19: MAKE TIME TO DEAL WITH DAILY ISSUES
This is one of the suggestions of Step D1 (Section 45) for falling asleep in the face of disruptive worries and fears.
It is common to let down your defenses as you are falling asleep. Then if there is stimulating unfinished business that you have been putting aside, it can return to conscious awareness and energize you to the point that sleep is more difficult.
The contents of the disturbing issue are probably consistent for each person, and may reflect unresolved themes that should be addressed in psychotherapy – fears, recollections of embarrassing actions or words, forbidden fantasies, angry thoughts, etc.
19a. Diagnosing the Problem
An informal diagnosis can be made by asking what happens when the person is about to fall asleep. If he/she consistently
- worries about upcoming events
- has emotional reactions to the past day’s events
- reviews successes and failures
…it suggests that issues are being pushed aside during the day and returning at bedtime. Chances are that these are issues that the person has not looked at consistently and reasonably.
19b. Making Time
A cognitive solution is to have the person set aside time each evening to address any unresolved issues, so sleep can develop naturally at bedtime. The time should be well in advance of bedtime, when the person is still alert and able to focus.
This can take the form of homework, to pick a time each evening to review the previous day and look forward to the upcoming one, looking for problems or worries that are hanging around and likely to be disruptive.
Various authors have made this kind of suggestion (Hauri and Linde, 110-113, Glovinsky and Spielman, 152-154). Typically a half-hour is recommended, in a place that is quiet and free from distractions and disruptions. A person who worries can simply relax and the worries will come.
19c. Making a List
Suggest that the person record the worries as they come, on paper or note cards. When new worries stop coming, they should be organized into categories and the categories identified – possibly, money, upcoming events, relationships, etc. Then the person should come up with some solution to each of the sets of worries, something good enough to say that they have been considered and a beginning made.
The idea seems to be that focusing, articulating and partially resolving each of the categories can make it easier for the person to set them aside and fall asleep.
A person could also set aside time each week, depending on his/her typical style of ruminating. The details will depend on the person’s style – making a list of issues might work for some people, or keeping a diary of thoughts.
You can also suggest keeping a bedside notepad to record any such issues that come up in the middle of the night, and enter them for review the next day. This goes along with a mantra like, “I’ll be just as smart tomorrow.” Or “I’ll be able to deal with this tomorrow when I can look it up on the computer or face the person I’m mad at.”
19d. Using the List
There are many ways to use the list – as a basis for working out issues the following day, as a reminder of things that need to be dealt-with, as a starting point for continuing the list, and so on.
A written list can also be a source and reminder of issues to deal with in psychotherapy.
19e. An Alternative Using Images
For people who think visually, McKenna (p. 90) suggests turning worries into pictures and manipulating the pictures – moving them farther away, including one’s self in the picture, draining the color out of it and making it smaller.
When the worry is in the form of action, some people might be able to modify the action, to take control of it and make it turn out differently.