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Coping Mechanisms: strategies and outcomes.
Coping with Crisis and Overwhelming affect: Employing coping mechanisms in the acute inpatient context.

Isabel Clarke
Consultant Clinical Psychologist

Address for Correspondence:
Isabel Clarke,
Consultant Clinical Psychologist,
AMH Woodhaven,
Loperwood, Calmore,
Totton SO40 2TA

When mental health breaks down, the human being grasps at ways of coping with the crisis. The goal of coping is escape from intolerable affect and the means are familiar as 'symptoms' of mental illness. For example, to shut down physically and cease to compete is depression (Gilbert 1992), and drugs and alcohol provide a straightforward way out.

As psychological therapists, our task is to devise, evaluate and, most importantly, persuade the client to adopt alternative, healthier, ways of coping; ways that offer less immediate relief, but which do not trap the person in a diminished quality of life.

By explaining breakdown in terms of coping with intolerable affect, this approach, developed and evaluated in an acute hospital setting (Durrant, Clarke & Wilson 2007), enables us to offer more adapted skills for coping with affect as the solution. This 'third wave Cognitive Behavior Therapy (CBT)' approach (Hayes, Strosahl, & Wilson, 1999) takes seriously the discontinuities in human information processing (Teasdale & Barnard 1993) and employs mindfulness to manage them.

The coping mechanisms considered are:

• Mindfulness

• Arousal management techniques

• Emotion Regulation skills (Linehan 1993a & b)

• Skills for coping with relationships with self and others, including a compassionate mind based approach to self esteem. • Coping with psychosis.

Many of these techniques are already familiar in...

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