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InFocus

When your world falls apart – how to combine mindfulness with problem solving to cope in a crisis

“There are many ways to combine problem solving with mindfulness, and no one way is more correct than another. The more you make it your own, the more valid and empowering it is”

What happens when you’re in a place where your worst fears become a reality? When life suddenly becomes unbearable?

For example, when a parent has been ill for a long time, and their hospital visits and medications have become the norm. All that time, you are in a heightened state of anxiety without even realising it because it’s the new “normal”, right? This might go on for years. Then the worst happens, the very worst: they die. You never knew that that could actually happen. And your world falls apart as theirs ends.

Or when your relationship has been a bit “off” for so long that you accept it as a normal stage of your relationship? Many together-forever couples do move from crazy head-spinning romance to settled, comfortable times, to years when they’re happiest spending small amounts of time together. It may be that you’ve been in an increased state of anxiety or stress for years, even though you’re still together. All that time, you’re hypercoagulable and hypertensive, rarely taking a full conscious breath. Then the relationship ends, and it’s like you’ve been on a cliff edge for so long you can’t remember being anywhere else. Then the sky comes crashing down and sends you falling into the chasm over the cliff.

How can soft mindfulness bring comfort or coping abilities when your life is in turmoil?

A study published in the Canadian Journal of Psychiatry explained that people who meditate are more able to tolerate their own distress than people who don’t (Farb et al., 2012).

One part of the pre-frontal cortex associated with stress regulation is the anterior cingulate cortex (ACC). Poor ACC function tends to correlate with impulsive behaviour and mental inflexibility, which are common among people who are under stress. Experienced meditators display more activity in the ACC and better stress regulation (Taren et al., 2015).

Poor anterior cingulate cortex function tends to correlate with impulsive behaviour and mental inflexibility, which are common among people who are under stress

As veterinary professionals, we’re used to and good at creating problem lists, triaging them and problem solving, or at the very least, problem management. We use flow diagrams, spider diagrams and spreadsheets to calm our minds at work. And we have checklists to force our minds to stay focused and clear in a crisis. We can also use these tools when the crisis is our life.

Practising mindfulness

Mindfulness encourages us to focus on the present moment as if our life depends on it. And yet, sometimes the present moment is too painful, and you just want to be unconscious, unaware or asleep. But that agony isn’t going anywhere soon.

Sleep can help you pass the time and be a bit more rested. Eating and drinking water are essential to function, and we need to function even amid a crisis.

After this, taking time to create problem lists and spreadsheets is so helpful and second nature to us – at the very least, giving it a go won’t make things worse. When your world falls apart, things are already as bad as you believe they can be.

When someone dies, whatever their religious beliefs and affiliations, there are a known series of steps that have to happen. Hospital and hospice staff, undertakers, powers of attorney, executors of wills, etc, and others just appear out of nowhere to walk us through those steps. (I’ll be forever grateful to the guys in the funeral home for literally walking my kids and me through what we needed to do, where we needed to be at what time and which car to sit in. They provided water, umbrellas, kindness, silence and a pen and paper for our eulogies. They held our hands.)

But when our relationships or our dream jobs end, there are no undertakers or funeral home staff to hold our hands. It may be that the person or people who used to hold our hands and help us to navigate these nightmares are gone with the relationship or the workplace. It can be even lonelier than bereavement sometimes. Yet it feels like a bereavement, and we have to grieve.

How do I combine problem solving and mindfulness?

There are many ways to combine problem solving with mindfulness, and no one way is more correct than another. The more you make it your own, the more valid and empowering it is. When you have no power or energy, anything that restarts your power bank is helpful.

When my kids were small, if they had problems and wanted to chat, they would tend to blurt out everything in what seemed like one breath – a “brain dump”. Then they would look to me for answers. As a child and adolescent counsellor, I knew that giving them all the solutions (my solutions) would do more to disempower them than it would do to help them. So, I devised a way to help them, which I still use today.

There are many ways to combine problem solving with mindfulness, and no one way is more correct than another

As they spoke, I would listen actively and intently, then I would write what they said down. It was this act of writing things down that made them feel recognised and validated. Then we’d pause, sometimes for a bewilderingly long time. Then pretty much every time, they would produce their own solution. Whether it was a practical thing they could do or an acceptance of it, the solutions varied all the time. But at the end of the activity, their eyes were fresh, and their minds uncluttered. I learnt from them and their insight more than they learnt from me in those times.

In a way, mindfulness encourages us to see things with wonder and fresh eyes, like a child. Children are naturally mindful and caught up in the present for most of their early years. That’s why many of them have an easier life compared to adults.

Adopting that childlike awe and curiosity in a crisis can help with creating problem-solving flow diagrams and spreadsheets. Writing things down is a bit like journalling for vets and nurses, with our own spin on it and using our own inherent talents.

A step-by-step guide to making a problem list

Because we are often clueless when our world falls apart, I’m going to suggest one way of combining mindfulness and problem solving, as the hearse driver did for me: lay it out one step at a time, clear as day, so you don’t fall over.

I’m going to suggest one way of combining mindfulness and problem solving […] Lay it out one step at a time, clear as day, so you didn’t fall over

Step one

With an A4 notebook, you could make several problem lists and triage them. For example, one page could be about urgent problems that day, such as:

  • How do I get from A to B?
  • How do I prepare for work tomorrow? Or do/can I work tomorrow?
  • I need food and water
  • I need sleep
  • I don’t need…  (eg social media, news apps, melancholy break-up songs, etc)

Create three columns on the page and list these problems in the first one. (A bit later, the middle column will be where we write down the physical and emotional feelings we have, while the far side of the page is where we’re going to write some solutions.)

Ideally make this page a few pages into the book rather than the first page. I’ll explain why later.

Step two

The next page can be a list of problems for tomorrow, like work, clothes, food and water, and people you need to contact urgently. Again, list these on one side.

Step three

The next page can be problems/targets for the next week. This could be funeral arrangements in case of bereavement, notifying landlords if you have to move out or organising your CV if your job has ended.

Step four

Another page can be a list of worries about the future. For example:

  • How will I ever love or trust someone again?
  • I’m never going to have a child
  • How will I ever find a secure job again?
  • What if I’ve made a terrible mistake?
  • How will I afford the bills?

These problems will loom large, but you can allow yourself to “awfulise” or catastrophise here. Although there are dangers associated with this, it is naïve to think that a life crisis won’t give rise to awfulising, so don’t judge yourself for it at this moment.

Step five

Staying with your page on worries for the future, write down the emotions and physical feelings each problem causes in the middle column. For example, next to “how will I ever love or trust someone again?”, you might write the emotions of loneliness, desolation and terror or the physical feelings of chest ache, sleepwalking and disassociation.

Please write down what you feel.

Take time to close your eyes, breathe and examine the feelings you have about each individual thing. Make a long list, and try to give each feeling at least 10 breaths.

Step six

Then on the far side of the page, you can write down strategies or ideas you may have for dealing with each problem, aside from noticing it and the feelings it causes. You might not have any strategies or ideas at this early stage, and that’s OK.

This list will be added to and crossed out as time passes. You might even leave it blank – there are probably no strategies for “fixing” the terror of feeling unlovable, for example, but there are probably ideas you have about paying the bills.

Step seven

Go back to the previous page of problems/targets for the next week, as these are often much easier to work through when it comes to making strategies. You can start filling these in on the right column of the page. Your practical mind might come to play here, which can feel empowering. But before you do this, record all your physical and emotional feelings in the middle column.

If you have any inkling of empowerment and/or if you notice your mind is calming down by untangling this plethora of problems and feelings as you go through these processes, try to stop, take a breath and make that feeling as prominent and as long-lasting as you can.

If you notice your mind is calming down by untangling this plethora of problems and feelings […], try to stop, take a breath and make that feeling as prominent and as long-lasting as you can

Notifying the landlord that you’re moving out or designing headstones for a grave can make it feel very real and final, and that can be indescribably painful. But the more time you spend acknowledging that pain, the faster it will dissipate. Crying is a normal human reaction to intense pain. Allowing yourself this physical reaction to the emotions you’re naming is part of your grieving, self-care and recovery.

Step eight

The pages of problems for tomorrow and problems for today are your emergency care, and it’s often about getting through the day ahead because you have no other option.

You might have no emotions about organising food, water and travel for today and tomorrow. You may feel numb and in shock, like an android. Write these feelings down if you can, even if they are feelings of numbness. Physically you might feel nauseous, exhausted, hungry or not hungry. Again, the more you put feelings into words and acknowledge them by writing them down, the easier they are to bear.

You never know how strong you are until being strong is the only choice you have

Bob Marley

Over the next few weeks, you can add to all these pages and subtract from them as well. Your way of thinking and your ideas may evolve rapidly.

Step nine

When you feel like it, you can add to the pages you kept blank at the beginning of your book. This can be about your regrets or mourning or question marks about the past. For example, you might feel like those years in your relationship or all those attempts at IVF have been wasted years. You might have regrets about not spending more time with your loved one who has passed away. That’s how you feel now.

You should fill up the pages with lists of emotions and physical feelings. There probably aren’t any solutions to these things from the past and that’s partly why I feel it’s something to examine when the immediate crisis has passed, but it’s your choice.

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