Elizabeth Easton:

Hi everyone. I'm Elizabeth Easton, and I'm here today to talk to you about the power of caregivers. So first, let's start with what is a caregiver. When we say caregiver, we mean anyone who cares about the loved one in our care. So parents, spouses, partners, close friends, anyone who is going to provide love and support to the person that we are treating. That is you.

First, let's identify how you're showing up today. What is it like to be in this position, to be watching a video to learn how to support your loved one? Are you excited? Are you energized by the idea of taking on new skills, and better understanding the mental illness and your power in supporting your loved one? Are you overwhelmed, which is a very, very common response to this work. Do you feel like you've learned skills and they haven't worked before? Do you feel like you've learned skills and they worked, but they stopped working? Those are the moments that we're really going to focus on.

First and foremost, if what you are doing is working, please keep doing it. If you are feeling like it's no longer working, or you're getting stuck, or it works in some instances and not others, that's really the focus of this and the subsequent videos to follow. We're going to support you with advanced caregiving skills, learning the skills that you need to be able to support your loved one in the context of their mental illness. And maybe just the context of their mental illness when it's at its extreme, when their behaviors are the most intense, when they're having the most trouble working through them, and you're having trouble identifying how to help them do so. We refer to this as advanced caregiving skills. You already have caregiving skills. What can we do to give you the skills that you need in the context of this illness, or maybe even at times of highest stress?

Why caregiver involvement? Well first, neuroscience supports it. In learning about how the brain works, even in times of great stress, like trying to manage a mental illness, we know that the power of a loving, caring relationship can be so much more powerful than even a relationship with a very skilled clinician. The role of the individual and the caregiver emotional style is a factor in the onset and the maintenance of behavioral and mental health issues that we can actually address. Does this mean that you as the caregiver are responsible for your loved one having a mental illness? No. And we're going to review that as we go through this process. It is far more complex than that. However, understanding emotional styles, your own and your loved ones, can help you find your way out. It can help you build that roadmap that you need.

Caregivers have the right to support. In other countries, like the United Kingdom, they have actually put in legislation that says that not only should caregivers be involved, they have the right to be involved. Why? Well, we understand that mental illness not only affects the person who is suffering, but affects everyone connected to them. So, you have the right to receive support, guidance, and these advanced caregiver skills, to not only help your loved one, but to also help yourself through this process. Your relationship is reorganized. It looks different from any other moment in your relationship, most likely, right now. So, let's help you figure out what to do in this moment.

The number one reason to involve caregivers and healing in treatment is improved outcomes for all involved, for the loved one in our care, as well as for their caregivers. Reduced psychopathology, so reduce symptoms. Reduced mental illness severity. Improve quality of life for both the patient and the caregivers. Reduced need for formal treatment. Reduce the stress for the family, for the individual, and in the relationship. And reduced caregiver burden. Caregiver burden, or burnout, is more related to the feelings that your efforts putting forward are not working, than it is about you putting forward the efforts. That's what we've come to understand from caregivers like you, who have been involved in research studies, or even just sat in my office and explained to me why they feel like they are at such a loss.

It's not that they have to help. They're compelled to help. It's that when they help, they don't feel like it's having the result that they needed to have. That's our job, to help you feel like you have the skills that are refined and effective, and that you've had a chance to practice them to support your loved one, even in the hardest moments.

In terms of that burnout piece, what we have found is that what is most detrimental to the mental health of a caregiver, of a parent, or a spouse, is to witness their loved ones suffering and to feel helpless or ineffective in the face of that. We do not necessarily want you to do more. Instead, we want you to feel that you can do different, and build from there. That if what you are doing is no longer working, we can refine and refocus you on something that could help in that moment, and give you a new roadmap.

But most important, we're focused on the one degree effect. So what does that mean? If I was to get on a plane, and my pilot was one degree off in his flight path, would I make it to my destination? I wouldn't. That one degree over time can make a huge difference. So, what does that mean in terms of you supporting your loved one? If you make even one degree of shift, shooting for more, but in the most complex, stressful times, even a one degree shift with some of the skills you're going to learn from some of these videos, could that have a great effect over time? In moments when you are feeling the most stressed, the most tapped out, think about that one degree effect. Is there one or two small changes you could make in both your interaction with your loved one, as well as your support of yourself, that could ultimately affect that change?

In the work that we're going to teach you, it is connected to something called Emotion Focused Family Therapy. One of the tenants behind emotion focused family therapy is this. In addition to providing information, the caregiver is active in leading or co-leading behavioral and emotion focused interventions, such as emotion coaching, which is one of the videos we have offered for you, in session, at home, by telephone, text, or email, and the service of reducing behavioral symptoms and increasing competence and skill with emotions.

So, what does that mean? Well, that one degree effect we just talked about. If you could send a text or an email, let alone join a family session, or do a long phone call, or interact in person, all of those things will have an effect on your loved one's wellbeing and healing. How? Well, if we look at symptoms, and the emotion skill, and building confidence, this is what it looks like. Someone, your loved one, has endured a painful experience, or several painful experiences. Even just having a mental health issue is a painful experience. We apply a targeted, emotional support, intervention.

Now by we, I mean clinicians. But even more so, when caregivers apply a targeted emotional support skill, confidence and skill with emotions and stressful situations rise for the loved one, as well as for the caregiver. So, we look for those skills leading to a greater confidence when those situations arise again, or in the depths of those painful experiences in those moments. By applying a targeted intervention, we increase confidence and skill, first for the caregiver using the skill, then for the caregiver to use the skill with their loved one. That's our role.

What will we be the result? No need for maladaptive coping behaviors, strategies, or problematic relationships. Their need, your loved one's need to rely on maladaptive ways of coping, would hopefully reduce. They would no longer need those strategies because they have both what you have supported them with, as well as now their own internal capacity to meet those needs. We talk about this as co-regulation, as you helping them regulate and helping them work through, until they are able to do it more on their own with increased confidence and skill.

The foundation of this work. First and foremost, mental health issues have a huge impact on families, have a huge impact on all of our relationships. What we know as well is that caregivers do not cause mental illness. Causes are far more complex. Here are some of the examples of what all loads into a mental illness issue.

Genetics. We know many of the mental illnesses we struggle with today are connected to the genes that we inherited, or the environment's impact on those genes, which is what epigenetics refers to. We know that temperament has a great impact, what we are born with in terms of being more a harm avoidant temperament versus novelty seeking. All of that means, is how do we approach our world? Do we jump in with both feet, or do we tend to error a little more cautious and slowly? In the video that is subsequent to this video called Super Feeler, we'll talk about that concept more.

Puberty. Many of us have uttered the phrase. You could not pay me to go back to that age. What do we mean by that? Well, often it refers to the kind of things that are occurring during puberty, body changes, hormone changes, relationship changes, more complex emotions. All of that is going on at a very tenuous age. And it is a time when many mental illnesses actually first start. Social cultural factors, what the world around us says is good, bad, right, wrong, okay to feel, not okay to feel, normal, not normal, it's a lot, and it's a ton to navigate. Our life stressors. Unfortunately, we cannot keep people from facing some of the major stressors that occur. Whether it's loss, change, growth, all of these pieces come together, and they do have an impact on our ability to manage.

Emotion processing is something we're going to talk quite a bit about in these videos. How do we recognize what we are feeling, when we are feeling it, to how extreme we are experiencing it, and then what to do about it. That is all under the umbrella of emotion processing. It both affects the onset of illnesses and it's also a way out.

And then, Family Environment. When we say family environment, we mean everything from your childhood experiences, your caregiver's reaction to emotion processing, and even your current relationships. Your chosen family at this point in your life, for many adults, and even kids, their friends, their relationships that impact how they view the world, how they view themselves, and how they work with emotions. Again, this is another place where we can make an impact.

So, if you look at what these videos and our work with you is going to focus around, it is the areas of family environment, and emotion processing. Many of the other areas that impact mental illnesses, we cannot do much about the temperament and genes we are born with, going through the process of puberty, facing life stressors, facing the social environment. Those things are going to occur around us. What we can have a sense of agency around, is how we process our emotions, and how the people around us support us in doing so and process their own. There are many other factors that come in to the onset and maintenance of a mental illness. These are the main ones that we can describe today. And then we're going to focus on now that you know that, how are you going to work through?

The foundation of the work has one more component, and we've already started talking about it. Emotion processing style is believed to contribute to mental illnesses, but more importantly, it's also the way out. Not having used these skills, such as emotion coaching, with your loved one prior to now, did not get you here, but it can help you get out. It can help you and your loved one move forward, heal your relationship, as well as help them through their difficult time.

One way that we're going to help you work with your loved one's emotion processing is emotion coaching. You'll see this in a subsequent video. To give you a sense of what that skill is, this is the metaphor we use. Emotion is like an elevator, and reason is found on the ground floor. You're going to learn the skill of emotion coaching to help your loved one when they feel overcome by emotion, and are no longer on the ground floor. If you imagine us as caregivers coming towards our loved ones when they're overwhelmed, we are on floor one, but they are on floor nine or 10. So, how do we get them back down to floor one where reason lives, where we can help them problem solve and move through? We're going to teach you the skill of how to help them get there, how to connect to what they're experiencing, and help them calm and regulate.

The first goal of emotion coaching is to help to regulate and connect. And then, we're going to help them reason. Key outcomes of emotion coaching, as you will learn in subsequent videos as well, are: Increased cooperation. They're more willing to connect with us in avoidance of further escalation. De-escalation. If they are already very heightened and very overwhelmed, how can we help them regulate down? Regulation. Help them feel more in control, feel more calm. And, internalization. We are going to act as caregivers, as co-regulators. We're going to connect and help them to regulate, and over time they will internalize that skill and be able to do this more for themselves.

Not doing it, did not lead you here. But doing it can get you out. The reason we say that, is that many people will learn the skill of emotion, coaching, and think I should have been doing this all along. It's important to note, your not doing this before now with your loved one, did not get them here. I know I've said this before in this video, and I will repeatedly say it again. Not doing it, did not get you here. However, it is a powerful skill to help you and your loved one move forward. So, that is our goal.

We're also going to talk to you in subsequent videos about the caregiver block. So what is that? It's a combination of emotion, related attitudes and behaviors, and love and wisdom. Let's break that down a bit.

Fear, shame, self-blame, hopelessness, helplessness, and complicated grief. These are the kind of emotions that we as caregivers are going to experience as we try to support our loved ones. These emotions can reach a certain point of intensity beyond the threshold where we can feel confident in managing them. What results from that, is attitudes, behaviors, that can leave you feeling stuck, or frustrated, or out of touch with your instincts as a caregiver. They can leave you confused. They can leave you with a blank mind, where you have no idea how to continue to move forward, and they can leave you incredibly frustrated.

So, our job is to help you recognize when you, as a caregiver, are in those places, and what is that, that is pulling you down, that is leaving you stuck? And then to help you not avoid it, but to look at it, understand it, process it, and then to use it. Use it as a signal that something is not only going on for you, but is likely also going on for your loved one. At the end, at the core of caregiver block work, they are fueled by love and wisdom. Often the things that we experience as caregivers, are because our loved one may also be experiencing the very same thing. They may feel very stuck and unsure in those moments as well. So, we're going to use our caregiver blocks as a way to signal something more is going on for us, as well as potentially for them. When we feel frustration, for instance, it's often that our loved ones are also frustrated. So how can we help them identify that, and process through it?

What we have learned from caregivers who have come before you, who have tried to support their loved one with a mental illness, is that fear and self blame are the most common emotions that can arise. That can leave caregivers, shackled, stuck, trapped, unsure how to move forward. These emotions can rise so intensely that caregivers then have a low sense of empowerment, of being able to support and help their loved one. And they may also use problematic behaviors.

What do we mean by problematic behaviors? Everything from denial, that there is even an issue in the first place for their loved one, to avoidance of supporting their loved one in the way that their loved one may need. Criticism, hostility, struggling with understanding that their loved one didn't choose this illness, and maybe even enabling, or in combination, helping their loved one avoid the things that stress them. Are these things problematic because caregivers don't care? No. Far from it. The reason that caregivers get boggled down by fear and self-blame is because they deeply care. They are incredibly overwhelmed, and they care so much for their loved one, that they would do anything to help. That is why they experience these levels of fear and self-blame.

So, what leads to the problematic behaviors? Those emotions arise so high that they no longer can access their instincts as a caregiver, what they know will truly help. So, our job is to help caregivers, to help you understand when these moments have arised, what leads to these moments, and what to do about them, so that you're not engaging in behaviors that can end up leading you and your loved one further away from healing and health.

So, these videos are for you. They're to help you identify not only skills, but also what is coming up for you as a caregiver. What could be burning you out as you try to apply these skills, and leaving you feeling shackled to your own pain, and helping you look at these emotions like fear and self-blame. Our job is to help you feel more empowered, not only in helping your loved one, but helping yourself when these emotions arise. And what we have found is that supporting caregivers with these emotions can lead to further empowerment, and can increase caregivers' desire to provide very active support, both with behavioral interventions, as well as with emotional interventions.

That's why we're doing it. To help you feel unshackled to your own pain, to your own feelings of frustration, to your own feelings, of being at a loss of how to help and support. And help you feel empowered, confident, and that you have a toolbox so you have a set of skills to do in these moments. Maybe not every time. I can't promise you that you will never feel stuck again. I wish I could. You will feel stuck. And our job is to help you identify what are the kinds of things that are going to lead you feeling the most stuck, and what are a few of the things that you can do on your own, as well as to seek support from the people that care about you in order to be able to move forward.

So, what next? What should you watch next? Well, I spoke about the Super Feeler. That is the next video I'd recommend you watching in further understanding the role of temperament and mental illness. Next, there's a video on Emotion Coaching. This video is to give you a skill, right away, for you to be able to use with your loved one, as well as with other people in your life. And finally, Further Information on the Caregiver Block. What that means, how to know that you're in one, and what to do once you realize that you are shackled to your own pain and feelings of low empowerment.

We're here to help. Thank you for tuning in, and I'll see you on the next video.

Elizabeth Easton:

Hi everyone. I'm Elizabeth Easton, and today I'm here to talk to you about super-feelers. First, before we dive into this, let's talk about, how do mental and behavioral health issues develop? The best way I can describe it is, it's a perfect storm between all of these variables. Mental illnesses develop from genetics that are inherited, the environment's impact on those genetics or epigenetics; from the temperament that we are born with, which we're going to talk more about in this video; puberty, this incredible period of time where so many body, hormone, brain changes are occurring as well as all the changes in our relationships; social cultural factors, the things going on around us, and the perspective of what is normal or abnormal, of what is okay and not okay, our society's views on mental illness and health; life stressors, the things that we face in our lives that we can't necessarily avoid; loss, change, these are the things that will come out of the blue and affect us even in our strongest moments can challenge us to be able to have the resiliency we may have had at other times; emotion processing, which we'll talk even more about in subsequent videos like emotion coaching; and the family environment.

The facts are none of us grow up and learn about how to manage emotions in a vacuum. We watch the people around us, whether that be our caregivers, our friends, our peers. We learn how to handle emotions and manage all of these other things based on what we see and what we learn from our environment and our relationships. What we also have come to understand is that emotion processing and the family environment can be our way out, can help us move forward, but first let's understand what we have inherited. So we're going to talk more about this idea of temperament or super-feelers in this video.

So what is a super-feeler? You're not going to find this necessarily in the diagnostic manual that we as clinicians use to try to diagnose mental illness. Yet, as you understand this concept, you may see that it leaves many people vulnerable to developing mental illnesses. So first, what makes a super-feeler? Well, we believe that some people are just wired this way, that they are born with a capacity to experience emotions and identify emotions in a more attuned way, and I'll get to that here in a second.

We also know that early life experiences, particularly in childhood and adolescence can really affect our ability to process emotions and our emotion processing style due to the brain development processes that are occurring during that time. So again, what is a super-feeler? How are they unique? Well, they're incredibly attuned. We often refer to super-feelers as sponges. They are absorbing the emotion, the energy around them. They are looking out for signs and signals that people may not be doing okay, and they're extremely attuned to their own experiences of feeling discomfort. They experience things intensely.

So not only are they absorbing all of these emotions and the pain or frustration or sense of insecurity around them, they experienced them in a heightened, even more intense way. They're more sensitive to perceived threats, meaning if they walk into a room and someone seems to be stressed, or maybe even frustrated with them, they're going to be even more likely to respond intensely to that than the typical person. They're going to perceive facial expressions and body language, and they may even attribute it to themselves that it has something to do with them, what they have done or not done. They may miss attribute body signs as being about them.

They can feel very alone. So often the experience of the super-feeler is that they are the only ones that notice the emotion and feel it so intensely and see a potential threat that when other people don't react in the same way, they feel very different and they feel very alone. They can also hide this part of themselves. The experience of many super-feelers is being told that they are maybe over sensitive over attuned, or even maybe dramatic. The experience can lead them to then hiding this part of themselves, pulling it close and not talking to others about it, yet, still feeling very overwhelmed by it, and they often manage others in order to manage themselves.

So if you can imagine walking into a room and experience a sense of tension and experiencing that tension at a very high, intense level, and wondering if that tension may be about them in some way that perceived threat and looking around and seeing no one else necessarily bringing it up. What they may do in order to help with them, their own sense of emotion is to try to manage others' emotions. If others can feel better, if the tension can come down for others, then that tension will also reduce in themselves.

So what do we know about super-feelers? Well, many super-feelers are highly likely to succeed in caring professions. So it could also be a super power. If you are keenly aware of emotions and feel them intensely, and you have an ability to support others in their emotional worlds, and that helps you feel more of a sense of feeling regulated, calm, well, you could use that to your advantage. You could become a doctor, therapist, any of these worlds where you may be helping people with a challenge, particularly in the emotional world. So many of us who are supporting you through this process of having a loved one with a mental illness may also be super-feelers, and we use it to our advantage. It helps us be attuned and connected and support them our loved ones.

So what should we expect from super-feelers? Well, super-feelers try to find a way to reduce or avoid the emotions they're experiencing. Understandably so. They're experiencing not only their emotions, others' emotions, and they're experiencing them in a very intense way. So what do they do? They typically use unhealthy behaviors to try to avoid. Avoidance in and of itself is an unhealthy behavior. We see this as leading them then to be more vulnerable to mental health issues, as well as to chronic health issues. So what does this look like in real life? So mental health issues, such as obsessive compulsive disorder. When feeling this sensation of anxiety and feeling that sensation intensely, where we may feel that anxiety at a three out of 10, a super-feeler feels it as a nine out of 10 and very quickly.

So they may use something with OCD, like knocking on the door five times before opening it because they're convinced if they use that behavior, it will reduce the amount of anxiety that they're experiencing and keep something bad from occurring, that perceived threat. So what happens? They use that behavior consistently, first, when big anxiety comes up and then every time they start to feel that sensation of anxiety. Over time, that leads to reduced functioning. They're not able to engage in their lives the way they used to. That leads to the mental health diagnosis.

So you can see that being a super-feeler may leave you even more vulnerable to having these consistent use of unhealthy behaviors and therefore a mental health issue. So how do we respond and help? We need to support super-feelers to manage their emotions until they develop the advanced skills to manage them more effectively on their own.

You'll hear this throughout these videos, as co-regulation. We need to come towards them to help them identify what they may be feeling to help them feel less alone in what they may be feeling, and then help them identify strategies different from the unhealthy behaviors they may be using. Most importantly, they need our compassion and they need validation that what they're experiencing is part of being human and that we understand that they experience it at a heightened level than other people.

If as we've gone through this, you recognize that maybe what if you're a super feeler? Well, here's what we've come to understand that is even better as a caregiver. If you are someone that experiences emotions very intensely, that has a heightened attunement to when your loved one is experiencing a painful emotion, that puts you in an even stronger position to be able to help. So we're going to teach you how to use it.

In subsequent videos, you're going to learn things like emotion coaching. You're also going to learn things like caregiver blocks, how to be attuned to your own emotional world. We're going to help you find a way to use it. It can become your super power as a caregiver. So it is very common for many caregivers to walk through this process and identify not only is my loved one, potentially a super-feeler, so am I. So let's help you use it.

Subsequent videos, what to watch next, additional caregiver videos to check out or the emotion coaching video, which I'd recommend watching next, and then the caregiver blocks video. If you haven't seen it, there's also the video on the power of caregivers. I hope this was helpful.

Elizabeth Easton:

Hi, everyone. I'm Elizabeth Easton. And today, I'm here to talk about emotion coaching. So before we get into learning the skill of emotion coaching, let's first look at what we're up against, as caregivers. So imagine that Tom Brady has a major knee injury and he is facing having to have knee surgery in order to continue to play football. Tom Brady is told, "We can do this knee surgery and you're going to be able to get back to your sport. However, in order to do the knee surgery, you're not going to be able to use anesthesia." Many of us would view Tom Brady as being highly motivated to get back to football. That if he had a knee injury, he would immediately sign up for that surgery and be all in.

Would he hesitate if he was told, "But you wouldn't be able to have any anesthesia. You would be on the table, we would be working on your knee, cutting into it, manipulating it, and you would be awake the entire time." Would he hesitate, maybe even refuse to go through the surgery to get back to something that he valued so much? That's what we're up against. Have you ever said that your loved one in our care is just not motivated to get better? Could that actually be that they are motivated to get better, but the process, the treatment they will need to go through is seen as so painful, that they hesitate and maybe even refuse because they're not sure they could handle the pain that they're going to have to go through? Could that be what's underneath their not being motivated? That's the idea behind this.

We need to see that our loved one's in care. It's not that they don't value recovery, it's not they don't value the things in their lives, that they don't value their relationship with you and what you want for them and what they want for themselves. It's that when they view the process of recovery from a mental health issue, they view it as so painful, like surgery without anesthesia. And they're not sure they can handle that level of pain in order to get to the other side with what they want and what they value. So that's what we're up against when we try to support a loved one with recovery. But there's hope, there is a way to help them feel like they have the confidence and the skill to make it through that pain.

First, we have to start as caregivers from the place of compassion, of I understand why they wouldn't want to go through it, why none of us would want to go through it because the process of recovering from a mental health issue is facing incredible pain in order to build resiliency. Self-efficacy is a common term used to describe that confidence and skill. So what is self-efficacy? An individual's confidence to complete a task or accomplish a goal. Self-efficacy is the product of our past experience, observation, persuasion from others, and emotion. Our ability to feel confident in the face of emotion. Self-efficacy is highly linked to academic achievement and the ability to overcome phobias.

So self-efficacy is not just used in the mental health world, it's used in the world of do we move forward with academic achievement, with career achievement? Do we, even as a child, do we attempt to go learn how to ride a pedal bike, like my son recently did? It's also connected to the world of mental health, around things like overcoming a phobia. So for instance, if you had a spider phobia, would you be willing to overcome that phobia? So some people would say, and maybe you just said to yourself, "Absolutely not, there's no need for me to do so." But what if you couldn't have something that you wanted in your life, unless you overcame that phobia? You may still be saying, "Maybe that thing is not worth it." But ultimately, it comes down to your feeling confident and managing the discomfort that could come from facing that phobia.

So self-efficacy is a very common term that we use in the world of mental health treatment. Do people feel like they have the skill and confidence to face the emotion in order to build resiliency? So that's what we're going to be focused on. In understanding how to apply the skill of emotion coaching. This skill is used to help others, to help our loved ones feel greater confidence and skill when facing emotion. Stages of change, stages of recovery really, is what we're going to talk about next. So what affects motivation? So in looking at this table, motivation is what we're going to focus on first. So looking at the column around motivation. These are common terms we use in the field, around trying to describe where someone is, in the stages of change, in facing a problem and moving towards changing in order to get on the other side of it.

So the first level is pre-contemplation. Having no awareness and no intention to change. Some of you right there, might be thinking, "Yup, that's my loved one right now." So we have moved away from saying that a loved one in our care is resistant to change because that doesn't really capture what's going on. We've moved towards this idea of saying, they're pre-contemplative. They have no awareness that what they're going through, or what they're doing is a problem. And what comes with no awareness, is no intention to change. Well, what if we take that a step further? And we say that they have no intention to change because when they need to face whatever it is they need to change, they feel like the emotion that could come up, that they would have to face, would be unbearable.

That the fear, helplessness, hopelessness, grief, and maybe even shame, that sense of not being good enough, that if they had to face that in order to change, they couldn't do it. It would be unbearable. So what if we saw pre-contemplative as they have very, very low self-efficacy to face the emotions they will have to face? They don't have confidence that they could do it, and do it well, so they avoid. And that's what that resistant state is about. So then they are stages, there's a continuum to that. There may be people that you are caring for, who have a greater awareness that there's a problem. And maybe in the very beginning planning stages, for what they need to change, but they're not yet committed to doing it. It takes a ton of effort from you and the people around them to convince them to make this change still.

In our field, that's considered contemplative. So what if that level of emotion that they were facing wasn't quite unbearable, but if it still was seen as debilitating? That maybe they could muster up the idea of doing it, but to actually face that emotion, they get paralyzed. They're just not sure how to move forward. Let's keep going down this table. Then there's preparation. People in preparation are planning for change and are committed. So they're not necessarily doing the behaviors needed for change yet, but they're planning for them, they may be very cooperative with the people around them and helping them plan for it. And they are committed that they want this change in their life.

What if that means that they are facing overwhelming emotions? Not quite debilitating, and definitely not unbearable, but they're still overwhelming. There's some hesitancy there to start implementing the behaviors right away, but they're starting to move towards it. The emotion that they may be facing is probably still overwhelming, but they can start preparing to go towards it. So next would be action. Implementing change behaviors, they are actively engaging in more healthy behaviors instead of using the unhealthy ones. In that period of time, the emotions are probably more manageable. They can identify what they're going to be feeling, and they have strategies to manage them.

Now, that can fluctuate quite a bit. They can feel like it's manageable and then other times, feel that it's overwhelming and slip back into preparation. So this is not just a linear process. Based on their confidence, their self-efficacy with facing that emotion, you can see them wax and wane, usually between preparation and action, back to preparation and then to action. So what's last? Maintenance, they have put in the behavioral change and they are maintaining that behavioral change. It doesn't mean they don't stumble and go maybe back to preparation, maybe even back to contemplation. Maybe something new arises and they don't want to have to face that they also have to do that thing, and they're back in pre-contemplation.

All that, that means is, they have a greater sense of self-efficacy in some areas versus others. They have the confidence and skill to face, maybe some emotions and not others, or to face all emotions in one set of things, but not those others. So the greatest example that I can use with stages of change, is for people who want to stop smoking. Initially, they may have seen all the research, including the surgeon general's warning on the side of the packet, and seen that they probably should not be smoking, that they're a major health risk. They see that and they say, "Yeah, it's not that big of a deal," pre-contemplation. Then they may move to contemplation. "Okay, yeah. I get that it might be leading to lung cancer and I could start working towards that change. But I'm not committed to making it yet."

Then we move to preparation. "I can start planning for that change, maybe learning about other behaviors I could use when I want to have that cigarette, when I have the urge to have the cigarette. And I'm committed to making that happen soon, to working towards it. Then they start putting those behaviors in place, chewing the gum, using a toothpick, finding something else to do instead of smoking. And then they're consistently maintaining that. What's occurred during that time? Their self-efficacy of facing the discomfort of having the urge to smoke and not using the behavior. They have faced it and felt more and more confident each step of the way that they can manage that discomfort.

It moved from unbearable, to debilitating, to overwhelming, to manageable, to now this looming sense of, "Yeah, that discomfort could overwhelm me at some point. But I feel like I've got it. And it's still hanging over here, but it's not right in front of me all the time." So we've learned to see motivation level, if they were just motivated, this would all get better. We've learned to tie that to a person's sense of confidence and skill to face emotion. Okay, so why am I teaching all of that? Because we're going to teach you how to become an emotion coach, how to help people build their sense of self-efficacy, of confidence and skill to face emotion. In order for them to potentially move through these stages of change even quicker, with our support.

So what does that mean? You're going to become an emotion coach. What is an emotion coach? Caregivers increase their role as their loved one's emotion coach in order to facilitate the behavioral supports. So what are the behavioral supports? Those include things like setting limits, and supporting the processing of emotion. So what is all of that in a nutshell? We're going to teach you an advanced caregiver skill. We're going to teach you to support your loved on through their emotions, as well as through this behavioral change. So it can be more effective and maybe even more efficient. So let's walk you through what the skill is. First, I need you just to be a typical human walking through this world right now.

Now I'm going to ask you what your first impulse, what do you want to say to this situation? This little boy comes up to you and let's say you're mom and dad. And he says, "I feel so sad. Nobody likes me." What's your fist impulse of what to say? Commonly, many people would say, "That's not true, I like you. You're so likable." These are the most common impulses we have, to reassure, to cheer lead, to deny that it's a problem. Super common, very normal. So why would we want to avoid going into our loved one's emotion of feeling sad, by immediately shifting to reassuring and cheerleading and helping them problem-solve their way out of it? Really, it's around emotion avoidance.

We might be avoiding that sad feeling, by trying to help them get out of it quickly. Why would we want to do that? Well, maybe because we want to free them from their emotional pain. We don't want this little boy to feel sad. Their emotional pain causes us emotional pain and we want to avoid our emotions as well. We're going to talk a lot, during this process, about the neuro biological wiring we have to the people we love. Their emotional pain is connected, wired to our emotional pain. If you saw somebody walking down the street, stranger, and they tripped, you would maybe... come towards them and, "Oh, that's awful, I know that feeling. It feels horrible." And maybe you'd even laugh, you can admit that one, right? It's kind of funny to see somebody trip, right?

But what if that someone is someone you love, someone you are wired to and you see them trip and fall? That feeling that just came over you, that is the neuro biological wiring, that we if see someone that we love go through something painful, it's almost like physiologically we are in that pain too. That's neuro biological wiring. So when our loved one feels sad, we feel sad and we want to get them out of that sadness, so we also don't have to feel that sadness. And also because of great empathy and compassion. We don't know what else to say, maybe. We surely don't want to say something that's going to make it worse. So we go to problem-solving to helping them out of it.

We don't agree with, or understand their pain, so we don't agree with this little boy that he's unlikable and that nobody likes him. So we want to convince him that, that's not true because fundamentally we don't agree. And we weren't necessarily taught how to respond to emotional pain. It's not like we sat down with the people who taught us how to manage emotions and they said, "No, the only way through emotion, to build resiliency, to build confidence, and skill in facing that emotion, is to face it." We may hear things like, "Face your fears." But nobody really sat down and explained to us, you have to face your fears if you're going to get to the other side of them. You can't avoid them.

You have to face your sadness in order for it not to swallow you up, face your anxiety, et cetera. To gain strength in the face of these emotions, you need to face them. So how did we get here? Intergenerational patterns of people not necessarily relaying that message or relaying that skillset. I don't know about you, but I didn't necessarily have the sadness talk with my parents, where they sat me down and said, "So, honey, you're going to feel emotions sometimes and those emotions are going to be hard. And the way to work through those emotions, is to face them in order to feel stronger, not avoid them." I mean, maybe some of us did and that's great.

I have a son, I'm a psychologist, I have sat and had that conversation with him. So I'm starting to break these intergenerational patterns, but it's not necessarily a conversation that I have ever had with my parents. If we think of this in larger context, if we go all the way back to when many of understand this idea of be strong. So this avoidance of emotion, being celebrated in our culture. Things like this, don't worry, be happy, anger's a bad emotion, boys don't cry. Where did these things come from? Well, in the context of World War II, when soldiers went off, mostly men, soldiers went off and they fought in World War II, facing some horrific things.

And people back left managing their families and managing financial challenges and everything that was occurring during that world during that time. And we look at what people needed to do to be able to get through it. Many people needed to armor up. Showing vulnerability, showing what they may see as weakness during that time could have potentially made them a target or kept them from being able to survive. So we armored up. Those soldiers came back from war and they learned from the front lines, that if they showed vulnerability, that they could get killed. So they needed to muster through, they needed to buck up, they needed to face it, and get through it, and get on the other side of it to be able to come home, and be able to live the rest of their lives and support their families.

Well, they brought that energy home, understandably so, from their trauma and from what they needed to live through. And these messages started to come up, these traumatic experience was to this message of don't go there, don't show that vulnerability, we need to get through. And then you see reverberations of those messages that we still hear today. That life is rough and you got to be tough to get through. Otherwise, it could overcome you. You may not be able to continue to function. So we saw this pretty dramatic change in the world, that is really reverberations from intergenerational patterns that came from times like that. That we still see today.

And many of us didn't necessarily then sit down with our caregivers and have them express, "Hey, that's not going to help you in the face of challenging emotions. Really, we need to face our emotions, build resiliency to facing them, so that we can have the self-efficacy to get on the other side of them and move forward and have what we want in our lives." You don't need unhealthy behaviors like denial, and avoidance, and repressing emotions to get through. Those things actually, we now understand, lead to mental health issues. What should we do instead, gradual exposure, building confidence one step at a time, to face it, to manage through it, to feel more confident in the face of what's going to come towards you. That resiliency is what's going to help.

And that's really the nature of mental health treatment. So first, we need to continue to talk about what are the basics of emotions? That emotions themselves are fundamentally adaptive and the aid in survival. How? Well, we've come to understand that emotions are actually just an alarm system. They provide information about what is occurring for the self, and what is occurring in the world around us. They help us survive by providing an efficient, automatic way of responding rapidly to important situations. The emotions we experience, particularly the body cues of the emotions we experience, they prepare us for action. So what's an example of that? Many of us learned the rule of when you're going to cross the street, you need to look left, look right, and look left again. So we learn the skill.

What prompts us to do that skill, is that when we approach a street, we get nervous that we could get hit by a car. So that anxiety of something bad could happen, like getting hit by a car, leads us to use this rule of left, right, left. That anxiety protects us. It's just a signal that something bad could happen, and we need to do something to respond. That anxiety prepares us for action. Now, that anxiety can go awry, it can became very overwhelming. And if we, over time, avoid it, ignore it, or see it as a five-alarm, instead of a one-alarm, we can end up avoiding experiences. So take that example, kind of silly, but take that to an extreme. Someone who never crosses the street again, because they're too nervous that even if they use that rule, that they will still potentially get hit by a car.

Or in the example of obsessive compulsive disorder, that if they don't look left, right, left and do that three times in a row, they will definitely get hit by a car. So they start to form these unhealthy behaviors in response to that emotion, that get pushed to the extreme and are used now consistently and it gets in the way of them ever crossing the street, or delays their ability to do it in a timely fashion. Now you're starting to get into the realm of more mental health illness, where those coping strategies to protect ourselves, go awry and go to the extreme. So what have we understood about how emotions move through the body? That anxiety, like the anxiety we experience of not wanting to get hit by a car, that, that will rise and then that will fall.

So we see it as this feelings mountain. So this is a common image that we use, kind of a fun kid image that we use, that all anxieties follow this pathway. They rise and then they fall. They hit a peak at some point and they come down. Emotions have hormones and neurochemicals connected to them. When we're approaching that street, the stress of we could potentially get hit by a car, that stress is the cortisol hormone getting released from our brain and it surges through the body. It's these neurochemicals that really help us protect ourselves. And that is that physical experience, that body experience of emotion. Listening to emotions reduces the stress on the body, by bringing the systems back to baseline.

So instead of feeling that anxiety and pushing it away, or feeling it and being consumed by it, and being unsure if it's ever going to end, and being sure instead that it's going to go on forever. The most experiences with anxiety, is that it will go on forever and it will kill us. That leads to avoidance and it leads to this five-alarm system, that can occur when we experience anxiety. So instead, if we listen to the emotion and we turn towards it, we try to understand it by identifying it, and finding ways to cope with it. What we've learned is that instead of avoiding, going towards can actually help us go over this mountain a little quicker. When we avoid, that peak we're going to find at a much higher level than when we face it, it's more likely to come down quicker.

In other words, feelings need to be felt and expressed, they need to run their course. And then we can resume more flexibility. So when we experience a body felt sensation of an emo, we need to look towards it and lean into it, as opposed to avoid. When we avoid, that peak, that mountain peak becomes more like 14,000 feet instead of maybe 8,000 feet. It will get worse as we avoid. If we look towards it, it will come down sooner. Another great concept in understanding how emotions affect our brains and our bodies, is this example from Daniel Siegel's work. This is from the book, The Whole-Brain Child. But I really recommend this reading for any caregiver because it also helps us understand our own brains.

So let's think of the concept of the downstairs brain, the downstairs brain is this lower region of our brains, it's more primitive and reactive. It's responsible for things like breathing, fight, flight, or freeze, which you commonly hear connected to anxiety, and strong emotions. So here's how Daniel Siegel describes the downstairs brain, "The downstairs brain includes the brainstem and the limbic region, including the amygdala. Scientists talk about these lower areas of the brain being more primitive because they're responsible for basic functions, like breathing and blinking. For innate reactions and impulses like fight and flight, and for strong emotions, like anger and fear."

So the downstairs is really the first part of the brain to develop and the first part of the brain to really run this emotional process for us. So babies, young kids, experience emotions very intensely and they tend to be in these categories of fear and anger. And they respond with big impulses to them. The upstairs brain is a little different. The upstairs brain is more sophisticated and analytical. It's responsible for decision-making, body control, empathy, self-reflection. So if you stop for a second and think about what part of the brain you would like for your loved one to be in, when you're trying to support them, you want them in this part of their brain, in their upstairs brain.

Here's how Daniel Siegel describes that. "Your upstairs brain is completely different, it's called the middle prefrontal cortex. Unlike more basic downstairs brain, the upstairs brain is more evolved. This is where more intricate mental processes take place, like thinking, imagining, and planning. Whereas the downstairs brain is primitive, the upstairs brain is highly sophisticated, controlling some of the more important, higher order, and analytical thinking." So when we need to problem-solve our way through something, when we need to learn why the behaviors we're using are unhealthy, and how to use more healthy behaviors instead, what part of the brain do we need to be in? The upstairs brain.

So how the heck do we get there? How do we help our loved ones get there? Well, we need to help them build a staircase between the basement, the downstairs brain, and the first floor, the upstairs brain. Emotion coaching, the skill you're about to learn, can help connect those parts of the brain. Through emotion coaching, caregivers can act as temporary coregulators, while their loved increases their ability for the self-regulation. So how is that possible? How do you help them build a staircase, as the caregiver? Well, there's a very cool super power that you have as a caregiver. Remember that neuro biological wiring I mentioned earlier? So that neuro biological wiring works both ways.

When they're in pain, we're in pain as their caregivers. It can also work in the inverse. When we are regulated, we can help them regulate. Think the last time that somebody you loved, somebody you cared about showed that they loved, cared about you. What did they do? What did they say? That feeling that arises of me working late last night and my husband bringing me dinner, that feeling of him caring for me. That feeling we feel physically is something called oxytocin getting released from our brain, that surges through our body. The love hormone. It is also a calming hormone, it calms our body, it calms our brain. That's what happens when you, as the caregiver, show care and concern for your loved one.

We're going to teach you the skill of emotion coaching. That is going to be a way for you to come towards them, to connect with them, to help them regulate. And even if you don't do this skill perfectly, if you fumble over your words, if you're not quite sure how to execute it well, your just showing that you love and care for them is going to release the oxytocin and it's going to help their brains regulate. It's going to help them become more flexible, it's going to help them walk upstairs to their upstairs brain. So that's what our goal is, in teaching you this skill.

The common keys, the common outcomes of emotion coaching are helping our loved ones regulate, helping with deescalation, helping them avoid further escalation, increase in cooperation between them and us. And over time, their internalizing the ability to regulate and validate themselves within in an emotion. So as we use this skill with them, they will in turn be able to use this skill on their own, with their own emotions, over time. So a quick disclaimer for those of you who have younger loved ones. Your loved one may need even more emotional support than others because their response system will likely be less sophisticated. Their brains are not completely developed, particularly this upstairs brain, their prefrontal cortex, until around the age of 25.

Which means, if it's not fully developed, it's not able to work as well as we need it to, to problem-solve, regulate, have self-reflection. And even on top of that, mental illness, as we've just learned, can impact this part of this brain as well. It can pull them into downstairs brain even more often and even quicker. So they have fewer receptors in their brains until it's fully developed. They're going to need even more support, even more emotion coaching, than maybe our adult loved ones. Now that being said, our adult loved ones whose mental illness may have started when they were much younger, prior to age 25, 26, their brains were impacted as well.

So assume that if you apply this skill to someone who doesn't have a mental illness and someone maybe above the age of 25, assume it will work a little quicker and more effectively for them, than it would for someone who is younger and for someone with mental illness. So some very sophisticated scientific evidence is going to come your way. So this is a key phrase you're going to want to remember as you're applying the emotion coaching skill. Never in the history of calming down, has anyone ever calmed down by being told to calm down. I know I'm getting a little kitschy here, but the idea behind this is the idea behind emotion coaching.

If you can think about the last time you felt overwhelmed and maybe somebody in your life, whether they said it directly or just said it in their tone of voice, told you just to calm down. It doesn't work. So when we're using the emotion coaching skill, we want to have this in the back of our mind, just telling someone to calm down, is not likely to help. So what do we do instead? So the steps of emotion coaching. Step one, validate. We want to convey an understanding of the other's emotional experience and then we want to prove that we really get it, we understand why they're experiencing that. In step two, we want to come forward with emotional support and practical support, problem-solving.

We'll walk through step two here in a minute. But I'm going to encourage you to not apply step two until you really apply step one. So what is step one? What is validation really? Validation, well let's first talk about what it's not. So this is a great cartoon. It walks you through an example where a guy walks up to a desk and he says, "Will you validate my parking?" And the woman behind the desk says, "Well, you did a great job." And she walks him through all of the great ways that he validated. So although that is very funny and seems to be moving closer to validated, than just saying, "Here you go, I stamped your ticket." Really what this is, is not a great example of validation. It's cute, but it's not quite what we're talking about.

So validation is not cheerleading, telling someone they did great and we're so proud of them. It's not reassurance of everything's going to be okay. It's not jumping into problem-solving right away. And it's not using logic in order to correct what they're doing and why it's not working for them. These are great things to do, just not yet. These are examples of step two, not step one. In step one, we want to come towards them to first say why they may be worried, why they may be thinking the way they're thinking, or why they may be doing what they're doing. Then we're going to come forward with some of these things in our emotional support and practical support step.

But it's important to know your go-tos. For instance, I'm a problem-solver. The first thing I do when a loved one is overwhelmed, even though I'm a psychologist, is to come forward, not with emotional support, but come forward with what we need to do to get out of the problem. That's my go-to, it's my autopilot. So at times, if I'm going to use the emotion coaching skill and we'll talk about when to apply it later, if I'm going to use the skill I need to pause and first I need to use step one and I need to validate. And I'm going to walk you through that here in a second. So what is step one? I can understand why you might feel, think, want. Step one is you coming towards the other to convey an understanding of their experience.

I can understand why you might feel, why you might think, or I can understand why you might want. This is a sentence you're going to kind of memorize. So let's use an example that many of you have had to face in helping your loved one seek treatment. I can understand why you might think that going into treatment is not going to helpful. Pause for a second. What three letter word are many of you tempted to utter next? But. I can understand why you might think that treatment is not going to help, but here are all the reasons why treatment is going to be helpful for you. It's my go-to, I want to jump right to problem-solving. I get that you feel that way, but let's not feel that way any more for all of these reasons I'm about to give you.

There's not necessarily a problem with what I'm doing there, except I conveyed their experience and then I pivoted very quickly. I get why you might feel that way, but here's all the reasons why I want you to look at it differently. In that pivot, we are touching on are emotion and then we're very quickly moving away from it. So as you have already learned, the power of a processing emotion, of looking at it and working through it, and then shifting to problem-solving. And that can be your path forward. So how do we help them look at it, sit in it, understand it, and process it, and then shift? We're going to move from but to because.

I can understand why you might think that way, is going to be transformed into, I can understand why you might think that treatment is not going to be helpful for you because. Now, if you'll notice, the sentence not only has because, it has because three times, because, because, because. Not only are you going to convey your understanding of their emotional experience, you're going to prove that you get it. And each of these becauses, particularly doing more than one, can help you really prove, I get it. The idea behind that is, when the external environment mirrors the internal experience, it can turn off those alarm bells and reduce the intensity in the brain.

So let's take the example of your loved one not wanting to come into treatment, maybe they don't want to seek therapy, they don't want to seek a higher level of care. I can understand why you don't want to go into treatment because you have sought treatment before and you didn't feel it was helpful. And because when you got your hope up that it would be helpful, it was even harder when you experienced it, to not be as helpful as you wanted it to be. You felt even worse. And because seeking treatment can be so painful. Having to face all of these emotions and having to learn to do things differently can be like seeking surgery and not being able to have any anesthesia. Okay, did you notice how that felt a little different from if I had just jumped to problem-solving and giving them all the logic behind why they wanted to seek treatment?

I'm trying to match the external environment, working with me, to their internal experience of what they're feeling about seeking treatment. And hopefully that is going to help reduce the alarm bells, quiet the alarm bells in the brain. Then I'm going to come forward with the, and here are the reasons why I want you to do it anyway, why I encourage you to seek treatment anyway. And that is step two or the support step. Emotional support, some examples of that is comfort, reassurance, providing hope. So for instance, in this case, you may say, "I understand all of that, I have heard you say it. I believe in you, though. I believe in your ability to conquer this and I'm never going to give up hope that we're going to find the right skills and the right treatment to help you get on the other side of this. I believe in our ability to do that together and you're not alone in doing it."

Then, coming forward with practical support. So examples of practical support, distraction, redirection, providing kind of an exposure. Let's do this one step at a time, problem-solving, setting a limit of I need you to go anyway. I need this, you need this. And maybe even taking over. So an example of taking over is with a young child, setting the limit and saying, "We are going." Or taking away maybe some of the things we have at their disposal that may be distracting them or keeping them from doing what they need to do. So let's go back to this example of going into treatment. What's some examples of practical support? I believe in your need to do this, and I don't want you to do it alone. Why don't you and I call the number of that therapist together? And I'll be there with you as you do it. And if it helps for me to take you to the therapy sessions and to be there with you afterwards.

If you're looking at higher level of care, you can say things like, "I will help you find the information you need to access a treatment center." So these are all examples of what you could have done, maybe even did do prior to helping your loved one get into care. That is still needed, I don't want you to stop doing this emotional support and practical support. But we need to do it second, not first. So let's go through a couple of examples of what our impulses are. So first one, I'm going to have you take off this now, advanced caregiver skill of emotion coaching. So set it aside for a second and just be a typical person in our typical culture. And think of what is your autopilot? What is your default reaction to some of these comments?

I don't want to recover. Yes you do. I feel fat. You shouldn't feel that way, fat's not a feeling. My depression and anxiety is all my fault. No, it's not. I will never recover. Yes, you will. I'd be better off dead. Of course, not. I hate you. I love you, you love me. I don't want you involved. Okay. These are just a couple of examples of the defaults that I have heard from caregivers like you. And you're not to blame for them. They are how our brains are wired to respond to comments like these. Do the adverse, convince them it's not true, convince them that they could see it differently. Of course, that's you're autopilot. And in some ways we're going to use that in step two. Maybe not those exact reactions, but the idea behind them.

What are we ultimately doing? We are teaching your brain to turn right, when it is wired and conditioned to turn left. It is conditioned to say, "That's not true." To say, "There's a different way to look at it." To say, "Let's help you out of that way of thinking or feeling." But what we're understanding is that you may need to face and process through those emotions before we can shift out of them. So you're going to do the same thing. You're going to help your loved one turn towards it, turn right, instead left. Process the emotion, instead of avoid it.

Emotion is like an elevator and reason is found on the ground floor. So often I hear from caregivers, I'll even show them some of these slides and they will say, "Is my loved one learning this too? If you could just teach them that facing their emotion is better than avoidance, maybe they'd stop avoiding." And I get that, the problem is, when we're overwhelmed, we are not on the ground floor, where reason lives. We're not on floor one, we're on floor nine or 10. We can't access that information, that learning that we need to face emotion, instead of avoid it. We can't access why it's important to still receive surgery, even if we're not going to have anesthesia, right?

We're at nine out of 10. Going back to that other example from Daniel Siegel, the downstairs, upstairs brain, we are not in upstairs brain where reason can be used. We're in downstairs brain, where we are responding on reaction and impulse. So what the heck do we do? In this metaphor with emotion as an elevator, we're on the ground floor, trying to support our loved one with working through it differently, with processing through it. So what do we need to do? We need to get them from floor nine or 10 down to floor one. How do we do that?

I can imagine why you wouldn't want to seek treatment because you have done this before, you have sought treatment before and it wasn't always helpful. And the kind of treatment that you need, the kind of skills you're going to need to use are going to leave you having to experience more challenging emotions, not less. They're going to get more intense before they come down and they feel less intense. And because the process of facing emotions that intense is exhausting. And you're not sure, maybe you're not sure you have the energy to do that again. I can understand why you're wanting to avoid going to that place again. I just want you to know that I am here with you and I understand what you're going through as best as I can.

I wouldn't want to face more pain if I had the option of avoiding that pain either. But man, are you strong. I have watched you face incredibly painful things and I believe in your ability to do it now as well. And I don't want you to do it alone. I know in the past you may have felt like I just didn't get it, I'm sorry for that. I'm going to keep trying to understand. I will join treatment with you, and learn more skills and gain a better understanding of what it's like for you to face this pain. And I'll support you in doing it. And I'm going to learn too and I'm going to need you to teach me, if you're willing, how I can better support you as well.

So looking at that example, is that different from how you may have approached that before, how you did approach that before? If what you did to help them get into treatment worked, keep doing it. If it didn't work, or you're right now, trying to help them understand why they need to stay in treatment, why they may need to seek a different treatment, why they need to face the challenging things that their clinicians are asking them to do. Try to use this approach. See if you can help them come down to the first floor and then come forward with that emotional and practical support, that you likely are already very good at applying.

The body is the teacher. So think about what it's like to be in that resistance state of I don't want to. Really think about that for a second. Put yourself in that state. So if there was something you were asked to go face and you really didn't want to, you felt that debilitating or unbearable feeling and you didn't feel confident to face it. Maybe it's even around this emotion coaching skill and using this with your loved one. I don't want to. See how that feels in your body. Your shoulders tense up, your stomach tenses up, everything gets to a protective place. And I want you to pay attention to everything from the neck down. I don't want you to pay attention to what you're thinking necessarily. Just notice what the body, from the neck down, is experiencing as I walk through our typical response to a resistance state.

I can understand why you don't want to go into treatment, but you need to do it anyway. You need help, you need support, and you've tried it other ways, and it's not working for you. And I don't want you to do it alone, but I need you to do it. Notice how the body responded. Did it relax? Is it more flexible? Is it open? Is there a chance that it actually tensed even more, that you armored up even more? Yet, this is what many of us are conditioned and taught to do in the face of resistance for anything, especially something like going into treatment. Let's try to use the emotion coaching skill instead. Take a second, put yourself back into that resistance state, feel it. Notice from the neck down, what it feels like to be in that state of I don't want to. I can't.

Let's use the emotion coaching skill again, neck down. I can understand why you don't want to go into treatment because you have faced it before and it was so hard, and you're exhausted right now. And because you didn't feel like it was necessarily helpful, if anything, you felt like it made things harder. And because you got your hope up and you felt even more crushed on the other side and you felt even more alone as you tried to do things differently, and just felt even more overwhelmed by the emotion, and even more alone in facing it.

I can understand why you don't want to face it again right now. I'm here with you, I don't want you to feel alone in this. And I know I have not always been there, coming towards you about why you don't want to do something. Instead, I've probably just tried to convince you to do it anyway. I want to understand more. I want to come towards you more. And I want to see your pain and I want to be with you in it. I want us to take this one step at a time. Take a breath with me real quick. What's the first thing I can do to help you face this challenge, help you face this decision?

Okay, neck down, what did you notice? Some of you, as I went through the becauses, you may have felt this increased flexibility, maybe this increased pull towards me. Maybe you just noticed your shoulders come down a little bit, your hands unclenched, maybe you noticed you leaned into your chair a little bit more. Maybe you actually experienced the emotion even more initially, and it brought you up on that mountain even higher in that experience of the emotion. That is what emotion processing can feel like. The emotion rises and then it hits its peak, and falls. Did the support step help increase flexibility more the second time around, help you feel seen, heard, understood, help you feel more connected, or at least maybe slightly less alone?

Now imagine receiving that skill over, and over, and over again. Could it lead to increased flexibility, support, regulation? That's our goal, that's what we're trying to accomplish in using the skill. Now, I'm going to end on this. You're not going to be able to use this skill all day, every day. It's tiring, I'm tired even after coming up with that example and I planned it for this video. It is tiring. So, first thing I'm going to ask you to do, identify some of the behaviors or symptoms that your loved one is struggling with that are the most concerning. I say child here, but loved one, anyone that is struggling from this illness. Identify some of those behaviors and symptoms, would you write them down? I'll give you a minute to do that.

Now, as you're doing that, after you have them written down, one, two, or three, doesn't need to be an exhaustive list. Your top one, two, and three, I want you to rank order them. Circle the one that's number one, the most important thing for them to work through, the most important behavior change. And then identify number two, and maybe even identify number three. When those things arise, that's when you're going to use this emotion coaching skill. You don't have to use it for everything. When those thing arise on phone calls, when you're visiting them, at home when you see them struggling with it, that's when you're going to use the skill.

Before helping them problem-solve, before reassuring them, can you use a couple of becauses? I can understand why that's a struggle, I can understand why you might be feeling, I can understand why you might be thinking, I can understand why you might want or not want. Come towards them, connect, help them regulate and then help them shift and provide that support. Try it out. Try it out with people in your life, outside of that relationship with your loved one that's in treatment, with their siblings, with your partner or spouse, with your coworkers, with other people in your life. Get some practice, get some self-efficacy with the skill there first.

And then apply it to your loved one and see how it goes. And please remember the one degree effect. If you can get one because out, if you can stay in that emotion just a little longer than you did before, what effect is that going to have over time? So, what to watch next. The next video I recommend is the caregiver block video. If you missed them, there are two other videos prior to this one that I had recommended, go and watch them now. The power of caregivers or the super feeler. If you have learned those skills before, it can still be helpful to go back to these videos to help get your head around what your job is as the caregiver. And please know, I believe in your power, there's neuroscience to support the power that you have with your loved one. Good luck, I believe in you.

Elizabeth Easton: 

Hi everyone, I'm Elizabeth Easton and I'm here to talk to you about caregiver blocks. So first, as we jump into what is a caregiver block and what am I going to do about it. We need to start with this core belief. Loved one's want their caregivers to help them heal even when they try to convince us otherwise. This is a core belief behind Emotion-Focused Family Therapy. This is an approach to support caregivers with supporting their loved one's, by providing advanced caregiver skills like the one we're going to review today. Your loved one's wants your support, even when they push you away and try to convince you that it's the last thing they want. If you haven't had a chance to watch the video on the Power of Caregivers, I encourage you to do so. Not only do we believe in your power to help, neuroscience supports it. So if you haven't had a chance to watch the video on Super Feelers, both your loved one's super power and yours or watch the video on emotion coaching. 

I encourage you to watch those as it'll give you a little bit more context to what you're about to see with emotional blocks. Quick review, how do behavioral and mental health issues develop? Again, in those other videos I go into more detail, but I think it's important that we touch base on really what we're focused on here. These are all of the things that we have learned, this perfect storm that can lead to the onset of mental illness and two of these factors can also help us move through the mental illness. Those two things are family environment and emotion processing. We understand that mental illnesses do not develop in a vacuum, but our emotion processing style can affect how we manage challenges in our life. Like life stressors, puberty, all of the things that can become major stressors in our lives or minor stressors. Our ability to understand how we feel, what to do with those feelings and how to connect with the people around us to seek support, that is all encompassing our emotional processing style. 

We also understand that changes to how we process emotions can be the best way to help us out of mental illnesses and our caregiver, the people who love us, who care about us, that are involved in our lives. Whether that is physically caring for us and or emotionally caring for us, that how they help us with that emotion processing can also have a huge effect. So, that's what we're going to focus on today. What are the things that can get in the way for you as a caregiver, as someone who cares about and provides love and support for the people in our care? How can you affect their treatment and recovery process? Even more importantly, what could get in the way for you as a caregiver in being able to do that? So the first thing we're going to talk about is something called animal models. Animal models are connected to the work of Janet Treasure. So the book there that you see on the right is a common book that caregivers read and trying to understand how to help for instance, in the case of this book, a Loved One with an Eating Disorder. 

But these animal models can be used to apply to any of us, who are caregivers for others. Who care and love the people around us and want to support them with the emotions that they experience. So the first type of animal model is the emotional type. So as I walk through these, I want you to identify at your most stressed, what do you tend to do as your autopilot? How do you tend to experience and express emotions? The first type is the jellyfish. The jellyfish feels emotions very intensely. They feel the emotions come up, they feel them intensely arise and they tend to express them. They also tend to move from emotion to emotion very quickly. Jellyfish, also tend to express them and the people around them know whether or not they're feeling something and often what they're feeling. So the people around you may not have to guess whether or not you're overwhelmed or stressed, they can read it all over you. So there's no guessing game, there's no trying to decode your behavior. They know right away. 

Then, there's also the ostrich, they may experience the emotions just as intensely. But the ostrich emotional type experience it and hunker down. They don't necessarily express what they're feeling or demonstrate what they're feeling in their body language, in their voice tone, in what they say. In some ways, it's almost like they'll stick their head in the sand and say, "I'm not going there." Right? So if you think about the jellyfish versus the ostrich, really is about not whether or not you experience the emotion, it's what happens after you experience it. Is it outwardly expressed sometimes in intense ways when you are really, really stressed? Or do you stick your head in the sand and go pretty blank? Do you not show much? So I'm going to ask you to identify for yourselves, how many of you are a jellyfish? Now, how many of you may tend to be an ostrich? Great. If you didn't identify one or the other, just a little hint, you might be an ostrich. Now, what is the in between? 

If we think of the jellyfish over here, an ostrich over here, the in between emotional type is the St. Bernard. The St. Bernard responds with calmness, with warmth and compassion. They can kind of stay in that in between state, where they're not too overboard in how they're expressing it and they're also not expressing anything at all. They're right in the middle. They approach emotions with interest and affirmation. So in terms of being a caregiver, that's how they're going to respond emotionally to their loved one's distress. If you're a dog lover and you think of a St. Bernard, this is kind of how they walk through their world, right? So what I want you all to understand is, most often many of you are walking through your days in a St. Bernard emotional type. You're able to respond in these ways to your loved one. When you are incredibly stressed, which is often linked to when your loved one's incredibly stressed, you may tend towards that extreme of the jellyfish or that extreme of the ostrich. 

I'm not saying you're in those states all the time, you're likely not. It's that 5, 10% of time when you're at your most stressed, that those may be your autopilots. The next animal model is your caregiving type. Not only how you respond emotionally, but also how you tend to care give, how you tend to encourage maybe their behavioral change if they need to make changes. So the first type at your most stressed, how many of you are the kangaroo? The kangaroo tends to approach things by saying, "I'm going to pick up my loved one, I'm going to stick them in my pouch, and I'm going to jump them through this process where they don't have to be affected." It can all be also be considered as the bubble wrap approach. I'm going to bubble wrap them, so that they are isolated and they're insulated, and they don't have to be exposed to the things that can overwhelm them or harm them. So, that is one caregiver type approach at it's very extreme. The other is the rhino. The rhino tends to approach things in a very practical problem-solving way. 

I see the issue, I want to get you on the other side of the issue. So, I am going to ram you through it and we're going to problem solve and make you get through it, push right through that issue. Where the kangaroo said, "Let's have you avoid and maybe go around and I'll insulate you around it." The rhino says, "No, we're going through it and we're going through it quickly, and I'm going to get you on the other side of it." What I want you to understand is both of these approaches have value. I don't want you so overwhelmed that you won't be able to function, that's the kangaroo type. The rhino type is, I don't want you so overwhelmed and paralyzed, let's get you through this. Both can be helpful. At their extreme, they may not be as helpful as the dolphin. The dolphin is going to help you find the in between. If you've ever seen a dolphin with their young, you'll see that they swim above them, below them, next to them and when their dolphin, their baby dolphin is getting off course, they nudge. 

They nudge them to do something different. They don't ram them, they also don't hover over them and not allow them to make choice, they nudge and that's really the idea. That balance of caring and controlling, that guidance, security, safety of, "We've got this, I'm here to support you. You keep moving and I'll nudge you in the direction when you need nudging." They don't over manage, but they will take the lead when they need to. That's the caregiving type that most of us are in most of the time. When we get to our most stressed, we tend to go to those extremes. Now, combine those types. You are looking at a jellyfish with horns. When my loved one's experience distress, I experience distress and you'll know and they know when I'm experiencing the distress. They can see the emotion. I'm highly attuned to what they're experiencing and man, do I feel it and show it. My response to that is to problem solve them through it. Here's how we're going to be able to solve this. So, I am a jellyfish with horns. 

It's kind of a funny way to approach this, but what's helpful around us is just to understand that this is human nature. That we all have the propensity to be the St. Bernard dolphin and we have the propensity to get really stressed and push to these extremes. Having a loved one with a mental illness, pushes us to our extremes. So, it's important to be aware of when the jellyfish and the rhino, when the ostrich and the kangaroo or any combination of those things, when they're coming out of us. Because, they may keep us from being as effective as we want to be in supporting our loved one. One other piece about the animal models that I've seen in my own life. My husband and I, as we're parenting our child, who is six... It'll be interesting to watch this video in a few years. Who is six years old. When he is distressed, I come forward as a rhino when I am also stressed, my husband comes forward as a kangaroo. I bring that example up because we tend to try to counterbalance each other. 

I would say on most days, we're both kind of dolphins. But I tend to the rhino problem solving side and he tends to the emotional side and the, "Let's keep our son from having to face all of it." So when we do that, I will tend to go to the rhino and he'll counter balance me with my son and go to the kangaroo. The more I rhino, the more he may go to the kangaroo to balance me out. Together, we may be the perfect dolphin. But what my son is getting, is a rhino and a kangaroo and he doesn't know which one is going to be more helpful and he's confused. This is super common in our co-parenting or couple relationships. When one problem solves one way, the other one tends to counterbalance with problem solving the other way and responding the other way. When one goes to the jellyfish, that may lead the other to start ostriching, because it's so overwhelming. Or one goes to the ostrich and doesn't respond a lot emotionally, the other may respond with the jellyfish to bring the emotion up. 

We do this as human nature. Not because we are ill, not because it's diagnosable. We do this as human nature to counter balance each other in relationships. So our goal is to gain insight into what is our go to? What's our autopilot? How do we know we're in jellyfish? How do we know we're rhinoing? How do we know where kangarooing? How do we know we're avoiding the ostrich? We pull these pieces together to give us an awareness of what state we are in as we go towards our loved ones who are distressed. The greater awareness we have, the greater effectiveness we'll have in supporting our loved ones. So the next piece that I want to walk you through in the caregiver blocks is, what does it take to support your loved one? So first, I want everybody to take a deep breath and I ask you to do this as I walk through this next set of slides. In through your nose, and out through your mouth. Let's do one more. In through your nose, and out. 

That is the quickest way for us to get our brains to replace, to learn something new and also for us to look internally at what's going on for ourselves. So the first thing I'm going to ask you to do is check your guilt at the door. Guilt is a funny thing, it can be helpful, it can show us what we need to pay attention to. "I wish I had done that differently. I wish I had responded differently. I just rhinoed, that wasn't that helpful. I want to be more of a dolphin. Okay. Why did I rhino? Because, I want to help them get through this problem. How do I nudge instead of shove? Okay. Guilt was helpful there. I'm going to use what's helpful. Why did I do it? Why did I not do it? Okay. Let me take that understanding and bring that forward." The rest of the guilt is not motivating. It could keep you from moving forward. 

If you get stuck in this process of guilt, even after you've identified what can be helpful, what you want to do differently going forward, and you're still ruminating on what you did or didn't do. It can be helpful to find some practices of self compassion. To be able to shift away from that, to get away from what's unhelpful about guilt. One example of that self-compassion work is the work of Kristen Neff. If you just google her website, she has several meditations and practices around self-compassion. You can find self-compassion, self-kindness in a variety of avenues. That meditative work, that journaling work, it can be really helpful for you to identify what's coming up for you that's keeping you stuck and locked in that cycle of guilt. Another understanding that can be helpful of what's keeping you locked in that cycle is identifying what is guilt and what is shame. Shame is slightly different, where guilt is, I did something wrong, shame is, I am wrong. Where guilt is, I did something that wasn't good enough, shame is, I am not good enough. Shame can be more paralyzing, more debilitating. 

What we understand about shame is that everyone experiences it, but most of us do not talk about it. It is one of the most often, common, experienced emotions, but it is the least often, least common emotion we are willing to share with others or even willing to sit in and feel ourselves. Shame actually develops before we can even form words, let alone understand words, let alone express words. It's pre-verbal. So if you think about the last time that you felt ashamed about something you did or didn't do. That feeling that comes over your body, it is so overwhelming and it is so hard to describe. Where guilt can be motivating, shame is debilitating, it is so overwhelming. So what the heck are we going to do with it? Because as caregivers, it comes up so often. Even learning some of the skills that people like myself, clinicians may teach you. Your first impulse that you may not even be aware of could be, "I should have been doing this all along." The could have, would have, should have's. Though sometimes can reflect guilt, that can be motivating and help you do different. 

But sometimes they can actually keep you locked in shame of, "I wasn't good enough and I will never be good enough." So let's talk a little bit about how to respond to the guilt, to the shame, self-blame and all of the other emotions that commonly arise. Why do we need to talk about them? Why are we spending time focusing on them as caregivers. Because our job is to not react to our loved one's distress, but to respond and if we're trying to use those skills to respond. But we're stuck in our own process of reacting to these emotions, we're not going to be able to be as effective as we want to be. So what is a caregiver block? It's a combination of emotion and the related attitudes and behaviors, as well as love and wisdom. The common emotions that I'm going to talk you through in the next few minutes are fear, shame, self-blame, helplessness, hopelessness, and complicated grief. These are the common emotions that arise for caregivers. 

Next, those common emotions can lead to very common attitudes or behaviors that can end up leaving you feeling stuck, feeling frustrated, feeling out of touch with your instincts as a caregiver. So, these things can block us from being able to respond in a way that can be more helpful and most importantly, these emotions arise out of love and can foster incredible wisdom. If we think of our emotions, as well as our loved one's emotions as just signals, that something is going on. Then we can see the emotions that arise in us as caregivers as a signal, something that's happening for us and something is happening for my loved one. We can then find ways to work through that experience of that emotion for ourselves. See it as our great love and attunement to our loved one and then use it to maybe use a skill like emotion coaching, to be able to be attune and help them process through their emotions. It actually can bring you incredible wisdom. First, let's look at more, what are these emotions and how do you know that you're stuck in them that they're keeping you stuck? 

So these are some of the common emotions and the ways that I've heard these emotions described by caregivers. Fear, "She will get worse if I do this." Many of the things that we ask, not only our loved ones to do in the process of recovery from a mental illness. But we ask you to encourage them to do, to set limits around, to tell them to do in the face of their emotions and their distress. Often times it leaves their emotions to get bigger, more intense before they come down. So many of you will have the thought and the intense fear even of, "They will get worse if that's how I respond." Hopelessness, "I'll never get him back." They will not only get worse, the emotions will get worse, but then their behaviors may get worse and then, "I'll never get onto the other side of this and I'll never see them again. I'll never see the joy in their eye. I'll never hear their laughter." 

These are some of the common things that I've sat with caregivers and it helps them describe and understand that they are stuck in helplessness and, "I don't know what else to do. I don't know how to get them out of that place. I have learned skills. I have tried to apply the skills and I feel so stuck and helpless at this point. What else am I going to do? I never thought this would be us." That grief of looking at this point and my relationship and my life and my loved one's life. "I never thought that we would be seeking treatment for a mental illness. That I'd have to learn skills of how to help them through anxiety, through depression, through eating disorders, through all of the things that they are facing, "I never thought this would be us." "I'm not the right mom for her." This was an incredibly powerful phrase said to me by a mom who came to this realization in one of our sessions, as I was helping her look at what was keeping her stuck and avoiding applying an exposure therapy intervention. 

What eventually came out of her mouth before she even realized she said it was, "But, what if I'm not the right mom for her? What if someone else could do this better than I could." It was a big moment. Not because she had this realization and this thought for the very first time. But because she has had it since her child was very, very young and had never said it out loud, had never admitted it to anyone else. It was the story of shame deep inside of her, that in many ways was leading to her doing the things or not doing the things that we were helping her learn to do with her loved one. She realized that this is one of the phrases that was blocking her from being able to successfully apply that and then if you only knew, "If you only knew how I used to respond to my loved one, or even how I did a couple hours ago. Instead of using the kind of skills that you've taught me. 

Instead of being able to be the dolphin, I was ramming them through like a rhino or I have helped them avoid their distress like the kangaroo. If you only knew how long that's been going on or how intensely I have applied that." It's these stories, it's these phrases, it's these thoughts, it's this that keeps caregivers stuck. It's this that keeps us from finding self-compassion, that of course you have done things and not done things that you have learned over time, have not been as helpful as they could be. These are the emotions, these are the things that can arise, that keep us from being able to go forward and also do those things now. So we need to look at them, we need to unpack them, we need to process them. To help us build resiliency, to help us build skill and confidence as they arise, because they will again and then be able to get on the other side of them and do what we want to do as caregivers that we have found to be more effective. Intense emotions can be so uncomfortable, so what do we usually do? 

The tree metaphor has been particularly helpful for me in unpacking what the natural human response is to intense emotions. Everything you see here at the top of the tree are the behavioral markers, denial, avoidance, criticism, rejection, accommodation, enabling, blaming and defensiveness. These are the behavioral reactions to intense emotions. Everything down at the bottom of the tree or in the roots, are the emotions that could be fueling the use of those at times often, unhealthy behaviors, unhelpful behaviors. Things like fear, grief, helplessness, hopelessness, self blame, and shame. The same emotions I just took you through in the slide before. So first, when we think about applying this tree, look at the behaviors up top and I ask you to think about your loved one in our care. Do they at times demonstrate some of those behaviors? Sometimes all of those behaviors in a given day? Now look at the bottom of the tree and the roots. Do you think those behaviors could be rooted in the intense emotions underneath like fear? Like helplessness? Like hopelessness? Or even feelings of shame? Of not feeling like they're not good enough? 

Now, I want you to think about those behaviors and filter them through this filter. When you see those behaviors in your loved one, I want you to think, they must be experiencing those emotions underneath and those emotional blocks are what we do when emotions get too overwhelming. We use the behaviors up top. We get blocked, we get stuck, we get frustrated and then we use the behaviors up top to reduce the intensity of the emotions. That's the new filter that I'm going to have you put on whenever you see the behaviors, that's what you're going to filter it through. These emotions must be going on. Now, I'm going to ask you to take a deep breath in through your nose. I want you to look at the bottom of the tree, those emotional markers again. Do you as a caregiver at times experience some of those same emotions? Now, look at the top of the tree. Do you at times as a caregiver, use the behaviors at the top of the tree to help reduce the intensity of those emotions? 

If you just nodded your head, if you just said yes out loud, if you just thought in your mind, maybe, probably, you are not alone, welcome to the club. You are a caregiver. You are a caregiver supporting someone with one of the most challenging things in life, their mental illness, and you are a human being. This is the process of just being human. What we do with intense emotions, is seek to lower the intensity and we use many of these behaviors up top to do so. So, what do we do if we realize that we get stuck in that space? Well, this is a great thing that I learned from a book called My Stroke of Insight. Jill Bolte Taylor, is a neuro anatomist who went through a stroke and she wrote a book about it. She also does a great TED talk, but she doesn't talk about the 90 second rule in that TED talk, but I love this and I have used it with caregivers for years. 

So what is the 90 second rule? Did you know that it takes 90 seconds or less for emotions to be automatically triggered, surge through the body and then dissipate. That means for a minute and a half, you can feel the emotion, feel it surge through your body and then have it go away. Once the emotion or that cortisol hormone, stress hormone response is gone. Then, it becomes a choice to continue to reinforce that emotional loop. So you feel the emotion, let's look at that in a slightly different way. That means for 90 seconds, you watch the emotion arise, you can feel it surging through the body and then you could watch it go away. After that, you could still continue to feel that fear and anxiety so on. You need to look at the thoughts that could be re-stimulating that circuitry, that could be leading to that release of that stress hormone in your brain and having it surge through the body. 

If that 90 seconds of that feeling becomes 90 minutes, 90 hours, 90 days, you need to look at the thoughts that could be re-stimulating that 90 seconds over and over and over again. That is how you interrupt that loop. Identify where you're thinking, could be leading to that research. So it's a great thing to learn. It's good to learn about the common emotions we experience, the behaviors that can help us identify we're experiencing them and then recognize, "Man, I have been in this feeling for hours instead of 90 seconds. So what am I thinking about that could be re stimulating the circuitry." But I don't want to stop there. So what do you do if you're stuck in emotions for longer than 90 seconds? Well, the first thing you need to notice is that it's happening. That you're experiencing the emotion and it's surging over and over and over again, and you're stuck. So, what do you do to notice? Pay attention, mindfulness. What are the body cues? What are your body cues for anxiety? For anger? For sadness? 

If you go through the emotions we just went through, for hopelessness, for helplessness, for fear. What are your body cues? Where do you feel it in your body? What are the automatic thoughts that you have? "I can't do this. This won't work. It's too much." What are the autopilot behaviors, that top of the tree stuff? Rejection, criticism, self-blame. What are the kind of things that we bring forward to try to manage that 90 seconds that became 90 minutes? So notice your body cues, notice your automatic thoughts, notice your autopilot behaviors. These things can be really helpful for you to gain awareness of, "I'm in the 90 seconds and it's going on for 90 minutes." Then, what do you do? Breathe. Take a breath with me. The quickest way to stop that clock at 90 seconds is to take those breaths, particularly in through the nose and out. Another way of looking at that is box breathing. When I went to create my slide for this and looked for an image that could teach a very common strategy of deep breathing, box breathing came up, but it came up as tactical breathing. Why? 

Because box breathing, this deep breathing strategy is actually taught in the military to help people in combat situations. Get regulated and be able to do more effective things. So it helps them get through the 90 seconds, to be able to respond in a way that's going to be more effective. So if a Navy Seal can do this in combat, we can do this in the face of our own emotions and our own daily stressors and we can help our loved ones do the same strategy too. Why do we need to learn these things? Why am I helping you gain awareness of your animal models? Gain awareness of the common emotions that could rise and leave you stuck? Gain awareness of the skills to do when you get stuck? Because, we as the caregivers are our loved ones anchors in the storm. We are helping them figure out how to weather that 90 seconds, that becomes 90 minutes, that becomes 90 days. 

If we can regulate ourselves first, if we can have compassion for the natural emotions that are going to arise and the autopilot behaviors and thoughts that are going to come with them and our tendency to want to avoid them too. If we can gain that self-compassion, that awareness can lead to change for us too. It can help us learn the advanced caregiver skills that we need to apply. It can help us feel stronger and more confident in the face of supporting them, which in turn can help them feel stronger and more confident in the face of emotions, in the face of their recovery process. We are their temporary co regulators. The first step is for you to have self compassion, for you to learn regulation skills for yourself and for you to feel greater strength and confidence in facing emotions and then I have no doubt in your power to support your loved one. So what to watch next? If you stumbled across this video and you haven't watched some of the others, like the Power of Caregivers, Super Feeler, or the Emotion Coaching Skill. I encourage you to go watch those videos. 

If you've watched all four, awesome, go try to apply some of the skills. Reach out to the caregivers for you, to the people who care for you and talk to them about what you've learned. Talk to them about the challenges as well as the successes and using these skills and understanding these concepts and most importantly. Watch this stuff over and over and over again, as many times as you need. I hope this has been helpful for you. Thanks.