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Everyone knows that a twisted ankle requires elevation and a bag of frozen peas. Minor cuts and scrapes get bandages and Neosporin ointment. Colds get chicken soup, cough drops, and tissues. But what’s the common remedy for rejection, rumination, or low self-esteem?
As psychotherapists, we proudly use our expertise in evidence-based methods in the treatment of severe anxiety, depression, and relationship angst, but we rarely talk about standard protocols for everyday emotional problems that aren’t listed in the Diagnostic and Statistical Manual
and that most people experience, but typically don’t consult a therapist about. Ask 10 practitioners how they address loneliness, for example, and you’ll likely get 10 wildly different responses.
Manhattan psychologist Guy Winch felt an instruction manual for the emotional bumps and bruises of life was long overdue. In his book Emotional First Aid
, he compiles current research and theory to provide suggestions for handling familiar issues like loneliness, loss, guilt, and a sense of failure. In our interview, he shares his thoughts on emotional first aid.
Why do you think our training as psychotherapists mostly ignores everyday issues like rejection and loneliness?Guy Winch:
We tend to focus on the illness, because if it’s not diagnosable, clients won’t get reimbursement. So we talk about the big-ticket items and pay less attention to common, day-to-day issues. But while medicine has increasingly emphasized educating the public about prevention so patients don’t have to seek medical treatment as often, psychology has been slower to move in that direction. Of course, people don’t need to run to a therapist every time they suffer guilt or rejection, but we don’t discuss the exercises people can do to recover their self-esteem when it suffers a blow.Ryan Howes:
Let’s dive into one of your favorite topics. What’s your first-aid approach to guilt?Guy Winch:
Guilt is interesting, because it’s actually one of those things that’s good in small doses, but too much or too little isn’t good. Guilt alerts us to when we’re about to do something or have done something that can harm another person; then it allows us to either not do the thing or take corrective action and issue apologies or restitution. So it’s great as a relationship preserver. That’s its primary function: to maintain bonds in small societies and social groups.Ryan Howes:
So when does it become a problem?Guy Winch:
Guilt is incredibly distracting, and when we’re distracted by feeling guilty, we have trouble concentrating and enjoying life. In fact, we may consciously and unconsciously make efforts not to enjoy things. People can feel guilty for weeks and months and years, so that’s no small pickle. Guilt makes us feel punished. There was a study in which students were allowed to administer electrical shocks to themselves when they played a computer game that deprived a fellow student of a lottery ticket. The device wasn’t connected, but the researchers wanted to see whether the students would flip the switch for such a minor thing, and they did.Read the full interview with Guy Winch, "Emotional First Aid: Looking Beyond the DSM," in the January/February 2014 issue of Psychotherapy Networker magazine.