The Stress Doc Letter
Cybernotes from the Online Psychohumorist ™

Aug 03, Sec. I

Fight when you can
Take flight when you must
Flow like a dream
In the Phoenix we trust!

Table of Contents

Offerings:       Training Kit & Book; AOL Chat
Shrink Rap:    Crisis Sequence Model
Main Essay:    Resilience and the Art of Rejecting Rejection:  Part I

Sec. II
Main Essay:    Resilience and the Art of Rejecting Rejection:  Part II
Readers:         Word Games; Wise Sayings By Wise Men; Lone Ranger and Tonto
Heads Up:       Ladies Home Journal; News8Austin (Cable TV)/Web Sightings
 

A.  Offerings:

1. Training/Marketing Kit: Want to strengthen your ability to lead or market a stress workshop or any kind of speaking/training program?  Consider the Stress Doc Training/Marketing Kit, which includes both "how to" manual, 20-minute highlights video, and articles, as well as the opportunity for phone coaching.  For more info:   Training/Marketing Kit http://stressdoc.com/kitbook.htm or email.

2.  Stress Doc Book:
From Stress Brakes and Shrink Rap to Safe Stress and Cool Moon Cats:
The Wit and Wisdom of the Stress Doc, Stress Doc Enterprises, 1995

A 90 page compilation of my former syndicated radio essays, pioneering songs in the field of psychologically humorous rap music - "Shrink Rap" Productions - a creative visualization poem and other humorous lyrics/poems. "Stress Brake" radio essays are short (300 words), fast-paced and witty, covering such topics as stress, burnout, anger and conflict resolution, time management, creativity, men's and women's issues, romantic relationships, codependency, etc. (They make excellent fillers for newsletters.)

Price: $20 (which covers priority postage and handling)

Make check payable to:  Mark Gorkin

Send check to:

Mark Gorkin
Stress Doc Enterprises
1616 18th Street, NW  #312
Washington, DC 20009-2542

3. Chat Group:
Stop by my AOL/Digital City Shrink Rap (TM) and Group Chat DC Support Chat, Tuesdays, 9:30-11pm EST DC Support Chat. It's a dynamic, lively, at times witty and always warm, thoughtful and supportive problem-solving group. We raise questions and share our ideas, hopes and experiences with each other.
 

Shrink Rap:

A number of events have conspired, or inspired, me to resurrect an old conceptual model from my Assitant Professor days at Tulane University.  I'll be leading a "Managing Anger and Preventing Violence" course in November under aegis of PESI Healthcare.  And I'll be using a "Crisis Intervention" perspective.  The model was the theoretical foundation of a course I taught for a decade -- Crisis Intervention and Brief Treatment.  Also, this model will be used in a fall workshop with the Metro-D.C. Association of Legal Administrators.  The model was first presented by Lynn Hoffman in Social Casework, "Uncovering the Precipitant in Crisis Intervention."  (In the late-70s, I believe.)  I have expanded upon it.  I think the model has wide-ranging applicability as an intervention tool both with individuals and systems.

Crisis Sequence Model

The model involves the sequential examination of past and present emotional conflicts, life events, and bio-psycho-social reactions and interactions.  A Crisis Sequence analysis provides both a historic and diagnostic picture of a person and his or her environment during the build up to a heightened period of vulnerability and subsequent eruption into a state of crisis.  This model can also be a useful tool for examining organizational systems in crisis.

Definition of Crisis:  Crisis is a heightened state of physiological and emotional vulnerability in the face of a critical, ego-sensitive threat or problem.  The individual has an acute need to regain a sense pf psychic and situational control as well as mind-body equilibrium, that is, there is a need to reduce the profound tension and disorientation and return to a more functional (if not pre-crisis) level of adaptation.  However, and most critical, this "no exit," threatening and critical issue seemingly defies resolution and is momentarily overwhelming the person's coping resources and responses. 

Core Conflicts

Core conflicts are the internalized, mind-body beliefs, pain, memories, inner voices, etc. that evolve during the course of life, especially fostered by traumatic experiences or critical losses in childhood and adolescence.  These conflicts are also fueled as the child (often unconsciously) internalizes the psychological and interpersonal pain and patterns of the significant others in the child's life.  Genetic or family predispositions also influence foundational temperament.  Such Core Conflicts include:  separation anxiety and abandonment, helplessness and rage, unresolved grief or trauma, clinical depression or anxiety traits, inadequate self-esteem or sense of competence, immature bio-psycho-social identity.  While very often generated by childhood events, sometimes later experiences, for example, an abusive marriage, might exacerbate core conflicts as well as create their own core issues.

These issues may seemingly lie dormant until sufficient life stressors hit or the person experiences a major biochemical or hormonal shift, e.g., adolescence or menopause.  (Of course, psychosocial stressors invariably interact with physiological states.)  Also, while not conclusively documented, mid-life may be a stage where numbers of people experience life-work and mind-body transitional tensions or crisis periods.

Hazardous Event

This is the stressor event that initiates the Crisis Sequence.  This event can be a material and psychic blow, for example, losing a job or not getting an anticipated promotion.  The event can be a surprising development, that is, suddenly learning that a relatively young parent, or a parent in seemingly good health, has had a stroke or heart attack.

Also noteworthy is the potential presence of background hazardous events, for example, having a child or spouse in the military, and wondering if the significant other will be stationed in a war zone.  The Hazardous Event may commence when the individual is sent off to combat.  These background hazards often have a strong situational component. 

Also, such stressors may not be jolting, but they do chronically gnaw at the individual.  For example, working the graveyard shift for a year as a stress and violence prevention consultant for the US Postal Service was definitely a background hazard, and occasionally foreground as well.  (And my post-assignment elevated blood pressure was concrete evidence.  Before this tour of duty, my blood pressure had always tested normal.)

For a more complete picture of the crisis sequence, it's useful to get information on significant, novel, or surprising, and disruptive occurrences three-six months, six-twelve months, and, even one-two years prior to the Hazardous Event.

Vulnerable State

This is the subjective, mind-body reaction to the Hazardous Event.  In broad terms, there is a threefold reaction:
a) threat (anxiety, obsession)
b) loss (grief or depression, loss of control, rage, or helplessness) and
c) challenge (heightened arousal, vigilance, and readiness for purposeful action).

Heightening the intensity, painfulness, and confusion of the Vulnerable State is the fact that Core Conflict issues tend to get stirred under prolonged threat or loss as well as chronic stress and hypervigilance conditions.  For example, a person who was physically or sexually abused as a child may find working for a domineering or demeaning supervisor particularly hazardous and threatening.

Coping:  No Crisis

If the individual can manage the Hazardous Event and productively cope with the Vulnerable State emotions, then the Crisis Sequence usually terminates at this point.  The individual may have gained some resources or skills in the process.  However, if stress management and coping attempts are marginally successful or, worse, dysfunctional, then the person will continue along this crisis pathway, increasingly susceptible to a crisis-triggering stimulus.

Precipitating Event

This is the event that precipitates or sets off a full-blown crisis:  intense disorientation or agitation, profound sense of helplessness or hopelessness, feelings of rage and shame, as well as fears of being emotionally exposed or just totally "losing lt."  What also can be confounding for the individual in crisis is that a Precipitating Event can appear to be rather trivial -- the proverbial "straw that broke the camel's back."  What has been overlooked or denied is the pressure that has been building on the individual over an extended period of time.  In this smoldering context, a broken copy machine might be enough to trigger a fiery outburst or to push the crisis candidate over the edge.

Also, at this point, the Core Conflict floodgates (that is, the psychological defenses keeping at bay or out of everyday consciousness Core Conflict issues and pain) have burst open.  This "break down" often leads to emotional flooding and intensifies the crisis "sturm und drang."

Crisis State

A key point is that this dramatic and acute state of disorientation and turmoil is time-limited, usually lasting one to six weeks.  The mind-body cannot tolerate indefinitely this profound rupture, confusion, or helplessness, and acute stress, if not panic condition.  Crisis is a "no exit" challenge; something must be done.  This fact helps explain why the Chinese depict "crisis" with the symbolic characters of "danger" and "opportunity."  The "danger" of crisis is potentially fourfold:
a) the individual is confronted by a psychologically, if not physically, overwhelming or acutely threatening situation which demands a response
b) he or she lacks adequate resources to manage or cope with this chaotic disruption or disaster, whether mostly perceived or frighteningly real,
c) the flooding of Core Conflict emotions and pain adds to the profound disorientation, helplessness, loss of control, and/or paralysis, and
d) the individual often chooses self-defeating, if not destructive, behavior to shut down the crisis, that is, depressive withdrawal, anxious avoidance, or addictive numbing and escape, e.g., excess drinking, gambling, compulsive shopping, impulsive sexual activity, etc.  This maladaptive coping response only exacerbates the dark mood and mental (or physical) state of the crisis-stricken individual.

Crisis Opportunity

Conversely, it is just the dangerous aspect that sets the stage for the growth potential of crisis.  As we've seen, the person feels trapped while habitual problem solving is proving fruitless, yet he or she must take some action as tension keeps climbing.  Now, this individual may feel compelled or desperate enough to reach out for new and more productive sources of help.  Allowing for greater dependence in times of crisis is critical.  Reaching out during these turbulent times and trials for needed resources or a different perspective, for emotional nurturing, and novel problem-solving skills and strategies is the "opportunity" side of crisis.  Taking these productive steps yields a more solid and supported situational foundation and mind-body equilibrium.  And, again, this achievement tends to occur within the one-to-six week crisis problem-solving and adaptation window.

Not surprisingly, my critical intervention mantra for responding to individuals in crisis:  "Strike when the ego is hot."  If a person can reach out for help, and can engage in emotional grieving, he or she is more open to making significant behavioral changes and adaptations at these crisis problem-solving moments, than at less stressful times.  As Nobel prize-winning author Albert Camus, noted:  Once we have accepted the fact of loss, we understand that the loved one obstructed a whole corner of the possible, pure now as a sky washed by rain.

And there is a crisis learning curve.  Effective coping with an initial crisis sequence often helps prepare an individual for positively responding to hazardous and critical events and for managing subsequent crises or post-traumatic effects.

Crisis Problem Solving and Post-Traumatic Coping

Speaking of intervention, here are five strategic tips from my article, "Traumatic Stress/Crisis Intervention Techniques and Tips," written in the shadows of 9/11.  That horrific event certainly threw all of us into a vulnerable tailspin, if not into full-blown crisis.

1. Strive for Realistic Control. Discourage the person from trying to achieve an absolute sense of control of his or her external environment, as this will invariably leave one feeling more at risk. Personally, taking the Amtrak train up to NYC three days after the Twin Towers terrorist attack, while initially a bit unsettling was, ultimately, an anxiety-reducing, confidence building step. The Serenity Prayer is also relevant here:

Grant me the serenity to accept the things I cannot change, the courage to change the things I can and the wisdom to know the difference.

2. Seek Sources of Support. Encourage individuals to find sources of support when feeling the need for nurturance or reassurance. Are there supportive/nurturing resources available at home, at work, through church, with friends - in person, over the phone, on the Internet; is there an online or offline support group available?

3. Take Some Concrete Action Steps. Encourage the person to focus on two or three actions steps that would help the individual feel a small but significant degree of enhanced safety and security, that is, a greater sense of control. For example, one woman stated that getting a gas mask for her and her cat and stocking up on bottled water would help her feel better. (I declined asking what the cat would think of her plan.)

4. Explore the Need for Counseling. Let people know about the counseling option. If in the next few weeks the person feels stuck in one of the grief stages or the post-traumatic symptoms are not subsiding, professional guidance is indicated. One woman approached me after a recent organizational grief session. Some personal "past issues" had surfaced briefly. She shared having recently met a terrific guy and didn't want her baggage to mess things up. After exploring her workplace mental health insurance coverage she will be calling for an appointment; a classic example of a proactive crisis problem solving response.

5. Communicate Optimism. Reaffirm that post-traumatic stress is natural, that crisis can heighten a person's problem solving capacity, enhance a person's communal circle of support and that the grief process may be a catalyst for potent healing and growth producing energy.

As I once penned:  Whether the loss is a key person, a desired position or a powerful illusion each deserves the respect of mourning. The pit in the stomach, the clenched fists and quivering jaw, the anguished sobs prove catalytic in time. In mystical fashion, like Spring upon Winter, the seeds of dissolution bear fruitful renewal.
 

Main Essay:

Part I of this II-part series has the Stress Doc outlining five of ten strategies for trumping rejection with resilience.  Recommendations range from the existential and psychological to the commercial and virtual.  Are you ready to confront your "Intimate FOE?"


Resilience and the Art of Rejecting Rejection:  Part I
Five of the Stress Doc's "Top Ten" Rejection Busters

The online mental health resource, The Bright Side ™, requested an article on dealing with "rejection."  The piece is for the Society of Composers and Lyricists' publication, The Score, whose members are frequently on the cutting edge, and not just in the creative sense.  Most composers are freelancers who submit their work on project after project only to be rejected over and over.

Well, the timing couldn't have been better for this assignment.  Once again, I'm an unrequited author.  This time a mid-sized Boston publishing house turned down my 200-page Practice Safe Stress book proposal.  As relayed by my advocate, the acquisitions editor, according to the publisher:  "There are too many stress books out there."  However, the editor made a counter offer:  submit a proposal for a breezy, humorous, magazine style "how to" book on recovering from burnout.  While initially skeptical of this superficial approach, that is, the People Magazination of our society, the desire to obtain a publisher prevailed.

In a furious weekend, I pulled together a thirty-five page proposal, including a 2x3 matrix of prevention and recovery activities -- from a week of cruising to brief coaching.  One matrix category consisted of three types of activity:  work, love (including self-nurturing, hence the cruising), and spirited play.  The second dimension involved how quickly the action could become operational -- short-term or mid- to long-range.  Anyway, now both the editor and publisher "loved" the proposal:  "It's perfect; don't change anything."

As my brother would say, "Despite having no expectations…I'm still usually disappointed."  The familiar result:  an email from the editor with the subject heading, "Disappointing News."  This time it was the bookseller who declared, "Too many burnout books on the market."  Thanks a lot, fellas!  (I'm still holding on to the rationale that, despite my best efforts, the proposal wasn't dumb enough.)

To my surprise, after a day of moping around, and a good night sleep, I was back in the saddle, at least with my book manuscript.  It was full speed ahead to self-publish.  As for the burnout-lite proposal, presently my attitude is time will heal and it will also tell.

The Making of Resilience

Contributing to my capacity for bouncing back was having been burned before, grappling with the psychological fallout, along with gaining some hard-edged coping skills.  (Now some might claim that a moderate dosage of Wellbutrin provided the cushion that helped break the depressive fall.  In my book, hardly a sufficient explanation.)

A resilience training experience occurred three years ago. At that time, I was anticipating publication by AdviceZone.com.  I struggled for six months with the editorial process, and never was truly satisfied with the editorial relationship or with our final product.  But again, "To hell with it; I want to be published."

Alas, this dot.com was a dot.bomb, and the book project disintegrated.  After a period of meltdown mourning, two positives emerged.  The first involved reworking the less than satisfactory manuscript into a product that I felt proud of…whether it was published or not.  Second, I realized, akin to my former radio and television days, when it comes to publishing, "I no longer count on nor discount any possibility."  Years of disappointment in trying to get a book published -- from being approached by a New York City agent as well as another editor of a large house -- has developed some psychic calluses.

And while not as prestigious as a book, over the years, having hundreds of articles appear in online and offline (i.e., hard copy) publications is a source of affirmation as a writer.  This fact helps soothe the frustration of the as-yet fulfilled title and role of "book author."

And speaking of role, in Hollywood-like script fashion…as one door closes another door or, at least, a window of opportunity, begins to materialize.  (But is it more smoke and mirrors as I stumble through this labyrinthine, not so fun [publishing] house?)  Just last week, PESI healthcare, a national training company soon to be promoting Stress Doc-led "Managing Anger" seminars, expressed interest in marketing my products.  And my PESI contact will explore with the Powers That Be the option for publishing my manuscript.

"Top Ten" Rejection Busters:  I-V

So with rejection and resilience hot off my mental press, here's a strategic blueprint for experiencing, integrating, and rebounding from rejection -- "The Healing Art of Rejecting Rejection:  Part I":

1.  Embracing the Journey.  While getting the book published (in my case) or obtaining the compositional contract for the next project is, of course, the end goal, make sure the process of writing and creating is truly compelling.  You have to love what you do; you must have a critical mass of belief in yourself and the belief in the necessity and vitality of your work to withstand the "slings and arrows."   Being a creative entrepreneur often means periods of "dark night of the soul" angst and financial uncertainty.

And you cannot not just believe; you must breathe in what you do.  One takes in air through writing and composing; sparks are fanned into passionate fire.  For you, when it comes to creative expression, is there "no choice?"  Be honest:  do you compose to capture your (and life's) melancholy and joy, to quiet the relentless gnawing, to relate the obscure and the obvious, to transcend hurt and humiliation, and to release the music within?  In fact, eventually, rejection itself becomes a moving life force:

For the Phoenix to rise from the ashes
One must know the pain
To transform the fire to burning desire!

Finally, do you write to open your own Pandora's Box, to help confront your "Intimate FOE":  Fear of Exposure?  Do you know that the last of the escaping furies -- hope -- resides within?

So the process must be as sustaining as the prize.  The unconventional journey becomes your true destiny, for destination success or salvation, if not ephemeral, often proves short-lived.  The artistic way involves breaking up or breaking out of the career and life puzzle.  (And sometimes burning out or breaking down comes along for the ride.)  As the 20th century giant, Pablo Picasso, observed:  Every act of creation is first of all an act of destruction.  No one said the journey was easy.  Still, the flexibly focused mind is forever on the edge of "breaking away."

2.  Distinguishing Rejection Regression from Burnout Blues.  Rejection hurts, alas, not the end of story.  When the "no" shuts down an important project or anticipated contract, one on which expression, excess pride, peer status, and/or security have been riding, then swelling streams of emotions -- shock, sadness, shame, anxiety, and anger -- may coalesce into a raging river of grief.

While not wanting to give false reassurance, there really is an up side.  Acknowledging and patiently grappling with the pain while accepting some TLC -- Tough Loving Care and Tender Loving Criticism -- is what transforms grief into rebirth and growth.  As I once penned:  Whether the loss is a key person, a desired position, or a powerful illusion each deserves the respect of a mourning.  The pit in the stomach, the clenched fists and quivering jaw, the anguished sobs prove catalytic in time.  In mystical fashion, like spring upon winter, the seeds of dissolution bear fruitful renewal.

However, if the project has become a near holy quest, that is, not just a goal, but a "my entire self-worth is on the line" goal (what I call an "egoal"), then you are vulnerable to greater disruption.  Ironically, at some point, two of your artistic aptitudes -- passion and persistence -- may contribute to your undoing or, at least, to a state of disabling exhaustion.  Remember, "There's a fine line between vision and hallucination."

Imagine for a moment you are a NASCAR driver and your mind-body is the racecar.  If you keep relentlessly driving and pushing without taking a pit stop (at minimum to regroup), you likely will blow a fuse, if not an engine or tire.  As I've previously written (The Score, Summer 2003), one is ripe for "The Four Stages of Burnout":
1) Physical, Mental, and Emotional Exhaustion
2) Shame and Doubt
3) Cynicism and Callousness
4) Failure, Helplessness, and Crisis.

Complicating the "Burnout Blues," is prolonged stress.  Chronic tension often awakens those critical demons whose shrill and judgmental voices are seeping through the cracks in your defensive armor.  Now you will absolutely have to take time for the pain and the grief.  Seeking some short-term therapy is wise.  (And having a friendly pit crew couldn't hurt either.)

3.  Diversifying Efforts, Results, and Revenue Dreams.  The "Burnout Blues" doesn't only occur from frequent rejection.  It also can develop when you keep playing it safe -- when, for example, you do the same narrowly focused writing or composing over and over.  (Would this be to avoid possible rejection?)  Eventually, your niche of success can have you stuck in the ditch of excess.  I call it the Bjorn Bored Syndrome (BBS), for the late-70s to early-80s Swedish tennis great, Bjorn Borg, who suddenly burned out on the circuit.  Despite the glamour and money, after five consecutive French and Wimbledon Championships (along with the hours of monotonous, numbing practice) the thrill was gone…and so was Bjorn.  He was a victim of BBS:  "When Mastery times Monotony provides an index of Misery!

The Stress Doc moral:  Fireproof your life with variety.  And this maxim works both for preventing mind numbing exhaustion and for better coping with rejection.  For me, diversification involves a professional mix of writing, speaking, training, consulting, and a small therapy practice.  Many won't have such an array of options.  But even one other role, or an additional source of reward and/or revenue, can soften the blow.  This added role can be in your field or far a field, just as long as it provides some combination of:
a) a new learning curve or an environment that allows for relaxation and rejuvenation,
b) self-affirmation and/or recognition for you, any team members, and/or your audience, and
c) some psychic gratification, if not a tangible reward.

Not surprisingly, the Stress Doc's second and complementary "variety" maxim for "rejecting rejection":  Don't put all your ego eggs in one basket!

4.  Getting Out of the Be All and End All Box.  For writers and artists it can be hard letting go of a path or a project.  So much time as well as energy, ego, and effort have already been invested -- the "sunk costs" phenomenon.  To let go can feel shameful; it's a failure or defeat.  As many a successful person has learned:  One may have to retreat partially to advance eventually.  Okay, let's get practical:  What about part-time work?  Clearly this option can seem double-edged.  The downside:  it's taking you away from your calling.  Conversely, having some structure in the day, as well as some predictable income, can lower stress levels.  There's a chance to retreat, recover (from exhaustion), and regroup.

Now, with a more patient perspective, being refueled and re-funded, options will likely appear.  You may be ready to get back into the race for rejections.  The more efficiently you get "no's" out of the way, the more effectively you can target a more responsive market.

But perhaps most important is this cognitive shift:  accepting the fact that for most individuals -- creative and otherwise -- the journey toward success and achievement tends to evolve when traveling aboard the train making frequent local stops, with resultant meandering, getting lost, yet having a chance for experimentation, and gaining hard-earned wisdom.  Goal achievement rarely occurs simply by jumping on a high-speed express.  (See previous dot.bomb reference.)

5.  Coming to Grips with Commercial Virtuality and Cyber Reality.  Along with my recent being taken for a roller coaster ride with the book publishing company, several years writing and delivering essays on cable and public television, as well as for commercial and public radio, have honed a cautious, if not somewhat cynical, attitude.  Without belaboring the obvious, the commercial media often opts for a low, if not the lowest, common denominator.  There can be a reluctance to risk backing novel or unusual perspectives and approaches.  The bottom (feeder) line:  Will it sell?

However, today's wired and web-based world provides unprecedented opportunity for getting work out through alternative avenues -- from burning and distributing CDs to creating websites and blogs (interactive forums) that help spread the words and sounds.  (I won't get into Napster issues here.)  For example, I'm writing these articles for The Score because the Business Development person of The Bright Side ™ found my website -- www.stressdoc.com -- and a coast to coast partnership started evolving.

Another valuable web development was having List-A-Day.com select my monthly Stress Doc Newsletter as its web publication of the day.  They made my day, especially when noting my insightful and fun "psychohumor" essays.  It's nice to be read and to have essential aspects of your work be truly seen.  (Email stressdoc@aol.com for the free newsletter.)

One more encouraging anecdote.  This year, the BBC in London interviewed me.  They were looking for a stress expert.  The radio program manager's selection was based on my site's originality and the quality of content; according to this manager, it wasn't as "commercial" as the sites of larger stress reduction companies.

And as affirming as the awards or the recognition is the genuinely appreciative feedback from readers -- whether it's for sharing my own trials with depression or highlighting strategies for overcoming dysfunctional organizational dynamics.  (A number of readers share select articles with their deserving managers or top management.)  While it took awhile, I've come to believe that my words can truly touch a heart and mind and, sometimes, even a soul.

Clearly, the big business marketplace and corporate commercialism are not the only arbiters of value and arteries for success.

Here are two final quotes for transcending the regressive and rejecting mindscape.  The first approximates the words of the radical and innovative poet, e.e. cummings:  To be nobody but your self in a world night and day trying to make you like everybody else, is the hardest fight you will ever fight…And never stop fighting!

And another inspiring Stress Doc slogan:  Go web young cyber-ite!

Five more offerings next time.  Hopefully, these five healing strategies will make it easier cutting rejection down to size and facilitate retreating and rebounding, while also helping you to…Practice Safe Stress!