Emotional Insulation: What is it and what does it have to do with BFRBs?

One way to think about my goal as a therapist is to help my clients build up emotional insulation. Emotional insulation is the protective layer between the self and the world. It enables us to go through the ups and downs of social and work interactions with a positive sense of ourselves. It is like emotional skin.

If I can help my clients internalize a positive sense of self, it will help them get through the barriers they have faced in forming intimate and satisfying connections with others. We all have different levels of emotional insulation, and what we do have can be worn down over time or strengthened.

Emotional insulation is an umbrella term for all of the emotion regulation strategies we develop while growing up. These start at the level of the skin, as babies learn to relax through skin to skin contact. In the best case scenario, a child internalizes a positive sense of herself through love in the home. She gets help navigating the difficult situations she faces over the years, and has learned to tolerate frustration and disappointment.

When there isn’t enough good feedback to draw from and we don’t have that sense of being safe and good enough in the world, we have to search for other, external ways to relieve our emotional pain. Just like a baby will scratch itself if its cries go unheard for too long, we can find harder comforts when we are faced with a challenge. Picking and pulling can stand in when emotional insulation is insufficient.

For an example, let’s look at the very different experiences of two boys, Jim and John who each try out for the baseball team in 9th grade.

Jim is a pretty confident guy. He has learned some basic baseball skills with his dad growing up. When they practice in the yard through the years, his dad is proud when Jim hits the ball well. When he has trouble with his swing, his dad gives him some more tips on how to hold the bat. When he tries out for the baseball team his first year of high school, he has a so-so perfomance, and finds out that he has only made the JV team.

Because Jim has a sense of himself as generally OK, he isn’t pierced through with the pain of failure. He is emotionally insulated, and can handle disappointment without falling into self-attack or despair. He gets help coping with the experience. His dad is disappointed on his behalf but is not disappointed with him. Jim cries a little as his dad hugs him close. They are quiet for a while and then they talk about how to move forward. Jim will practice hard, and will shine on the JV team and next year will make varsity.

 John is similarly interested in baseball, and has also practiced in the yard with his dad for many years. His dad was a baseball star and really wants him to be great at it too. Sometimes it seems like he just has two left feet, and whenever he misses a ball his dad yells at him. If he misses too many his dad throws his baseball cap on the ground, and stalks inside. John doesn’t know how to cope with these moments and he starts pulling out hairs that have recently begun sprouting on his chin.

When John enters the 9th grade, he too tries out for the baseball team. He tries his best but still ends up on the JV team. He doesn’t have inside of himself the sense that he can cope with this failure, and he dreads going home and telling his dad he didn’t succeed. 

We can see how the impact of not making varsity this year will have a much deeper impact on him than on Jim. He may decide that he will be the best player, and spend his entire summer practicing to be the best, or he may quit altogether. The hard comfort John has found, hair pulling, will be with him until he finds a therapist to help him build a layer of self-compassion.

This first task of building emotional regulation is begun in individual treatment, where clients begin to internalize my positive regard for them. For many, the second building block comes through participation in one of my therapy groups. With a better sense of self, it becomes easier to work through barriers to connecting with others. In both forums, feelings are put into words in place of harmful behaviors.

Group Work in the Time of Coronovirus

If you are a therapist or someone in therapy, you are most likely now having sessions on a video format like Zoom. There are so many challenges to face on this new format, from efforts to preserve confidentiality, to technical issues, to the difficulty feeling connected through a screen. I am discovering that finding a comfortable position for my body and especially my neck is difficult and incredibly important!

The first time I held a therapy group via Zoom, I was nervous. There was so much to think about, from helping my clients hide their last names on their Zoom profiles, to making sure each client could find a safe, private, internet-connected place for the session, to figuring out how to bridge group members to one another from such a distance. I was surprised that all members of both of my two groups were willing to give the online format a try.

From the first group session, I was pleasantly surprised that the online format was more effective than I had expected. It was so nice to be able to see one another’s faces within this isolating time, and I noticed how relieving it was for group members to share their experiences of coping with the virus.

Many still had to go to work, some as front-line health care workers. Others had lost their jobs and were coping with financial insecurity. Members shared care and concern for one another’s struggles. Some who are less social enjoyed that others were sharing their experience more than usual, while some were anxious and restless cooped up at home.

As is always true in any group, no one was alone in any of their reactions, and joining together came naturally.

As the leader, I find that I have to be a lot more active in online sessions, paying very careful attention to members’ facial expressions, helping to navigate silences by wondering aloud about what collective anxieties might be under the surface, asking directly about difficult topics like how it is to live alone or to be constantly with spouses and children.

I have also found that there are gifts to be discovered in these online sessions. In one group, I noted aloud that one member was very restless and fidgety, while the others were very still. I wondered what was happening for each person outside of the screen. With so many of my clients struggling with body-focused behaviors, I wasn’t surprised to hear that many hands were active, fiddling with fiddle toys or skin or nails.

I asked what we all might need and one member suggested that we stretch. We all stretched our bodies and it felt so good! I felt in myself the desire to do a Lion’s Breath—a yoga move combining an exaggerated facial expression with the tongue out, eyes wide and mouth wide open with a yell, something like “AAAAAHYH.” I asked if members would be willing to do it with me, and sensed a lot of reluctance.

I did it first, straight into the camera. “AAAAHYH!” There was laughter and some softening of the resistance. I pressed forward. “Now all of us together, straight into the camera, 1, 2, 3….AAAAHYH!” Lion’s breath, loud and open, from every screen. We all laughed, and the laughter felt so good that we did it again. “1, 2, 3….AAAAHYH!”

The following week, with 2 minutes to go in the session, a member requested the Lion’s Breath. We did it together again, twice. With a new member joining the group next week, a request was made that we teach her the lion’s breath so that we can continue to include it in each session. And a new group tradition was born.

Among many other things I am grateful for here in isolation at my home, I am grateful for the ability to connect to the therapy groups in my week, both those I lead and those in which I am a member. If you are interested in joining an online group in Austin, austingroups.org is a wonderful resource, and if you live somewhere else, agpa.org will help you find an online group therapy connection.