Mark Goulston M.D., F.A.P.A.

Just Listen

Having a Breakdown? The best tip I ever heard

How to go from breakdown to breakthrough.

Posted Dec 06, 2010

Nearly all breakthroughs are preceded by breakdowns.  To keep those breakthroughs making you stronger, better and more successful the secret is to keep saying to yourself when you’re in the middle of a breakdown, “This is a breakdown.  You will survive it and it usually leads to a breakthrough.  Now don’t do anything to make it worse for 72 hours.”

When I ask people who have had breakthroughs in their lives how often they were preceded by breakdowns, close to 90 % of people agree.

The challenge is that when you are in the middle of a breakdown, it is usually not invited, feels awful and in some cases feels as if you won’t survive or you are about to go crazy.

The secret is that when you’re at the beginning or the middle of a breakdown, acknowledge to yourself that you are in one and say to yourself what you feel.  Better yet, keep a journal where you put down the date and when you’re in that breakdown fill in with as much detail as possible whichever of the following applies:

  • “I feel disappointed because _______________.”
  • “I feel frustrated because __________________.”
  • “I feel angry because _______________________.”
  • “I feel afraid because _______________________.”
  • “I feel hurt because ________________________.”
  • “I feel self-doubt because ___________________.”
  • “I feel guilty because ________________________.”
  • “I feel ashamed because ____________________.”

Don’t feel the need to explain, convince, justify or anything.  Just name, say the feeling to yourself and then just feel it (instead of hiding from it, denying it or blaming it on someone else).

And of course if the pain from that breakdown feels unbearable, seek out a trusted friend or family member or mental health professional to “talk it out and talk it through” which will help you not do anything to make it worse.

Dr. Matt Lieberman at UCLA has done research in “Affect Labeling” (naming emotions accurately) that has shown that when you do this it significantly lowers the emotional agitation you feel (referred to as “amygdala activation”).

After you have given your feeling a name, acknowledged it and felt it, the real challenge is to not do anything to make it worse for 72 hours (coinicidently that is the amount of time a person who is a danger to themselves or others or gravely disabled can be put on an involuntary hold by a psychiatrist, no doubt to give them time to calm down and away from acting on some irresistible impulse).

Not doing anything to make it worse is important not just because it can be crisis averting and in some cases life saving.  It’s because when you do something like get drunk, binge eat or spend, beat up on someone, lay into someone verbally you have to then deal with the guilt, embarrassment and/or shame at having done so.  And dealing with those emotions and apologizing to others can distract you from discovering the breakthrough that you will make a few days later.

I can’t prove the following, but I believe that what happens in a breakdown is that something occurs that loosens the connections between your thinking (human/upper), emotional (mammalian/middle) and “fight or flight” (reptilian/lower) brains.  That may be why people use the terms to describe breakdowns as becoming” “unglued,” “unhinged,” “wigged out.”  This occurs, because whatever just happened and the way our three brains are “glued” (configured) together don’t match.  And since that something that just happened can not “unhappen” what has to give is the face off between world and you, is your brain.

When your three brains feel loosely glued together, it feels as if the next step is their falling completely apart and some people describe it as feeling “fragmented” or “shattered.” In reality, it is just the time before your three brains will reconfigure and “mindsee” the world differently.  It is from that different “mindsight” that breakthroughs occur.  As Henry Ford said: “If you believe you can or can’t, you’re right.”

The next and equally important step after allowing your breakdown, recentering and becoming ready to reengage the world in an a effective way is to pause and say to yourself, “Now what?”  At that point, think of what outcome you really want to accomplish, in the near term and long term, then select the milestones to achieve to get there and finally what you will need to do reach those milestones (this will be the focus of a subsequent blog entry).

Having a breakdown that led to a breakthrough happened to me at the end of my medical internship in 1977.  I thought I was about to lose my mind as I did my last rotation in the Surgical ICU at Harbor UCLA Hospital.  I was good with my hands and with understanding people (and about to go into psychiatry), but not particularly good at remembering details.  At one point four of my five patients in the ICU were near death.  I told the surgical resident, “Look I’m good with my hands, and I will put any in any catheter, i.v. disimpact (dig the hardened stool out) of any patient, or do any “scut work” (medical procedures) you want, just help me to not make the situation any worse.”  It was my good fortune that he took me up on that trade.

Just when I thought I was about to still go off the deep end, it was all over.  Within 24 hours of dealing with my last medically dying patient I was on a Swissair plane to Switzerland for ten days of R & R by myself, before I would start my Psychiatry studies at UCLA.

As I sat in my coach class seat, I pulled out an inexpensive spiral notebook and wrote my first entry, “I can’t believe I made it.  They have released a madman!.”

For most of my life I had been an A-B student in math science, a B-C student in English and couldn’t remember ever having written anything creative, ever.   So it was very novel for me to keep a journal.  At the beginning, my journals contained many of the feelings listed above.  But the free expression of feelings and feeling of them that writing them down led to much more.

Little did I know how that first little notebook in June, 1977 would lead to 206 volumes, more than 50,000 pages, five published books (with my latest, “Just Listen” reaching #1 at amazon and in China and Germany), a Tribune nationally syndicated career advice column, 1100+ published columns, articles and blogs at the Huffington Post, Harvard Business, Business Insider, Psychology Today, Divorce360, Basil & Spice, Daily Speculations, expert quotes and/or commentary in the Wall St. Journal, NY Times, Forbes, Fortune, Newsweek, Time, Oprah, Today, NBC/ABC/CBS/CNN/msNBC/BBC/HBO/CNBC television.  Here is the downside.  I can no longer add or subtract or correctly write a check without a mistake.

And now thanks to the 2010 Academy Awards.  I have a new name for my journal…“Hurt Locker.”