Keeping Me Well - Cardiff and Vale University Hospital

How do I manage my uncertainty about the future?

Face COVID – Responding to uncertainty :

  • Uncertainty is our brain’s way of telling us that we need to act, because it thinks we’re in danger. But it doesn’t realise that we’re safe!   
  • Uncertainty can be managed like any other thought or feeling – through de-fusion (distancing from thoughts). We can notice what our brain is telling us, without ‘buying into’ those thoughts and feelings.  
  • Remember, our thoughts and feelings tell us useful information about the way that we want to live our life, and the things that we value. We should notice these thoughts and feelings in order to do this.  

De-fusion  

  • The more we struggle with our thoughts and try to get rid of them, the more they come back. Imagine I told you not to think about a pink elephant – it would end up being all you can think about!   
  • So, if we can’t stop our thoughts and feelings from coming up, what can we do? Well, we don’t have to get involved in them – kind of like walking away from the school bully, if we don’t get drawn into what they’re saying, we can walk away without a fight – a fight that’s only going to get us in trouble in the long run!  
  • This is what’s meant by ‘de-fusion’. De-fusion is the process of noticing, but not getting involved in, our thoughts. The process of being the chess board and noticing what’s going on in the game, without getting involved.
  • The aim of de-fusion is for us to allow our thoughts to exist, but to sit comfortably with them, rather than letting them ‘hook’ us and control what we do and how we act  
  • It’s important that when we’re using de-fusion strategies, we don’t try to get rid of thoughts or change them in any way. We just allow them to be there  
  • You might need to consider what difficult thoughts and feelings you’re willing to have, in order to get better. You might need to decide whether you are willing to sit comfortably with your brain telling you that you need to push yourself to the limit in order to get better, even when what you really need is rest and to be gentle with yourself. If you can do this, you can notice that your brain is giving you a short-term solution, and you can make sure you stick to your long-term plans rather than getting drawn into the battle.

De-fusion Exercises:

  • Imagine you’re sat on the bank of a river. It can be somewhere you’ve been before, or somewhere you would like to be, real or imaginary. Each time you have a thought, pleasant or unpleasant, place it on a leaf and watch it gently float by. Do not try to speed the river up, or get rid of the thoughts, just notice they are there. If a thought gets stuck, allow the leaf to hang around and pass in its own time. If you notice you’ve been hooked by a thought and dragged away from the exercise, gently bring your attention back to the stream and place that thought on a leaf

  • You can do this same exercise with clouds in the sky, rather than leaves on a stream, if you feel more comfortable. You can also imagine your thoughts are balloons and attempt to let go of the string you are holding. You could try to write your thought on a piece of paper, crumple it up and throw it away.
  • Practice this skill as often as you can. When preparing to do this exercise, your brain might tell you that you have better things to do, or that you’re too busy, or that it’s boring or pointless.   
  • This exercise also allows us to create some distance between ourselves and the language of our thoughts
  • When you have a thought, notice and name that thought. For example; when you next have the thought ‘I am never going to get better’, try and distance yourself from that thought by putting ‘I’m having the thought that’ or ‘I notice I’m having the thought that’ in front of it. For example, ‘I notice I’m having the thought that I’m never going to get better’, or ‘I notice this situation is making me feel anxious’.
  • Remember, your thoughts are just your brain kicking you into action – your brain has created them, and you can decide how you want to respond to them. You can struggle with them and try to get rid of them, or you can notice them and move forward in the way that you want to.
  • If a sailor notices a storm coming as they’re travelling into port, they can drop the anchor. This allows them to ground themselves whilst the storm passes (rather than attempting to find their way out of the storm). 
  • Sometimes your thoughts and feelings can be like a storm – they can hook you and drag you around, and you can feel out of control. If your thoughts and feelings get too much, and you notice them controlling your behaviour, you too can drop the anchor.
  • Notice that around these difficult or uncomfortable thoughts and feelings, there is a body that you can control. Plant your feet into the ground, stretch up to the sky and notice your breathing.

    Notice 5 things you can see and 4 things you can hear. Notice that there is a lot going on around you, as well as your thoughts and feelings, and that you are in control of what you do with the information your brain is giving you. 

Dropping the anchor script

  • When you have a thought, such as “I’m never going to get better”, try imagining this being said by your favourite cartoon character, someone like Daffy Duck!  
  • The purpose of this exercise is not to ridicule your thoughts, but to recognise that they are only thoughts, they are a creation of your brain and that you can control how you respond to them.   
  • Our thoughts occur in specific contexts. When we’re feeling fatigued, we might think that we’re never going to get better, for example. But if we imagine these thoughts being said in a different voice, we can see that they are funny sounds, and they then don’t have the impact that they once did.  
  • Take one word from the difficult thought (e.g. if you’re having the thought that you’re broken or sick, take the word “broken” or “sick”).  
  • Notice all of the words that are associated with this one – all the words that come to mind when you think of “broken” or “sick”, or your chosen word. Then repeat the word roughly once per second for two minutes.  
  • Notice what happens to the word – notice that it stops sounding like a word, and it stops being associated with all of those other words. Humans have an incredible, unique ability to think using words, but to any other species, or anyone who does not speak the language, words are just a series of funny sounds!
  • Your thoughts might seem overwhelming because of all of the things they’re associated with, and all of the difficult feelings that they bring up. But this exercise helps us to recognise that these thoughts are a series of sounds – they don’t control you, and you can view them for what they really are.  
  • Imagine your hand is that of the kindest person you know. Imagine it holds all of the kind things they have ever done   
  • Notice your body and where you feel these uncomfortable thoughts or feelings. You might feel tight chested, or you might feel neck pain, for example.  
  • Now hold that kind hand to the part of the body that needs it most. Imagine all of that kindness flowing into you. Hold these uncomfortable thoughts and feelings lightly, like a gentle flower, and imagine this kindness flowing around them, holding them, and soothing them.  
  • Our brain is like a radio – it tells us all of the things that have gone wrong, and tries to foresee all of the things that will go wrong, too. Sometimes our brain can tell us really useful, helpful information, but sometimes it forces us to relive difficult memories and experience uncertainty about the future. When our brains give unhelpful or difficult thoughts, we can call this ‘radio doom and gloom’. 
  • Sometimes we ‘tune in’ to the radio and the messages it gives us, and sometimes the radio just plays in the background, and we don’t give it much extra thought.   
  • What we want to do is allow radio doom and gloom to play without getting ‘hooked’ by what it’s telling us. And we want to be able to notice and appreciate the radio when it tells us things that are useful.
  • This is very different from trying to walk away from the radio. Remember, the more we try and get rid of difficult thoughts, the more they fight back. 
  • It’s also different to bringing in a different radio to play more positive messages – this just results in a battle going on whereby you get caught in the middle, spending so much time battling to think positively about the future that you miss out on the here-and-now.   
  • Instead, we want to simply notice that radio doom and gloom is playing, but give it no further thought. Let it play away in the background.  
  • Our de-fusion strategies allow us to ‘tune out’ radio doom and gloom when it plays songs of uncertainty, so that it doesn’t impact us as much
  • This means that we can be more present in the here-and-now, and live a more meaningful life.
Keeping Me Well - Cardiff and Vale University Hospital

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