Thursday, September 22, 2022

Critique of "Maladaptive Coping", Emotional Regulation, and Other Related Concepts

Saw the following comment in social media group centered on trauma-informed care...

"It’s a life skill to regulate. Many kids have learnt maladaptive coping skills when they are disregulated- such as self harm - in all its forms - cutting, burning, binging, purging, using alcohol and drugs, violence etc. when I teach self regulation skills the first step is identifying the feeling and what it’s trying to communicate and validating this. When it’s done right it’s not about suppressing emotions but rather knowing what to do to when they come up that’s not going to make the situation worse."

Some thoughts. Still a rough draft, but these are topics I've been wanting to address for a while. So challenging to find the right words.

1) I'm noting how everything in the comment is centered on the individual
Really hoping we continue to push past the individual-alone focus that so much of health and trauma work hyperfocuses on.

2) Maladaptive is a loaded phrase
Even self-harm, as vicious at it is, can be seen an understandable response to something being triggered. We need to separate the impact - the physical harm itself - form these value-based scientific sounding descriptions of "correct" and "incorrect" behavior.

The harm is real. It's also only one of a larger complex of potential harms being experienced (emotional, social, cognitive). Any or all three of self, others, and society can be focuses of our efforts

3) Let individuals self-determine which skills inflict less additional harm in their minds
We constantly take away the individual's power to declare what harm means to them. We can certainly suggest other strategies and we can honor individual choice to give them more self-ownership of choice and say in what harm means to them.

4) We overemphasize physical harm and underemphasize emotional and cognitive harm
Note how everything in the above list being called problematic is physical and material in origin? It's all use of substances and/or physical harm. I think we focus on these things because it's so objective. We can see these things. Society loves objective observations. That means proof. That means evidence.

But even objective evidence is subjective. We're not asking how the individual feels about these things.

We can't directly see, nor ever fully prove, what the inner experience of the mind is experiencing. That harm can't be proven, and tends to be looked for less and policed less. If you're not physically cutting but have gone completely dissociated from self to attempt to appear outwardly "normal", that will count as a success in mental health metrics.

Does that mean we should not care about the physical harm? No.

Does it mean we need to step back and think through what we can see versus what we can't? Yes.

Per #3, do we also need to remain vigilant in not over-prescribing value systems of which harm is "good" or "bad" on others? Yes.

5) A note on the term "coping"
I prefer a term like "addressing" versus "coping". To me, coping has too much connotation of success. It can almost imply deal with or solve.

Sometimes emotional reactions aren't "solved". We can distract. We can push through and remain outwardly functional to meet demands often placed on us by society (work, be productive, etc.)

But what are those activities really? I almost feel like suppression of emotion to maintain outward function and prevent other long-term harm needs it’s own term. It’s a horrific ask to make of an individual versus actual “from surviving to thriving”.

Maybe it prevents certain other harms (addiction and abuse of substances, violence to others, etc.). But at what other costs?

Look at, for example, the phrase “distress tolerance”. Isn’t that an awful thing to ask an individual to do? To “tolerate” distress? Versus to have routes for ending or resolving it?

6) Is it a "skill" to regulate or is that sometimes a socially-enforced harmful demand?
How much is regulation is truly within our actual control? Open question.

II worry that, like everything else in modern Western life, we place so much on the individual. An arguably impossible amount.

Can emotions sometimes be fully processed and resolved? Yes.

Can that at least sometimes be accomplished by self alone, especially for a person who already has a lot of other resources? Yes.

Beyond that, I worry about everything modern society teaches about emotions.

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