Coping Skills: Managing Triggers in Residential Mental Health Treatment

Knowing what is wrong and changing it are two vastly different things. When you are struggling with a mental illness, your maladaptive emotional and behavioral patterns can trigger a cycle of distress that leaves you feeling helpless and unable to move forward. But by harnessing the power of the plastic brain in a residential treatment environment, you can create the conditions for sustainable recovery, allowing you to disrupt unhealthy patterns and make real change.

 

Julia was no stranger to mental health treatment. The idea that she had a psychiatric illness wasn’t new, but a fact she had lived with since she was 23 years old and first diagnosed with depression and generalized anxiety disorder. It had become a part of her, like ivy wrapped around an oak tree. “I went to all kinds of therapy,” she tells me. “Every Thursday for ten years I sat on a couch and talked about my symptoms and, in the process, discovered pretty much everything a person can discover about their mental illness. Except how to make it better.”

It wasn’t that her therapists didn’t tell her about coping skills or encourage behavior modifications. They did, over and over. But once Julia left that office she was thrown back into a world of ever-present triggers that left her unable to implement the sage advice of her therapists. “Sitting there in the office I would think of course I should do breathing exercises! Of course I should visualize! Of course I should have a predictable routine for myself and sleep well and eat well and exercise!” But then she’d have a late night at work. Or conflict with her boyfriend. Or a million other triggers, great and small, that threw her back to square one.

Knowing and doing are not the same. I knew but I could not do. I was stuck. Finally I went to a new therapist who said, ‘This isn’t working for you, you’re not able to make the changes you need to make at home in between therapy appointments, you should think about residential treatment.’ It was something I had never considered because in my mind residential treatment was for people with far more severe conditions. But that’s what finally did it.

Triggering the Cycle of Distress

Mental health disorders can feel like nebulous, enveloping states that consume your entire state of being. In reality, however, they are far more granular, manifesting in particular emotional and behavioral patterns throughout each day. Mental health treatment seeks to create interventions that disrupt these disordered patterns, both as the result of treatment and as part of the process of treatment.

However, while many of us know what we should be doing, real life can make the actual doing difficult and sometimes even impossible. This is particularly true in the midst of a vulnerable psychological state; external and internal stressors can act as triggers that make us revert to the damaging patterns that have become so deeply ingrained in us. These patterns are the path of least resistance, involuntary and unconscious responses that both produce and are produced by states of psychiatric disturbance, keeping us locked in a cycle of distress. Each time we respond to triggers in a disordered way, we are strengthening the pattern and further damaging ourselves, taking us further and further from recovery.

The Possibilities of the Plastic Mind

For many people with mental health disorders, the mind can seem an inhospitable thing, even an adversary. Indeed, one of the dangers of mental health disorders is the effect they have not just on the psychological mind, but on the physical brain itself. As Kays, Hurley, and Taber write in The Journal of Neuropsychiatry and Clinical Neurosciences,  “Both animal and human research has provided supportive evidence that chronic stress and some forms of mental illness have deleterious effects on the brain, both structurally and functionally.” The longer we stay in states of distress, the less sound our brains become.

But perhaps the most remarkable thing about the human brain is its ability to change—not just in response to damaging stressors, but as the result of healing practices. It is not a static organ, but a resilient one that continuously remodels itself in response to our experiences, thoughts, and behaviors, allowing us to fortify healthier pathways through conscious re-conditioning, if we so choose. This neurological phenomenon, or neuroplasticity, is one of our greatest assets in the pursuit of better psychiatric health. As Kays, Hurley and Taber point out, “[T]here is promising evidence that the dynamic qualities of the brain may play a pivotal role in how one copes with stress and mental illness,” which is why neuroplasticity is increasingly becoming an area of focus within mental health treatment via biological psychiatric interventions.

However, direct brain stimulation through treatments such as rTMS and ECT are not the only way to encourage neurological restructuring and neurogenesis. Medication, psychotherapy, exercise, and even meditation can all have measurable effects on brain structures and functionality, encouraging recovery and strengthening pathways to healthier emotional and behavioral patterns. Dr. Jackie Kinley, a psychiatrist and researcher at the QEII Health Sciences Centre, explains:

If you can strengthen somebody’s neural pathways so that when they’re under stress and when they’re anxious, or tense, or when they’re not feeling well, so they can actually learn how to regulate emotions, how to settle themselves, ground themselves, then they’re at less risk of actually getting ill … we can actually activate different brain regions, [allowing clients to] harness their own internal pharmacy. Your body has a tremendous capacity to heal and grow under the right conditions and circumstances.

While all of this is tremendously promising for both contemporaneous and future mental health treatment, the trouble is often setting the stage for these “right conditions and circumstances.”

Creating the Conditions of Recovery

Neurological, emotional, and behavioral changes don’t just happen because you want them to. They are the result of sustained practice, the way a pianist plays the same piece for hours until its memory seeps into her muscles, letting her play without having to think about each note individually. If the piece becomes second nature, she can play through the mobile phone ringing, the wrong note played by the violinist, the audience member who insists on unwrapping a cough drop for all the world to hear. In the same way, sustained practice of healthy patterns of thought and behavior allow you to consciously use those patterns until they become your path of least resistance, the place your brain automatically goes despite triggers. And in this way you are able to disrupt the cycle of distress to pave new roads for yourself toward recovery.

Being immersed in a residential treatment program in which you continuously have opportunities to engage in therapies that stimulate the brain in healthy, productive patterns offers ideal conditions for this type of healing to begin in a way that cannot be replicated in weekly outpatient therapy.  The residential environment removes many of the detrimental stressors of everyday life to give you the outer tranquility and structure you need to devote yourself to creating change in both big and small ways. You are able to get up in the morning and  eat a nutritious breakfast, predictably organize your day, exercise, take any medications as directed, and get enough sleep—the basic building blocks of physical and mental health. As this routine replaces your old one, it begins to grow roots in your mind, weaving its way into the fabric of your self and setting you up for success as you translate these patterns into your life outside of residential care.

But residential treatment also does something more: it provides holistic, continuous support and guidance as you face the inevitable triggers within the treatment environment itself, whether in individual sessions, group therapies, or day-to-day living. Although removal from overwhelming everyday triggers can be a deeply relieving experience, triggers as a whole cannot be banished, nor should they. The purpose of treatment, after all, is to create mental well-being despite inevitable stressors by giving you the tools you need to cope and manage triggers. By practicing these skills and replacing maladaptive thoughts and actions in a controlled and monitored environment, you can find and implement new ways of approaching your emotional and behavioral health even as you encounter moments of internal or external distress. In the company of experienced clinicians and compassionate peers, you are a pianist learning to play your life in a new way until it sinks into you and you can play despite the distractions that come your way.

Bridges to Recovery offers comprehensive residential care for people struggling with mental health disorders as well as co-occurring substance abuse and eating disorders. Contact us to learn more about our renowned program and how can help you or your loved one start the journey toward sustainable healing.

 

Image Source: Unsplash user Alexandre Chambon