How to survive a devastating, heart-breaking, life-shattering, rock-bottom crisis.

I write this blog post from personal and professional experience. What works for each person is different and you will have to find your own way. Think of this as improvising a recipe that works for you. Many of the ingredients will be the same from recipe to recipe, but they are combined in different ways to make completely different dishes. With eggs you can make a broccoli quiche or a chocolate cake or a cobb salad, depending on what you mix them with and how you prepare them.

What follows is a list of ingredients to start with. There are three main sections: how to look at it (the philosophical part), coping skills, and medication.

Philosophy of tests

I’m writing this in America, where the cultural expectation is to put on a show of happiness, because being happy means you’ve succeeded at life and being unhappy means you’ve failed and you’re a burden to others. That is so stupid! Here’s the truth: life is painful for everyone. Everyone’s tests are personal based on their strengths and weaknesses. Actually, I think our strengths and weaknesses are often the same qualities. For instance, I have an abundance of compassion for other people, but a deficit of compassion for myself. Another person might be strong in perseverance when meeting work goals but weak in persevering through interpersonal conflict. Some people think you trip over love in the street and others think it’s the result of hard work. Enough of judging others—we don’t understand each other’s tests, and we think other people don’t have tests as bad as ours because their tests wouldn’t be tests for us. Everyone has tests. And we get the same tests over and over until we learn whatever it is that makes us not vulnerable to that test anymore. And then we get a different test. And then the old test comes back in a more subtle way just to make sure we really did develop that virtue that we needed.

There is nothing you can do to make the ocean calm. Nothing. Ever. Sometimes the waves are small and the winds are favorable, and you succeed or fail by how you adjust your sails and your rudder. Other times you have to ride out the hurricane or the doldrums, which take completely different skills.

All people are interdependent. The saying, “No man is an island” is really true. Self-sufficiency is another myth that Americans are particularly fond of, and it makes us not want to be a burden on others and therefore we try to suffer through our tests alone. This is inefficient to the point that it sometimes makes getting through the test impossible, and it deprives others of feeling useful and helpful. I know this and I still don’t like asking for help. Feeling vulnerable is a really uncomfortable feeling. But honestly, if you can’t manage vulnerability, I swear the universe will send you test after test until you can. Who wants that?

“God/Life will never give you more than you can handle.” Well... sorta...  God/Life will never give you more than you can handle by relying on God/the Universe, which pretty much means any test is fair game. If you look at life as a school, your challenges are what develop your abilities, and you have to be pushed beyond your current capabilities in order to develop new strengths.

Okay, on to coping skills, in no particular order.

Breathe. Seriously. People suffering the panic of a devastating personal crisis hold their breath. Make yourself breathe. And then focus on your breathing as an easy way to meditate. There’s a type of Buddhist mediation called Tong-Len. You breathe in, imagining yourself breathing in the suffering of everyone who is going through the same thing you are, and then breathing out comfort to all of them, including yourself. Sounds woo-woo but it actually helps you get centered because you realize that your suffering is not unique or special, which is oddly comforting, and you realize that there is comfort to be had, eventually if not immediately. Also, measured breathing slows down your autonomic nervous system, which helps you calm down. Breathing slower than you think you need to is key.

Pray/Meditate. I’m willing to accept the good ideas of any religion or person or philosophy, and the early Christian monks (called the Desert Fathers and Mothers) had lots of good ideas. One of them is “ceaseless prayer.” It comes from the Bible: ”Pray without ceasing.” (I Thessalonians 5:17). I have my own recipe for this and you will have yours. I think of it as repeating, perhaps just in your mind, anything that comforts you. One possibility might be reminding yourself that, “The only constant is change” or “This, too, shall pass,” knowing that nothing, even your horrible, searing pain, lasts forever. Or you might recite something on a loop in your mind that is inspiring to you.

If you can’t focus enough to pray/meditate the way you want, pray for the ability to pray better, use meditation to build your capacity for meditation. Your attention will drift in and out; just bring your attention back when you notice it.

Another helpful thing is putting forth your very best effort in anything/all you do as a small step towards building the world you want to live in, rather than dwelling on the suffering in the world you do live in. You can be kind to an irritating, uncaring customer service rep. You can do your best at professional work, mopping the floor, gardening, parenting—anything that you do that contributes to the betterment of the world in large or small—even tiny—ways.

 

Guided Imagery. I like the guided imagery by Belleruth Naparstek, who is a trauma therapist. Audible has a few of her works. The trauma set is very good. Some people find the guided meditation too intense, but the affirmations, in and of themselves, are helpful. I like the way she words her affirmations in an “I can feel myself getting better” kind of way. They’re not stupidly unbelievable, like Stuart Smalley affirmations ("I'm good enough, I'm smart enough, and doggone it, people like me.") This author also has a book out called Invisible Heroes, about using guided imagery for PTSD, that has several scripts that really could be used to anyone’s advantage. There are a million guided meditations on the internet for all kinds of issues. Try some out.

Nature. Walking, fishing, hiking, sitting at the beach, sitting in a forest, gardening, looking at the sky, petting an animal or seeing an animal in the wild—Nature is always calming and always giving insights. I mean, you know, within limits—seeing a bear is only calming if it’s not chasing you. Leaning up against a tree is only calming if you don’t get pitch in your hair. My favorite places to walk on the island (like everyone else’s) are the Bloedel Reserve and the Grand Forest, but people walk everywhere around here. I also find going to the ocean helpful. I think to myself, “There are some things that are bigger than my problems, like the biggest ocean in the world, for instance.” And the ocean is life-giving, beautiful, dangerous, and terrifying all at once—just like life. Watching and listening to the waves is soothing and meditative. Here on Bainbridge, if you can’t drive to the ocean, just walk to the nearest beach; it’s the same thing on a smaller scale. Hurricane Ridge is a great place to hike. Mountains are so solid and huge that they feel comforting and there’s something about mountain air that is deeply calming. The whole Olympic Peninsula is an inexhaustible source of lovely places to hike. Closer to home, Foulweather Bluff is lovely. If you drive to Schoolhouse Road in Brinnon, you’re very likely to see a herd of elk in any season except the summer.

Lower your expectations. Don’t try to build an empire during a hurricane. After you ride it out, you can go back to empire-building. Just try to get through this hour, this day.

Work. Sometimes work helps because it gives you a feeling of accomplishment or competency, and either of those can give you strength when you’re feeling weak. Also, it can be a distraction from your problems.

It’s definitely harder to do a good job when you’re having a crisis, so take more breaks. Breathe. Eat. Take a walk. Then come back to it.

Read. You can watch TV, too, but I think reading is better because your own imagination symbolizes the content to your life in a way that someone else’s imagination can’t do. But sometimes it’s too hard to focus on reading. Read/watch what you’re drawn to. During a particularly hard time in my life, all I read was survival memoirs. My crisis wasn’t physical, like being lost at sea or having fallen into a canyon, but the mental skills it took to survive were surprisingly similar. I had to work through a lot of why me and figure out how to problem-solve and put one foot in front of the other despite being limited by trauma. The most helpful books for me then were Deep Survival and Surviving Survival, by Laurence Gonzales, and Adrift, by Steven Callahan.

Or read to escape into someone else’s life for awhile, or to another world entirely. Harry Potter is great on a million different levels: good vs. evil, love vs. power, community vs. acting alone, loyalty vs. selfishness, managing your fears, being vulnerable, doing the next right thing, trusting your intuition, good humor. The list goes on. Plus there’s magic.

Learn and/or engage in an activity that has organized, patterned activities. This comes from Laurence Gonzales. You can learn to knit, learn a new language, learn any number of things—but there’s something about learning that pushes your stress hormones back down. There’s also something about methodical activities that competes with your brain’s ability to freak out, so knitting is particularly good because it’s methodical.

Lean on your sturdy friends. My friends have cooked dinners for me, watched my children, given me rides when I was too sick to drive, etc. I have done the same for them. A crisis is when you learn who you can depend on in a crisis. Some of your friends will be better to have fun with, some will be better to have deep talks with, and some will be better to lean on—or some combination. We all have our strengths and weaknesses and some people aren’t sturdy enough to lean on but they’re fun to sing or kayak or go for a walk or go to dinner or play board games or baseball with. So hang out with them when you’re not in a crisis, or when you need a break from the crisis. Don’t expect a palm tree to have the strength of an oak nor an oak tree to have the flexibility of a palm, but they’re both good in their own way.

Work it out through your body. The best way to work out anger is through your body. Run, dance, chop wood, throw rocks as far as possible into the water at the beach—just do something physical.

The best anxiety and depression medications, according to research, are not medication at all, but exercise. You might be too depressed or wound up to feel like exercising. If you can, force yourself to do whatever small thing you can and work up to bigger things.

Travel. I think we’re always inventing ourselves for other people, and new places means no one knows you, so you have to invent yourself from scratch, and in so doing you re-invent yourself for yourself. Travel helps to re-write your internal narrative. My mother always thought of me as an absent-minded professor type who loved science but couldn’t match her socks. At home I couldn’t escape the stereotype, but when I spent several months in Belarus, no one knew that, and I didn’t feel limited by it. I was freer to explore who I thought I was. (But it won’t work if you try to outrun an addiction by traveling—sounds like it should work but it never does.)

Even if you can only travel to the mountains or Port Townsend for an afternoon, getting out of your daily routine is helpful in a crisis. And if you can go to southern Madagascar (the furthest populated land mass from here, which I may or may not have looked up when I wanted to be as far away as possible), so much the better.

Re-write your narrative, at least in your own mind. Your self-talk can have an impressive effect on your emotional health. You can’t just say, “I’m not a victim. I’m a survivor.” You have to know what you did to become a survivor. Think it through, chipping away all the self-blame and other-blame until you find the healthy and true story.

Help someone else. It’s pretty hard to feel like a helpless, vulnerable, miserable failure when you’re helping someone else.

Complain. Speak your truth, just be careful who you speak it to. Don’t tell someone that you know is going to tell you to buck up, or tell you that the person who hurt you didn’t actually hurt you, or tell you to count your blessings because lots of people have it worse. If someone else had their leg amputated, it won’t make your broken leg hurt any less. You can complain intermittently throughout your whole life as long as you’re actively engaged in your own personal growth.

Feel your feelings. Just lay in your bed and close your eyes and let your sadness or your despair or your hopelessness, or your fear, or whatever horrible, unbearable feeling you have, wash over you in full force. It will be awful, but it won’t last long, and you will feel a little bit lighter afterwards. It probably won’t last longer than about two excruciatingly painful minutes, most likely half that. And it won’t kill you. When you are in really desperate straights and you need relief, this can help.

It’s useful to learn that your emotions won’t kill you, because sometimes it feels like they will.

Cry. Cry the great big ugly cry. If you have to hide to do this, go ahead. Crying regulates your stress hormones. Go ahead and feel sorry for yourself, because the truth is that life stinks sometimes, but don’t let yourself get stuck there. Half an hour of self-pity is long enough.

Grieve. Grief never goes away. It washes over you in waves forever. The waves go from knocking you over to just soaking you to just getting your feet a little wet, but it never goes away completely. So get used to rolling with the grief waves. Sometimes you see them coming, sometimes you don’t. When they hit, step back a bit and do what you have to do to express that grief: cry, write, dance it out, talk it over, paint it, sing or listen to heartbreaking songs, pray. Whatever you find helps you, make a mental note of it so you can remember it on demand when you need it. If you express it, it will go away until next time. If you stuff it with denial or alcohol or busywork or judging others or anything else, it will nag at you constantly forever.

Acceptance. So much of our tests in life are because we have to accept something that we find unacceptable. It takes time to realize we can’t change it and we’re going to have to adapt to it.

Sleep more. For some reason, we need more sleep in a crisis. Stress and grief make us tired. Sleep heals.

Laugh. Laugh at yourself. If you’re wishing a slow, painful death on someone who hurt you, it doesn’t mean you actually want that person to die a slow, painful death (hopefully), but rather that you wish they understood what your pain feels like so they’ll stop hurting you. Or maybe you’re wishing a swift death on them like a plane crash, so they’ll be gone quickly and permanently and leave you alone. I’m telling you as a counselor and as a human being that this is so common it’s almost universal, and you are not the worst human in the world. See it for the ridiculous fantasy that it is. Take it one step further and make up a delicious, creative, pretend-curse, like, “I hope they fall out of an airplane and break every bone in their body but live to feel the pain.” Don’t judge me. Be creative.

Also, laugh at how stupid we humans can be in general. Laugh at the existential human predicament.

Watch comedy, look up jokes, try to see the humor in stuff, even if it’s gallows humor. I show my age by saying this, but Monty Python helps.

Acupuncture. Acupuncture is good for both emotional and physical pain. 

Joy. Build more joy into your life. Even in the midst of a storm you can find something beautiful. Notice the beauty around you—the sky, the trees, the water. Do things that you know you enjoy. Go to an art gallery or museum, take a bubble bath, buy flowers, ride a horse, sing, paint, write, restore furniture, read a good book, listen to music, go for a drive—whatever it is for you. Joy gives you strength.

Lastly, medication. Effective medications can be addictive or non-addictive. Each medication has its pros and cons, even if it’s not addictive.

There are a couple SSRI antidepressants that are also helpful for anxiety, such as Zoloft (sertraline). Some people respond to them better than others. Sometimes you have to try a few in order to find the one that works best for you, or that works at all. You can’t stop taking them all at once or you’ll get withdrawal symptoms like headaches or nausea; you have to taper down. But otherwise they don’t have addictive symptoms like cravings for more, messing up your life, and so on. For some people they don’t work, for some people they cause weight gain or loss, for some people they cause apathy, and for some people, more often young people, they make the depression worse. There are some other medications that help with anxiety that are not SSRI’s, that might be more helpful for those who don’t respond well to the SSRI mechanism. Find a good psychiatrist and work with him or her on finding the right medication for you if you want medication to be part of your crisis- (or ongoing pain) -management plan. It’s a perfectly valid choice as long as it’s responsible.

Benzodiazepines are often prescribed for anxiety. They are addictive and at high doses they cause nasty withdrawal symptoms. You should not use them if you have a history of addiction. They are also dangerous in combination with other things that slow your central nervous system, such as alcohol and pain killers. They can be helpful in some circumstances, though, when managed by a responsible doctor.

Naturopathic doctors can prescribe supplements, herbs, and practices that can be very effective for mental health conditions.

Being the addiction counselor that I am, I don’t think self-medicating with any intoxicating substance is effective in the long run. It gives you short term relief at the cost of long-term peace.

The way out is through. Pace yourself. This is a marathon, not a sprint, as they say. Even if you do all of the above, it will probably still be hard, just not as hard.

Substance abuse prevention thoughts

Most drug abuse prevention is taught to kids when they’re old enough to have drugs offered to them, and focuses on why they should refuse those offers. I don’t think that’s anywhere near as effective as what happens in the home before they get to that age. I’m far from a perfect parent myself, and I don’t have any kind of credentials to spout off about what makes a good parent, but over 30 years of counseling people with addictions has shown me that there are some skills that are commonly missing.

The most important thing, through every age, is making sure your child feels cherished, which is way different from spoiling them. In fact, a kid whose parents don’t set boundaries for him or her feels unloved, just as a kid whose parents are authoritarian feels unloved. Make sure you know who your kid is. Your kid needs to feel seen, known, listened to, appreciated and wanted for who he or she already is—that’s the key. If a kid feels he or she belongs and is good enough, she or he will be less susceptible to peer pressure later on.

Teach kids to take care of their bodies: to sleep when they’re tired, eat when they’re hungry, brush their teeth, eat growing food, limit sweets, take vitamins, get exercise—all of it. Teach them about staying away from harmful chemicals. Knowing what leads to feeling good and what leads to feeling bad is invaluable when drugs become an option.

Take care of kids’ emotions when they’re small as a prelude to teaching them to take care of their own emotions when they’re older: give them enough physical and verbal affection, help them manage frustration by taking them to a calm place, or even by letting them thrash it out with you there to make sure they don’t hurt themselves or anyone or anything. Teach them that all emotions are acceptable; it is only how we manage them that reflects on us. And that we can endure any emotion. Sit with them and help them endure unpleasant emotions. Addicts feel like they could die from their unpleasant emotions, which is partially due to the effect of the drug on their brains, but being able to tolerate unpleasant emotions and get back to homeostasis—knowing you can get back to emotional homeostasis—is a huge protective factor against drug abuse.

If you pay attention to your kids, their actions will tell you what they need from you. Are they falling apart in the evening? Maybe they need a calmer or earlier schedule, more time with mom or dad, more frequent meals. Reflect on it and you will know. If you see them as a book to be read and responded to, they will learn to see themselves the same way and will thus be better adapted to take care of themselves in varying situations.

Let kids know they can say no. Kids who grow up having their boundaries constantly violated learn not to set boundaries. Rarely, if ever, do we see people with good boundaries in drug treatment. Don’t make your kids hug people if they don’t feel like it. Knowing they can say no to a hug from someone at age three is a prelude to knowing they can say no to sexual abuse or drugs later on.

Model the responsible use of medicines, and teach them not to put things in their mouth that they aren’t sure of. (Duh. But see the connection?)

Sensory integration is important in early childhood and leads to less sensory problems in older kids. Playing out in nature is good for this, as are playgrounds (hanging upside down, spinning on the tire swing—kids do what their bodies need to do). I think sensory issues are often part of the picture with kids who end up in my practice, who often have ADD and related issues. Outside play may not be the whole answer, but I think it’s one protective factor.

Model abstinence from drugs and very limited use of alcohol, if any. Never get drunk in front of your kids. Don’t smoke weed so that they even know about it. Kids don’t get, “I’m old enough and you’re not.” They get monkey-see, monkey-do.

Don’t use intoxicants to manage your own stress. Model healthy stress management through living life at a reasonable pace, getting exercise, getting enough sleep, spending time in nature, getting support from people who love you, and doing things that you enjoy. Make home a place that everyone in your family likes to be. (If there is any kind of abuse going on in your home, this will be impossible.)

When your kids complain, listen to them and help them problem-solve within their own capabilities.

Teach children your values: honesty, integrity, critical thinking, grace and courtesy, compassion (for oneself as well as others), balancing perseverance against self-knowledge, etc.

Don’t let TV and the internet teach your kids values. The media teaches that happiness comes from status, money, beauty, and hedonistic pleasure. If your child measures himself or herself by those standards s/he will be less confident, less self-aware, and ultimately feel like a failure. When a child feels less-than, he or she is at much higher risk to use drugs. You can bond over drugs and make friends instantly; it’s a lot harder than making friends over shared interests, plus it’s a fake bond. So make sure you teach your kids what makes them valuable, not the media. If they feel valuable, they won’t be desperate for any friends they can get and thus gravitate towards the easiest ones. This comes with a whole slew of implications for media control.

Let kids be bored so that they will find their own solutions to it (but discourage addictive solutions like automatic screen time). Often kids will be the most creative when trying to reduce their own boredom. Being able to manage boredom is really important because boredom is a huge drinking/using trigger in addicted people. Teach your kids to listen to what the moment is telling them. 

Let kids experience (within reason, of course) the consequences of their own choices. When they make a poor choice, help them find a way to solve the problem they created, if possible, or at least help them find a way to endure it. If you don’t teach them, they will be stuck learning this from the police and will end up mandated into my office, possibly after an expensive and traumatic court process.

Help (and let) your kids do as much as they can so that they develop a feeling of being competent. Letting little kids have unstructured playtime contributes to this—and to healthy processing of emotions. Teaching older kids to handle tools or to cook contributes to it. There are lots of options. Feeling competent is one way of feeling good-enough, which is protective against peer pressure to get high, and also gives kids the confidence to pursue healthy interests that they otherwise might not.

Kids need nature. So do adults. It’s calming and balancing.

Make your house the hang-out house if you can. Get to know your kids’ friends. Listen to your gut about your kids’ friends. Teach your kids what makes a good friend and help them evaluate their own friends by a set of reasonable standards. Riding in the car and while walking are excellent times to get all the juicy info from your kids, and also to have important conversations that eye contact might make too intimidating.

Teach self-awareness. What makes this unique kid feel good about himself or herself and what makes him/her feel bad? Choosing activities based on how you feel about yourself after you engage in them is a better standard than basing your judgment on how you felt during the activity. Learning to anticipate how you might feel afterwards then becomes a good decision-making tool.

All people, kids included, respond more to positive reinforcement than to negative feedback. That means that telling them they did wrong might go in one ear and out the other, but catching them doing right and praising them will stick better (it’s like dog training). So praise them for thinking things through, for delaying gratification, for contributing to the household, for being responsible about their pets and their homework, and for managing their emotions—these are all skills that addicts frequently either never had or lost along the way.

Teach kids more advanced self-care when they’re old enough to understand. “HALT” is a good tool—when you feel hungry, angry, lonely or tired, then halt what you’re doing and take care of yourself. (I think of the A as standing for both angry and anxious.)

Encourage your kids to find and pursue what interests them so they will have something they can turn to for self-soothing, self-expression, and boredom control.

Trying to find the balance between busy enough to be stimulated and routine enough to feel safe and calm is important at all ages.

No one is a perfect parent, least of all me, but if I could tell parents how to keep their kids off my caseload, this is what I would tell them. Teaching kids to avoid drugs only comes at the end of a very long list of teaching them what to do, and years of setting a good example.

There is one common mistake that I would ask parents to avoid. Many parents think that allowing the child to have alcohol inside the home where it’s safe will teach them to drink safely. Not so—those kids are at higher risk for developing alcohol abuse problems. 

One last thing: no drug treatment counselor can overcome a kids’ exposure to parental substance abuse at home. It’s monkey-see, monkey-do with kids, so do what you want them to do.