Staying Present While Coping with Overwhelm, part 1: The Five Steps

Overwhelm is a natural, human response to a perception of life-threatening emergency.

Wayne Scott Favicon black and whiteAFTER A VERY PANIC-EDGED WEEK of tracking news about Oregon’s forest fires, following the latest pandemic news, and feeling threatened by our cruelly divisive national politics, for the first time today the air is so unhealthy that neither myself nor any family member is leaving the house, except to walk the dog. This past week I have been talking to therapists, counselors, and social workers about how hard it is to do therapy with clients. One of the common questions, hanging in the background of these supervision discussions, is: What do I do with my own distracting sense of overwhelm, when I am trying to be present for my clients? Everyone is exhausted.

As with so many things, once we can figure it out for ourselves, we are better able to help our clients. In part one of this post, I’ll talk about managinng overwhelm. In part two, due out in a few weeks, I’m going to explore what makes a ‘good enough’ therapist during a time of chaos.

Rethinking Overwhelm. We need to re-frame how we think about overwhelm. For many folks, especially action-oriented helping professionals, this incapacitating state of shut-down is not a familiar state. We may be used to lives of productivity and creativity and energy. So when we feel overwhelmed, it’s natural to go to a place of pathological self-judgment: What’s wrong with me? Why can’t I cope with this more effectively?  But that interpretation, while human, is neither helpful nor kind. The extra layer of shame is toxic. It just makes things worse. In his classic book about the Holocaust, Man’s Search for Meaning, Viktor Frankl wrote, “An abnormal reaction to an abnormal situation is normal behavior.”¹

So, how do we make sense of this ‘abnormal reaction?’ It helps to place overwhelm, or the freeze response, in the context of the autonomic nervous system (ANS). The ANS threads through our body, connecting the brain, heart, gut, and muscles. It controls many bodily functions that happen whether or not we are thinking about them (for example: breathing, heart rate, digestion, sexual arousal, etc.); hence the word “autonomic.” It’s also brilliantly equipped to recognize threats to our lives, to help us mobilize to act when we face those dangers, and, yes, to heal when the danger has passed.

In its simplest terms, you can think of the ANS as a menu of responses to perceived danger. The most primitive set–the fight, flight, or freeze defenses familiar to everyone–are survival functions built into our nervous system that we share with most creatures on the face of the earth. They activate powerful chemicals that allow our bodies to mobilize, to respond and survive. The most evolved aspect of the ANS is the ventral vagal, or social engagement system. the social part of our nervous system, which allows us to manage stress and danger through bonding with others.

Car metaphor. One way of thinking about the three strands of the ANS is that it’s like a car. The sympathetic nervous system, or fight or flight response, is like the car’s accelerator, helping us rush toward a challenge, or giving us the momentum to drive away. The ventral vagal, or social engagement system, is like the driver of the car, scanning the horizon, making eye contact with other drivers, bringing self- and other-awareness into the balancing act.

The “dorsal vagal,” or freeze response, resembles the brakes. It slows us down when we sense something that could endanger us, or bring us to a halt.

Overwhelm is a natural, human response to a perception of life-threatening emergency. But how is it helpful to freeze? Why would it be adaptive for any creature to freeze in the face of extreme adversity?

It can be helpful to think of the immobilization response in terms of evolution. It evolved in the earliest boneless creatures (cartilaginous fish) over 600 million years ago. First of all, it’s a way of conserving energy in extreme circumstances. The body slows down dramatically. A potential predator might lose interest in a creature that looks dead. Or if he’s going to kill you anyway, the parasympathetic response helps the body shut down in preparation for death. (The freeze response also is related to defecation, which some animals do when terrified, which also repels predators.)

In a less extreme situation, human beings can lean on this stream of the nervous system to achieve a sense of stillness and calm. One yoga metaphor for thinking of the parasympathetic is savasana, or the death pose, a state of deep calm.

How do we re-set when we feel overwhelmed? Neuroscience experiments confirm that it is difficult to shake one’s self out of a freeze state. One reason for the stuckness is that this autonomic response sits very closely to the human experience of shame, or outsiderhood, or not belonging. We don’t want to admit our vulnerability to anyone. Often, when I experience a freeze response in my work, I know it because I literally forget that I can ask for help. Loneliness for other people magnifies the sense of stuckness.

Some simple steps to re-set when you feel overwhelmed:

  1. Accept it without judgment. It is a natural human response to extreme adversity, an evolutionary gift that enables both survival and healing. It just might not feel that way. It might feel dissonant with your usual ways of engaging the world and stressors. What would it be like to allow your sense of overwhelm without judgment?
  2. Make a slow intentional shift. Recognize that, while the freeze response is natural and highly adaptive, it is also strong and immediate. We might be lured into thinking we can’t control it, when in fact we can influence it. And although it’s powerful, we have more control over it than we might realize. But we have to slow down and focus inward. Forget how to make cognitive sense of it for a minute and just focus on your body.
  3. Find your voice. Neuroscientists such as Stephen Porges talk about the intentional use of prosody to bring the shut-down nervous system back into balance: chanting, humming, vocalizing, song, reading poetry or prose out loud. In My Grandmother’s Hands: Racialized Trauma and the Pathway to Mending Our Hearts and Bodies, Resmaa Menakem shares numerous embodied strategies that involve prosody, including humming, buzzing, om-ing, singing aloud, among others. Check out this book!
  4. Seek support from nice people–eventually. For extreme overwhelm, it’s often counterintuitive to set up an emergency visit with your therapist or have an intimate face-to-face with your bestie right away. It can compound the sense of threat and make the shut down worse. Try sitting side by side and talking, experiencing a sense of connection while reducing the full-on assault of human niceness (think: car ride). This was helpful for me during the pandemic when I noticed, to my surprise, that sometimes I was having deeper, more vulnerable sessions with my clients when we were talking on the telephone, instead of meeting face-to-face. The titrated sense of human connection was easier to tolerate for their frightened systems.
  5. Manage expectations. Some of these steps will produce temporary, here-and-now relief. But the world is still in crisis. Our bodies are alert to the shifting danger. It is likely we will find ourselves again overwhelmed. And that’s OK. The next time you find yourself struggling with overwhelm, do this instead: a. Say hello to the overwhelm; b. Thank it for how it helps your body survive; c. Remind yourself that you can influence it; d. Focus on your body; e. Sing or hum or buzz or om … or speak.

As a therapist, I am remembering to be patient with what can feel like the “slow” progress I sometimes see in my clients during the pandemic. It is important to continually reframe these self-judgments, reduce their sting, to see the ways in which “slowness” might be adaptive, even healthy, during crazy times. In The Heart of Trauma: Healing the Embodied Brain in the Context of Relationships, Bonnie Badenoch challenges us with the question, “How do we begin to trust and ride upon the unsure, tentative groundswells of remaining present with what is here in each moment?”

WE.  WILL.  GET.  THROUGH.  THIS.

NOTE: In part two of “Staying Present While Coping with Overwhelm,” due out in a few weeks, I’m going to tackle the question: How do I know if I’m a good enough therapist during a pandemic?

¹Check out my new consultation group for experienced clinicians, in which we’ll do a slow read of Frankl’s classic book.


FALL 2020 WEBINARS

There’s a POWER IMBALANCE at the heart of clinical supervision. It grows bigger when participants differ by race, gender, sexual orientation, etc. How can you address these often unspoken dynamics to promote learning? Join me and Rebecca Davis, MA, CSWA, LiCSWA for  “Navigating Intersectionality in Clinical Supervision,” September 17-18, 2020 (8:30 am – 12:00 pm each day). 6 CEUs (supervision)

COLLECTIVE TRAUMA, such as the coronavirus pandemic, exacts a profound toll on populations, straining people’s ability to regulate emotion and to prevent the development of trauma effects. “Boosting Resilience During a Pandemic,” offered October 15-16, 2020 (8:30 am – 12:00 pm each day), will integrate information about the neurobiology of trauma and the inner workings of the human nervous system with practical mindfulness strategies to enhance long-term resilience during a pandemic with no end in sight. 6 CEUs.

Helping professions have a renewed mandate to center RACIAL JUSTICE in their work, particularly when it comes to ethical decision-making. Tori Lopez, LCSW and I will be offering  Promoting Racial Justice in Ethical Decision-making,” October 22-23, 2020 (8:30 am – 12:00 pm each day). This dynamic, interactive webinar provides an ethical decision-making model that centers racial justice. 6 CEUs (ethics)

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Michele Riggs - September 15, 2020

Hi Wayne, for me and my team (I run an ACT team as well as supervise the c/m team at my outpatient office in rural Tillamook OR), we check in with each other every day. While I work for an agency which has rules about using PTO for needs. I recognize the value and heart of each of my staff/team members and so if they need a break, then I give it to them without using their PTO if possible. Taking care of myself on the other hand sometimes goes to the back of the list which I recognize is not the healthiest thing that I can do but for some reason the well being of others is something that I am very passionate about. The high needs individuals that we support usually don’t have a lot of support from family or community members and homelessness is something that continues to be a barrier for our most vulnerable. What I can say is that I am pretty good at “leaving it at the office” at the end of the day and I am aware of my own limits so that I think is what is helping me navigate both a pandemic as well as the recent fires that have displaced so many. Anyway, thank you for the ongoing thoughtful insights you present in your letters and also the wonderful training’s that you provide. I have enjoyed the ones I have attended. I also really enjoyed Mabel and Olive….:)

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Wendy Curtis - September 15, 2020

Wayne, thank you so much for your posts! They are so very helpful to this very exhausted, fatigued and sometimes hopeless therapist who wants very much to still be helpful to my beloved clients.

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