The Substance Abuse and Mental Health Services Administration explains that the concept of “wellness” refers to being in good physical shape and mental health. Since the two are closely linked, an imbalance in one area of life can cause distress in another. Similarly, taking care of one side of the equation can benefit the other.
Broadly speaking, there are eight dimensions of wellness. They cover every aspect of modern-day life:
All eight dimensions are important in recovery, and many treatment centers will have classes or groups that discuss each dimension in some level of detail. This is why, for example, a number of facilities offer (or encourage) exercise as part of their programs; running can relieve depression, clear the mind, boost short-term brain functioning, and heighten awareness, to the point of making a person “comfortable with the uncomfortable.”
Emotional avoidance entails denying the truth and reality of a situation. A person insisting, “I’m fine,” when it is clear they are upset or angry, and then refusing to talk through the problem, is sabotaging their emotional health in favor of putting up a strong front.
Enjoying life does not happen because the disappointments and frustrations of life are ignored, but because they are dealt with maturely and positively. This can mean saying things like, “I’m angry, because…” or “This makes me upset.” Such acknowledgements are the first step of dealing with the problem head on. Pretending that nothing is wrong, or instinctively denying that there is any distress, can be emotionally unhealthy.
The result of improving emotional wellness is that a client will be able to:
Furthermore, clients who are emotionally healthy can talk about what they’re feeling with others, even if they are angry or upset. Problem-solving with a friend, partner, or family member improves negative feelings, says Psychology Today, and this improvement cannot come if the problems and the negative feelings cannot (or will not) be articulated.
The idea of acknowledging and accepting negative thoughts is so important in emotional wellness that The New York Times, in declaring 2017 as “The Year of Conquering Negative Thinking,” lists the first step of overcoming negative thinking (for all its ubiquity) as simply not trying to outright stop negative thinking. A psychologist and the president of a mental health training and resource center explained that controlling thoughts requires work; someone who is emotionally unwell, whether due to addiction or a mood disorder, does not know how to do that work. Instead, worry over simply “stopping” the negative thoughts becomes an obsession in itself.
The remedy is to accept, without judgement or guilt, the existence of negative thoughts. This allows them to be broken down and reshaped into a more emotionally healthy outlook.
Guilt is an important part of an emotional balance, and practicing emotional wellness will help clients say “no” without feeling guilty. This could be anything from saying “no” to the invitation to go out drinking or smoke a joint to saying “no” to an uncomfortable favor in a relationship (whether personal or professional). Scientific American explains that “no” is one of the shortest words in the English language but one of the hardest to say because we feel obligated, pressured, or guilted into saying “yes.” Emotional wellness means being in confident enough to say “no,” but doing so in such a way that it doesn’t harm the relationship. This might mean that the “no” becomes a conversation in itself – finding a compromise or another solution. The relationship is furthered, and the client will not have to sacrifice personal (or professional) space.
Respect is a key part of emotional wellness; many kinds of mental health disorders, such as depression, poison the concept of self-respect, making the victim feel like they do not deserve to be liked or admired by anyone. Substance abuse works much the same way, being a factor in, and a result of, having low self-esteem. But in recovery, a therapist can work with a client on how to build that sense of respect up, to the point where the client learns self-respect. This does not mean that the client is happy all the time or becomes narcissistic.
Rather, emotional wellness means being generally content about life (even when things are difficult) and feeling good about oneself as a person. Character flaws can be accepted as opportunities to grow and not as weaknesses for self-hatred or shame.
Liking oneself translates to being flexible, able to adapt to the different and challenging situations that are a normal part of modern life. Those who struggle to accept themselves will similarly struggle to meet personal or professional difficulties head on and may resort to drinking or drug use to work up the nerve to tackle their problems. Clients coached in emotional wellness, however, know how to be mindful of their surroundings, their emotions and reactions, and other people’s emotions and reactions. These kinds of clients are able to put everything together to determine the best course of action: knowing how to say “no,” how to step away from a potentially difficult scene, how to control their anger and impulses, or how to let someone else have the last word if it means a mutually beneficial resolution. Being flexible does not mean always giving in or compromising, but it does mean setting boundaries and understanding how to change. People who do not have this kind of emotional balance can’t adapt; tough conversations can become arguments and fights, and unfavorable situations can end in using alcohol or drugs as the easy way of coping.
Emotional wellness is an important part of recovery because of the importance of regulating thoughts and moods as part of sober and healthy living. Regulating emotions means accepting them as natural and normal parts of being human – everything from happiness and excitement to fear and sorrow.
For many people, regulating emotions is much easier said than done, especially if there is a mental health or substance use disorder at hand. With counseling, a client can be shown how to acknowledge and handle emotions (even the uncomfortable ones) without getting overwhelmed. Psych Central describes a process of observing emotions (perhaps by saying them out loud, writing them down, or doing both), validating emotions (accepting them without judgement), and focusing on the present (making a concentrated effort to draw conscious attention to what is happening in the present moment). This way of “sitting with painful emotions” helps to contextualize and give ground to experiences, without them getting in the way of personal happiness or goals.
Being in the moment is one of the main concepts of mindfulness therapy, which the Drug and Alcohol Dependence journal says “improves emotional regulation and reduces drug abuse.” Mindfulness, says Psychology Today, means paying attention to the thoughts and feelings of the present moment, offering no judgement or criticism, and ascribing neither positive nor negative associations to the thoughts. Breaking them down as neutrally as possible is what allows clients to regulate their feelings and emotions; triggers, warning signs, and harmful thought processes can be identified before any compulsive responses are engaged.
A state of mindfulness can be entered in different ways, but a common method is by practicing specific breathing exercises, which are designed to draw the client’s specific attention to the action of inhaling and exhaling. This acts as a diversion away from feelings of anxiety, shame, anger, or depression, and it can start the mindfulness process. Deep breathing can lower increased heart rate and blood pressure, helping the client prepare for the next stage: paying close attention to their senses. This could be saying out loud what they can see, hear, smell, or feel (even the clothes on their skin). This step forces the client’s mind into the present, providing a sense of reality that works against the compulsion to give in to an episode of anxiety or depression.
With practice and learning from setbacks, clients can use mindfulness techniques to regulate their emotional wellness in recovery. When relapse threatens, the skill of focusing on breathing and senses can serve as a lifeline until the impulse to drink passes. A study published in the Psychiatry Research: Neuroimaging journal found that in eight weeks, patients who had undergone mindfulness therapy had better-developed senses of self and empathy, and lower stress levels. Magnetic resonance scans on those patients further showed that their brains actually changed as a result of their therapy; researchers noticed that the hippocampus, the region responsible for learning and memory, was denser after eight weeks of mindfulness. Similar changes were observed in the parts of the brain associated with self-awareness, introspection, and even compassion. There was less density in the amygdala, the region that regulates anxiety and stress, suggesting that the mindfulness therapy was effective in improving emotional wellness.
Mindfulness, writes a counselor in The Fix, can give both the client and the caregiver “valuable information about what is unfolding inside.” Emphasizing mindfulness thinking creates curiosity and fosters understanding about how and why a client’s mind works the way it does as well as what thoughts and feelings lead to other thoughts and feelings. Paying attention to this journey can encourage better and healthier decision-making, which is a vital construct in recovery. For clients with mental health or substance use disorders, there is often a lot of “background noise,” which tends to be judgmental, self-critical, or lopsided. Individuals are naturally made to feel distressed because of the diatribe, and they find escape and temporary relief in drugs or alcohol. What mindfulness does is slow everything down, stemming the flow of background noise into a trickle – one that is much more easily scrutinized and countered. With practice and guidance, individuals can learn how they can choose from a number of healthy, positive responses to the chatter.
Everybody experiences shame, and for most people, the experience passes. But for people with mental health and substance use disorders, the shame never fully goes away, and it often manifests in self-destructive and harmful ways, like the development of clinical depression, where it drains away all positive and good feelings about the self. It can poison relationships, where one partner becomes domineering, dysfunctional, and abusive over the other because of the deep-seated sense of self-loathing at the center of the union.
Transitioning from shame to emotional wellness in recovery entails forgiveness – more specifically, self-forgiveness. A writer in the Huffington Post notes that the idea of forgiving is not simply “letting go” of unhappy or uncomfortable feelings but processing them in a constructive manner – one that ultimately leads to a new and better place in life. Part of the solution is found in, again, acknowledging emotions; from this, the client will be shown how to take responsibility for whatever it was that caused the shame. With the help of a counselor, the client will be moved away from excuses, justifications, and blaming other people. Difficult as though this stage may be, it is vital for the development of emotional wellness.
Researchers at Baylor University suggest that by making amends for wrongdoings (perhaps wrongdoings committed while under the influence) it is possible to sincerely and productively self-forgive, which in turn helps guard against depression and anxiety.
Many of the people who experience deep shame as a result of an event in their past “feel morally obligated to hang on to those feelings,” usually out of a misguided sense of penitence; however, not knowing how to let go of those feelings can make the sense of shame into an obsession, one that pollutes other areas of life. In recovery, a therapist or a counselor can help a client in this situation understand how to use the idea of the shame proactively, making amends for the wrong and then moving on.