportionate to the situation in front of you, it’s a hint the feelings are coming from (or being magnified by) somewhere/something else.
Inertia: Getting out of bed, getting dressed, showering, eating – basic daily tasks become a struggle. A child might refuse to put their shoes on when going to play with a friend who has been mean to them or lie on the floor when they are supposed to go to school but are not feeling confident in a subject. You may find yourself blocked when trying to write something and stare blankly at your notebook for hours, or perhaps keep delaying getting ready for a date until you’ve made yourself so late that you have to cancel instead of show up.
Physical sensations: Headaches. Tiredness. Lots of poops. No poops. Tight chest. Shortness of breath. Twitching eyes. Muscle tension. Any bodily sensation can be an avenue for feelings to express themselves. For example, one of the authors of this article—as a small child, before they could explain feelings of fear and apprehension—experienced them as stomachaches. On a trip to a theme park, they kept asking to go to the bathroom every time they’d get in line for a big intense ride. For them, stomachaches meant “obviously you need to use the bathroom,” so they would go to the bathroom. They’d feel temporarily better (because they were away from the scary ride), but they wouldn’t actually do anything in the bathroom itself, much to their own confusion. Eventually, they and their family figured out their stomach hurt because they were afraid, and what they needed was soothing and reassurance, not a bathroom visit.
Avoidance: You pick up your phone, turn on the TV, go on Facebook, anything to distract yourself or buy yourself time from the thing you’re avoiding. This can also look like not answering emails from a professor who asks about a missed deadline, getting lost in daydreams frequently, leaving a friend’s texts unread, etc. In a child, this can often present like outright ignoring something that’s right in front of them as if it simply didn’t exist.
Difficulty naming: You make plans with a friend, and when they ask you how you are you say “fine,” and then go home frustrated that they didn’t support you. A child calls out again and again in the night, sounding fearful, but when you go to them they say “I can’t find my bear.” Saying the fear or worry out loud feels impossible.
Do any of these situations sound familiar?
Inconvenient Feelings and Directing Them
But I don’t want this feeling, you tell yourself. This is such a bad time. It’s not the right way to feel – I’m not being fair to my partner, my boss, my friend. I’m exaggerating. I shouldn’t care about this. I’m being childish. This is irrational—there’s no need for this. Other oppressive and normalizing forces like to show up here too – often gender. I need to man up and get over it. I’m being needy. Extra. Too much. Hysterical.
You can think of a million reasons why the feeling isn’t welcome, isn’t convenient, does not deserve the space it’s taking up. You push it away, push it down, reject or ignore it. You find ways to quiet it. Janet Bystrom, a therapist in Minneapolis, says we have three choices about what to do with this energy:
Point it at ourselves (fuck me) – substance use, self-harm, dissociation
Point it at others (fuck you) – aggression and physical violence
Point it at the sky (fuck this) – discharge the feeling safely through movement, art, communication
Here, let’s just acknowledge that options in the first two categories might serve us very well, until they don’t. It’s not always safe to feel feelings, or to inhabit our bodies. If we are experiencing ongoing abuse or trauma. If we are experiencing dysphoria (a sense of disconnect and unhappiness, frequently tied to ways that one’s appearance may not line up with one’s internal sense of self). If we are in a medical or family crisis that requires us to remain organized and productive in the face of big emotions.
Even as we move toward making space for and accepting feelings, can we also be compassionate with ourselves about the reasons we’ve delayed feeling them? Can we honor the roles our survival strategies have played in protecting us, thank them for their work, and let them know they can rest for now, or at least for a bit? (And of course, if you are still in a situation where you are surviving with some of the strategies named here, trust your assessment of safety and, if it’s available, seek guidance and support).
But let’s say we’re safe. Let’s say we have most of the support we need and are relatively stable. What do we do with these feelings we’ve been avoiding?
The Science of Survival and Feelings
We carve our own neural pathways with our actions. A famous adage in the field of neuropsychology is “neurons that fire together, wire together.” If we come to a fork in the trail, and one branch is flat, well-tended, and clear of debris, while the other is steep, rocky, and full of thorns, most of us will choose the clear path. It seems to take less effort in the moment (though the effects of that choice may have longterm implications). It’s familiar. We know where it leads.
Striking out through the brambles requires more equipment, more energy, more persistence. But a magical thing happens when we keep choosing the overgrown path. We begin to clear it. We bring our machete. We wear hiking boots. When we come to that fork again, choosing the overgrown path is a little bit easier. Of course, there will be days when we are tired, when we are overwhelmed, when we must choose the familiarity of the clear path. There is no shame in that. But when we choose the overgrown path, we make that path more available.
All this is to say that the new path may not feel comfortable; it may feel dangerous, and even viscerally wrong. When we have been trained to react in certain ways, our bodies may resist changing—and of course they will! They think changing will put us in some mortal danger! And, in fact, if we have a history of using suppression as a strategy to manage tough feelings, starting to open up to feelings overall will likely feel worse at first. (This is a common experience among folks working through emotional changes; stick with it if you can.)
So when have come to a place of realizing we do indeed need to change, we have to get ready to manage that new set of feelings and reactions. This doesn’t mean we have to dismiss our gut reactions, but that we have to dialogue with them in a new and different way. It means we have to take our worries, assumptions, and immediate reactions through a few more filters before we accept or use them.
For example, people who have become hypervigilant due to trauma pay attention to a lot of ambient cues of danger. Sometimes these cues signal realistic and imminent danger, but often they do not. Figuring out which is which can be very tricky when your body’s been trained to see them all as equally dangerous threats – getting on the subway taking on the quality of intense danger, for example. Conversely, some people are “hypovigilant” and rarely notice threats even when the red flags are glaring to those around them. (Read more about the science of this and “the window of tolerance” here from the perspective of a therapist.)
What Can You Do?
There is no magic one-size-fits-all recipe for how to shift your relationship with your feelings and create more space for them, but it’s key to go slow rather than trying to rush it. Self-compassion as you figure out this new path is also essential, because you’re doing something pretty damn hard—figuring out how to change the wiring you’ve been building for years, and even decades. That’s no small feat. Take care of yourself along the way. Turn back if you need to. But keep finding your way. We promise it’s worth it — even if ONLY to minimize the devastating effects chronic stress can have on the body (note: that linked article, while very thorough, conflates sex and gender).
In the next section, we offer a list of ideas for processing and feeling feelings in no particular order. Not all of them will feel right or available to you. Some may feel great in certain situations and terrible in others. If a strategy feels strange or uncomfortable, that is also information to pay attention to.
Practices for Processing and Accepting Feelings
Some Notes on Externalizing:
Externalizing is the process of separating one’s sense of self from the feelings, problems, social forces, and relational patterns that influence it. It is also the belief—and its associated worldview—that people are not their problems. What this looks like in practice can take a lot of different forms. You might do this reflection and separation on your own, with a therapist, or in a group. You might write down the stories in your mind about a situation or problem, and use color-coding or headings to link the stories with their related sources (i.e. “my dad,” “racism,” “transphobia,” “the mean administrator at my school”). You might develop an externalized metaphor or personification for a problem, like “the void”, “the sneaky hate spiral”, “the ferile cat.” Creating this separation between self and problems creates a reflecting space to take a position on the things that are influencing you.
therapist: and what do we say when we feel like this?
me: my depression is likely tied to capitalist alienation which leads to meaninglessness and isolation.
For those of us in highly individualistic environments (like the United States, which has historically been very influenced by concepts of “rugged individualism”), it can be tough not to solely blame ourselves for our issues. Western medicine and mental healthcare also have a long and unpleasant history of conflating people’s identities with their diagnoses. However, it’s critical that we see the full spectrum of influences, because there are many. It is both a disservice to our healing and a factually inaccurate way of assessing problems when we solely locate them in the individual. (This is also why it’s important that therapists discuss systemic oppression and politics rather than presume they should—or even can—be “values neutral.”)
That said, total separation isn’t really possible, and that’s okay; the point is to create a bit of room in our heads so we can see the issues from a different perspective. We can take a position – maybe we like the influence of the thing we’re evaluating and want more of it. Maybe we want less. Maybe we want to feel it, but don’t want to act out toward others in the ways it invites us to.
We come into relationship with the force or the problem, and in so doing, stand with a self that is separate from the problem. Externalizing can be an antidote to shame saying “we are bad” when we have done something bad. (This may be tricky for people whose systems of faith and value say that doing, or even thinking, “bad things” automatically means they are bad and full of sin. For people in that situation, more discernment work and evaluation will likely be important to address those challenges. People in this situation may also wish to externalize the views of their faith community and step into conversation with those views in new ways.)
An important thing to remember here is that externalizing is not a single strategy, it’s a process and a lens. Acknowledging the influence of oppressions, or positioning yourself as separate from your problems is not a thinking experiment to trick yourself into feeling better. Imagine what it might mean to truly believe that people are not their problems. Think of someone you don’t know very well who activates your defenses – what would it mean to your relationship and interactions if you believed that they were also under the influence of problems at times, just the way you are.
Externalizing is also not a get out of jail free card. Separating yourself from your problems or the societal forces that influence you does not exempt you from responsibility for the things you do while under their influence. For example, while it may be true that toxic masculinity lays the groundwork for sexual violence, the violence itself, and its impact on its targets, remains the responsibility of its perpetrator. However, taking a bit of space and a position on the influence of a problem on our actions could change our response to those influences in the future. For more on issues of accountability and larger social forces, you can explore the Transform Harm Resource Hub.
Below is a list of specific strategies you can use to process and manage feelings and how to bring them into your day-to-day.
Give It A Name
A perfect example of externalizing is on the show “Big Mouth”—a sitcom revolving around a group of middle-schoolers experiencing puberty and all its ensuing shenanigans. In this show, puberty is not just a set of seemingly random bodily changes, but instead changes that come as a result of Puberty Monsters & Monstresses influencing their lives. These creatures are ones that the teens can see and directly interact with. (At the same time, since teens can only see their own Puberty Monsters, the viewer is invited to hold the possibility that these monsters are actually just personalized manifestations of puberty that exist in their own heads.)
This makes puberty an inherently relational experience—one that the teens can navigate with someone else even in its most private components. For example, the Puberty Monsters & Monstresses give the teens advice (as well as argue with and sometimes even sabotage them), jumpstart physical reactions, provide a sounding board for their worries, and more.
The teens can also take a position in response to the puberty monster’s suggestions, argue with them, step away from what they are encouraging, or take their advice and jump in. The teens are autonomous objects, rather than subjects under the influence of external forces, who can reclaim their power, autonomy, and choice, from the forces that seek to influence them.
The technique of giving feelings a name (and even an image) can help us approach them creatively and with enough distance that we can deal with them in a different way than usual.
Practice:
What would it look like if you could dialogue with your feelings as if they were an embodied, physical presence sitting in front of you? How would interacting with them feel and be different? What kind of questions would you ask? What kind of things would you say?
Pick a feeling you struggle with and give it a name (e.g. jealousy, grief, pettiness, anger, happiness, etc.). Draw it, imagine it, and/or write a description of what it looks like. Consider how long you have known it, when it flares, what it suggests you do or don’t do, when it yells versus when it is silent, what people it tends to get excited around versus the people that make it go away.
Practice having a conversation with the feeling. (While you are doing this you might notice that other feelings or forces hang out in cahoots with this feeling – for now just name those and set them aside (“oh, hi, internalized racism!”). If this felt useful you can go back and repeat these steps with those too).
Be With The Feeling & Let It Land
In a Wrinkle in Time, Madeleine L’Engle writes:
[Meg] leaned her head against the beast’s chest and realized that the gray body was covered with the softest, most delicate fur imaginable, and the fur had the same beautiful odor as the air. I hope I don’t smell awful to it, she thought. But then she knew with a deep sense of comfort that even if she did smell awful, the beasts would forgive her.
Can we be with emotions this way? No matter how smelly, how distasteful, how unwelcome, just be with them. If they don’t have words for what they are bringing us, if they have only tension, or big angry energy, or silence, or tears, can we be with them?
For most people, that is actually a huge ask. Many of us are taught to suppress emotions, especially ones culturally labeled as “too big”, “unhealthy,” “negative,” “bad,” or “inappropriate.” But suppressing emotions doesn’t make them go away, and indefinitely punting them off to “deal with later” only leaves them room to grow and fester.
Therapist and mindfulness teacher Tara Brach calls the practice of being with the feelings “the turn of acceptance.” Brach guides her students to put a hand to their hearts in moments when challenging feelings arise, and to practice welcoming them. We might say “It’s okay that you’re here.” But maybe it doesn’t feel okay! We might instead say “I notice you.” You can take it a step further and say “And I am willing to listen to what you’re trying to tell me.” We might just tune into the sensations in the body and be silent. The hand to heart gesture may not work for us – we might rather plant our feet on the ground or connect with our belly, hands, or forehead.
No matter how you do it, experiment and find a way that works for you to simply create a welcoming, accepting, or compassionately curious environment for the feeling to land in so you can see what wisdom it has to share with you. Even the most uncomfortable of emotions usually have good insight for us!
Practice:
Watch or listen to “Here Comes a Thought” from the popular TV show “Steven Universe.” How can you integrate this kind of approach into your daily life? For some people, it means they keep a bookmark to this video on their phone to watch whenever they’re overwhelmed, or quietly sing the song to themselves when they’re spiraling in negative thoughts! For others, it means they do the same visualization as in the show: seeing intrusive thoughts or challenging feelings as butterflies (or the flying creature of their choice) than can then slowly float away once noticed.
Practice acknowledging feelings and explicitly naming them (this is where a Feelings Wheel can come in handy to help you identify which ones are present).
Try emotion mapping, which gives space to notice emotions without tying them to narrative. You just take a blank paper and draw/shade in the space taken up by each emotion that was in your day. You can color code so that each emotion has a color or spectrum. (Some people like to color their own feelings wheel as their map for this).
Separate Sensation from Story
From this place of acceptance, or even just curiosity, we might find it useful to notice sensations in our bodies without immediately attaching meaning to them. A crucial part of managing stress, trauma, strong emotions, etc. is about helping our nervous system recalibrate, and to do so, we need to pay attention to what’s even going on in there in the first place! For example, the amygdala—a small structure in the temporal lobe of the brain—is in charge of a couple of things, including detecting environmental threats and kickstarting our survival protocols (commonly known as the “fight/flight/freeze/fawn” responses). When we pay attention to what our bodies are doing and feeling, we can better figure out how to sit with it and what to do about it, including telling the amygdala to chill out.
So, especially when our mind screams urgently, it can be useful to instead slow down and get curious. Is there tightness in the body? Pain? Fluttering in the belly? Shortness of breath? Try to be with what is in this moment. Might this stance bring you more peace, even just for a few minutes?
Peace is this moment without judgment.
That is all. This moment in the Heart-space
where everything that is is welcome.
Peace is this moment without thinking
that it should be some other way,
that you should feel some other thing,
that your life should unfold according to your plans.
–Dorothy Hunt
At the very least, learning to listen here can help attune you for your next steps!
Practice:
Explicitly connecting mind and body here can be very useful, but it’s hard to do if you don’t have practice (and especially if you frequently are disconnected from your body and have been trained to ignore its sensations). Sometimes this feels more accessible in less charged moments – maybe an interaction with a coworker rather than a lover, or in a moment where you are activated by your own internal monologue rather than an external stressor. Even something as seemingly mundane as someone getting your order wrong in a coffee shop – can these interactions become opportunities to practice working with emotion?
The next time you have a strong emotion, pay attention to what’s going on in your body (e.g. areas of tension and relaxation, heartbeat and pulse, breathing, perspiration, etc.). Do your limbs feel tingly, heavy, twitchy, numb? What’s going on with your stomach? Is there any part of your body that feels an urge to move? What happens if you follow the movement? Is your breathing fast, shallow, slow, deep, measured? Is your jaw clenched and throbbing? Is there a knot in your throat? Does it feel like there are bees in your sternum?
Check or Challenge the Stories
Maybe you are riding in the car with a partner and having a tense moment around navigation. A storyline might start to form in your mind: “they hate how I have no sense of direction. Why can’t I be better at this? They must be so annoyed with me right now.” You might go further down the road, imagining fights you might have, how long this conflict might last. You may get anxious and quiet, or even preemptively defensive and irritable. Things may escalate and end up in an actual fight with your partner, or in a secret internal fight with yourself that your partner is oblivious to!
It’s very possible you were attuning to your partner’s body language and making an educated guess about their judgment of you. However, sometimes these thought spirals are actually forms of twisted thinking that are a bit more removed from a shared experience. It’s possible you assigned value and meaning to their actions that didn’t match their own, and reacted to your own story rather than a shared reality or even their intentions. So how to differentiate?
Rather than immediately blaming yourself or punting off responsibility to your partner, when your mind returns to the past—or begins to spin more stories about what this all means and churn up anger, self-blame or resentment—what would it be like to interrupt those stories, or even let them go? What might it look like to ask for reassurance, or get external help with those interruptions? What other ways can you engage to check in on the story you’ve built? How would your feelings and behaviors change if the story were different? What past experiences are informing your reactions?
Practice:
Read through a list of common cognitive distortions. Which ones do you find yourself doing frequently? Read through a list of antidotes to those distortions. Which might you be able to try out? Try practicing these first in “lower-stakes” situations and going from there. If you like a daily reminder, there are a number of “mood tracker” apps which can help you spot patterns and distortions in your thinking.
Related to this and the previous strategy set, consider what meaning your physical sensations may be trying to communicate (e.g. dehydration, low blood sugar, need for sleep, chemical imbalance of some sort, etc.), and how your emotions may shift if you address your physical body (e.g. decreased irritability, greater focus, heightened ability to manage emotions, etc.). If you want a guided walkthrough of common things to look for and how to address them, http://youfeellikeshit.com/ is an excellent and down-to-earth resource.
Clarify Attachment Wounds
The way we learn how to process our emotions is partly based on what we see others do around us. This is part of why our experiences with early childhood caregivers is so important (and is a cornerstone of “attachment theory”). As kids, we learn the “rules of emotions.” What feelings are acceptable, what feelings are not, what we’re supposed to LOOK like when we’re having a feeling, and so forth.
We also learn how to have (or not have) conflict, how to address (or not) interpersonal issues, and so on. These things continue to evolve as we grow, and it can be very useful to note what “core attachment wounds” and defensive patterns have emerged as a result. When we know those core wounds that sometimes flare up or lead us to react to present-day people as if they were people from our past, we can better address them both individually and collectively.
For example—one of the authors’ therapy clients loves cats. This person lived a complicated childhood, where responses to her needs were unpredictable. As a result, she experiences a lot of insecurity in her closest relationships as an adult. When her attachment wounds are activated by things like a partner not texting back immediately or her detecting a frustrated tone in their conversation, it is very difficult for her to engage. Instead she might back into a corner, make herself small, take space in solitude, pretend she doesn’t have needs or even lash out if confronted about it. It reminds her of how feral cats react.
So, she and her partner have developed a shared language about her “feral cat” showing up. Because her partner knows her “core wounds,” he does not position himself as her adversary, but rather joins with her to move through the past relational patterns that are currently activated. The “feral cat” language locates the problem outside of her, giving herself a bit of distance from shame and judgment about her actions when triggered. At the same time, her partner knows not to take her actions personally in those moments, to give her space, and to approach her cautiously and with a lot of compassion. Together, they figure out how to care for “the feral cat” and help it feel safe again.
When in a conflict with another person, try to join forces to tackle the issue, problem, challenging dynamic rather than each other. Part of doing that is through externalizing and clearly stating how you and your other person are aligning together rather than being adversarial toward each other. Try to name the problem as a specific thing that is external to both of you, or a “part” of you rather than the WHOLE of you (e.g. you and me and My Depression, or you and me joining to address The Anger).
Remind yourself that the person in front of you, when you’re activated, is likely bringing up a memory of people from your past. Try to specifically identify who you’re remembering, and recognize/affirm that the person in front of you is NOT that person. (Basically, help your body stop time-traveling and orient to the present moment.) It can help to focus on what makes the two people different, or in the case that you can’t or you’re in fact remembering a past version of this same person (e.g. a partner who cheated 10 years ago but has been faithful since), think of how *you* have grown since then and how you are a different person with new tools now to deal with the situation.
Curious about updates to standards around contraception, reproductive health and teenage pregnancy care, and safer sex for adolescents? Here are my livetweeted notes + some slides from a webinar overviewing key evidence-based practices which streamline reproductive health and teenage pregnancy services for adolescents. The webinar also gave data on what teens need and what kind of behaviors they’re engaging in. Though aimed at medical providers, I think the session produced nuggets of information for all kinds of folks!
The Time is Now:
Adolescent Friendly Reproductive Health Care Webinar
Speakers:
Erica Gibson, M.D., & Judy Lipshutz, MSW, RN, NYPATH
Heilbrunn Dept. of Population & Family Health, Columbia University
In 2013, the Youth Risk Behavior Survey said that over 60% of HS students reported using a condom at their last sexual encounter.
The average sexually active teen waits 14 months before seeking reproductive/sexual health services, and the catalyst is usually the desire for a pregnancy test.
The types of emergency contraception in the U.S. include Levonorgestrel pills (e.g. Plan B), the copper IUD (e.g. ParaGard), & ulipristal acetate pills (e.g. ella).
In July 2014, the The European Medicines Association issued the following statement: “emergency contraceptives can continue to be used to prevent unintended pregnancy in women of any weight or body mass index (BMI). The available data are limited and not robust enough to support with certainty the conclusion of decreased contraceptive effect with increased body weight /BMI.”
If you know me well, you know I like me some creepy things. I used to park myself in front of the Discovery Health Channel, watch Disney’s So Weird as a kid, and browse websites for tales of the supernatural. During my gawth intellectual phase, I listened to Cradle of Filth, googled all the fancy words and characters in their lyrics (e.g. Gilles de Rais, Erzulie, Lillith, Faust, Walpurgis, and so on), and ended up writing a term paper about Elizabeth “The Blood Countess” Bathory. I even thought I wanted to become a forensic scientist of some sort once I graduated high-school.
Instead, I ended up going to Brown University and concentrating on gender and sexuality studies, but the passion for these issues lived on. Nowadays, this interest in the “creepy and dark” manifests more obviously in things like my love of the TV series Hannibal, unique earrings (e.g. baby doll arms, a bobcat’s jawbones), and the history of medicine. I’m still entranced by mortality, rituals, bodies, and how we deal with all of these, so it must have come as no surprise to my friends and colleagues when they heard I was attending Death Salon LA.
After avidly consuming tons of posts from The Order of the Good Death website (finding it via the founder’s Ask a Mortician series on YouTube), I heard about this event and promptly freaked out with joy. I immediately told one of my colleagues (the inimitable Megan Andelloux, or “Oh Megan”) who shares my fascination with these topics. After some deliberation because our schedules were pretty packed, we booked our trips from Rhode Island to Los Angeles and got ready for a weekend full of intellectual stimulation.
In just one day at Death Salon LA, I learned about demonic semen transfer systems, the mortification of female saints, cadaver saponification, decorated Bolivian and Peruvian skulls that are said to be miraculous, the mummified Capuchin hanging wall friars in Palermo, the democratization of images via post-mortem photography, anthropomorphic taxidermy, anatomical Venuses, St. Bartholomew’s flayed skin that he held as a sash, death cabarets in 20th century Europe, and more.
The experience was wonderful and illuminating, and it balanced subjects so there would be something for everyone. Still, there was definitely a big emphasis on gender and sexuality, which I obviously really appreciated, and the interdisciplinary, multimedia approach catered to a variety of knowledge levels. I’m terribly excited to see where it goes from here, and though I probably can’t go next year (it’s in Europe in 2014), I’m looking forward to it in 2015 when it comes to Cleveland.
As a demonstration of my obsession with documentation, and as a means to share information with those who couldn’t attend this year, I tweeted up a storm while I was there, and upon returning to RI, crafted a recap of the media bits I nabbed in LA. You can check out the 2 days’ worth of relevant images, tweets, and pieces I corralled:
You can also see the version posted on the official Death Salon website. I was sadly unable to attend all the events, so I wasn’t able to recap the Atlas Obscura trip to a local cemetery or the Death Salon LA Soirée with death-themed food and drinks. I’ll leave you all to dig up those resources, no pun intended.
As a follow-up from my last article, discussing the importance of knowing one’s body and being more educated regarding health, here I bring you a list of tips and advice regarding how to interact with the medical establishment as it relates to one’s own body/health:
Follow doctor’s orders, but if you choose to disregard/modify them, make sure you’re taking informed risks. It’s foolish to assume all patients follow all directions ALL THE TIME. Assess your risks if you’re going to disregard a rule so you can make a truly informed opinion. Don’t believe everything you read online, though the ‘net can be a terrific resource. Trust articles in peer-reviewed journals more than random websites. To be a better consumer of information, you’ll need to up your media literacy skills (but that’s another post entirely). Regardless, as much as you can manage, follow your doctor’s orders!
Be honest with your practitioners. Don’t hide things from them because you’re ashamed or think they might judge you. Whatever the awkwardness, it’s more important to tell them the truth because that information is what will help them take care of you.
If you don’t like your doctor, get a new one. However, don’t confuse “don’t like because they’re incompetent or they make me uncomfortable” for “they sometimes tell me things I don’t want to hear and might be more strict than I want them to be.” Feel free, though, to shop around for a doctor that resonates with you, your personality, and your particular budget/insurance.
Don’t assume “no news is good news.” Doctor’s offices are often swamped, and it’s your responsibility to remember when to get (or at least ask for) your test results.
Before going in for a procedure, look online and talk to your doctor to learn what to expect. This is especially helpful when dealing with first time exams, particularly pelvic and prostate exams. It will help you know the timeline and what will happen, so it might help assuage stress. It can also help you catch if something’s missing! Did the doctor forget to give you something or do a certain procedure? Politely ask them about it, and why they chose not to do it. If you approach it tactfully and not in a condescending or impatient manner, it can be a way to show you’re invested in your health and have done your homework.
Give more information, rather than less. This doesn’t mean bore your doctor with the minutiae of your life, certainly, but that doctors sometimes need more information than we give them. If you think it MIGHT be related to your health, mention it just in case (for example, if you’re taking up a new intense sport, a friend passed away, you’re starting a new diet, etc.). You should also try to be concise, but not at the expense of important details. This is a process of trial and error, and the more you learn about how your body relates to your health and daily activities, the better equipped you’ll be to make these decisions about what’s relevant in the future.
Inspect your body and get in touch with it (literally and figuratively). I’m not saying you need massage oils, Celtic music, and a warm bath (though those can be lovely); I’m just saying pay attention to your body, feel it out, and look for changes. You can only tell when something is deviating from its normal state if you KNOW that normal state is in the first place. Don’t be afraid to touch yourself (again, literally and figuratively); consider it an investment in your health and future.
If you feel strange or develop a lump, a body of symptoms, pains, etc., WRITE IT DOWN. Keep a log of what you’re feeling and when it started, so when (and if) you have to talk to your doctor, you can give them a better picture of what’s going on and how long it has been a certain way.
Be potentially willing to educate your doctor. Though doctors receive a LOT of schooling, there’s a lot of information they still need. Especially when it comes to “alternative lifestyles” or structurally-oppressed groups/minorities, many doctors don’t have the skills and knowledge to treat them in sensitive, aware ways. Not everyone has the privilege/luxury to pick whatever doctor they want or see a doctor that fits their particular needs, so they’ll be in a position in which they need to deal with the hand they’re dealt and educate their practitioner. There are many online and print resources that you can make available to them, so you don’t have to harness all this knowledge on your own! It’s an unfortunate situation, especially for those who are usually placed in a position where they have to educate people around them regarding their identities/lifestyles, but until the structures that build these conditions are addressed and changed, it’s either a choice between educating a doctor or receiving sub-par and potentially inadequate care.
Be aware of language differences and particularly loaded terms. If a doctor asks if you’ve engaged in “risky behavior,” ask what they mean. If a doctor asks if you’ve “used protection during sex,” ask what they mean. These are vague questions loaded with assumptions and, not only is that problematic in itself, it can lead to misinterpreting the question and answering in a way that might sound/feel truthful, but doesn’t get at the meat of the discussion. Know that words you use might not be interpreted in the same way by doctors (especially when it comes to sexual health and sexual activities!).
Check on your family medical history. This is especially helpful when assessing risk factors and patterns of disease! If you are in touch with your biological parents or biological relatives, ask them for their medical history (or records, if they have them). If you’re not in touch with your biological family, start keeping records of your own; these can benefit potential future generations.
Voice your concerns and ask questions. Doctors aren’t mind-readers. If there’s something making you uncomfortable, tell your doctor. If you need to think about it and organize your thoughts beforehand, that’s fine, but make sure to let them know at SOME point. Like any other relationship, a doctor/patient one needs communication, especially because your health depends on it!
Remember what you discussed during the visit. Either ask them to write it down for you or bring a little notepad (or whatever writing device is useful for you). If you have issue with your sight or just prefer things that are audible, bring a small tape-recorder or something like it.
Educate yourself regarding STI-testing. Again, many doctors generally have a limited background in sexual health, so make sure to educate yourself, especially regarding new technologies, tests, and research. “Recommended” tests are based on statistics and population analyses regarding infection rates, but you should ask for tests based on your own sexual history and level of risk/concern, so look up information about those before going into the office. This is crucial for those who are non-monogamous (whether openly or clandestinely) and those who are LGBTQ, since doctors sometimes operate under a model that assumes heterosexuality and monogamy. As I mentioned earlier, language is also important, so make sure you and your provider are very clear about what you’re discussing (e.g. “sex” might mean “penis-in-vagina intercourse” to some people, while it may be a broader category for others).
More specifically, related to certain practices/tests:
Don’t go to the OBGYN while you’re menstruating. It makes it much harder and messier to do proper check-ups.
If you’re going to get a pap-smear, refrain from intercourse for at least 24 hours.
If you’re getting a physical, try to schedule it during NON-winter months, since by then, doctor’s offices are full of flu-ridden people. Read: they’re busier and you’re more likely to get sick, too.
I feel everyone should be in touch with their body. Many individuals hand over their health to a practitioner and don’t really check to see what they’re being given and/or told (which can be a problem if the doctor filled out the wrong prescription or didn’t know something integral about the patient’s health that could affect their care). I find it terribly unfortunate that so many people don’t know what’s going on inside them and lay their lives fully in health-care providers’ hands. Not to say we shouldn’t trust doctors, but to trust them blindly is a mistake. Healthcare is a two-way street and I think patients definitely have responsibilities to ensure that they’re getting the best care possible, partially because they have insider knowledge about their bodies/ailments AND because doctors aren’t perfect (did you know many of them receive less than one week of sex-ed as part of their professional training regimen?).
Patients need to know their bodies to better assist clinicians in collecting data to inform decisions about how to proceed in a medical setting AND they also need to educate themselves about the medical processes that are affecting them or COULD affect them (due to risk level, heredity, etc.). However, while I feel it’s somewhat irresponsible to just go to a doctor without knowing anything about one’s body or the medical care one is receiving (or hopes to potentially receive), I must acknowledge that not everyone has access to this sort of information. Heck, not everyone has access to the conversations that would even bring up the need for this type of preparation, never mind the actual information that would aid in it! For that reason, we need to not only urge people to get to know their bodies, but help provide systems that encourage it. We need an approach that deals with the individual, but also the structural issues that create (or help) body shame/fear/ignorance flourish.
With that said, it’s my hope that by personally promoting body-knowledge in certain circles and classes, it will become a more normalized practice and thus spread. Furthermore, there are many different levels of knowledge and awareness about these issues, so while not everyone has to have a PhD, we should all strive to cover as many bases as we can with the backgrounds and life situations in which we are enmeshed.
But back to the point: know your body.
Why? If a patient is unaware of what standard procedures are, what to look for in a provider, how to recognize warning signs for specific illnesses, how could they advocate for themselves and ask for what they need? How could they tell if their doctor forgot something, or if their doctor is incompetent (or, vice-versa, amazing)?
The reason I bring this up is because I’ve gone through some interesting patient/doctor interactions and I’ve reaped the benefits of my preparation. For example, I went to the OB-GYN a few years back and she was very impressed by my knowledge concerning HPV (Human Papilloma Virus), Gardasil (an FDA-approved vaccine that protects against certain strains of HPV), blood-work, and urinalyses. She repeatedly said how amazed she was that I understood all these terms and knew what was going on. I explained that I like knowing what I put in my body and understanding the things I’m told, so whenever I get a lab result, vaccination, or prescription, I look up information about it. For example, when we did my check-up, I talked about how I’d had my Gardasil shots and so I felt I wasn’t super at risk for genital warts, but that I knew the vaccine only protected against certain strains–16, 18, 6, 11–though not all of them, BUT that 2 of those it covered were the ones that caused 90% of genital warts and the other 2 were the ones that caused 70% of cervical cancer. I also discussed that I was skeptical about having a UTI (which parts of my urinalysis seemed to point to) and we both concurred that it was probably just a contaminated sample, citing the number of bacteria and squamous epithelial cells as proof.
Because of this research and knowledge, I was able to ask things and explain some of my concerns while simultaneously pulling in facts to substantiate my questions and comments. I think this was the biggest thing for me, honestly; being informed helped me articulate better what I needed, thought, and was afraid of in a language that was meaningful and appropriate for the setting. Furthermore, it helped me realize when I was later dealing with an incompetent doctor!
Next: how to prepare to be a better-educated patient!
I feel everyone should be in touch with their body*. Many individuals hand over their health to a practitioner and don’t really check to see what they’re being given and/or told (which can be a problem if the doctor filled out the wrong prescription or didn’t know something integral about the patient’s health that could affect their care). I find it terribly unfortunate that so many people don’t know what’s going on inside them and lay their lives fully in health-care providers’ hands. Not to say we shouldn’t trust doctors, but to trust them without inquiry is a mistake. Healthcare is a two-way street and I think patients definitely have responsibilities to ensure that they’re getting the best care possible, partially because they have insider knowledge about their bodies/ailments AND because doctors aren’t perfect (did you know many of them receive less than one week of sex-ed as part of their professional training regimen?).
Patients need to know their bodies to better assist clinicians in collecting data to inform decisions about how to proceed in a medical setting AND they also need to educate themselves about the medical processes that are affecting them or COULD affect them (due to risk level, heredity, etc.). However, while I feel it’s somewhat irresponsible to just go to a doctor without knowing anything about one’s body or the medical care one is receiving (or hopes to potentially receive), I must acknowledge that not everyone has access to this sort of information. Heck, not everyone has access to the conversations that would even bring up the need for this type of preparation, never mind the actual information that would aid in it! With that said, it’s my hope that by promoting body-knowledge in certain circles and classes, it will become a more normalized practice and thus spread. Furthermore, there are many different levels of knowledge and awareness about these issues, so while not everyone has to have a PhD, we should all strive to cover as many bases as we can with the backgrounds and life situations in which we are enmeshed.
But back to the point: know your body.
Why? If a patient is unaware of what standard procedures are, what to look for in a provider, how to recognize warning signs for specific illnesses, how could they advocate for themselves and ask for what they need? How could they tell if their doctor forgot something, or if their doctor is incompetent (or, vice-versa, amazing)?
The reason I bring this up is because I’ve gone through some interesting patient/doctor interactions and I’ve reaped the benefits of my preparation. For example, I went to the OB-GYN a few years back and she was very impressed by my knowledge concerning HPV (Human Papilloma Virus), Gardasil (an FDA-approved vaccine that protects against certain strains of HPV), blood-work, and urinalyses. She repeatedly said how amazed she was that I understood all these terms and knew what was going on. I explained that I like knowing what I put in my body and understanding the things I’m told, so whenever I get a lab result, vaccination, or prescription, I look up information about it. For example, I talked about how I’d had my Gardasil shots and so I felt I wasn’t super at risk for genital warts, but that I knew the vaccine only protected against certain strains–16, 18, 6, 11–though not all of them, BUT that 2 of those it covered were the ones that caused 90% of genital warts and the other 2 were the ones that caused 70% of cervical cancer. I also discussed that I was skeptical about having a UTI (which parts of my urinalysis seemed to point to) and we both concurred that it was probably just a contaminated sample, citing the number of bacteria and squamous epithelial cells as proof.
Because of this research and knowledge, I was able to ask things and explain some of my concerns while simultaneously pulling in facts to substantiate my questions and comments. I think this was the biggest thing for me, honestly; being informed helped me articulate better what I needed, thought, and was afraid of in a language that was meaningful and appropriate for the setting. Furthermore, it helped me realize when I was later dealing with an incompetent doctor!
Next article: how to prepare to be a better-educated patient!
*When I initially wrote this article, I had a very poor understanding of how trauma and mental health impact people’s ability to advocate for themselves. Even though I made some notes about that, my continued study has deepened this well of knowledge. While I still heavily promote patient education, health literacy, and client’s advocacy, it feels extremely important to underscore the need to not shame people for “not being good enough advocates for themselves” AND point to the many structural barriers that impact those abilities AND the ways in which power dynamics between providers and patients affect a) what people are able to say, b) who will be listened to, c) what actions can be taken.
In fact, it probably means it’s on the brain MORE…and that’s why we need positive, accurate information regarding sexual health, not to mention an eradication of abstinence-only programs that don’t provide the appropriate tools for teens to make their own choices about sex and their bodies. Omitting information and knowingly neglecting to address certain issues and questions is reprehensible!
So here are some resources for the under-18 crowd (or anyone in need of some sweet sex-ed?), courtesy of Violet Blue. 🙂
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Don’t believe the hype! Get real sex info on these bad-azz sites.
Just because you’re under 18 doesn’t mean you shouldn’t know the truth about sex, and what other people are asking about it. Plus, a lot of things you hear in school are sex myths and could get you in trouble, so you really need to know what’s up (down there). These sites will tell you all about sex and staying safe, while staying cool with your friends and yourself. Also, if you’re not sure about how you feel about sex, if you might think you’re not like everyone else, or think you know a gay or transgender person (or like WTF gay sex is!?), these sites will tell you what’s up.
They can even help parents get a clue about something you need to tell them, or want to ask about.
Super funny video show about everything from older boyfriends to backdoor sex: great teen sex topics (but not how-to’s) and your parents ahould watch it too.
Violet Blue ® 2009. Accept no imitations. Tiny Nibbles copyright 2001-2009.
[4/12/18: edited to remove some ableist language and add note below]