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Alicia Salzer, M.D. Headshot

Crisis Coping 101: What to Do and What Not to Do

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CRISIS COPING

There's an expression I once heard in Weight Watchers: Prepare or risk despair. Sounds ominous, right? Well, the point (and it is a good one) is that there will be moments when a snack attack goes to bat against your willpower and wins. And if you don't anticipate these moments and stock the fridge with healthy snacks, chances are you are going to wind up reaching for the same carbo-licious nonsense that made you head to the weight loss center in the first place. Personally, I know that if those carrot and celery sticks aren't attractively pre-sliced and stowed in a tempting array, I am going to go for the cupcake.

Well the same is true for our coping skills. If coping with crisis is your forte and you look back on how you have survived past challenges with pride, then you can stop reading here. But if you are like most of us, you really aren't sure how you cope and are kind of wondering right now, "What is the coping equivalent of a carrot stick?"

No one copes perfectly; a crisis is, by definition, challenging to our balance. Nevertheless, we should all be able to answer the following questions: What works for me? What are my common pitfalls? What is my strategy for when I realize I need to kick coping into high gear?

A good place to start is actually to ask, "What's my cupcake?" When you look back at the last time you found yourself in a crisis, do you cringe at the amount of drinking you did? Do you regret the fact that your unchecked stress made you snap at the people who were closest to you? Did you take to bed or immerse yourself in work to the detriment of problem solving?

In my experience, there is one unhealthy coping strategy that underlies all of the above: ruminating. Ruminating should not be confused with problem solving. The latter gets things checked off a to-do list, whereas the former gets you stuck in "why me?" "woe is me" and "oh, how bad it is going to be" mindsets.

Ruminating is a big time waster. Sometimes your crisis is a false alarm: your boyfriend's message that he wants to "talk" really means he wants to talk. Or your biopsy, thankfully, comes back negative. But in the days you have spent imagining the worst, you have stressed your body by putting it in a state of perpetual alarm and neglected the things in your life that needed to get done, and undoubtedly your anxiety has taken a toll on the people in your life.

Rumination is the enemy of healthy coping. It keeps you stuck in your head, preventing you from moving into action. It isolates you from the support you are going to need. But here's the biggie: it's also a trigger for all our unhealthy coping behaviors. The onslaught of negative emotions that accompany it are what leads us to look for soothing and respite in unhealthy ways, like declaring it cocktail hour at 1 p.m. or diving headlong into a tub of Rocky Road.

Unfortunately, ruminating about the worst-case scenario is the default coping strategy for most of us. It's empty coping-calories. The solution? The dual energy boost of action and distraction.

By "action" I mean that there are things to get done. Ultimately there is work that accompanies all bad news. Focusing on what needs to get done helps us contain the emotional aspects of the equation so that they don't overwhelm us. Making appointments and arrangements is good medicine.

We all need healthy, non-caloric, non-alcoholic ways to downregulate our emotions in a crisis. If you know you are susceptible to certain pitfalls like drinking, overeating, isolating yourself or ruminating, now is the time for those "prepare or risk despair' interventions that may enable you to preempt those unhealthy habits.

Plan some evening outings with your girlfriends in the lonely time slots when you are most likely to be missing your boyfriend. Decide that whenever you want a drink, you are going to grab your dog for a walk instead. If you are afraid you might take to bed like last time, arrange for a friend to show up each morning to go with you to the gym or for pre-work coffee. If you know you have a tendency to bury your head in the sand, ask a friend to accompany you to your doctor's appointments, or to sit by your side as you research your diagnosis on the Internet so you don't run away from potentially overwhelming moments. Don't just do what you usually do. Approach the days ahead with planning, support and a firm conviction to avoid falling into whatever bad habits you have struggled with in the past.

Other than action, the other piece of healthy coping advice I have is distraction. This may seem a strange piece of advice coming from a shrink. We rarely tell people, "Don't think about it." But when confronted with harsh versions of reality, we often need help figuring out how to turn down the volume on the negative emotions we are bombarded with. Here I offer the opposite advice of that old 12-step adage, "Keep it simple." Good distracting distractions often require that we "keep it complicated."

What I mean by this is that in emotionally distressing times, it's not enough to look at a flower; we need to really scrutinize and study the flower, to train our attention on it to a degree that is consuming. This type of sensory focus allows us to remain in the present and engage our senses enough to give our minds a break from the emotions that go hand in hand with crisis.

Study that flower in excruciating detail. How many colors do you see, and in what gradations? If you were mixing paint, how would you go about mixing just the right shade? Do the colors blend, or are they clearly demarcated? Are the leaf edges jagged or straight? How many leaves are there? If I asked you to cover you eyes and quizzed you on the details of that flower, would you be able to answer?

Many people with hearty coping skills immerse themselves in working out as a coping mechanism. They know that pushing their body to the max dispels extra adrenaline and demands a focus that provides a great distraction. But pushing a sensory experience to the max is also a great exercise in distraction, whether we are focusing on the subtleties of the flavor in our peanut butter or the intricacies of the various instruments in a song. The point of this "keep it complicated" exercise is to add more complicated levels of observation and detail when your difficult thoughts keep creeping back in.

People who cope with strength and grace have done their homework: they keep those carrots and celery cut. They often have pre-specified routines that they turn to in times of crisis that keep them coping productively and avert the pitfalls that have caused them to get stuck in the past. Take a moment to think about how you cope. Your prep work will pay off.

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