By Dr. Steve Nickolaisen
When I was 27 years old, I had just emerged from a difficult relationship and was in the thick of
my challenging graduate school journey. I often felt depressed. I recall one particularly difficult
night. I was lying awake in bed, feeling intense sadness and heartache. I was drowning in a sea
of negative thoughts, and my mind was circling the drain. I thought I was a failure because of the
relationship ending. I felt alone and undesirable. I also feared I would fail in graduate school and
various doubts ran through my mind. Then, I began to have suicidal thoughts and related
imagery. This was quite disturbing to me. The next several minutes were arduous…my mind
alternated between the aforementioned negative thoughts and suicidal thoughts. I felt
increasingly anxious and helpless. I ended up turning on a movie, trying to distract from the
anguish of these inner processes. It took some of the edge off, but the disturbing thoughts and
emotional pain would puncture through intermittently and cause distress. Late into the night, I
was finally able to fall asleep.
Eight years later, I want to reflect on what could have helped me most that night…what could
have helped this discouraged younger version of myself in deep emotional pain. Writing this will
be healing for me, but I am hoping it will help anyone who reads it.
First, I would try to turn towards my emotions with acceptance and self-compassion. I have often
found that if I can accept intense emotions and give myself space to sit with them and use my
coping skills, things become more manageable. I would have said something to myself like
this… “Steve…it’s okay to feel this way… you have just been through a really difficult
relationship and it is normal to hurt…it might be important for you to turn towards that pain
tonight and sit with it…hurting as much as you do tonight is temporary and the intensity will
pass eventually…take care of yourself tonight and find soothing activities.” One question that I
often ask to help promote a self-compassionate dialogue, is, “what would I tell a friend in the
same situation?” This question bridges into Socratic Questioning, which I will elaborate on later.
I have realized over the years that a large part of the intensity of emotions is physical discomfort.
That night, I was experiencing heartache…literally an aching and tension in my chest. My
muscles felt tense, and my throat felt tight. Moreover, I was short of breath. A deep breathing
exercise would have been helpful. For me, breathing in for a few seconds, holding for a couple
seconds, and breathing out twice as long is effective. If I wanted to enhance the breathing
practice, I would focus my attention on the physical sensations of the intense emotion…accepting
the physiological discomfort as best I can and trying to observe any changes in it as I sit with it.
Doing this for a few minutes may have taken the edge off…it is hard to think clearly with blaring
physiological discomfort.
As a practicing psychologist today, I immediately recognize that younger Steve was drowning in
a sea of distorted self-deprecating thoughts. Recent experiences had activated a strong current of
believing he was undesirable. He was worried about ending up alone. Also, he was telling
himself he was a failure because his relationship ended. I see that he needed help in disputing
these thoughts…understanding that these thoughts were not true. Socratic questioning techniques
could have been helpful. Socratic questioning involves using questions and related dialogue to help one consider alternative information and perspectives (Beck et al. 1979). A few relevant
questions that may have helped Steve see other viewpoints come to mind…
- Is there any actual evidence that you are a failure? Is everyone who has a relationship end a
failure? Is everyone who has a relationship end undesirable? - Do you really think you will be alone for the rest of your life?… Have you been in other
relationships that ended and found someone else to be with after? Can you think of all the times
you have been able to connect with people over the course of your life? - Are there other areas of your life where you feel successful or that you are not a failure? You
are worried about failing out of grad school…what does the evidence say? How have you
performed in graduate school up to this point?
This socratic questioning dialogue can be very difficult to do inside your own head, so writing
the dialogue out or talking out loud about your negative thoughts with a safe person is even more
powerful.
In summary, the formula that has often helped me navigate intense emotions accompanied by
dark thoughts is as follows:
a) Accept your emotional experience and promote a self-compassionate approach/dialogue
to the difficult emotions.
b) Engage in a practice that ramps down physiological distress. While doing this, try to get
out of your head and connect with your bodily sensations. When possible, focus on the
uncomfortable physical sensations and notice their ebb and flow.
c) Examine the evidence and challenge negatively distorted narratives that are running
through your mind and causing suffering.
I truly feel that if I were able to intervene in some of these ways that night, things may have been
more manageable. Furthermore, I hope this will help someone navigate difficult moments in
their lives.
Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression.
New York: Guilford.
