In This Episode: Amy Mariaskin, PhD shares her new book, Thriving in relationships when you have ocd What is Family accommodation and how does it apply to ocd Ocd family accommodation vs family support,  What is OCD reassurance and how it can creep into one’s relationship Relationship ocd, also known as rOCD Relationship issues with ocd and how to manage them Sexual orientation OCD, Gender related OCD, and Harm OCD and the impact this has on relationships Attachment styles in ocd and how to understand them to help you navigate communication.  Links To Things I Talk About: Thriving in Relationships When You Have OCD: How to Keep Obsessions and Compulsions from Sabotaging Love, Friendship, and Family Connections Amy’s Instagram https://www.instagram.com/ocdnashville/?hl=en ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor:This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety...If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This Your Anxiety Toolkit - Episode 312.  Welcome back, everybody. This is going to be a really important episode for you to listen to. Today, we have the amazing Dr. Amy Mariaskin, who is what I consider to be a very dear friend, someone I very much respect. She has written a book about relationships and OCD, and we talk all about it. We go deep into some of the core skills and discussions she has in her upcoming book. And this is just going to be an episode I really feel like you could take away and put some skills together right away. I’m so thrilled. So, thank you, Amy, for coming on this show.  But before we do that, I would like to do the review of the week, and I really hope you listen carefully to this. Not because it’s reviewing the podcast, but because I actually think the person who wrote this, who put in this review, is following some key points that I want you to consider. And this is what I encourage a lot of people to do. So, let’s go.  This is from Detroitreview and they said: “Thank you, I just started listening today after having a few weeks of anxiety and irregular thoughts that I never experienced. I randomly chose your podcast and am thankful for your experience, knowledge and personal and situations. As a 46-year-old father of two boys and loving wife, your podcast gives me a sense of calming. I’m taking notes on each cast.” Guys, I encourage you to do this. This is a free resource. It is jam packed full of skills. I encourage you to take notes. So, I love that you’re doing that Detroitreview. “While I started with the most recent, I have listened to #301/302/303.” And then they went on to say: “And they’ve already given me strategies that I’m using. I decided to start from your first podcast in 2016.” And that is what I encourage you all to do, mainly because those first 11 episodes are core content. I want you to take the content I talk with my patients about all the time. He went on to say, “I have been so impressed. I’ve listened to 1-2 daily. I’m up to 10 and 11. There’s so many things to listen to and I’m so grateful for you. The meditations are amazing. Keep up the great work.” Thank you so much for that review, Detroitreview. That is exactly my intention. This is a free resource, you guys. I want you to take advantage of the skills and tools so that you can have a toolkit for yourself. And so, I’m so thrilled for that review. It just makes me feel like, yes, that’s exactly what I want you guys to take from this podcast. Okay, before we get over to the show, let’s talk about the “I did a hard thing” segment. This one is from Kelly, and they said: “I recently faced one of my biggest fears – general anesthesia.” Holy moly, Kelly, I feel you on so many levels with this. “I started struggling with some gallbladder issues and was told I needed to have it removed. I was terrified, and I didn’t think I could go through with it. Thoughts were racing out of control. I sought help with therapy and your podcast. Thoughts are thoughts and not facts was huge for me. It was calm the day of the surgery, and I did it. Thank you.” That is amazing. You guys, listen, thoughts are thoughts. Just because you have them doesn’t mean they’re facts. I love that they’re bringing in that key concept as well.  Alright, let’s go over to the show. This is the amazing Dr. Amy Mariaskin. She’s an OCD therapist. She’s an advocate. She’s an author of an upcoming book. You must go and check it out. I’ll leave the link in the show notes. I am so, so honored to have you on the show, Amy. Let’s get over to the episode. Kimberley: Welcome, Amy Mariaskin. I am so excited for this episode today. Can you do a little introduction of who you are and all the good things about you? Amy: Yes. Thank you so much. I’m excited to be here. I’m Dr. Amy Mariaskin. I’m a licensed clinical psychologist and owner and director of the Nashville OCD and Anxiety Treatment Center in Brentwood, Tennessee. I’ve been working with OCD and anxiety for over 15 years now, and I just absolutely love it. Kimberley: And you wrote a book? Amy: And I wrote a book. I know I need to get better about that. I was like, “Oh, do I say it now or do I say it later?” Kimberley: You say it all the way. Amy: All the time. I wrote a book. It was fun and not fun and everything in between. And I think we’ll be talking quite a bit about it. It’s called Thriving in Relationships When You Have OCD. Kimberley: Right. Now, when you told me that you were going to write this book, I was so excited because I feel like at the crux of everything we do, a lot of the time, the reason people with OCD want to get better or the thing that propels them is how much their OCD impacts relationships. Not always, but I feel like that’s such a huge piece of the work. So, I am so grateful for you for writing this book, and it is an amazing book. I’ve read it myself. You did a beautiful job. And I want to cover some of the main pieces that you cover in your book today and go from there. So, first of all, congratulations. I know writing a book is not easy. Amy: Thank you. Yeah, it’s been a dream for a long time. So, I’m excited about the accomplishment and I’m ready to figure out the next topic. When Ocd Is The Third Wheel Kimberley: Yeah. I love it. I love it. Okay. So, Chapter 1, I think it’s funny. I’ll have to tell you how, when I was reading your book, I was lucky enough to get an early manuscript. I remember sitting, it was with my kids at track and they were running. And I opened the book and the first chapter said, “The Third Wheel: Understanding OCD’s Role in Relationships.” And I was like, “That’s exactly it.” So, I was excited right off the bat. Tell me, what do you mean by the third wheel? Tell me a little bit about that. Amy: Yeah. First, I should also thank you for writing the wonderful foreword for the book. So, if anybody is a fan of Kimberley, yet another reason that you might be interested in this book. Well, let me think. So, yeah, the third wheel analogy, it felt very apt because when I work with couples, I often imagine, and sometimes I’ll have couples imagine that the OCD is like this other presence in the room sitting there with us. Not physically, but in all the things that are important for relationships, all the ways that we develop intimacy, and that we even structure our time or the activities we choose to do together that OCD can wiggle right in there and can be this like third presence. And the thing is, it’s really easy, I think, for somebody without OCD if they don’t have good education or they don’t understand it, to get that third wheel confused with the person with OCD itself. So, like, “Well, you never want to go out,” as opposed to saying, “We both want to go out.” And here’s this other guy, OCD, really bossy, really pushy, really oppressive, who’s also coming along with us. And even when you do the things that you love, OCD can come along.  So, it felt to me like this sense of something in the relationship that makes it both unbalanced and is this separate component and that both people, in coming together, have to find creative ways to connect around it or eventually connect and evict it more and more. And so, that’s why I chose that metaphor. Kimberley: Yeah, I love that. And it’s funny because I remember when I was an intern and I was seeing a family or perhaps the wife who had OCD, what was interesting is I’m sitting in my chair and I noticed that the family members always sat across from her as if it was like her versus them, like who’s on which side of the team. And a big part of it was like, all you guys need to be over on that side of the room. You’re the team. I’ll be over here with OCD and we’ll work this out. But I think that that, even metaphorically, is such an important part of how OCD can turn everyone against each other. Is that how you’ve experienced it? Amy: Yeah, I think at times there are a lot of conversations about how everybody has a common goal to figure out how to live with one another, develop intimacy, connections, be they friendships, parenting relationships, romantic relationships, even work relationships, and things like that, how to form those and how to come together around common goals. And sometimes OCD can be, again, confused as a goal that one person in the relationship has. And the truth is, everybody’s suffering in a way, and that everybody can be a part of that process of, again, reducing symptoms or evicting it, things like that.  I do the thing as well when I have people in my office to just look at where are they sitting or when OCD comes up, what is the body language? Are both people really like arms crossed? Is the person with OCD hanging their head in shame, which we know could be such a powerful emotion and such an inhibitor of connection and vulnerability. So, I look for some of those and I remind them, “Head up, we’re all talking to OCD right now, and we’re all working with that, and we’re all on the same team.”  Family Accommodation & Ocd Kimberley: Such an important message. Thank you for that. I think that’s beautiful. So, let’s say the third wheel, I always think of like you go on a date and the third wheel shows up. And we know that definitely happens with OCD. You addressed a lot in your book about family accommodation. Can you share what that means and how that can impact a relationship? Amy: Yeah, absolutely. Accommodation is this thing where we’re extending this metaphor. You’re on a date, you’re with somebody, and the third wheel rolls on up. It’s, “Hey, my buddy from college is here, what’s up?” Essentially, accommodation is like, “Hey, why don’t you have a seat right here? Here’s the menu, here’s a place mat.” It is anything that the person in the relationship without OCD is doing to make OCD have a comfortable place at the table. So, that’s the metaphorical way. That’s abstract, but bringing it down to practically what it looks like, it means doing things generally in the service of what feels comfortable in the moment for the person with OCD. We’re going on a trip and I have concerns about contamination and I really want you to check all the hotels, do all this research to make sure that none of these places have ever had bedbugs or things like that. Then when we get there, we’re dirty from traveling, so I’m going to need you to take a shower. And so, the person, the spouse is taking showers and doing research and perhaps taking over responsibilities from the person with the OCD in order to provide that short-term relief. But it ends up, again, making a place for OCD in the relationship. And it reduces that motivation for the person with OCD to change.  Family Accommodation is tricky. There are a lot of ways that it can happen. I think reassurance-seeking is certainly one that I think we’ll talk about, but providing excessive reassurance about things to the person with OCD in a way to keep them comfortable but keep them caught up in compulsions. And I think it’s important to note that a lot of times, partners will hear about accommodation. And just as much as we think being apprised of accommodation and looking out for it is important, it’s also, I think, really important that partners understand that that’s nuanced and that they don’t take it to like, “Well, I’m not going to do that for you. That might be accommodation,” or, “I’m not going to reassure you about anything,” or “Is that your OCD?” I guess I say that to say that it’s a little tricky, but it’s really anything that is preventing the person with OCD from experiencing discomfort and thereby strengthening the cycle. Kimberley: Right. No, I’m grateful that you bring that up actually, because probably the one that I get asked the most from parents, and this not in every relationship, but with parents, is like, okay, my child is having a really hard time getting homework done, their OCD is impacting them. So, if I don’t help accommodate them, if I don’t do some compulsions for them, read for them or so forth, they won’t do their homework. And then there’s an additional consequence. So, they’ll say like, “I feel like that’s too risky. I could actually be letting my kid fall behind, so I can’t stop doing this accommodation.” What are your thoughts on that? Again, how would you approach that type of situation? I mean, there’s many examples. Amy: Sure. I think with a situation like that, first, I would validate the parents’ love and desire for their child to do as well as possible. Most accommodation is coming from a place of love and not a deliberate enabling or anything like that. Of course not. So, I really provide a lot of validation there. And then I help them reframe it as, “One way to be loving and supportive in the long run is to really cheer your child on in taking over, taking on more and more ownership of that.” So, does that mean, “I know that I’ve been reading. Right now, I’ve been reading for you, and that makes it easier to do your homework. We also know that you have OCD and we know that your brain tells you, you’ve got to reread and reread and reread. So, can we be on the same team together, fight that rereading? I’m not going to read it for you because I love you, because I know you can do this. Boy, is it going to be hard at first and I’m going to be there to cheer you on and motivate you.” I sit with kids, I’m always about gamifying it. “Do we want to just race through this? We don’t have to be perfect.” Again, it depends on the symptoms, if it’s perfectionism or what’s getting in the way.  And then what I say is, if a parent says, “Well, then they’re really just not going to get their schoolwork done,” sometimes then I’ll say, “Well, if it gets to the point where it is interfering with things like that, then it may be that they need a little bit more support.” Because it’s like, with kids, your job is school and with the adults, your job can be a job or it can be care taking. It can be a lot of different things. But if one of those major domains of living is affected, then it may just mean that you need more support. So, we might up the number of sessions per week or refer out to another program or things like that.  But those kinds of things would be the same things I would say in any kind of relationship where there’s an accommodator, which is, wow, you love your friend or partner or coworker so much that you’re willing to do this stuff for them so that they’re not suffering or so that they can demonstrate their potential as in the case of the kid with homework. But here’s why that’s not the loving response in the long run. Ocd Family Accommodation Vs Ocd Support  Kimberley: Right. You’re right. I mean, you mentioned like, then we have the complete other end of the spectrum where people are going, “No, I’m cutting you off completely.” And I think too, I think it’s important, as you said. Some accommodation happens in every relationship. I don’t particularly like cleaning hair out of the sink drain. That’s not my favorite. So, I’m going to ask my husband to do it, knowing that I take the trash out or whatever. We trade-off. So, how might people identify accommodation through the lens of OCD compared to loving exchanges of acts of service?  Amy: Right. Oh, I love that question, because essentially, what we call compromise in relationships could be called accommodation – accommodation by a gentler name. And I think part of that has to do with, what’s the motivation there? You do such a wonderful job in your podcasts and online and everything of talking about how doing the hard things are important, and how if you’re not doing the hard things and you’re avoiding difficult things that can really shrink your world over time and put anxiety or OCD in the driver’s seat. So, if the motivation, if a child or a spouse or a friend is asking-- well, if you are asking a child or a friend or a spouse, if you’re saying, “Hey, can you do this for me,” or “I’d feel a lot more comfortable if you did this,” thinking about, is it a compulsion or a preference to me? There are so many different ways that we can look into that, but is it in the service of just like, I could, but I prefer not to? Or is it, I feel like if I do that, I’m going to be too anxious or I’m going to do too many compulsions, or something bad is going to happen? So, I think if the motivation there is more avoidance due to anxiety as opposed to just preferences, I think that’s helpful.  Sometimes I’ll say to people when they’ll say to me like, “Well--” and I think division of labor in the house is such a good example. When people say, “Well, I don’t ever take the trash out,” I will often ask, “Well, what happens when your roommates are out of town?” Let’s say they’re living in a roommate situation. And if they say, “Well, it just piles up and I can’t deal with it,” then I say, “Aha, this might be a place that we need to work on and chip away.” And again, reducing accommodations doesn’t mean like all of a sudden, I’m a garbage master and I’m the only one doing it. It might mean that I’m doing some exposures to get up to the point where I can have that role in the household.  So, I love that question of like, well, what if you had to do it? What would that be like? And if it’s really hard, then hey, let’s help break down some of those barriers and reduce accommodation. OCD Reassurance Kimberley: Yeah. I usually tell clients like, “Okay, let’s just do it so that we know you can, and then you can move on to the next exposure.” Tell us about reassurance. You talked about it a little bit. And in your book, actually, the thing I highlighted, because I read it in Kindle, that I love the most is your reassurance tracking. Tell us a little about that.  Amy: Yes. Because again, I love that you’re highlighting this because reassurance is something that is okay. Reassurance happens in all relationships. Again, we might call it by different names. It might just be checking in. It might be clarification. It might be getting information from one another. So, I developed a worksheet that’s also available with the book that allows for people to track when they’re asking for reassurance from loved ones, and to answer a series of questions that aren’t going to give you a 100% certain answer of whether or not it’s compulsive, but are going to give you some clues. So, on the worksheet, it says, people write down the situation. So, for example, I was asking my friend if she was mad at me. That might be the situation. And then there’s a column that says, what were your emotions?  Again, if we’re seeing anxiety, guilt, shame, some of those words might be a clue that our OCD is at play, but not always. And then people track, did you ask only once? Because we also know if it’s truly the type of reassurance, “Oh, I just need to know. I’m having a vulnerable moment. I just need to know, is this okay with you? Are you upset?” Then asking once and accepting the answer is generally how it goes. So, if you’re asking more than once, if you answer no to that, it’s a clue that it could be compulsive reassurance. And then also, was the source credible?  I feel like I talk about this example a lot, but I just love it so much, which is that I worked with a little girl who was really worried about getting strep throat. She would ask everybody for reassurance about her tonsils. I mean, anybody and everyone. At one point, she took a picture and she was just old enough that she got social media. She put it on her Instagram and she was like, “Do you guys think I have a strep throat?” That was the caption. That was the little caption, which is like, she was laughing about it afterwards, but that’s not a credible source. I mean, she wasn’t even friends with all the docs in town or anything, or ear, nose, and throat specialist. So, was the source credible?  Now, often if it’s social reassurance, it is a credible source. If I ask you, if I say, “Kimberley, was I too long-winded,” you’re going to be able to tell me. So, you would be a credible source. If I leave this room right now after doing this podcast and I ask somebody, “Do you think I was long-winded? Do you think I was?” and they’re like, “Well, we weren’t there,” that’s that answer. That’s that question about credibility.  And then the last one is, did you accept the answer? Anxiety and OCD have this way of undermining. Well, pretty much everything, but undermining any answer we get and countering with it. ‘What if,’ or ‘Are you sure?’ ‘But I think...’ So, if it’s starting with a ‘but,’ a ‘maybe,’ a ‘what-if,’ then again, it may not be that helpful reassurance-seeking. Relationship Ocd (Rocd) Vs Relationship Issues With Ocd Kimberley: Yeah, I love that. And thank you for adding that because I just love that template so much. That is just like gold. I love it so much. Alright. So, as you move into Chapter 4, I believe it is, you talk about specific subtypes of OCD that are commonly impacted in relationships. Can you share just briefly what your thoughts are around that? Amy: Yeah. I love this question too because as I’ve been talking about the book, a lot of people are like, “Oh, great, a book about ROCD, or relationship OCD.” And my answer to that, or my response to that is, “Yes, and...” Just a step back, any subtype of OCD can affect and often does affect relationships. Why? Because OCD goes after what’s important to us. And for many of us, our connectedness with one another is just so important. That being said, there are subtypes of OCD that are relational in nature. And so, I do have a chapter that is more devoted to these types, and one of which is relationship OCD. This is a passion of mine. I’ve done now a few iterations of an ROCD treatment group at my clinic, and I have other plans to expand that group and do some cool programming around that.  But relationship OCD, it’s basically when OCD symptoms are about the relationship itself or about the person with whom you’re in relationship. So, it could be about-- we think about it a lot of times with romantic relationships, but it could be any relationship. To use a different one, it could be, am I a loving enough parent? Do I love my kids enough? How do I know? Do other parents have these thoughts? So, it could be about the relationship or it can be about the individual. Like, my spouse doesn’t like the same music that I do, and are we ever going to get past this? And so, something that might be seen as, yes, it’s an actual difference, but then there’s all this story making around the difference and how the difference is going to be the demise of the relationship. Those are the two flavors of ROCD, relationship and partner-focused.  I also want to pause here and say that oftentimes when people talk about ROCD, I feel like there’s this pull to say, “Well, if you know you have ROCD, if relationship issues come up in your relationship, it’s probably your ROCD.” And that’s just like another backdoor to the certainty that we all want. I think all relationships have some crunchy bits and some edges that chafe. And so, I want the people with ROCD to feel empowered to also develop the relationships that they want and then notice that maybe the ROCD turns up the volume on some of their concerns, if that makes sense.  Kimberley: It’s hard, isn’t it? Because so many times a patient will say, “But I don’t know if I really love-- is he the one?” And we’re like, “Well, we’ll never know.” There’s no way to objectively define that. And then someone, a friend is like, “Well, if you don’t know, it must be a problem.” It’s so hard for those people because people without OCD also don’t know all the time either, so it’s a common concern. Sexual Orientation Ocd & Gender Related Ocd Amy: Right. No, that’s a great point. So, I have some stuff about relationship OCD in there and then the identity subtypes of OCD as well. So, sexual orientation OCD and gender-related OCD. I put those in there because oftentimes our identity is the foundation from which we interact with others and create relationships and things like that. So, I talk a little bit about sexual orientation OCD, not just even in dating, but in finding a community and friendship and things like that. SOOCD can rear up and lead to lots of social comparisons or it can just really try to sabotage certain relationships, and with gender-related OCD as well, be it somebody who is cisgender and wondering if they are transgender or vice versa. I’ve worked with people in the transgender community who have OCD and have these unwanted thoughts about like, “Well, what if this is not who I am? What if I’ve been doing this for attention?” And then, therefore, are wanting to compulsively disengage from their community because of the feeling of like, “Well, I don’t feel authentic enough.” So, that’s a way in which that can root in relationally. Kimberley: Right. So, we’ve got relationship OCD and identity. What are the other ones?  Harm Ocd & Its Impact On Relationships Amy: Yeah. And then the last one that I highlighted in here in that section is harm OCD. And I put that in there because harm OCD, which again is a huge category, which I would say under that are anything that’s violent. That could be sexual as well. So, sexual violence toward others or sexual intrusive-- obviously, all intrusive thoughts, but intrusive thoughts about being sexual with children. I would roll all that into the harm OCD category. And this one is just, it’s always so striking to me the ways in which OCD can take something that’s really important. Like, I want to be a good person, I want to be a kind person and then undermine it. So, the amount of people I’ve worked with harm OCD who are experiencing isolation and really the self-imposed isolation, the irony of which is “I’m isolating myself because I don’t want to harm others,” but then they’re withholding themselves as this fantastic person to be out in the world. And so, that’s what I always say, is you’re doing more harm isolating, but sort of. Get out there. You have so much to offer and in fact, your OCD has attacked this area because it’s important for you generally to have relations with others. Kimberley: Yeah, I love that. So, I love how you’ve given us a way, and as you said, it can impact any relationship outside of those subtypes as well. What I’d love to do is give you the mic and tell us just now, in general, give us your best relationship ideas, advice, tips, tools, whatever you want to call them, for the person with OCD and the loved ones of people with OCD. Amy: Yeah. Thank you. I feel like that’s a dangerous thing to be giving me the mic. Kimberley: It’s all yours. Go for it. What’s the main thing you want people to know? Amy: I think I want for people to be able to-- number one, there’s no right or wrong way to have a relationship provided that everything is consensual and respectful. And so, taking a step back-- and actually Russ Harris just put out this. I don’t know if you saw this, but this incredible list of relational values words. So, there’s an activity where-- or I don’t know if it’s new, it’s new to me. That’s clarifying what are your relational values and what are they with different relationships? Is it playfulness? Is it intimacy? And so, figuring out what you want and having your spouse do the same. In our relationship OCD group, most recently, we had people and their significant others, I shouldn’t say spouse, do this and figuring out ways to connect around those things. I think it comes down to connection and to supporting each person, like supporting each other’s goals.  I think I’m bringing this up in part because I think sometimes there are these narratives out there about like, we have to have all the same interests or opposites attract. And again, to that, I say yes, and... For some people, they want people with really similar interests and for others, they want somebody who’s going to be different. But I think what we can do is support each other and try to see the world through your loved one’s eyes and try to celebrate when they’re celebrating.  I think part of this is like, I’m married to somebody who’s a huge thrill seeker. He’s paragliding. He just got his private pilot’s license. He does things that are not in my nature. If he’s gone out and he’s done some sort of paragliding trip in a different country, and he’ll come back and he’ll say, “I found a lift here and there were thermals,” in my head, I’m like, “You didn’t die. You didn’t die. Yeah, you didn’t die.” And I have to stop my own anxious story about it or my own interpretation of “I wouldn’t like that” and just be there with him in that moment of sharing his joy. It’s finding joy in others’ joy. It’s being there with other people’s emotions about whatever they are. Because I think with anxiety and OCD, it can always be this upper-level analytical process of like, “Oof, I don’t like that. Is that okay?” or things like that. I know a lot of the Gottman’s research will talk as well about how very important it is to just support one another, be cheerleaders, et cetera.  Attachment Style & Ocd  I think too, knowing your attachment style. And this is a whole topic that we could spend forever on, but knowing if you’re somebody who-- when you get close to others, do you feel more resistance in getting closer or do you feel worries about like, “Ugh, I don’t want to lose myself by merging with someone else”? Or do you have more resistance around, “I’m worried they’ll abandon me, I’m worried they won’t love me enough?” And that’s a very, very, very rudimentary look at two of the concepts of attachment, that more avoidant attachment where it’s, “I’m worried I’ll be subsumed by the other person and I value independence,” or more anxious attachment, which is, “I’m worried they won’t love me enough or I’ll be abandoned.” Knowing that and knowing when those thoughts come up, take a pause, take a step back and check in with yourself and your body and the facts and things like that, instead of reacting in that moment. When anxiety is there, it wants us to just react to every alarming or provocative thought that we have. So, yeah, those are some things. I know that I had them scrolling through because I know I had more in the book from the Gottman. They’re top of mind. Kimberley: I think back to when I was first married, I was so young. So, if someone had explained to me attachment styles, it would’ve made the first five years so much easier. You know what I mean? My husband would go away. He’s actually away right now. He would go away because he loves to fly fish. And for me, I would feel anxiety because he would leave and I would interpret, because I’m anxious, and I was like, “No, this isn’t hard for me to be alone.” It would quickly turn to anger towards him for having a hobby. I’m totally fine to say this too. I’m feeling anxious here by myself. He’s off doing something fun for him. So then I got angry that he’s doing fun things and leaving me to have my anxiety. He would come home not to a happy wife. He would come home to wife with her hands on her hips. You know what I mean? And I think that that is so common for people with anxiety. When you’re feeling anxious, you feel like they’re doing it to you like, “Why are you doing this to me?” And then that can create a whole narrative that can interfere in relationship. So, that’s just a personal example of how, if I had have known my anxious attachment early in our marriage, I think that would’ve saved us a lot of fights. Amy: Yeah. Oh, I love that example. And I feel like for me, as somebody who tends toward the other side, I tend to feel more worried about being stifled by relationships. I want to be fully seen and encouraged. And so, sometimes, in particular with friendships, if I’ve had people who are like, “I’ve felt exactly the same way,” or “I had the same experience,” or “We should do this all together. Let’s get matching jackets,” I’m like, “I am an individual.” I get really threatened because my feeling is-- my brain’s automatic interpretation is they don’t see you because they think that you are just-- they assume like we’re all the same, whereas they’re just like, “We want to affiliate.” So, I’ve had to do some work there as well, even with friendships, to know like it’s not-- people aren’t trying to kidnap my identity and merge it with theirs. They’re actually just being loving.  Kimberley: Right. But it feels threatening. Yeah, absolutely. I think the last question I have for you is, it goes back to that accommodation reassurance piece, particularly related to these dynamics. And maybe this is just my experience, I’d actually love to hear yours. What I do find is, when the person with OCD is coming from an anxious place, like often overanalyzing things, hyper-attending hyperawareness of things, their need for reassurance or their need for everyone to follow what OCD tells the family to do, I have found that the partner, because it’s so overwhelming for them, tends to flip to the other end of the spectrum where they don’t worry about anything or they’re like, “It’s fine.” Or maybe even they’re frustrated of like, “It’s fine, it’s fine.” Have you noticed that as a trend in dynamics of a relationship? Amy: Yeah. Sometimes almost like there’s a dismissiveness. Yes, I have noticed that and I think that there are so many reasons why that can happen. And I think for the partner and their experience, getting at what that is and what’s motivating that is so interesting because, to the person with anxiety or OCD, it can feel really invalidating, or it can feel very comforting. But I think a lot of the times, it can feel invalidating and the partner might be doing it because they might be having their own feelings come up about, “I don’t know what to say.” I’ve tried to use facts and sometimes facts can bounce right off of OCD if you’re not in the mindset to accept them. OCD is skeptical about everything. So, I’ve tried everything and I’m really now at this place of like, “I am so tired.” And it’ll come out. “I’m so tired of hearing you talk about this.” And that’s when, as a clinician, I see time out. I think you’re both really tired of this cycle that OCD has you both in.  So, yeah, I will see that. And I think sometimes when that’s the pattern as opposed to a lot of overly accommodating, I think when that’s the pattern, the element for me in working with couples to inject back in there is the validation of, “This is really hard.” And also for them to take a step back and realize, well, not everything is going to be OCD either. Sometimes if there is reassurance-- I mean, again, the irony is sometimes this pattern can lead to more reassurance because then it’s like, “Well, you just dismissed me. You said that there’s nothing wrong in our relationship that you did it in a manner that felt dismissive. And so, now I’m going to ask again.”  So, yeah, deconstructing that pattern. Does the partner feel angry? If so, you’re angry at this pattern, not your partner. Does the partner feel helpless, hopeless? Did they feel scared? Are they grasping at straws? So, yeah, that would be how I would look at that when I see it come up. Kimberley: Oh, thank you. I’m so grateful that you shared all that because I think they are all great questions that need to be addressed within the relationship. Thank you. So good. Okay, tell us about your book. I want to be respectful of your time. Tell us about your amazing book, which I think every family that has members should read. Tell us about it. Amy: It’s called Thriving in Relationships When You Have OCD: How to Keep Obsessions and Compulsions from Sabotaging Love, Friendship, and Family Connections. It’s available for pre-order as of the recording of this, which is in October, but I think this is going to come out later. It will be hot off the presses December 1st from New Harbinger Publications, available on Amazon, available through New Harbinger, I think available on other websites. People keep sending me links and I’m like, “Wow, that’s really cool.”  So, yeah, I tried to cover all different kinds of relationships. We talk about family relationships, parenting, romantic relationships, sex and intimacy and those kinds of relationships, friendships, work, and really just a relational lens to what can be a very isolating and security disorder. And I don’t want anyone to feel like they have to go at it alone. Kimberley: Thank you. Again, hats off to you. Much respect. You did a beautiful job writing the book. It’s an honor. I was so honored to write the foreword. And I think, again, it’s like a handbook I think everybody needs to have on the onset of being diagnosed. Here’s the book to make sure you can protect your relationship and nurture the relationship outside of OCD. So, thank you. Amy: Well, thank you for having me.

In This Episode: What if people notice I am anxious? How to handle the fear that people ill judge you  Tools to manage anxiety Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety...If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 311.  Welcome back, everybody. I am so happy to have you with me today. Today, we’re talking about what to do if people notice how anxious you are. This is something that I’ve even thought about myself. When you’re having anxiety, it’s like, “Are people noticing how anxious I am?” And when you worry about that or you think about that, sometimes it can actually create more anxiety for you. Quite a few of you have asked this question to me in the past, specifically around when doing exposures. As you go to do your exposures, then you have this secondary thought of like, “Oh my goodness, are people actually seeing how anxious I am?” So, I wanted to do a podcast just about this topic.  Before we get into the episode, let’s quickly run through the “I did a hard thing” for the week. This one is from Anonymous and they said: “My son just started preschool this month. For context, my OCD and anxiety has me housebound for the last two years, and never in a million years did I think I was going to be able to handle this. I still feel discomfort and struggle with intrusive thoughts, but the sparkle in his eye when I pick him up makes it all worth it. This has reinforced the importance of pushing through even when it’s hard.” Anonymous, this is so good. Look at you go. And I think we can all resonate with being so overwhelmed with anxiety, but we make decisions based on our values, not our fear. And then we get to see people sparkle in people’s eyes or our own eyes. And I’m so excited to have you share that with me. So, thank you so much. All right, quickly, review of the week. This is from Sybil Cross and they said: “Compassionate and competent care. My ERP therapist recommended this podcast to me and I love it! It is both educational and supportive. It helps me learn more about my OCD and feel comforted, all while retaining its therapeutic value. Thank you for all your hard work and love, Kimberley!” It is my pleasure. Thank you, Sybil, for sharing that amazing review. Please do go and leave a review. I know I say it every week, but you do not understand how helpful it is to me. I am really doubling down in 2022 and next year on really making sure this podcast reaches as many people and makes a massive impact. So, your reviews mean so much to me.  All right, let’s get over to the show. Have you ever been out and about doing your thing socially and then all of a sudden, you have anxiety and then you start to worry, what if people start to notice that I’m anxious? If this is you, you’re going to want to listen up because today we’re going to go through what to do if people do notice or what to do if you’re afraid of people noticing that you have anxiety.  So, thank you so much for joining me again today. I love spending time with you, talking about all things anxiety. Let’s talk about what to do if people do notice that you have anxiety. So, the first thing to ask yourself, and I love asking questions because I think it really helps us to really understand the actual problem, but what I’m going to ask you is, what’s your actual fear? If you’re afraid of someone noticing that you are anxious, what are you actually saying there? Are you afraid that maybe they’re going to judge you for having anxiety? Or are you afraid that there may be some consequence for having anxiety? Sometimes people are afraid in certain work environments or school environments. Or is it that you’re afraid that if they notice you have anxiety, that then you’ll then have even more anxiety and then that creates a perpetual cycle? Let’s take a look at these outcomes depending on which one you struggle with.  So, let’s talk about first the fear that they might judge you. Now, if this is you, there is a pretty good chance you may have social anxiety. Social anxiety is a specific anxiety disorder around the fear of being judged by others socially or feeling humiliation or embarrassment around others socially. And often what we understand about social anxiety is it’s actually not so much an anxiety disorder. Well, yes, you will feel a lot of anxiety, but we actually understand it to also be a shame disorder. Often people go out and then enter the social environment and they’re afraid that if someone notices an adequacy or a floor, that they’ll be judged and that will create a lot of shame for them. Remember, fear and shame is often associated together. They often go together. And shame is really about us having a thought that there’s something wrong with us, that we are inherently bad.  So, if your fear is that you’re going to be noticed and they’ll catch you, and then you’re going to feel shame, what you’ll want to do here is work at being able to navigate your shame. Stay here and we’ll talk about that a little bit later. It could be also that you’re afraid of humiliation or embarrassment. Some people don’t want to be judged because then they know they’ll get stuck in a cycle of regret. “Why did I do that? Should I have done that? What could I have done different?” which looks a lot like mental rumination, which we know is a mental compulsion, a common behavior we do to try and reduce or remove anxiety.  So, we can talk a little bit more in a second about how to manage that. First, let’s talk about another concern people have, which is that you’re afraid that if you get noticed for having anxiety, that you might have more. The thing to remember here, and you probably know this from me already, is the more you try to make fear go away, the more likely you are to have a strong wave of fear. So, remember, what you resist persists. So, if you’re saying, “What if someone notices that I’m anxious and then that makes me more anxious,” if you’re paying a lot of tension to their facial expression, trying to figure out what they’re thinking about you, chances are, you will have more anxiety because of how much attention you’ve put on their opinion of you. The last piece here is, will there be consequences? So, let’s really talk about that. Some people are concerned that if they are visibly anxious, let’s say you’re giving a presentation at work or school or you’re meeting your boss for your yearly meeting or your teacher for a check-in and so forth, that there will be consequences if you’re visibly jittery, nervous, stuttering, shaky. Some people are afraid that they’ll get noticed for sweating. And sometimes there can be consequences. Maybe a part of your job or your schooling is to be able to perform. And if you’re engaging in avoidant behaviors, yes, there may be some consequences that go along with that.  But what I’m going to encourage you to do to manage this is talk to your boss, talk to your teacher, talk to your coach, whoever it may be that you’re concerned will employ these consequences. Ask them what we can do and what they can do and how you can get supported as you manage your anxiety. Hopefully, it’s an environment that supports mental health struggles and supports mental health in general. And usually, I have found, if you go to your boss or your teacher or your dean or your parent or your coach or whoever it may be, and you let them know that you’re struggling, they may have some really helpful tools or they may actually be able to help you to manage that in that environment. So, 100%, while I know bringing it to their attention is actually your fear, that can often very much help.  Now, if you’re in a situation where you don’t feel comfortable going to them and sharing that-- it could even be with a friend, or a partner, a boyfriend, girlfriend, someone you’re interested in. If you’re really afraid of that and you don’t want to share, that is entirely okay. But what it does mean is, and this is where we get to the tools, you’re going to have to give yourself permission to have anxiety.  So, number one, the main thing I’m going to tell you if you have this fear in any certain way is, if you are going into this circumstance or this event saying you shouldn’t have anxiety, you’re going to have more anxiety. We know that to be true. So, what do you do instead? You can practice allowing your anxiety to be there and actually saying, “This is a good thing.” And I know it doesn’t feel good, it doesn’t feel fun, but what you’re saying is, “Here is an opportunity for me to have the anxiety and show up anyway.” Number two, here is an opportunity for me to have the anxiety and show up and really see who are the true friends, who are the unconditional friends, who can be caring and compassionate in this environment, and can I face this fear, and baby steps, make small wins, and have small achievements where you’re able to increase your willingness to have the anxiety, increase your tolerance of discomfort and sensations that you don’t like.  The next thing I want you to do is, number three, the most important, you will be shocked how important and how helpful it can be if you practice self-compassion. If you are using the tool of self-criticism to manage this, chances are, you’re going to make your anxiety a whole bunch worse. So, instead, try validating yourself. “It makes complete sense that this is hard for me. It makes complete sense that this would create anxiety for me.” Maybe you would say, “Anyone else in this situation would have anxiety.” And I know your brain is going to say, “No, no. Jack, John, and Jennifer could do this without anxiety.” The thing to remember is, they might be a few steps ahead of you and you can get there too. Our brains are neuroplastic. We can actually get there too with practice, small wins and self-compassion. The self-criticism is only going to make you more anxious. Really, I think you probably already know this, but I think it’s important for you to understand, self-criticism only makes it worse, and we want you to do great, and we know you can do great.  Number four is, be an observer to what’s going on. So, let’s say you’re about to do this event or this social experience with somebody, or you’re about to have a conversation, and you’re shaking or you’re sweating or you’re stuttering, or whatever it may be. Your job is to be an observer of your thoughts about that.  Now, here is an example. I am often with anxious people. It’s a normal part of my day. I’m an anxiety specialist, but I go into a lot of exposures with my patients. We go to Costco, we go to the supermarket, we go to the outdoor park, and my patients practice exposing themselves to the exact thing they’re afraid of. And what you’ll find here is the average human that they interact with are incredibly forgiving. Humans want to like you. They don’t want to not like you. They want to be in connection with you. They don’t want to be out of connection with you. And when you’re struggling, if that is the case, 99% of the time, they have enough empathy and compassion to help you along. And so, a part of this work is you increasing your ability to see the good of the human race.  Now, I know you may have had a few experiences where people weren’t so kind, but the good people are out there. It’s just a matter of practicing. And when I go on exposures with my patients, they’re actually pleasantly surprised. We might go to the supermarket and we might say, “Okay, I want you to go and ask 10 people for the time, or I want you to look 15 people in the eye and say good morning to them. Or I want you to ask five people a question, where is the local bank, or can you tell me where such and such street is?” And 99% of the time, they walk away going, “Wow, people are actually kinder than I thought.” There are people who don’t want to talk to them, and that’s usually because they’re anxious too. And so, it’s important for us to understand and have an understanding of the human race here, and give ourselves permission to show up imperfectly when we’re around other people. Now, another thing I want you to think about here is, how can I practice on purpose facing this fear. I know what you’re thinking. You’re like, “Let me just shut this down. Where’s the pause button?” But I really want you to understand that there are hundreds of opportunities in your day where you can practice showing up anxious on purpose and how many of those can you put in a day. Put them in your calendar, plan for them, leave work, or leave for school a little early so you could get an extra couple of practice runs in with this.  If someone had, let’s say, a fear of being shaky, I actually encourage them to be shaky. Sometimes we even induce shakiness for them. We might have them have a cup of coffee before they do the exposure so that they’re on purpose feeling this feeling and they’ve got a lot of practice doing it. And then the last thing I want you to remember is, once you’ve done all these steps and you’ve done the hard thing, because I always say it’s a beautiful day to do hard things, I want you to then practice what we call response prevention. Response prevention is, now that you’ve done the hard thing, you’re to practice not engaging in rumination and self-criticism, the things that actually you used to do, which only make you feel worse and actually reinforce the fear. You’re going to practice not doing those things and instead engage back into the world and just practice moving on, practice engaging in what you are showing up to do, practice engaging in the things that you love and that you value. Instead of sitting there looping about how it went and what they thought and what they think about you and how did they perceive you and you should have said this and you shouldn’t have said that, your job is actually to catch the urge to engage in that rumination and then bring yourself back to the present. Now, if you can do those things, you are leaps and bounds ahead of where you would be if you weren’t engaging in those things. And we know that small steps lead to medium size steps, which lead to massive steps forward.  Now, what is the one thing I want you to take away? Because I really love giving you a takeaway here. Number one, the more you try and avoid the fear, the more you’re probably going to have it. And then the last thing here I’m going to say is, go gentle. Go easy. Catch how you’re engaging in self-criticism. The truth is, we have a lot of research to show that people aren’t thinking about you nearly as much as you think they are. Most of the time, they’re thinking about them. They’re thinking about what they’re going to have for lunch and their meeting that they have coming up and, “Whoops, I forgot to get milk at the grocery store.” They’re not hyper-attending to every little mistake that you make as much as you think they are. And if they are in fact judging you that heavily, that is a strong relation and reaction of what’s going on in their mind. It actually shows us a lot. It’s a reflection of what they value and what they’re judging about themselves. And so, really other people’s judgment is often just a reflection of their judgment about themselves and the way that they think. And our work is actually to focus on actually being the person you want to be or who do you want to be? How do you want to show up? What are your values? What kind of person do you want to be?  So, I hope that’s been helpful. At the end of the day, you will be judged. This is something I have had to learn the hard way. I have had to learn that not everyone is going to like me, and that is okay. I am a messy human being. I am not perfect. I was never supposed to be perfect. And my job is to give myself some grace and some compassion for the fact that I’m just a human, messy person, just like you’re a human, messy person. And that’s true for every human. Okay?  Have a wonderful day. Do remember it’s a beautiful day to do hard things and I look forward to talking to you again next week.

SUMMARY:  What if you don’t identify with the concept of an obsession being a FEAR? It’s a repetitive thought or feeling, but you’re not scared of a specific outcome.  What is the UNCERTAINTY when it comes to these obsessions?  Guilt Obsessions:  WHAT IS OCD GUILT?  OCD Guilt over past mistakes “I shouldn't have done that”  “That was a mistake”  OCD Guilt as a simple intrusive thought- no known mistake “Is it bad that I did that”  “Did I make a mistake?”  “What could be the consequences”   REGRET obsessions.  I’ve heard a lot about how guilt is a common intrusive feeling in OCD but not much about regret.  “I wish I didn't do that”  “I wish I had done it another way”  Guilt and Regret accompanied with sadness??  How to stop OCD guilt?  How to treat OCD guilt and regret Links To Things I Talk About: Feeling guilty doesn't mean you have done something wrong https://kimberleyquinlan-lmft.com/ep-161-feeling-guilty-doesnt-mean-you-have-done-something-wrong/ How to let go of the past https://kimberleyquinlan-lmft.com/ep-70-how-to-let-go-of-the-past/ I screwed up. Now what?  https://kimberleyquinlan-lmft.com/ep-293-i-screwed-up-what-now/ ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety...If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 310 Welcome back, everybody. We are at Episode 310. I just recorded it as 210 and I’m still in shock that we have hit 310 episodes. I recorded it and I was like, “Hang on a second. That doesn’t sound right.” And it wasn’t, and that still shocks me to this day.  All right. Today, we are talking about a very important topic, which is guilt and regret. And I’ve called this episode Guilt and Regret: The Most Misunderstood Obsession, and I believe that to be true because a whole bunch of you are walking around wondering whether you have OCD or not because a lot of what you hear is that OCD is all about anxiety and uncertainty. But what about the folks who don’t have a lot of anxiety and a lot of uncertainty, but they’re having obsessive guilt and obsessive regret in the form of OCD guilt and OCD regret? So, I wanted to talk about that today.  Before we do so, let’s quickly do the “I did a hard thing” segment. For those of you who are new, this is where listeners and followers share the hard thing that they’ve done. Why do I do this? Because so often, you guys forget that just because your hard thing is hard for you doesn’t mean there’s anything wrong with that. I want you to see that hard things are hard things and we should celebrate them and we should share them, and this is a platform I want to do that with. So, this one is from Mars, and Mars said: “After many weeks and years of hard work, I finally managed to reach an important stage of my career, and I ended up with two job offers.” Amazing. “Both were great really for different reasons, and I couldn’t choose. I went back and forth and tortured myself four months trying to get certainty about which one is the right choice. I’d never been so anxious in my life. Finally, today, I sent the final email, even though I wasn’t certain about the choice, it was the hardest thing I’ve ever done, but I finally feel like I can move forward with my life again.”  Mars, number one, congratulations. Sounds like you’ve worked really hard. And number two, you’re also doing this hard thing where you’re allowing the discomfort into your day, into your life, and you’re moving forward anyway. Thank you for sharing that. That is such an amazing accomplishment. Interesting, isn’t it, how you’ve shared here too like it was around the certainty, but it sounds like that was similar to what we’re talking about today, and let’s talk about that. So, let’s start from scratch. Start from the beginning. So, often people will come into therapy and say, “I didn’t seek treatment for the longest time, because all I’m hearing is OCD is the uncertainty disorder, and I don’t feel a ton of uncertainty in the way that I’ve heard other people do with OCD.” What do I do if I don’t identify with this concept of the obsession being around fear and uncertainty? What about if you have a repetitive thought or a feeling, but you’re not scared of the specific outcome? And this is so important, guys, because we do hyper-focus on uncertainty and I really do believe that uncertainty is the root of lots of OCD obsessions and a lot of our suffering if we don’t accept that uncertainty. But what about those who have obsessive guilt and obsessive regret? So, let’s talk about it. Guilt OCD - Guilt Obsessions Let’s first talk about guilt obsessions. So, what is guilt obsessions, or what is OCD guilt? Ultimately, it’s a thought or an action that occurs. That’s the trigger. So, you had a thought or you did some behavior, and then you are having this onset of guilt. Remember, an obsession is an intrusive thought, feeling, sensation, urge, or image. And so, in this case, we’re talking about intrusive feelings. And so, what’s happening here is you’ve had a thought or you’ve done something and then you feel this very, very real feeling of guilt, very real feeling of guilt. Most of my patients who struggle with OCD guilt or obsessive guilt will say, “I genuinely feel like I’ve done the equivalent of killing a person. That’s how much guilt I feel.” Even though you might be very clearly able to identify like, I didn’t kill a person, or it doesn’t make total sense on why I’m feeling this high level of guilt, that’s so disproportionate. and that can be really confusing. And so, they’re really confused as to what’s going on.  So, they might show up in-- the guilt may be accompanied by intrusive thoughts like, “I shouldn’t have done that. That was a huge mistake. I wish I didn’t do that. How can I avoid that in the future?” And then you can easily see why we then move into compulsions, like avoidance, rumination, tons of reassurance seeking. In therapy, a lot of people go to therapy, not even OCD therapy because they don’t even know they have OCD yet, and they spend all this time doing EMDR and biofeedback and hypnosis and all of this deep therapy work, exploring the deep meaning of the guilt, only then to realize like, “Wait a second, this is OCD. I’m doing all these compulsions and I’m even doing them in session.” Now, as I mentioned, OCD could be as simple as an intrusive thought of you’re walking down the street and you just get the onset of guilt after some kind of trigger where there’s no known mistake. Or it could be that you did something that didn’t completely line up with your values, but again, then you have disproportionate degrees of guilt. Disproportionate.  If it’s just a simple intrusive thought that has no known trigger or no known mistake, maybe your thoughts are related like, “Is it bad that I did that? Did I make a mistake? Was that right? Did that line up with my values? What could be the consequence of this?” And it can be incredibly painful.  Regret OCD- Regret Obsessions So, now let’s move over to regret obsessions and compulsion. So, with regret obsessions or regret ocd, they usually are presented more as, “I wish I didn’t do that. I wish I hadn’t done it that way. I wish I had done it in a different way.” It’s often accompanied with a deep feeling of sadness, like regret this deep feeling. Again, it can be an intrusive thought, but it often is just an intrusive feeling. This deep sense of, “I wish I didn’t do that.” Sometimes it’s accompanied with dread. “Oh, I hope I never do that, have this emotion, or do that thing again.” It can be incredibly painful. And again, people can get stuck in really the wrong kind of therapy, ruminating, ruminating, trying to solve what it was.  Sometimes I’ve had patients even come to me and say, “Oh, I saw you because you do self-compassion and I want to be able to forgive myself,” and they’re doing compulsive forgiveness. I believe in forgiveness. I’m not saying there’s anything compulsive about forgiveness in the day-to-day. But if they’re doing it to get rid of an obsessive degree of regret, an OCD degree of regret, and that involves obsessions and compulsions, well then, that forgiveness practice can become impulsive.  OCD Guilt Over Past Mistakes I always laugh because I’m doing this breathing training, this meditation training right now. And some of them, the trainers who obviously are not OCD informed will say, “Breathe in your discomfort and breathe it out and let go of it and release it.” And I think that’s a beautiful practice. But for a person with OCD, that can become compulsive. And so, it’s important when you have OCD to catch these little nuances and these little behaviors and activities that can end up becoming a problem.  So, let’s talk about how to stop this obsessive guilt or this OCD guilt, and let’s think about this a little bit in terms of how you might master this sensation and this feeling that you’re having. So, a couple of things before we move on is I have done quite a few episodes on guilt or letting go of things in the past in other episodes. So, I wanted to let you know, you can also go over, I did one episode about feeling guilty. It’s Episode 161. I did another episode, which was highly requested, Episode 70, which is called How to Let Go of the Past. And I did another episode, which was actually me talking about my own sense of getting through something that I felt regret and guilt for, which was Episode 293 and it was called I Screwed Up, Now What? So, we’d actually have tons of sources here on the podcast about that, and I wanted to share those in case you wanted to really delve a little deeper. But let’s talk about how to stop this OCD guilt.  How To Treat OCD Guilt And Regret All right? So, as you know, trying to stop an emotion usually doesn’t work. So, we don’t want to try that. That’s not going to work. Same with regret. How to treat OCD regret, I don’t encourage it. What we want to do instead is we want to be able to acknowledge it and observe it and do nothing about it. Now, I am a big believer in this. Truly I am. Whether you have OCD or not, when it comes to guilt, when it comes to regret, when it comes to shame, I’m going to encourage this very mindful approach.  Number one, are you able to catch it in its tracks? That is number one. That is a tactical skill, is awareness, to be able to catch, “Oh, I am stuck in this guilt bubble or this regret bubble or this shame bubble.” Just like you would when you’re stuck in OCD. You’re able to catch, “Oh, I’m engaging in a pattern of behaviors that looks a lot like OCD.” Same goes for this situation. So, I’m observing and being aware of it. And then number two, catching where I’m wrestling with it. What safety behaviors do you have in relation to this feeling? Again, when it comes to OCD, it doesn’t matter what the obsession is, it doesn’t matter whether it’s associated to uncertainty or not, it doesn’t matter if it’s real or feels real or not. What we want to do is take a look at the safety behaviors we’re engaging in and first ask ourselves, are these helpful and effective?  So, if you have guilt or regret, and your way of coping with that is to beat yourself up in hope that you never do it again, how effective is that? Is that working for you? Is it actually preventing you from doing things in the future that may trigger off regret and guilt? No. Are you avoiding certain things so that you don’t have to have this guilt and regret in the future? Do a quick assessment on those safety behaviors and ask yourself, does this help me in the grand scheme of things, knowing that OCD may pull guilt and regret on me for the most minor thing again tomorrow? Is it effective for me to try to make my life really small and avoid things because of an emotion that I may have to experience?  Remember, the emotion will not hurt you. You’ll allow it to rise and fall. It is painful. I’m not going to lie, it is painful, but it won’t destroy you, especially if you have a relationship with guilt and regret and with this discomfort where you’re not resisting it. Remember, what you resist persists.  So, you want to take a look at, do a functional analysis, do a review on how effective is my safety behaviors. Are you engaging in reassurance-seeking compulsions saying, “Do you think I did something wrong?” Going to your partner, “Do you think I did something wrong?” Maybe you’re confessing. “I feel guilty that I did this thing. I want to tell you what I did so that I can let it off my conscience.” Now again, within a normal degree, we do this to some degree. I always laugh. Several years ago, my son, who was four at the time, came home and blurted out to my husband that mom had run through a red light, just out of the blue. He’d figured out that red lights were bad and you can’t drive through them and he’s like, “Mom went through a red light,” the minute he saw him. Of course, he was like, “No, you didn’t.” And I had to admit to it. But after that, I felt this urge to admit to things so that I could absorb myself of that guilt and regret that I had. And we all do it. I want to normalize that. I don’t want to pathologize those kinds of behavior. But if you’re doing that repetitively and it’s interfering with your relationships and it’s creating more and more stress for you, and you do it once and you don’t completely feel absolved and you feel like you need to confess again, this is a safety behavior that isn’t effective and that’s causing long term problems and is feeding the cycle of OCD. We want to break that, guys. We want to break that. So, what I want you to look at here is, again, awareness. Are you able to acknowledge what’s going on? Are you able to identify the compulsions that are problematic? And then are you able to let it be there? Let it be there. Do nothing about it. Now, if you’re a real badass, which I know that you are, you will then, if you’re really ready, you might even do something fun and pleasurable while you feel guilt. Now that is doubling down. While you feel the obsessive guilt, while you feel the obsessive regret, you’re actually going to go have some fun and enjoy yourself. So important. This is a super important piece of the work that we do.  How To Stop Relationship OCD Guilt Now, for those of you who have relationship guilt or relationship OCD guilt in relation to your OCD, this is so important. It’s so important that you catch the safety behaviors that you’re doing and then you reengage with your loved one, because often what we do is we either do a whole bunch of compulsions or we shut down completely. We stop hanging out with them, we stop opening our heart with them, we stop engaging in intimacy with them. And that can become a big problem. For those of you who have real-event OCD and guilt associated with real-event OCD, the same thing is applicable, which is we want to go through those steps, and then we want to practice opening up our life being fully engaged in our life, in the things that you value, whether the real event happened or not. I often get emails and DMs from people saying, “I feel like my real event is worse than other people’s real event, and so therefore I should suffer, or I should figure this out.” And I want to say, “That’s a very tactical trick that OCD plays on you to get you back into doing compulsions.”  And so, I want you to be aware specifically to harm obsessions, relationship obsessions, real event obsessions, sexual obsessions. This is such an important piece because that’s often where it shows up. But again, it doesn’t have to be fear and uncertainty related. Sometimes the guilt and the regret can be the actual obsession that people experience. Okay?  So, as always, we want to throw a massive dose of self-compassion onto this. Self-compassion in and of itself is an exposure for many people. and often people with specifically this OCD guilt and OCD regret when they practice self-compassion, it is like the ultimate exposure. The ultimate exposure. And I really want to encourage you guys to surround yourself with kindness, encourage yourself with kindness, motivate yourself with kindness, nurture yourself with kindness when you’re struggling and you’re experiencing a high level of discomfort. It doesn’t have to be fear. It can be around these other emotions that you experience, and shame. Shame often comes along with this. So, we want to make sure that we are doing everything we can to engage in self-compassion as much as we can. Okay? All right. That’s it for now. Let’s quickly do the review of the week. This is from Triphonik and he or she said: “Love this podcast. Kimberley’s podcast is so inspirational, relatable, and helpful. I have been dealing with OCD since my early 20s. I went through extensive therapy, medications, and lots of prayer! I got to the point where my OCD was not taking over my life anymore & hardly noticeable. I’m now 43 & I’ve recently gone through some lapses with it after these years. It really shook me to the core. Following Kimberley’s anxiety toolkit podcast was helpful in getting me back on track with the tools I’ve learned from my past along with some new ones! Her spirit and her level of sincerity with the knowledge and experience she has helped me so much! I’m so incredibly grateful to have found this podcast. Thank you, Kimberley!” Thank you so much, Triphonik. Your reviews mean the world to me. Really, they do. And I’m just so happy to be on this journey with you.  All right, folks, I’m going to see you next week and I’ll talk to you soon.

SUMMARY: Not having a subtype makes it hard to get diagnosed with OCD  Not fitting into a subtype can make you doubt having OCD.  When you don’t see other examples, you can feel like an outsider in the OCD community.  All the subtypes seem to have their “people.”   The doubt can make you feel that it really is about the content, not OCD.  What if I don't fit into a typical OCD Subtype Examples:  What if I picked the wrong name for my baby?  Obsessions about the weather and whether you will enjoy the weather?  This nail color makes me feel strange.  What if I don't remember this the way it was?  What if my partner cheats on me? What if my child suffers?  What if my taxes were not correct?  How will I know when it is time to stop therapy?  General Anxiety Vs Ocd? Dimensional Obsessive COmpulsive Scale (Jon Abramowitz)  Concerns about germs and contamination Concerns about being responsible for the harm. Injury, Bad luck  Unacceptable thoughts  Concerns about symmetry, completeness, and the need for things to be “Just right.”  Does ERP work for these obsessions?  Does the process of treatment work any differently than it would with a “subtype”?   Ideal Treatments for OCD ERP  ACT SC MINDFULNESS Links To Things I Talk About: ERP School (An online course for OCD) https://www.cbtschool.com/erp-school-lp Dimensional Obsessive COmpulsive Scale (Jon Abramowitz) http://www.jabramowitz.com/uploads/1/0/4/8/10489300/docs.pdf Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety...If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION What If I Don’t Fit Into The Typical Ocd Subtypes? Welcome back, everybody. Thank you so much for joining me. I know your time is so valuable, and so I am so honored to spend this time with you to talk to you about today common question that I get asked. Well, actually, no, it’s not a common question, but it has been a question that I have been asked over the years by clients and followers, and listeners. And I was proposed with this idea as something that we really need to address. And so, here I am. And my goal is to always address the things that maybe aren’t getting addressed if possible. And so, today we are going to talk about, what if I don’t fit into the typical OCD subtype? So, what if my obsessions don’t line up with the typical classifications and categories that we have for OCD? Ocd Subtypes So, for those of you who maybe are new to this idea, we have OCD as a general diagnosis. And then under that umbrella of the diagnosis, we have-- over the years, the clinical and OCD community have created subtypes of OCD to help us, number one, categorize different groups of obsessions so that we can then direct the treatment to being very specific. We also do that to build a sense of community so that you feel less alone. Let’s say you have a harm obsession that can be very stigmatizing and feel very, very overwhelming, and you can have a lot of guilt and judgment about that for yourself. So, knowing you’re in a category, in a group with other people can actually soften the blow of the stigma and the judgment around that obsession. Same goes for sexual obsessions, pedophilia obsessions, and so forth. Again, as a clinician, as I’m training my therapist, these subtypes are actually helpful so that we can help the newer therapists have a treatment plan specific to that person’s obsession. However, what about the group of people who don’t line up perfectly in those groups? And so, in today’s episode, we’re going to talk about what to do if that is you, what to do if you’re a therapist and you’re dealing with this, some skills that you might use, and maybe a few shifts and reframes here, I’ll use some clinical research that may help you shift the way you look at this problem. And maybe we can even stop calling it a problem. We could actually not address it as a problem and actually move through that together. Okay?  Before we do that, let’s get straight to the “I did a hard thing.” I haven’t even read this hard thing you guys, so I’m as excited as can be. This one is from Hannah, and this is what Hannah had to say: “Earlier this year, I suffered a debilitating OCD episode that focused on harm OCD,” so, there we are, we have a subtype already explained, “Specifically the fear of sleepwalking or going crazy and harming my family. At the time, I had no idea I had OCD as I had always been told I was just an anxious person. So, this well and truly threw me to the point that I couldn’t get off the couch, take my daughter to and from school or be alone. I wanted to admit myself into a mental health facility for fear that I was a real danger to my family and my daughter in particular. Long story short, after weekly ERP with a therapist and starting an SSRI, I did a very hard thing by being at home alone with my daughter for a whole weekend while my husband went away for work. I don’t think I’d be able to do it and I had been feeling anxious for months prior to knowing it was coming. But I did it and I actually ended up enjoying our time together despite some fairly consistent rumination.” Hannah, oh my gosh, this is so good. You are such a walking billboard for how effective ERP and medication can be. I love that you did this. This is so good. And so, congratulations. I am so honored that you shared that with us. And look at you go. Look at you go. All right. Again, quickly, let’s do the review of the week. This one is from Austin-mang, and they said: “I finally did it and signed up for therapy. My session is this Friday. I’ve been doing my best to prepare and was uncertain about what to expect my first session. This show helped me to know exactly what to expect and gave me some great mindset tools going in. Thank you!” Austin-mang, it sounds like you did a hard thing too. This is so wonderful. So, thank you guys for sharing your hard thing, and thank you so much for leaving a review. It does help me immensely build trust for those who are new to the show.  All right, let’s get to it.  A Common Question: “I Dont Fit Into A Typical Ocd Subtype?” So, let’s backtrack to the main concern here, which is what if I don’t fit into a typical OCD subtype. Now, this is a hard thing for people, because not falling into that subtype can make it hard to be diagnosed. I was just thinking about this yesterday. Ten years ago or longer when I first started treating OCD – it’s been nearly 15 years now – if you typed into Google “What if I harm my baby,” maybe one or two articles would come up, but you would find an article about OCD and then you would slowly, if you’re able, get to treatment. Remember, our mission here is to reduce the amount of time it takes someone with OCD to get diagnosed and treated. Right now, it’s seven to 14 years, which is absolutely horrendous, but we’re getting better. We’re getting better.  So, if you typed in “What if I harm my baby” or “What if I sinned,” you would probably come to an article that may lead you to, you may have OCD. What if I get sick and die? If you typed your what-if thought into Google, you’d probably find an article somewhere. But there are a group of people who if they typed their fear in, OCD would never come up. It would never show up on a Google search. If you told your doctor, they might not be able to identify this as OCD, because as far as we’ve come with educating, these subtypes have actually helped us educate doctors, nurses, teachers, and caregivers so that they can be more likely to pick up on children’s and young adult’s OCD. As much as we’ve done this, if you don’t have those specific subtypes, it can make it very difficult to get diagnosed. The next piece here is a lot of people, and this is what I really hear a lot in my community online, on Instagram – if you follow me on Instagram, it’s @YourAnxietyToolkit – is some people will say, “Because I don’t fit into this subtype, I have a lot of doubt that I have OCD at all.” We know OCD is a doubting disorder, but often people with OCD even doubt, even if they fit into a subtype, they doubt that they have OCD. But if you don’t fit into one of these categories that we’ve put, these loose categories that we’ve put, that can make it even harder to really double down with your treatment and feel confident in your provider and feel confident in your diagnosis and so forth.  There is a lot of times when people don’t talk about their specific obsession, when it doesn’t fall into that subtype in fear that someone would say, “You don’t have OCD. You don’t follow any of the subtypes.” And I’m sure maybe even some uneducated clinicians have shared that with their clients like, “No, you don’t meet criteria because you don’t meet a subtype.” And hopefully today we can actually get rid of that and hopefully resolve that issue. And what really comes and becomes apparent is, as we were talking before, let’s go to the “I did a hard thing.” They said they had harm OCD. And as I said before, it can feel really validating to know you have your community like, “Oh, I have perinatal OCD.” So, you have your little-- you can find a group of people who have the same obsessions, and that can be really validating. It can be very, very comforting to feel like you have that community. But for those who don’t feel like they fall into a subtype, they may actually feel quite isolated and alone, like unseen. And that doubt can really make it really difficult.  And what I thought was really interesting is somebody said to me, the doubt can make you feel that it really is about the content, not the OCD. So, remember, we’re always talking about like, it’s not about the content. The content doesn’t matter. And in this case, they were saying, no, it really does feel like the content matters because if your content is within a category, well then you get that community, you get that reassurance. Not compulsive reassurance, but you get a little reassurance like, “This is OCD, you’re on the right track, keep going.” So, I have such compassion. If you are somebody or your client is somebody who has an obsession that doesn’t fall into these categories, let’s really make sure we validate them. Let’s really make sure we slow down to understand what that is like for them. Examples Of Ocd That Do Not Fit Into Traditional Subtypes Let’s talk about some examples of what this might look like. So, examples of what it might look like if you don’t fit into a typical OCD subtype might be: What if I picked the wrong name for my baby? Some people could go, “Oh, that’s just a normal concern. Let’s come up with a solution.” You know what I mean? That would be probably, “Let’s work at making the right choice.” And I have had clients in the past who’ve gone as far as changing their baby’s name multiple times. I’ve seen this case multiple times, trying to just figure out the solution. But you can see here, it’s not a general fear. It’s something that is repetitive and they can’t seem to get rid of that uncertainty. And even if they do change it, the uncertainty still returns and it’s very urgent. Again, we can really see that’s OCD. Clear and clean OCD. It’s got the obsession, it’s got an urgent compulsion that is repetitive, that causes distress. It doesn’t line up with their values. So typically OCD. Some people have obsessions about the weather and whether they’ll enjoy the weather. And you might immediately think, well, again, that doesn’t sound like OCD. But again, let’s look, it doesn’t matter about the content, it matters on the process. Is this person ruminating about this a lot? Are they stuck on trying to find the correct answer or the answer that resolves their uncertainty? Is there an incredible amount of distress? Are they trying to solve this with urgency? If that is the case, we have a very clean and clear case of OCD.  I’ve had clients who’ve spent a lot of time obsessing and compulsing over the nail color that they picked or whether nail-- simple things like things they’ve chosen for their body – tattoos and so forth. And again, we could say that’s a generalized anxiety or that’s a common concern, but if it’s done repetitively and urgently and it’s causing them an extreme amount of distress, and it’s often targeted around uncertainty or anxiety or disgust, clean and clear OCD.  Some clients I’ve had have said, “What if I don’t remember something the way that it actually was? What if I can’t remember it the exact way that it was? What if I lose a part of the memory?” Now, this might show up around, let’s say the loss of a loved one. What if I don’t remember them? And we might say that is a total normal stage of grief, except this person is trying to solve this memory issue repetitively, urgently over and over again, struggling in massive amounts of distress. The uncertainty of this is really destroying them. And again, clean and clear case of meeting criteria for OCD, but they don’t seem to make these into these categories. They don’t seem to slide into a category.  I’ve had patients have obsessions about whether their partner cheats on them, and we could say, “Oh, well, they were probably--” in some cases, they have been cheated on before and we go, “That makes complete sense that they would worry about that. That’s not OCD.” But we look at the presentation and it goes far beyond generalized anxiety. It goes far beyond daily normal anxiety concerns for that situation. Again, it could become massive amounts of reassurance-seeking, rumination, avoidance, compulsions, self-criticism, self-punishment. And we can see that the way these compulsions are playing out meet criteria for OCD. And you might even say there, “Well, that’s kind of relationship OCD.” But that fits into the category. And we could argue that maybe you’re right, but I really wanted to highlight how often. Let’s say, if the partner had cheated on them and they’re having this obsession, usually, people would not put it in the category of relationship OCD because the partner had cheated on them or because a family member had cheated on their partner and they were somewhat traumatized by that event. We can sometimes miss cases because it doesn’t fall into a category.  I’ve had people and clients who’ve worried obsessively and compulsively about their thought, what if my child suffers? What if my child goes through hard times? And again, we would go, “Oh, that makes complete sense. Every parent feels that. Every parent worries about that.” But then again, it crosses a line into massive amounts of rumination, massive amounts of checking, massive amounts of reactivity. It might not even be that it’s the typical compulsions. It might be just a great deal of reactivity done because the uncertainty of this is so overwhelming.  I’ve had patients have obsessions about their taxes. What if they weren’t done correctly? They go back and they check them and then they go back and have a second opinion, and then they-- and again, we could say, “Well, isn’t that kind of like a bit of a moral obsession?” But when we ask the patient, they might say, “No, it’s not about that. It’s just about the fact that it’s uncertain.” Again, doesn’t fit into a typical subtype. One other example I have is a lot of patients I’ve had have had the obsession, how will I know when it’s time to stop therapy? Now that’s a common rational concern. That’s actually a really good question to ask. Well, how will I know? But again, the obsession is excessive and causing them great distress. They spend a lot of time trying to figure it out. They can’t figure it out. There is no solution. The uncertainty is so overwhelming and overbearing and painful, they end up doing a lot of compulsions.  And so, there we have all of these examples, and I’m sure you probably have more of where your obsession doesn’t fit into a typical subtype but is so clearly OCD.  So, here is what I want to offer you. In this case, I’m going to give you the answer up front, and then we’re going to work through it together. The truth is, the subtypes really don’t matter. The only reason they matter is they help with treatment and they help with validation in helping people to feel not alone. But we must remember that nowhere in the criteria for OCD does it say you have to have a subtype. The only criteria you need to have is to have an obsession, a repetitive thought, feeling, sensation, urge, or image. And that obsession has to create a lot of distress in your life and can impact your functioning. Not always, but it can. And then must contain compulsions. And the compulsions are either covert or overt, meaning they’re behavioral, they’re physical, or they’re mental. They must cause a lot of distress in your life. They must take a certain amount of time. And if you meet that criteria, that’s all we really need for you to move forward with your recovery, and I want to encourage you to move forward as fast as you can. Try not to get caught up. Remember the subtypes. Just think about me being a therapist who trains staff. I have ERP School, which is our online course. That is for people who don’t have face-to-face therapy, who don’t have access to therapy, who want to learn how to structure ERP for themselves. I talk a lot about subtypes there, but only because it’s an education tool to help people get direction for their treatment. But if you don’t meet that criteria, that means nothing about whether you can recover or not. So, that’s the main point, and now we’re going to talk about how we can do this. Now, first, before we do this, I actually want to introduce to you something that is a science-based measurement tool we use for OCD that may be very validating to you folks if you don’t have a specific subtype that you fall into that category. Dimensional Obsessive Compulsive Scale (Jon Abramowitz)  Now, Jon Abramowitz and his team has created what he calls the Dimensional Obsessive-Compulsive Scale. If you Google it, it should come up. I will do my best to link it in the show notes. And this ultimately doesn’t have anything about subtypes. It really just has four categories of concerns that people with OCD have. And what I found so wonderful about that is if we throw out all the subtypes and we just look at the symptoms, we look at the process that someone with OCD goes through, you’ll probably find you fall into one of these categories. If you don’t, still don’t worry because-- but I think that this is-- I love the way that they’ve really put this together because it simplifies everything. It makes it a whole lot less confusing. So, let’s go through them together.  Number one, category 1 is concerns about germs and contamination, and they go through to explain that. If you download it, you’ll get more information about this.  Category 2 - concerns about being responsible for the harm, injury, or bad luck. And so, for that one, that includes harm OCD, it includes religious obsessions, self-harm OCD, moral obsessions. A lot of those subtypes can fall into these little categories, but I like that these are really basic.  The third is simple, unacceptable thoughts. And in these cases of people with OCD that don’t fit into the subtypes, we could easily just say, “You fall into the unacceptable thoughts category, that these thoughts are unacceptable to you. The uncertainty is unacceptable to you.”  And then the fourth category is concerns about symmetry, completeness, and the needs for things to be just right. And what I think is so helpful about that is so often these cases where they don’t fall into these more typical subtypes, I find often they do fall into somewhere around this idea of the need for things to be completed or just right or resolved. Hopefully, this Dimensional Obsessive-Compulsive Scale helps catch a net underneath all of these subtypes that can validate you, that you still fall under the category of having OCD, that you can still move forward with your treatment. You go full fledged into your ERP and move forward ultimately.  Ocd Vs General Anxiety Disorder (Gad)  Now, that being said, we also need to look at the overlap, or maybe we should actually say the spectrum of where generalized anxiety can meet OCD. Some of these, as we said, some of these obsessions fall under maybe that’s more generalized anxiety, but we know that you could have generalized anxiety fears. But if they’re presenting with obsessions and compulsions, we’re actually going to treat it like OCD. And some people – I’ve actually really loved the OCD community – are now arguing that general anxiety and OCD are the same thing, just on a spectrum, from not so severe to very, very severe. And they’re doing that. People with generalized anxiety are doing obsessions, having obsessions, and doing compulsions. The biggest one being mental rumination and avoidance.  So, let’s round this out by talking about what to do now. So, if this is you, here is what I want you to remember. At the end of the day, and this is what I say to my clients, at the end of the day, it doesn’t matter what we call this. We could call your set of symptoms bibbidi-bobbidi-boo, and we would still use the same tools to get you effective results because what do we know? It doesn’t matter. Whatever the content is, what do we know is the problem that you’re struggling to manage the uncertainty that you’re having, that you’re having a great deal of distress and discomfort, and we need tools to be able to manage and ride that out.  So, again, if we call it this specific subtype, we call it OCD, we call it generalized anxiety, we call it bibbidi-bobbidi-boo, at the end of the day, they all require us to stop trying to suppress the thought because we know suppressing the thoughts make it worse. And then we can practice exposing ourselves to the situations where those thoughts come up without doing those compulsions. So, if you’ve taken ERP School or you’re interested in taking ERP School, we go thoroughly through what ERP is, which is exposure and response prevention. What it is, is that we expose you to the thought and fear and the obsession that you’re having. And then we practice, slowly but surely, reducing – this is called response prevention – reducing the compulsive behaviors that you do that reinforce that fear and obsession. That’s ERP. It’s actually pretty structured. We walk you through it in ERP School, but if you have an ERP therapist, they’re going to walk you through identifying your obsession, even if it doesn’t meet those categories, identifying what is your fear, and then practicing, exposing you to the life that you want to live, whether that fear shows up or not, and then practicing reducing those compulsions. The process of treatment is the same, disregarding the subtype, whether you have a subtype that you fall into or not. It is effective either way.  Ideal Treatments For Ocd And so, what I’m going to encourage you to do, and I’m just going to think of this as me finishing out the podcast, but giving you some direction, is if you meet criteria for OCD, and that involves doubting your disorder-- I remember once John Hirschfeld when I was training to become an OCD therapist. He said to me, if he had his way, he would add to the criteria for OCD that you must doubt your disorder because it’s so common for people with OCD to doubt whether they have the disorder. So, here we want to do is we want to have a plan where ERP is the meat and cheese of your treatment. And what you can do then is supplement treatment with either acceptance and commitment therapy, self-compassion, mindfulness. Sometimes people use DBT. There are new supplements coming to treatment all the time, which is wonderful, but the meat and cheese is to make sure you’re doubling down on that exposure and then the reduction of those compulsions. Okay?  My message to you is you can still 100% recover from this disorder. Look at the “I did a hard thing” today and look at the review even, talking about the benefits of practicing ERP. So, that’s what I want you to focus on.  If you don’t have access to an ERP therapist, we have a course available to you. It’s $197, which is actually less than one session with any of my staff or most ERP therapists. That is about seven hours long and will walk you through this process. So, if you’re interested, head over to CBTSchool.com. The course is called ERP School and hopefully, it will give you the tools and the education you need to feel like you can get the ball going here, even if you don’t fit these typical subtypes.  Okay, that’s all I have to say about that. I hope that this has been absolutely jam-packed with helpful skills for you to learn. I hope it absolutely validated your concern if, in fact, this is a concern that you have, and it is my honor to be on this journey with you.  So, as I always say at the end of almost every episode, it is a beautiful day to do hard things. Thank you so much again for supporting me. I just adore sending out these free resources for you and hopefully filling up your cup if your cup is feeling very empty. Please also, one thing I should have said, be gentle guys. OCD and anxiety in general can be a mean beast in our minds. And one of the best antidotes to that can be kindness, gentle self-care, loving, nurturing presence. And so, I hope that’s what I am for you and I hope that is what you are for you as well.  Have a wonderful day, everybody.

In This Episode: Andrew GottWorth shares his story of having Obsessive Compulsive Disorder (OCD) and how ERP allowed him to function again.  addresses the benefits of ERP and how ERP is for Everyone  How Exposure & response prevention can help people with OCD and for those with everyday stress and anxiety  Links To Things I Talk About: Andrew’s Instagram @justrught ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more.  Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION  This is Your Anxiety Toolkit - Episode 308.  Welcome, everybody. I am really pumped for this episode. We have the amazing Andrew Gottworth on for an interview where he just shared so many nuggets of wisdom and hope and motivation. I think you’re going to love it. But the main point we’re making today is that ERP is for everyone. Everyone can benefit from facing their fears. Everyone can benefit by reducing their compulsive behaviors. Even if you don’t technically call them compulsions, you too can benefit by this practice. Andrew reached out to me and he was really passionate about this. And of course, I was so on board that we jumped on a call right away and we got it in, and I’m so excited to share it with you. Thank you, Andrew, for sharing all your amazing wisdom.  Before we head into the show, let’s quickly do the “I did a hard thing” for the week. This one is from Christina, and they went on to say: “Thought of you today, and you’re saying, ‘It’s a beautiful day to do hard things,’ as I went down a water slide, terrified, as I’m well out of my comfort zone.” This is such great. They’re saying that’s on their holiday, the first time they’ve taken a holiday in quite a while. “It’s difficult, but I’m doing it. I’m trying to lean into the discomfort.” This is so good. I love when people share their “I did a hard thing,” mainly, as I say before, because it doesn’t have to be what’s hard for everybody. It can be what’s hard for you. Isn’t it interesting, Christina is sharing a water slide is so terrifying? Christina, PS, I’m totally with you on that. But some of the people find it thrill-seeking. And then I’m sure the things that Christina does, she might not have anxiety, but other people who love to thrill seek find incredibly terrifying. So, please don’t miss that point, guys. It is such an important thing that we don’t compare. If it’s terrifying, it’s terrifying, and you deserve a massive yay. You did a hard thing for it. So, thank you, Christina.  Again, quickly, let me just quickly do the review of the week, and then we can set back and relax and listen to Andrew’s amazing wisdom. This one is from Anonymous. Actually, this one is from Sydneytenney, and they said: “Incredible resource! What an incredible resource this podcast is! Thank you for sharing all of this information so freely… you’re truly making a difference in so many lives, including mine! (I am also reading through your book and I LOVE it. You nailed it in marrying OCD with self-compassion - what a gift!!!)” So, for those of you who don’t know, I wrote a book called The Self-Compassion Workbook for OCD. If you have OCD and you want a compassionate approach to ERP by all means, head over to Amazon or wherever you buy books and you can have the resource right there.  All right, let’s get over to the show. Kimberley: Okay. Welcome, Andrew Gottworth. Thank you so much for being here. Andrew: Yeah. So, happy to be here. Really excited to chat with you for a bit. Kimberley: Yeah. How fun. I’m so happy you reached out and you had a message that I felt was so important to talk about. Actually, you had lots of ideas that I was so excited to talk about. Andrew: I might bring some of them up because I think, anyway, it’s related to our big topic.  Erp Is For Everyone Kimberley: Yeah. But the thing that I love so much was this idea that ERP (Exposure and Response Prevention) is for everyone. And so, tell me, before we get into that, a little bit about your story and where you are right up until today and why that story is important to you. Andrew: Yeah. So, there’s a lot, as you work in the OCD field that it takes so long between first experiencing to getting a diagnosis. And so, with the knowledge I have now, I probably started in early childhood, elementary school. I remember racing intrusive thoughts in elementary school and being stuck on things and all that. But definitely, middle school, high school got worse and worse. So, fast forward to freshman year of college, it was really building up. I was really having a lot of issues. I didn’t know what it was and really didn’t know what it was for nine, 10 years later. But I was having a really hard time in college. I was depressed. I thought I was suicidal. Learning later, it’s probably suicidal ideation, OCD just putting thoughts of death and jumping up a building and jumping in a lake and getting run over and all that. But I didn’t want to talk about it then, I think. Andrew’s Story About Having Obsessive Compulsive Disorder A bit about me, I come from Kentucky. I count Louisville, Kentucky as the Midwest. We have a bit of an identity crisis, whether we’re South Midwest, East Coast, whatever. But still there, there’s a culture that mental health is for “crazy people.” Of course, we don’t believe that. So, my tiptoe around it was saying, “I’m having trouble focusing in class. Maybe I have ADHD.” And that’s what I went in for. For some reason, that was more palatable for me to talk about that rather than talk about these thoughts of death and all that. And so, I did an intake assessment and thankfully I was somewhat honest and scored high enough on the depression scale that they were like, “Hey, you have a problem.” And so, ended up talking more. So, back in 2009, freshman year of college, I got diagnosed with depression and generalized anxiety disorder, but completely missed the OCD. I think they didn’t know about it. I didn’t know about it. I didn’t have the language to talk about it at the time because I didn’t have hand washing or tapping and counting and these other things that I would maybe see on TV and stuff, which – yeah, I see you nodding – yes, I know that’s a common story.  So, I entered therapy in 2009, and I’ve been in therapy and non-medication ever since. But I had problems. I still had problems. I would make progress for a bit. And then I just feel like I was stuck. So, I ended up being in three mental hospitals. One, when I was doing AmeriCorps up in Milwaukee, Wisconsin, and had a great experience there. Two, three days up there at Rogers, which I’m very grateful for. And then stabilized moving forward. So, I ended up-- I dropped outta college. I dropped out of AmeriCorps. I then went back to college and again went to a mental hospital in Bowling Green, Kentucky. I was at Western Kentucky University, stabilize, keep going. Learning lessons along the way, learning cognitive distortions and learning talk therapy, and all these.  So, let’s keep fast-forwarding. Another mental hospital in Atlanta, Georgia. There’s a long-term outpatient stay, Skyline Trail. I’m thankful for all of these places along the way. And I wish somewhere along the way, I knew about OCD and knew about ERP, our big topic for the day.  So, finally, gosh, I can’t quite remember. I think 2018, a few years ago, still having problems. I had gone from full-time at work to part-time at work. I was just miserable. I would get into my cubicle and just constantly think, I’m not going to make it. I got to go home. I got to find an excuse to get out of here early. I just need to stay sick or I got to go home, or something came up. And so, every day I’d have an excuse until I finally was like, “I’m going to get found out that I’m not working full-time. I’m going to jump the gun, I’ll voluntarily go down in part-time.”  So, that worked for a bit until OCD kept going. And then I quit. I quit again. And at that point, I was like, “I’ve failed. I’ve quit so many things – college, AmeriCorps.” I was a summer camp counselor and I left early. “Now this job. I need something.” So, I went again to find more help. And finally, thankfully, someone did an intake assessment, came back, and said, “Well, one problem is you have OCD.” I was like, “What? No, I don’t have that. I don’t wash my hands. I’m not a messy person. I’m not organized.” Gosh, I’m so thankful for her.  Kimberley: Yeah, I want to kiss this person.  Andrew: Yeah. But here’s the duality of it. She diagnosed me with it. I am forever grateful. And she didn’t do ERP. She didn’t know it. So unbelievably thankful that I got that diagnosis. It changed my life. And then I spent several weeks, maybe a few months just doing talk therapy again. And I just knew something didn’t feel right. But I had this new magical thing, a diagnosis. And so, my OCD latched onto OCD and researched the heck out of it. And so, I was researching, researching, researching, and really starting to find some things like, “Oh, this isn’t working for me. I’ve been doing the same type of therapy for a decade and I’m not making progress.” Unbelievably thankful for the Louisville OCD Clinic. So, at this point in this story-- thanks for listening to the whole saga.  Kimberley: No, I’ve got goosebumps. Andrew: I’m unemployed, I have my diagnosis, but I’m not making any progress. So, I go, “Throw this in as well. Not really that important.” But I go to an intensive outpatient program in Louisville before the OCD clinic. And I remember this conversation of the group therapy leader saying, “I need you to commit to this.” And I said, “But I don’t think this is helping me either,” because the conversation was about relationships, my relationship was great. It was about work, I wasn’t working. It was about parents, my parents were great. They were supporting me financially. They’re super helpful and loving and kind. It’s like, “None of this is external.” I kept saying, “This is internal. I have something going on inside of me.” And she said, “Well, I want you to commit to it.” I said, “I’m sorry, I found a local OCD clinic. I’m going to try them out.”  So, I did IOP, I did 10 straight days, and it is a magical, marvelous memory of mine. I mean, as you know, the weirdest stuff, oh gosh. Some of the highlights that are quite humorous, I had a thing around blood and veins. And so, we built our hierarchy, and maybe we’ll talk about this in a bit, what ERP is. So, built the hierarchy, I’m afraid of cutting my veins and bleeding out. So, let’s start with a knife on the table. And then the next day, the knife in the hand. And then the next day, the knife near my veins. And then we talked about a blood draw. And then the next day, we watched a video of a nurse talking about it. Not even the actual blood draw, but her talking about it. So, of course, my SUDs are up really high. And the nurse says in the video, “Okay, you need to find the juiciest, bumpiest vein, and that’s where you put it in.” And my therapist, pause the video. She said, “Perfect. Andrew, I want you to go around to every person in the office and ask to feel the juiciest, bumpiest veins.” Oh my gosh. Can you imagine?  Kimberley: The imagery and the wording together is so triggering, isn’t it? Andrew: Right. She’s amazing. So, she was hitting on two things for me. One, the blood and veins, and two, inconveniencing people. I hated the inconveniencing people or have awkward moments. Well, hey, it’s doing all three of these things. So, I went around. And of course, it’s an OCD clinic, so nobody’s against it. They’re like, “Sure, here you go. This one looks big. Here, let me pump it up for you.” And I’m like, “No, I don’t like this.” Kimberley: Well, it’s such a shift from what you had been doing.  Andrew: It’s totally different. I’ll speak to the rest because that’s really the big part. But ERP over the next few years gave me my life back. I started working again. I worked full-time. Went part-time, then full-time. Got into a leadership position. And then for a few other reasons, my wife and I decided to make a big jump abroad. And so, moved to Berlin. And I have a full-time job here and a part-time disc golf coach trainer. And now I’m an OCD advocate and excited to work with you on that level and just looking at where my life was four or five years ago versus now. And thanks to our big-ticket item today, ERP. Kimberley: Right. Oh, my heart is so exploding for you. Andrew: Oh, thank you.  Kimberley: My goodness. I mean, it’s not a wonderful story. It’s actually an incredibly painful story. Andrew: You can laugh at it. I told it humorously. How Andrew Applied Erp For His Ocd Kimberley: No. But that’s what I’m saying. That’s what’s so interesting about this, is that it’s such a painful story, but how you tell it-- would I be right in saying like a degree of celebration to it? Tell me a little bit about-- you’re obviously an ERP fan. Tell me a little bit about what that was like. Were you in immediately, or were you skeptical? Had you read enough articles to feel like you were trusting it? What was that like for you? Because you’d been put through the wringer. Andrew: Yeah. There’s a lot to talk about, but there are a couple of key moments when you mention it. So, one, we’re going through the Y-BOCS scale, the Yale-Brown Obsessive Compulsive Scale, something like that. So, she asks me one of the questions like, how often do you feel like a compulsion to do something and you don’t do the compulsion? “Oh, never. I’ve never stopped. But you can do that?” It was just this moment of, “What do you mean?” If it’s hot, I’m going to make it colder. If it’s cold, I’m going to make it warmer. If I’m uncomfortable, I’m going to fidget. I’m a problem solver. Both my parents were math teachers. I was an all-A student and talk about perfectionism and “just right” OCD maybe in this context as well. But also, I love puzzles. I love solving things. And that was me. I was a problem solver. It never occurred to me to not solve the problem. And so, that was a huge aha moment for me. And I see it now and I talk about it now to other people.  Am I Doing Erp “Just Right”? But another part of ERP with the just right is, am I doing ERP right? Am I doing it right? Am I doing ERP right? And of course, my therapist goes, “I don’t know. Who knows? Maybe, maybe not.” So, depending on where you want to go with this, we can talk about that more. So, I think in general, I hated that at the time. I was like, “I know there is a right way to do it. There is. I know there is.” But now, I even told someone yesterday in our Instagram OCD circles, someone was posting about it, and I said exactly that, that I hated this suggestion at first that maybe you’re doing it wrong, maybe you’re not.  I will say, as we talk about ERP for everyone, someone who maybe is going to listen to this or hears us talking on Instagram and wants to do it on their own, this idea of exposing yourself to something uncomfortable and preventing the response – I don’t know if this is wrong, but I will say for me, it was not helpful. In my first few weeks, I would do something like-- I was a little claustrophobic, so I maybe sit in the middle seat of a car. It’s good I’m doing the exposure. I’m preventing the response by staying there. I didn’t get out. But in my head, I’m doing, “Just get through this. Just get through this. I hate this. It’s going to be over soon. You’ll get through it and then you’ll be better. Come on, just get through it. Oh, I hate this. Ugh. Ugh.” And then you get to the end and you go, “Okay, I made it through.” And of course, that didn’t really prevent the response. That reinforced my dread of it. And so, I would say that’s definitely a lesson as we get into that.  Kimberley: And I think that brings me to-- you bring up a couple of amazing points and I think amazing roadblocks that we have to know about ERP. So, often I have clients who’ll say early in treatment, “You’d be so proud I did the exposure.” And I’d be like, “And the RP, did that get included?” So, let’s talk about that. So, for you, you wanted to talk about like ERP is for everyone. So, where did that start for you? Where did that idea come from? Andrew: I would say it’s been slow going over the years where-- I don’t know how to say this exactly, but thinking like, there must be higher than 2% of people that have OCD because I think you have it and I think you have it and I think you have it, and noticing a lot of these things. And so, maybe they’re not clinical level OCD and maybe it’s just anxiety or I think, as I emailed you, just stress. But it’s this-- I just wonder how many friends and family and Instagram connections have never had that aha moment that I did in my first week of IOP of, “Oh, I cannot try to solve this.” And so, I see people that I really care about and I joked with my wife, I said, “Why is it that all of our best friends are anxious people?” And I think that comes with this care and attention and that I’ve suffered and I don’t want anyone else to suffer. And so, I see that anxiety in others. But getting back to what I see in them, maybe someone is socially anxious so they’re avoiding a party or they’re leaving early, or-- I mean, I did these two, avoided, left early, made sure I was in either a very large group where nobody really noticed me or I was in a one-on-one where I had more control. I don’t know. So, seeing that in some other friends, leaving early, I just want to say to them, you can stay. It’s worked for me. It really has. This staying, exposing yourself to the awkwardness of staying or maybe it’s a little too loud or it’s too warm. And then let that stress peak fall and see, well, how do you feel after 30 minutes? How do you feel after an hour? I want to scream that to my friends because it’s helped me so much. I mean, you heard how awful and miserable it was for so long and how much better. I’m not cured, I think. I’m still listening to your six-part rumination series because I think that’s really what I’m working on now.  So, I think those physical things, I’ve made tremendous improvement on blood and veins and all that. But that’s also not why I quit work. I didn’t quit working. I didn’t quit AmeriCorps because there’s so much blood everywhere. No, it’s nonprofits, it’s cubicles. But it was this dread that built this dread of the day, this dread of responding to an email. Am I going to respond right? Oh no, I’m going to get a phone call. Am I going to do that? Am I going to mess this up? And because I didn’t have that response prevention piece, all I had was the exposure piece, then it’s-- I can’t remember who said it, but like, ERP without the RP is just torture. You’re just exposing yourself to all these miserable things.  Kimberley: You’re white-knuckling.  Andrew: Yeah. And it’s-- I love research. I am a scientist by heart. I’m a Physics major and Environmental Studies master’s. I love research and all this. And so, I’ve looked into neuroplasticity, but I also am not an expert. Correct me if I’m wrong, but from what I hear, you’re just reinforcing that neural pathway. So, I’m going into work and I dread it. I’m saying, “I hate this. I can’t wait to go home. I hate this.” So, that’s reinforcing that for the next day. And tomorrow I go in and that dreads bigger, and the next day the dreads bigger.  And so, seeing that in other colleagues who are having a miserable time at work is just getting worse and worse and worse. But I also can see that there are parts they enjoy. They enjoy problem-solving, they enjoy helping students, they enjoy the camaraderie. And so, I want to help them with, well, let’s see how we can do ERP with the things you don’t like and so you’re not building this dread day after day and you can do the things you value. Seems like you value us coworkers, seems like you value helping the students, seems like you value solving this problem, and that’s meaningful. But I’m watching you get more and more deteriorated at work. And that’s hard to do that in others.  ERP Is For Everyone Kimberley: Yeah. I resonate so much from a personal level and I’ll share why, is I have these two young children who-- thankfully, I have a Mental Health degree and I have license, and I’m watching how anxiety is forming them. They’re being formed by society and me and my husband and so forth, but I can see how anxiety is forming them. And there’s so many times-- I’ve used the example before of both my kids separately were absolutely petrified of dogs. And they don’t have OCD, but we used a hierarchy of exposure and now they can play with the neighbor’s dogs. We can have dogs sitting. And it was such an important thing of like, I could have missed that and just said, “You’re fine. Let’s never be around dogs.” And so, it’s so interesting to watch these teeny tiny little humans being formed by like, “Oh, I’m not a dog person.” You are a dog person. You’re just afraid of dogs. It’s two different things. Andrew: Yeah. So, it’s funny that my next-door neighbor, when I was young, had a big dog. And when we’re moving into the house for the very first time, very young, I don’t know, four or something, it ran into the house, knocked me over, afraid of dogs for years. So, same thing. Worked my way up, had a friend with a cute little pup, and then got to a scarier one. And also, funnily to me, my next-door neighbor, two in a row, were German, and they scared me, the scary dog, German. And then the next one was the “Stay off my lawn, don’t let your soccer ball come over.” So, for years, I had this like, “I’m not going to root for Germany in sports. I don’t like Germany.” And then here I am living in Germany now. Kimberley: Like an association. Andrew: Yeah. So, I think fear association, anxiety association. And then I’m also playing around with this idea, maybe do a series on Instagram or maybe another talk with someone about, is it anxiety or is it society? And so, talking about things that were made to feel shame about. So, I don’t know if you can see on our webcam that I have my nails painted. I would never have done this in Kentucky. So, growing up in this, I remember vividly in elementary school, I sat with my legs crossed and someone said, “That’s how a girl sits. You have to sit with your foot up on your leg.” So, I did for the rest of my life. And then I wore a shirt with colorful fish on it, and they said, “Oh, you can’t wear that, guys don’t wear that.” So, I didn’t. I stopped wearing that and all these things, whether it’s about our body shape or femininity or things we enjoy that are maybe dorky or geeky. I just started playing Dungeons and Dragons. We have a campaign next week. And I remember kids getting bullied for that.  I don’t know if you agree, but I see this under the umbrella of ERP. So, you’re exposing yourself to this potential situation where there’s shame or embarrassment, or you might get picked on. Someone might still see these on the train and go, “What are you doing with painted nails?” And I’m going to choose to do that anyway. I still get a little squirmy sometimes, but I want to. I want to do that and I want that for my friends and family too. And I see it in, like you said, in little kids. A lot of my cousins have young kids and just overhearing boys can’t wear pink, or you can’t be that when you grow up, or just these associations where I think you can, I think you can do that. Kimberley: I love this so much because I think you’re so right in why ERP is for everyone. It’s funny, I’ll tell you a story and then I don’t want to talk about me anymore, but-- Andrew: No, I want to hear it. That’s fine. Kimberley: I had this really interesting thing happen the other day. Now I am an ERP therapist. My motto is, “It’s a beautiful day to do hard things.” I talk and breathe this all day, and I have recovered from an eating disorder. But this is how I think it’s so interesting how ERP can be layered too, is I consider myself fully recovered. I am in such good shape and I get triggered and I can recover pretty quick. But the other day, I didn’t realize this was a compulsion that I am still maybe doing. I went to a spa, it was a gift that was given to me, and it says you don’t have to wear your bathing suit right into the thing. So, I’m like, “Cool, that’s fine. I’m comfortable with my body.” But I caught myself running from the bathroom down into the pool, like pretty quickly running until I was like, that still learned behavior, it’s still learned avoidance from something I don’t even suffer from anymore. And I think that, to speak to what you’re saying, if we’re really aware we can-- and I don’t have OCD, I’m open about that. If all humans were really aware, they could catch avoidant behaviors we’re doing all the time that reinforces fear, which is why exposure and response prevention is for everybody. Some people be like, “Oh, no, no. I don’t even have anxiety.” But it’s funny what you can catch in yourself that how you’re running actually literally running.  Andrew: Literally running. Yeah. Kimberley: Away. So, that’s why I think you’ve mentioned how social anxiety shows up and how exposure and response prevention is important for that. And daily fears, societal expectations, that’s why I think that’s so cool. It’s such a cool concept. Andrew: Yeah. And so, help me since I do consider you the expert here, but I’ve heard clinically that ERP can be used for OCD but also eating disorder, at least our clinic in Louisville serves OCD, eating disorder, and PTSD. And so, I see the similarities there of the anxiety cycle, the OCD cycle for each of those. So, then let’s say that’s what ERP is proposed for. But then we also have generalized anxiety and I think we’re seeing that. I’ve heard Jenna Overbaugh talk about that as well. It’s this scale between anxiety to high anxiety to subclinical OCD, to clinical OCD, and that ERP is good for all of that. So, we have those, and then we get into stress and avoidant behavior. So, I have this stressful meeting coming up, I’ll find a way to skip it. Or I have this stressful family event, I’ll find a way to avoid it. And then you get into the societal stuff, you get into these. And so, I see it more and more that yes, it is for everyone. Kimberley: Yeah. No, I mean, clinically, I will say we understand it’s helpful for phobias, health anxiety, social anxiety, generalized anxiety. Under the umbrella of OCD are all these other disorders and, as you said, spectrums of those disorders that it can be beneficial for. And I do think-- I hear actually a lot of other clinicians who aren’t OCD specialists and so forth talking about imposter syndrome or even like how cancel culture has impacted us and how everybody’s self-censoring and avoiding and procrastinating. And I keep thinking like ERP for everybody. And that’s why I think like, again, even if you’re not struggling with a mental illness, imposter syndrome is an avoidant. Often people go, procrastination is an avoidant behavior, a safety behavior or self-censoring is a safety behavior, or not standing up for you to a boss is an opportunity for exposure as long as of course they’re in an environment that’s safe for them. So, I agree with you. I think that it is so widespread an opportunity, and I think it’s also-- this is my opinion, but I’m actually more interested in your opinion, is I think ERP is also a mindset. Andrew: Yeah. Kimberley: Like how you live your life. Are you a face-your-fear kind of person? Can you become that person? That’s what I think, even in you, and actually, this is a question, did your identity shift? Did you think you were a person who couldn’t handle stresses and now you think you are? Or what was the identity shift that you experienced once you started ERP? Andrew: Yeah. That’s a good question. I’ve had a few identity shifts over the years. So, I mentioned-- and not to be conceited, although here I am self-censoring because I don’t want to come across as conceited anyway. So, I was an all-A student in high school, and then OCD and depression hit hard. And so, throughout college, freshman year I got my first B, sophomore year I got my first C, junior year I got my first D. And so, I felt like I was crawling towards graduation. And this identity of myself as Club President, all-A student, I had to come to terms with giving up who I thought I could be. I thought I could be-- people would joke, “You’ll be the mayor of this town someday, Andrew.” And I watched this slip away and I had to change that identity. And not to say that you can’t ever get that back with recovery, but what I will say is through recovery, I don’t have that desire to anymore. I don’t have that desire to be a hundred percent. I’m a big fan of giving 80%. And mayor is too much responsibility. I don’t know, maybe someday. So, that changed.  And then definitely, through that down downturn, I thought, I can’t handle this. I can’t handle anxiety, I can’t handle stress. People are going to find out that this image I’ve built of myself is someone who can’t handle that. So, then comes the dip coming back up, ERP, starting to learn I can maybe but also-- I love to bounce all over the place, but I think I want to return a bit to that idea that you don’t have to fix it. You don’t have to solve the problem. I think that was me. And that’s not realizing that I was making it harder on myself, that every moment of the day I was trying to optimize, fix, problem-solve.  If you allow me another detour, I got on early to make sure the video chat was working, sound was okay. And I noticed in my walk over to my computer, all the things my brain wanted me to do. I call my brain “Dolores” after Dolores Umbridge, which is very mean to me. My wife and I, Dolores can F off. But I checked my email to make sure I had the date right. Oops, no, the checking behavior. Check the time, making sure, because we’re nine hours apart right now. “Oh, did I get the time difference right?” I thought about bringing over an extra set of lights so you could see me better. I wanted to make sure I didn’t eat right before we talked, so I didn’t burp on camera, made sure I had my water, and it was just all these-- and if I wasn’t about to meet with an OCD expert, I wouldn’t have even noticed these. I wouldn’t have even noticed all of these checking, fidgeting, optimizing, best practicing. But it’s exhausting.  And so, I’m going to maybe flip the script and ask you, how do you think other people that are not diagnosed with OCD, that are just dealing with anxiety and stress can notice these situations in their life? How do they notice when, “Oh, I’m doing an avoidant behavior,” or “I’m fixing something to fix my anxiety that gives me temporary relief”? Because I didn’t notice them for 10 years. Kimberley: Yeah. Well, I think the question speaks to me as a therapist, but also me as a human. I catch every day how generalized anxiety wants to take me and grab me away. And so, I think a huge piece of it is knowledge, of course. It’s knowledge that that-- but it’s a lot to do with awareness. It’s so much to do with awareness. I’ll give you an example, and I’ve spoken about this before. As soon as I’m anxious, everything I do speeds up. I start walking faster, I start typing faster, I start talking faster. And there’s no amount of exposure that will, I think, prevent me from going into that immediate behavior. So, my focus is staying-- every day, I have my mindfulness book right next to me. It’s like this thick, and I look at it and I go, “Okay, be aware as you go into the day.” And then I can work at catching as I start to speed up and speed type.  So, I think for the person who doesn’t have OCD, it is, first, like you said, education. They need to be aware, how is this impacting my life. I think it’s being aware of and catching it. And then the cool part, and this is the part I love the most about being a therapist, is I get to ask them, what do you want to do? Because you don’t have to change it. I’m not doing any harm by typing fast. In fact, some might say I’m getting more done, but I don’t like the way it makes me feel. And so, I get to ask myself a question, do I want to change this behavior? Is it serving me anymore? And everyone gets to ask them that solves that question. Andrew: So, I think you bring up a good point though that I’m curious if you’ve heard this as well. So, you said you’re typing fast and you’re feeling anxious and you don’t like how that feels. I would say for me, and I can think of certain people in my life and also generally, they don’t realize those are connected. I didn’t realize that was connected. In college, I’m wanting to drop out, I drop out of AmeriCorps, I drop out of summer camp. I’m very, very anxious and miserable and I don’t know why. And looking back, I see it was this constant trying to fix things and being on alert. And I got to anticipate what this is going to be or else is going to go bad. I need to prevent this or else I’m going to have an anxious conversation. I need to only wear shorts in the winter because I might get hot. Oh no, what if I get hot? And it was constantly being in this scanning fear mindset of trying to avoid, trying to prevent, trying to-- thinking I was doing all these good things. And I saw myself as a best-practice problem solver. It’s still something I’m trying to now separate between Dolores and Andrew. Andrew still loves best practices. But if I spend two hours looking for a best practice when I could have done it in five minutes, then maybe that was a waste. And I didn’t realize that was giving me that anxiety.  So, yeah, I guess going back to I think of family, I think of coworkers, I think of friends that I have a suspicion, I’m not a therapist, I can’t diagnose and I’m not going to go up, I think you have this. But seeing that they’re coming to me and saying, “I’m exhausted. I just have so much going on,” I think in their head, it’s “I have a lot of work.” Kimberley: External problems. Andrew: Yeah. I may be seeing-- yeah, but there’s all this tension. You’re holding it in your shoulders, you’re holding it here, you’re typing fast and not realizing that, oh, these are connected.  Kimberley: And that’s that awareness piece. It’s an awareness piece so much. And it is true. I mean, I think that’s the benefit of therapy. Therapists are trained to ask questions so that you can become aware of things that you weren’t previously aware of. I go to therapy and sometimes even my therapist will be like, “I got a question for you.” And I’m like, “Ah, I missed that.” So, I think that that’s the beauty of this.  Andrew: I had a fun conversation. I gave a mental health talk at my school and talked about anxiety in the classroom, and thanks to IOCDF for some resources there, there’s a student that wanted to do a follow-up. And I thought this was very interesting and I loved the conversation, but three or four times he was like, “Well, can I read some self-help books, and then if those don’t work, go to therapy?” “No, I think go to therapy right away. Big fan of therapists. I’m not a therapist. You need to talk to a therapist.” “Okay. But what if I did some podcasts and then if that didn’t work, then I go to therapy?” “Nope. Therapy is great. Go to therapy now.” “Should I wait till my life gets more stressful?” “Nope. Go now.” Kimberley: Yeah, because it’s that reflection and questioning. Everyone who knows me knows I love questions. They’re my favorite. So, I think you’re on it. So, this is so good. I also want to be respectful of your time. So, quick rounded out, why is ERP for everybody, in your opinion? Andrew: How do we put this with a nice bow on it?  Kimberley: It doesn’t have to be perfect. Let’s make it purposely imperfect. Andrew: Let’s make it perfectly imperfect. So, we talked before about the clinical levels – OCD, eating disorder, PTSD, generalized anxiety disorder. If you have any of those, take it from me personally, take it from you, take it from the thousands of people that said, “Hey, actually, ERP is an evidence-based gold standard. We know it works, we’ve seen it work. It’s helped us. Let it help you because we care about you and we want you to do it.” And then moving down stress from work, from life. You have a big trip coming up. There’s a fun scale, home’s rocky, something stress inventory. I find it very interesting that some of them are positive, outstanding personal achievement like, “Oh, that’s a stressful thing?” “Yeah, It can be.” And so, noticing the stressful things in your life and saying, “Well, because of these stressful things are the things I’m avoiding, things I’m getting anxious about, can I learn to sit with that?” And I think that mindfulness piece is so important.  So, whether you’re clinical, whether you’re subclinical, whether you have stress in your life, whether you’re just avoiding something uncomfortable, slightly uncomfortable, is that keeping you from something you want to do? Is that keeping you-- of course, we-- I don’t know if people roll their eyes at people like us, “Follow your values, talk about your values.” Do you value spending time with your friends, but you’re avoiding the social gathering? Sounds like ERP could help you out with that. Or you’re avoiding this, you want to get a certification, but you don’t think you’ll get it and you don’t want to spend the time? Sounds like ERP could help with that. We’re in the sports field. My wife and I rock climbing, bouldering, disc golf. You value the sport, but you’re embarrassed to do poorly around your friends? Sounds ERP can help with that. You value this thing. I think we have a solution. I’ve become almost evangelical about it. Look at this thing, it works so well. It’s done so much for me. Kimberley: Love it. Okay, tell me where-- I’m going to leave it at that. Tell me where people can hear about you and get in touch with you and hear more about your work. Andrew: Mainly through Instagram at the moment. I have a perfectly imperfect Instagram name that you might have to put down. It’s JustRught but with right spelled wrong. So, it’s R-U-G-H-T. Kimberley: That is perfect. Andrew: Yeah. Which also perfectly was a complete accident. It was just fat thumbs typing out my new account and I said, “You know what, Andrew, leave it. This works. This works just fine.” Kimberley: Oh, it is so good. It is so good. Andrew: Yeah. So, I’m also happy I mentioned to you earlier that my wife and I have started this cool collab where I take some of her art and some of the lessons I’ve learned in my 12-plus years of therapy and we mix them together and try to put some lessons out there. But I’m currently an OCD advocate as well. You can find me on IOCDF’s website or just reach out. But really excited to be doing this work with you. I really respect and admire your work and to get a little gushing embarrassed. When I found out that I got accepted from grassroots advocate to regular advocate, I said, “Guys, Kimberley Quinlan is at the same level as me.” I was so excited. Kimberley: You’re so many levels above me. Just look at your story. That’s the work. Andrew: The imposter syndrome, we talked about that earlier. Kimberley: Yeah, for sure. No, I am just overwhelmed with joy to hear your story, and thank you. How cool. Again, the reason I love the interviews is I pretty much have goosebumps the entire time. It just is so wonderful to hear the ups and the downs and the reality and the lessons. It’s so beautiful. So, thank you so much. Andrew: I will add in, if you allow me a little more time, that it’s not magic. We’re not saying, “Oh, go do ERP for two days and you’ll be great.” It’s hard work. It’s a good day to do hard things. I think if it was easy, we wouldn’t be talking about it so much. We wouldn’t talk about the nuance. So, I think go into it knowing it is work, but it is absolutely worth it. It’s given me my life back, it’s saved my relationships, it’s helped me move overseas, given me this opportunity, and I’m just so thankful for it. Kimberley: Yeah. Oh, mic drop. Andrew: Yeah. Kimberley: Thank you again.

SUMMARY:  In This Episode: What to do what your chronic illness causes anxiety  The Difference between POTS and anxiety.  How to manage POTS related anxiety  What is an “Adrenaline Surge”?  The Treatment for POTS and Anxiety  POTS AWARENESS MONTH Links To Things I Talk About http://www.dysautonomiainternational.org/page.php?ID=30 Overcoming Anxiety and Panic https://www.cbtschool.com/overcominganxiety ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more.  Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 307.  Welcome back, everybody. I am so thrilled to be here with you today. As most of you may know, it is OCD Awareness Month or Awareness Week. It’s just passed, and that’s something I’m so passionate about advocating for. But in addition to that, it’s also Postural Orthostatic Tachycardic Syndrome Awareness Month. For those of you who don’t know, I suffer from postural orthostatic tachycardic syndrome. We call it POTS for short. I’ve had multiple people ask me to do an episode about when chronic illnesses cause anxiety, and I thought this is probably the best week to do it. Not only is it awareness week or awareness month for POTS, but I actually have had a little blip in my own recovery in my POTS. So, I wanted to share with you my story and share with you how I’m handling the anxiety and health anxiety and stress and grief of that, and also just address some tools that have worked for me and that I’m hoping will work for you as well. If you have a chronic illness or even if you don’t, I think that these are really core skills that we need to practice just in regards of managing daily stress as well.  You know what, before we do that, let’s go and do the “I did a hard thing” because this one is actually really touching and I would really like to feature. This was actually an email we received. I love getting your emails. If you guys are not on our newsletter list, please do go and sign up for our newsletter. We do give you access to the whole series. I created a whole website for the six-part mental compulsion series. It will be private just for people who sign up for the newsletter, and it’s got some amazing additional resources, PDFs, links that you really should check out. So, if you want to sign up for that, head on over to CBTSchool.com and you can sign up for our newsletter.  This person said: “I took a big leap of leaving my family and moving to China on my own.” Now, I totally resonate with this because I am in America on my own, even though I have my family. Leaving your home country is a big deal. It’s a huge deal. They go on to say, “The only thing, I haven’t been home to see my family in over three years, and I’ve been struggling so much. We hadn’t had a holiday in over two years, and I had been stuck in our complex for months. It was really, really hard. We finally were allowed out of our city, so we decided to go to Yunnan Province.” Hopefully, I pronounce that okay. “I was so worried that my OCD would come in hard and stop me from enjoying this amazing holiday we had planned for. I was strong and I did the hard things, thanks to you. I did a six-day hike at the start of the Himalayas, and I’m like, ‘Holy moly, that is amazing.’ I got engaged on Tiger Leaping Gorge. I ran down a bear and wolf-infested forest, and I slept in a tiny house next to pigs and cows.” What an adventure. “Kimberley, thank you. You have given me strength I needed. You are my inspiration.” This is what I mean by why I love the “I did a hard thing” because sometimes the hard thing is getting out of bed. Sometimes the hard thing is facing a fear that you know is in your daily life. But sometimes your fear is like living a life according to your values and doing some pretty huge, openhearted things. And so, I absolutely love this “I did a hard thing.” Thank you so much, Leanne, for submitting this because there was something about it that just made me giggle like, holy moly, you really packed in some adventure into a short period of time, and well-deserved after being in a complex for so many months and years. Thank you so much for leaving that here in my inbox.  Real quick, let’s do the review of the week so that we can head on over. This one is from Young Math Mama and they said: “BEST podcast for a daily mindset reset. This podcast was recommended to me by my therapist, and it is one of my favorite ‘homework assignments’ to help me have a good mindset and feel inspired to try my best. I’ve learned so much great information from Kimberley, but the most important thing, in my opinion, is that I feel motivated to improve one small thing every time I listen. I’m taking better care of myself, which helps me take better care of my family.” Literally, Young Math Mama, that is the absolute goal of this. I consider myself part therapist and part coach. I do a lot of coaching in my work and hopefully, I inspire you and motivate you all as well. Thank you so much, Young Math Mama, for submitting, and also Leanna.  Update On My Pots/Chronic Illness Okay, so let me give you a little background here. I haven’t shared this with you because I actually didn’t feel it was appropriate at the time for me to share, but I will share it now. As you guys know, I did a whole podcast about health anxiety, and this whole shocking episode where I had to get my teeth removed, one of my teeth got pulled out. Interestingly, since I had that infection in my tooth and I had it removed, almost all of my POTS symptoms went away. And the reason I didn’t want to share that, which is strange in hindsight why I wouldn’t want to share that, is number one, I wasn’t convinced it was long-term. Number two, I was really concerned that saying that would be really disheartening to some people who are still really struggling. Number three, I was a little worried. I had a bit of a placebo effect if I’m not going to lie. The doctor said it could actually help my POTS and then when it did, I was a little bit like, “Oh, is this the placebo?” I was just waiting for the shoe to drop, which is really not good practice. I wish actually now in hindsight I didn’t do that, but that is the way it played out.  I have actually had an almost full remission. I do have some bad days. I do have some bad blood pressure days. But I was able to stand for the first time in many years. What I mean by “stand” is the day that I actually realized that I was in recovery from that. In the mornings, I always fill up my kids’ drink bottles and we have one of those filters in the fridge. And usually, it takes probably like 45 seconds, maybe a minute to fill up a drink bottle. But because I can’t stand up for very long or I get really dizzy and I can faint, it usually takes me two goes to fill up a drink bottle. I would fill it up for maybe 20 seconds, then I would go sit down just for a minute or two. I could feel myself get less dizzy and then I would go to do it again.  You Must Find Rhythms I have found a rhythm in my life, that’s how debilitating it is. But I had found these rhythms and routines in my life to where I could still fill up my kids’ drink bottles and no one needed to know that I was dizzy. I had found routines to mask it and I’d found routines so I could get through the day. And then I started to notice, oh my God, I’m halfway through filling up the drink bottle and I don’t need to sit down. I could actually fill this whole drink bottle without feeling really dizzy and nauseous, which to you might seem like an easy part of the day, but to me, that’s just a luxury I didn’t have for two years. So, I’ve been so thrilled and so overjoyed and actually really protective of my body because I’m like, “Oh my gosh, I’m in recovery. I’m really doing so well.”  And then really why the “I did a hard thing” segment resonated with me is because when I came back from Australia, I was so happy and just my heart was so full and we hit the ground running. We really hit the ground running. My daughter started middle school, my son started second grade. They’re in two different schools now. My husband had gone back to another job. We’d just had some house remodeling done. The house was a disaster. We’d had a couple of other stressful events happen. About three weeks ago, I had gotten some really scary news about a loved one. I remember sitting on the couch and just being overwhelmed with anxiety. A massive cortisol, adrenaline surge just went through my body because I was really worried the lasted several days and then I didn’t sleep very well for a few days and then I stopped exercising as much as I was and probably didn’t drink enough water, which is all these things are really important if you have POTS. And I had also not kept up with how much salt I need to eat. I need to eat the most disgusting degrees of salt. It’s a common treatment for POTS. Most people are encouraged not to eat a lot of salt. People with POTS usually have to eat an immense amount of salt.  My Pots Relapse Unfortunately, I just started to have all of my symptoms returned. All of them I can manage, but the one that I’m struggling with the most is what they call an “adrenaline surge.” It’s common for people who have POTS. It just feels like you’re having a panic attack, but you’re not having a panic attack. You’re not worried about anything. I think that all of the stress and me loosening my recovery treatment is what caused it. But all of a sudden, I remember I woke up at three in the morning and I thought I was having a panic attack, but it was, now I understand, an adrenaline surge. It was just like someone had injected me with adrenaline and cortisol. At that time, I was like, “This makes sense. We’ve just had a couple of some scary things happen and life is pretty stressful. I’m obviously having a panic attack.” So, first I want to teach you or show you or demonstrate to you that even though I had woken up in the middle of the night with a panic attack, I used every single one of my tools. I was like, “All right, brain, thank you for waking me up and bringing this to my attention in the middle of the night. There is nothing I can do about it right now. I’m just going to let you be there and we’re going to lay here until you’re ready to leave. You don’t have to leave if you don’t want to.” It took about two hours, three hours, which is pretty long and strange. I was like, “This is a bit strange.”  When Your Chronic Illness Causes Anxiety & Panic But then the next night, again, all day feeling anxious, on edge, but also using all my tools. Like, “It’s cool, anxiety can come along, no big deal, I’m cool with it” kind of thing. And then next night, wake up in the middle of the night at 11 o’clock because I go to bed pretty early. 11:00 PM, massive panic, adrenaline surge. Oh my gosh. Okay, now what? I get up and I’m like, “Something is up. I’m obviously struggling.” I do what an average person would do, would be like look around and be like, “What’s going on with me? Is there something really anxiety-provoking that’s going on? Should I be worrying about something? Is this a sign?” And then I was like, “No, no, no, I’m going to use my tools.” This happened for several days until I realized this actually could be just generalized anxiety because I do struggle sometimes with generalized anxiety, but I actually think this is a part of my POTS. So, I did some research and spoke to a doctor and yes, it is in fact a part of my POTS symptoms and it’s one that I didn’t have before.  But the reason I’m sharing this with you today is, this is actually so common for people with chronic illnesses. If you have a chronic illness, there are these weird things that happen to your body and then it’s so easy just to chalk it up as like, “Oh, I’m having a panic attack,” or “I’m having anxiety.” And then you start panicking and having anxiety. If you’re not careful, you’ll start to do hypervigilant behaviors and avoidant behaviors and mental compulsions, and then it’s a full-blown anxiety disorder.  Pots And Anxiety: The Dreaded Adrenaline Surge If there’s one thing I have learned from having a chronic illness is to be so skilled with physical sensations that show up in my body because it can seem so similar to anxiety – dizziness, lightheadedness, agitation, feeling like you’re going to faint. These are all symptoms of POTS, but they’re also symptoms of anxiety. POTS and Anxiety can feel almost exactly the same. So, I’ve had to become very, very skilled. And I use the word “skilled” because this is not an innate thing I know. I had to practice what I preach and I had to be very objective, not subjective about what’s going on, and go, “Okay, you’re having dizziness. It could mean that you’re going to faint, but it also could mean you’re anxious.” So, let’s actually be really skilled in how we respond to this. Or you’re having a panic attack. In this case, you’re having a massive adrenaline surge is what they call it in the POTS world. You’re having this adrenaline surge, it could be a panic attack and it could be your POTS. Let’s work at being very logical and wise in our response to it. Let’s not be responding to it as if it’s a catastrophe or that there’s actually danger.  This has been so key for me. What I have found, and this is literally as we speak this week and I can say to you as we speak right now, I actually am having a massive adrenaline surge as we speak. It is so easy to interpret it as something is wrong, there must be danger, we’ve got to get out of here. But I’m working at just allowing it to be there and going, “Thank you, brain, for setting off this alarm. I understand. I’m going to allow it to be there.” The reason I’m sharing this with you and the reason I actually had scheduled to do this recording tomorrow, but today’s the perfect day to do it because I’m actually in quite a lot of suffering right now. It’s pretty painful. It’s pretty uncomfortable. I’m at like an eight 8 of 10 anxiety level, maybe even a 9 depending on where I’m at. I’m just actually going to go about my day. As I speak to you, I’m actually in a pretty big degree of suffering and I just want to be completely real with you. The reason, again, that I wanted to record this today is I was getting ready for work and I started to notice, I was putting all these black clothes on because I don’t feel so great. And I was like, “Wait a second, this is how invasive this can be in that I’m actually choosing black clothes. Not that there’s anything wrong with black clothes, but I’m choosing it because my body feels so uncomfortable. What could I do right now to fully embrace joy, fully just embrace the fact that it’s here?”  Choosing Your Values I have this bright, yellow dress that’s like a full circle dress. If you did a spin, it would go into a full circle and I love this skirt. I was like, you know what? I’m going to wear my yellow skirt today. Today is a perfect day to wear my yellow skirt, even though my body is having a massive reaction. My body is obviously in some kind of response to something, chronic illness-wise, and my body wants me to panic. My body wants me to be hypervigilant. My body and my brain want me to tighten up my whole body. But I’m going to put on this yellow skirt and I’m going to sit down with my friends, you guys, and I’m going to talk about this thing that I have to handle.  As I’m sharing about this, I’m just going to pause here for a second because it brings me to tears. I’m in a lot of pain emotionally. But in that pain, if you could see me right now, I actually have a huge smile on my face because I am so grateful that I gave myself the opportunity to practice these skills because they are actually reducing how much suffering I could have. I remember when I first had these symptoms that I did go into hypervigilance and panic because I was like, “Something is seriously wrong. Something is really wrong. We have to fix it. We’ve got to go to the emergency room.” And now I have these skills to where I’m not actually increasing my suffering by doing all of those compulsive behaviors. And that is key when you have a chronic illness.  Treatment For Pots And Anxiety (and other chronic illnesses) All the research I have done shows that having a chronic illness requires medical attention and therapy. Cognitive behavioral therapy, I did a whole bunch of research in prep for this, a whole bunch of research. If you have POTS, they recommend cognitive behavioral therapy. That’s because along with having a chronic illness comes anxiety and depression and other emotions. Along with having other chronic illnesses comes anxiety and depression, diabetes, Crohn’s disease, celiac disease. It could be even just having a chronic illness of having a disorder. A mental health disorder also creates a lot of anxiety in your life. This is key. I’m just so grateful that I have the ability to practice these skills and the ability to just sit in the mud. I am just sitting in the mud today. That’s what I’m doing. I’m so grateful that I have those skills and I really want to teach you guys those skills by modeling to you today. So, let’s break it down.  When you have anxiety, whether it’s in association to a chronic illness or it’s just regular anxiety, what I’m going to encourage you to do is do nothing at all. It’s actually quite easy when you think about it, but it’s actually really hard at the same time, is to do nothing at all different. Today, I am going about my day. I am going to allow my heart rate to go through my chest and beat so hard. I’m going to allow that lightheaded, blood pressure issue that I’m having to be there. I’m going to allow the dizziness to be there. I’m going to allow the raising thoughts to be there. I’m going to still show up in my yellow skirt. If I spin in a circle, it would be a full spinning circle. It would be so beautiful. And I’m going to keep my heart open. If you could see me right now, I’m not hunched up. My hands are soft, my cheeks are soft, my heart is open, my shoulders are dropped. I’m just here for it. I’m allowing it. Is it hard? Yes, it is painful as. Is it exhausting? Yes. Every night this week I’ve been going to bed at seven o’clock and just resting my body because I’m working really, really hard. And my body is exhausted because it’s pumping adrenaline all day long. These are some ideas I want you to implement into your life if you can. And a lot of it, one thing, of course, I didn’t discuss because it’s just such a part of my practices, I’m also really gentle with myself. Like, “Yeah, Kim, this is rough.” I use the word “suffering.” You even heard me use it. “This is a lot of suffering for you right now, hun. You deserve to go to bed a little early and it’s okay if you don’t show up perfect and you might drop some balls. Yeah, that’s okay.” That’s the main point.  Pots Awareness Month  What I will say at the end here is please-- you’re probably hearing some of this and going, “Oh my gosh, maybe I have POTS.” I really want to make sure you know the difference. Given that it’s POTS Awareness Month, postural orthostatic tachycardic syndrome is not an anxiety disorder. It is a disorder of the autonomic nervous system. It does mean that when you stand up, there is changes in your heart rate and in your blood pressure that cause you to faint. Lots of people with POTS can’t stand up at all. So, I’m so grateful for the fact that I can stand up, even though it takes me two goes to fill up a drink bottle. I can stand up better than a lot of people who have postural orthostatic tachycardic syndrome. I can walk. I can exercise. I’ve been building up my exercise routine according to the POTS exercise program.  Difference Between Anxiety And Pots  It’s important for you to understand that just having these anxiety symptoms doesn’t mean you have POTS. If you are fainting and you are actually having a really difficult time with nausea and multiple different autonomic nervous system issues, well then definitely go see your doctor and share with them your symptoms. If they think that you are a candidate for maybe getting tested for POTS, the type of test you would need is called a tilt table test. It is usually administered by a cardiologist or a cardiologist nurse. It’s a horrible test, and if you have POTS, it will be very painful and very difficult. But basically, it’s where they put you on a table and then the table tilts up really fast, and then you’re connected to all these cardio nodes, I guess, all over your body and they’re got a blood pressure machine and some people even faint during the test. They raise you and then they drop you down flat and then they raise you and they drop you down flat and they’re monitoring whether there’s shifts in your heart rate and blood pressure. And that is the test that will get you diagnosed for POTS based on whether you meet criteria. It’s a very unpleasant test if you have POTS because it does induce fainting for a lot of people or a severe amount of nausea for a lot of people. But if you are concerned, you can reach out to your doctor and see if you meet the criteria to get that test.  That’s it. I wanted to share with you what it’s like to have POTS and to share my ups and downs with having POTS. Also, one thing I will say, if you don’t mind and you want to stay with me just for a few more minutes, is having a chronic illness is also a very anxious experience. You never know whether you’re going to have a good day or a bad day. You never know what your symptoms are going to be. For me, I’ve actually been very blessed and the treatments have helped me a lot. For some people they don’t, but for some people, they can’t guarantee they can show up for work tomorrow. They can’t guarantee they can take their kids to the park. They just don’t know. It depends on the day and it depends on their body. So, there’s so much uncertainty with what your body will do and how your body will react. That in and of itself creates a lot of anxiety and uncertainty and it can be very, very depressing.  For those of you who have severe POTS, they can’t play with their kids. They can’t stand up long enough to run in the park. It can be very, very debilitating. So, if you have a chronic illness and you have anxiety and depression, that doesn’t mean there’s something wrong with you. It actually means it’s a normal natural part of having a chronic illness. I wanted to really make sure I advocated for that because some people think if you have a medical problem, it’s just a medical problem. But often medical problems create mental health problems and we have to look at the whole human. Even though I’m an OCD and Anxiety Specialist, I’m still going to admit to you guys, it still creates anxiety for me. I handle it pretty well, but some days I don’t. Some days I’m very sad about it and have a lot of grief and a lot of anger and a lot of frustration around it and sometimes even jealousy. Just jealous. I wish I could A, B, and C. I’ll tell you one story. There’s a person on social media and they constantly do their posts while they’re standing at a computer desk. Even just looking at her stand at a computer desk, she’s got one of those standing desks, I have so much envy because I’m like, “I could never ever do that.” Never ever do that unless somebody-- I don’t know. I didn’t even know how I would do it, but-- yeah, a lot of emotions show up.  All right. So, that’s it for today. I wanted to share with you a whole little update on what happens when your chronic illness causes anxiety. I wanted to highlight that it’s Postural Orthostatic Tachycardic Syndrome Week or Awareness Week. Actually, I think it’s Awareness Month. I hopefully inspired you to lean into your fear and not give it all the power because you’re actually stronger than your anxiety.  All right. Thank you so much for listening. I know it may have been a bit of a rambling episode, but hopefully, you took a few pieces away from it. I really, really appreciate you checking in. Please do go and leave a review. It is the best gift you can give me because it does allow me to then get trust of other people who are new coming to the podcast, and then we can help some more people.  Take care and I will talk to you soon.

In This Episode: The difference between Reassurance seeking vs. holding in emotions Why Reassurance seeking OCD is problematic and keeps you stuch What tools you can use to help you manage emotions with OCD Links To Things I Talk About: ERP School: https://www.cbtschool.com/erp-school-lp https://kimberleyquinlan-lmft.com/32-reduce-reassurance-seeking-behaviorscompulsions/ Newsletter https://www.cbtschool.com/newsletter Chatter Book:https://www.amazon.com/Chatter-Voice-Head-Matters-Harness/dp/0525575235 Episode Sponsor:This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety...If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 306. Welcome back, everybody. We are well and truly into OCD Awareness Week, and I have been so excited to be a part of some amazing awareness projects, being an advocate for the International OCD Foundation, doing a lot of social media on self-compassion this week. It’s been such a treat. This week, I actually wanted to discuss a concept that I-- actually, I say this often these days, but I get asked this question a lot in some various forms by my clients, so I wanted to address this question that I got with you. This is actually a question from one of the people in ERP School, which is our online course for OCD. If you click the link here in the bio or you can go to CBTSchool.com, we have a course called ERP School where we teach, or I teach step by steps that I take with my patients on how to set up an ERP plan so that you can slowly face your fear and reduce your compulsions and take your life back from OCD. Reassurance Vs Holding In Emotions One of the members asked a question, and there’s a whole portal in there where you can ask questions to me directly, and they asked: “I have a question to you regarding reassurance seeking.” They said, “I’ve been trying to stop doing my compulsions and my go-to is reassurance seeking.” “What is the difference between Reassurance vs holding in emotions?” Reassurance Seeking OCD Reassurance seeking is a type of compulsion where you usually go to Google or you go to a loved one or another person and you ask for reassurance on your fear or your uncertainty. They go on to say, “One thing I do understand about is why it’s bad and how it keeps the cycle going.” So, they do understand that reassurance seeking OCD is a problem. They do understand how it keeps the OCD cycle going. We talk a lot in ERP School about this OCD cycle. It’s a huge component of the treatment. We have to first understand the cycle so that we can then know how to stop the cycle. And they go on to say, “I know that I have to learn to rely on myself to manage my anxiety and seeking reassurance makes me dependent on others for my relief, which can increase my anxiety when they’re not around. But I’ve always been told by friends and family that talking about things that are bothering you is healthy because that way you get it out as opposed to bottling it in. When I don’t seek reassurance, I worry that I’m bottling it in and that the only way to feel better is to let it out by talking to others. How do I join these two seemingly healthy ideas?” This is such a core component of all the work that we do. And so, I really want to go deep into this with you here in just a sec. Now, before we move on, if you aren’t quite sure about reassurance seeking yet, you can go back and listen to a previous podcast we did, Number 32, which is called How to Reduce Reassurance Seeking Behaviors. It’s an amazing podcast episode that really goes deep into what is a reassurance compulsion. You can click that there. But let’s talk more about this specific question. Before we do that, let’s quickly do the review of the week. This is from Isha.Isha and they said: “An invaluable resource. I have read many books on anxiety and OCD, and yet I am continuously surprised to learn new things with this podcast. It is thought-provoking and brings forward new, helpful, and interesting content.” She went on to say: “Kimberly, your 6 Part series on Mental Compulsions has truly been life-changing for me. Despite reading dozens of books on OCD and Anxiety, including yours, I was astounded to realize how many mental compulsions I actually have. The approaches to dealing with them, suggested by a few of the guests (thank you, Hershfield, Nicely, and Reid), have been nothing short of miraculous for me. Thank you for your hard work here! It is deeply appreciated!” Again, you guys, if you go to CBT School and you sign up for our newsletter, you will be given a gift from me, which is a link where I have put all of those six-part mental compulsion audio files together and we’ve thrown in a whole bunch of PDFs that will help you really strategize your own way of managing mental compulsions. So, go sign up for the newsletter. If you go to CBTSchool.com, you’ll be able to get access to it there. And then one more thing before we move on, let’s quickly do the “I did a hard thing” segment. It sounds like this person who asked the question is doing hard things too, but this one was so fun, I wanted to share it with you. Anonymous says: “Having OCD has made wedding planning and the wedding process in general challenging for me. But this weekend, I made it to my bridal shower and I had the best time, even despite my OCD being along for the ride. I actually took the day as an opportunity to face the disorder head-on. I left feeling empowered as F***.” Amazing, Anonymous. I’m so happy and congratulations on your bridal shower. I hope you had the most incredible time. All right, so let’s look at this question. Let’s break it down. Okay. So, yes, this person has already shared they understand that reassurance-seeking keeps us in the OCD cycle, keeps the fear going strong, and only makes more problems. It makes problems for the person with OCD, but it also impacts the relationship. In fact, I would go as far as to say, those who engage in reassurance-seeking behaviors tend to have a bigger impact on their family members because they’re constantly going to their family members saying, “Would this happen? Could it happen? Do you think it could happen? What would happen?” And that person, because they’re not trained as a clinician, they don’t know how to respond. They haven’t been trained. Usually, they try many different ideas and it actually ends up making the person with OCD even more confused. And then that can create conflict in the relationship. We know this. We know that reassurance-seeking can be very, very problematic and we want to slowly reduce it. It sounds like this person is doing amazing work, but they’ve got this dilemma in saying, “But I thought I was supposed to let things out.” Let’s take a look here. Managing emotions with OCD When you have an obsession, naturally, your instincts are, “How can I make this fear go away or this discomfort or feeling go away?” You’re going to want to do a compulsion. The goal of ERP is to reduce those compulsions. So, now what are you doing? So, you’re reducing the compulsion, you’re not trying to get reassurance, and now you’re handling a large degree of anxiety and stress. Yeah, that’s true. You will have to rise and fall in discomfort. Absolutely. We know that that’s a part of the work. Willingly, ride the wave of discomfort. So, what I want to say to you here is you have some choices. You could ride that wave on your own. Let it go high, let it go low, let it go up and down, do what it wants, and you can practice actually allowing that discomfort and really building a resilience to that as you go. Similar to what Anonymous said in “I did a hard thing” is they left feeling empowered. When we do it on our own, we can actually feel incredibly empowered. Now, that is one option. That doesn’t mean to say that when things are really hard, naturally, we do want connection. That’s what human beings want. So, sometimes we do want to go to our loved one and say, “I’m having a hard time.” But there’s a really big difference between going to a loved one and saying, “I’m having a hard time. Will this bad thing happen? Or do you think it will happen?” and saying to your partner, “I’m going through some stuff right now, would you sit with me?” One is very compulsive and one is not. But this is where OCD can be very, very tricky. Sometimes, just having a partner there forms reassurance. If your fear is like, “Well, what if I’m going to go harm someone?” keeping them in the room, even though you’re not talking, that can still serve as a reassurance because you’re like, “Okay, they’re here. They’ll stop me if I’m going to do something bad and I snap.” So, we want to keep an eye out for how reassurance seeking doesn’t have to be just verbal, it can be physical, it could be us just looking at them to see their face and go, “Okay, they look fine, they don’t look stressed. Okay, that gives me the reassurance that nothing bad is happening.” Catch the little nuances that can happen here because as we know, OCD can be very, very sneaky. Again, we can use the option and it is healthy to go to your partner and say, “Hey, I’m really dealing with something. This is really hard. I’m riding a wave of discomfort.” But you’re doing that without getting any reassurance, without seeking any reassurance, without them reducing or removing your uncertainty or anxiety. So, you can do that. There are ways to do it. But the main thing to remember here is, are you doing this with urgency? Because that’s usually a very good sign that you’re doing something compulsive. Are you doing it in attempt to reduce or remove your discomfort? If you’re able to be in conversation with them and discuss and seek support from them without seeking it in an urgent way or trying to reduce or remove your discomfort, well then that’s fine. But here is what I want you to consider just to start, is I am all for support. In fact, it is a human need to have support. But what I’m going to offer you is an idea, which is, when it comes to OCD, if you’re going to them for support because of this discomfort, there is a chance you’re still treating the fear like it’s important, and you will suffer. I get that. You’re going to have a lot of emotions. But if you have the emotions and you’re like, “Oh my God, I feel so bad, I just have these thoughts, or having this anxiety,” and you’re giving that too much attention by saying, “I need your support, I’m really, really suffering,” sometimes that in and of itself can actually reinforce the anxiety. I guess you’re still probably thinking, well, what’s the balance? And there is no perfect answer. I’m sorry, I can’t give you a yes or a no. What I can say is, when it comes to OCD or anxiety, I personally am always going to encourage that you do it yourself as much as you can because that’s where you actually learn how much you can actually tolerate. Remember here, anxiety is always going to be sneaky and say in the back of your mind, “Kimberley, just in case, just so you know, my anxiety is high, but I can really turn it up and freak you out, so you better be careful. Do your best to avoid me.” That’s what anxiety says in some way or form. So, if we still treat ourselves as if we’re really fragile, we can actually reinforce that belief in that thought or intrusive thought. So, I personally am always for myself going to say, “Okay, fear is here, how can I ride this one out 100% by myself?” and this is the key point to remember. Ask yourself in that moment, because you’re probably having some pretty strong reactions right now. Ask yourself in this moment if you are having a strong reaction, “What is my strong reaction to that?” Is it “it’s not fair”? Is it “that’s uncool, that’s too much to handle”? That just shows you where our work is and here is the key point. What is it that you want them to provide you? Is it warmth? Is it compassion? Is it relief from the shame you feel? Is it to know that they won’t leave you or they’re not judging you? What is it that they’re, this one particular person in that moment, what is it that they can provide you? And now, can you provide it for yourself? Or, is this thing you’re looking for even really that helpful? So if you’re like, “Oh my gosh, I just need a safe place to land right now,” I beg for you to practice being the safe place to land. Not your partner, not your family, not your friends. You be that for you. You deserve to be the safe place to land. If there’s a sneaky part of this where you’re like, “No, I just want them to tell me that I’m good and not a terrible human being,” well, that is in fact still reassurance. Yes, we’re all allowed to get that reassurance, but you have to ask yourself, is that reassurance a healthy reassurance or is it something keeping you stuck in the cycle? You get to choose. I’m not saying what’s right or wrong here because each person is different. If I’m with a patient, we will look at this and go, “Okay, let’s talk about why you want your partner to provide you support. What is it that the partner support provides you?” And we pull apart whether that support is in fact benefiting their long-term resilience and success in treatment or actually slowing them down. There’s nothing wrong with getting support at all, but is this an opportunity where you can show up and be your best person? Be the first person that’s standing there going, “I got you.” Mindfulness & Self Compassion For Reassurance Seeking Now here is the other piece of this, which is they’re talking about bottling it in. Let’s say you decide, “Kimberley, I’m on with this idea and I am going to commit to 30 days or seven days or one day or 10 minutes where I’m actually going to be the support for myself. I am going to practice my self-compassion skills, my mindfulness skills, my radical acceptance skills, and I’m going to be it for myself.” That doesn’t mean you’re technically bottling it in. Bottling it in is when you have the emotion and you shut it down and you refuse to let it pass through you and you hold it in and you pretend it’s not there and you’re faking your way through it. If sometimes you need to do that, that’s still fine. But this question is around saying that’s a problem. Now here’s what I’m going to say. There’s really no scientific evidence to say that bottling things in is particularly bad, because how do we know what’s bottled in really? We can’t really measure what’s being bottled in, but we do know that if you don’t talk to people and you aren’t processing stuff that, yeah, it can create some problems. So, this again is, how can we be healthy in our expression and effective in our expression of what’s going on for us? Can you journal? For me, this might sound a little weird, but I am a little weird, is when I really have something I’ve got to get off my chest, I record an audio, I take a walk. I leave my kids and my husband and I take a walk and I record an audio of me just venting it out because, the truth is – this was particularly true during covid – me venting it out to my partner when he’s got his own stuff he’s working on, he’s also going through some things as well. It’s not helpful for me to dump it on him, so I would audio it into myself and listen back and listen for things that I could maybe work on.  So, there are ways. Another way is to practice just feeling your feelings. That’s probably the most important thing I want to mention here and which is why I wanted to really report it, is feel your feelings instead of bottling them in. Now, we recently did an episode about this and how this idea of sitting with your emotions. Go back and listen to that because that’s important. When we talk about feeling your feelings, it doesn’t mean lashing out and having them all over the place and being really unskilled in how you manage them, and it also doesn’t mean having your feelings and staring at the wall and just being like, “Oh my God, I’m just so overwhelmed with this feeling, but I’m sitting with it.” It’s saying, while you go and engage with your life, you allow and embrace whatever emotions to come up. That’s not bottling it in. You saying them out loud is not what’s preventing you from bottling it in. They’re two completely different concepts. Let’s finish up by really talking about what is a healthy way to ride a wave of discomfort instead of having reassurance-seeking compulsions play out. You could journal, you could feel your feelings while you engage with your life, and use skills that you have, mindfulness skills, skills from this podcast. Go all the way back to the beginning. We’ve got tons of good stuff at the beginning of the podcast episodes where you can actually mindfully experience your emotions while also engaging in life. You could do those. You could also go and ask for support and say, “Hey, it’s a really hard time. I just did a really hard exposure. My anxiety is really high. I don’t want you to try and reduce or remove my anxiety, but your presence here is really wonderful. Thank you.” You could be the one who shows up for you radically so hard. You could be like, “Hey Kimberley, what do I need? What do you need right now? How can I show up for you? Do you need my fear support? Do you need my nurturing support? Do you need my champion support? What do you need? And I’m here for you, sister.” That’s what I really want you to practice. You could also find an OCD therapist who’s trained in ERP and say, “Hey, I’m working through some things. Can we talk about it in a way that doesn’t provide me reassurance?” Because you trust that they understand how to not provide reassurance. And that can be a really helpful way. But there’s one thing I want you to remember here at the very end. The reason I’m saying it at the very end is I think this is probably one of the most groundbreaking things that I learned just this year, and this has changed my marriage. I’m not going to lie, it’s changed my marriage, which is this: At the beginning of this year, I read a book called Chatter. I will link it in the show notes. The book is-- let me pull it up really quick. The Voice in Our Head, Why It Matters, and How to Harness It by Ethan Kross. It is an amazing book. One of the things that blew my mind was the research that venting actually increases a person’s distress and does not benefit them. What? That is the opposite of what I have been trained in my career. I was trained that venting is a really healthy thing. I know some of you may be like, “Well, duh, I’ve had issues with this in my past.” But the truth is, it really showed the data on why venting actually makes us feel worse. It actually has a negative impact and there’s no benefit to venting. So, I’m going to leave you to think about that because for me, when I read that, I can be-- I’m not going to lie, one of my not-so-great traits is I can be a little bit of a ventor. A ventor? Is that a thing? I can be a person who vents and unfortunately, my husband is the one who has to hear me process stuff. I’m a real process kind of person. What I realized when I learned this is, holy moly, I’ve been thinking that this is important and this keeps us connected, but the truth is, it doesn’t. It doesn’t impact me positively. It doesn’t impact him positively, even though he is the most kind, supportive man in the history of the world. This is actually not a good behavior and I got to stop it. So, what I did is I called my best friend and I called my husband and I said, “From now on, I’m going to be much more mindful around venting. There will be times when I’m really struggling where I’m actually going to choose not to share about it in that moment. You might see that I’m spiraling on something.” I’m going to say, listen, now is not the time because I now understand the science that venting is not in fact beneficial. It just makes me feel worse and works me up more. So, I use all my tools and I double down and I ride the wave and I journal and I audio in and I ride the wave on my own. So, here are some ideas you take and choose what you want, but that’s the main concepts I want you to consider. And there’s your answer, is this whole idea of holding it in is not the only option. You can, in a healthy way, ride your emotions and your wave of anxiety and you can do it in a way that actually is very effective that doesn’t require anybody else. However, if you require somebody, no problem. That’s wonderful. I hope that you have the most amazing, supportive people in your life and it’s all good. So, that is it. I hope that is helpful for you guys. We did go around and around into all of the little cracks and crevices of this topic. If you’ve got any questions, you can always let me know. Please do leave a review because I hope this is helpful for you. I will see you next week. Next week, I’m actually doing a little bit of a personal episode, talking about a few shifts that I’ve had with my own chronic illness and how it’s impacted my own anxiety. All fun and games. Not really. No fun and games is what I should say. All right, my loves, have a wonderful day. Please do remember it is a beautiful day to do really freaking hard things. You’re not alone because I’m doing the hard things and your friends are doing the hard things and all the people listening here, thousands and thousands of people are doing the hard things too. Have a wonderful day, everybody.

In This Episode: We talk about how the ton of your voice really matters when it comes to self-compassion practices USING SELF-COMPASSION TO INCREASE MOTIVATION USING SELF-COMPASSION TO BETTER APPRAISE EVENTS How you can improve your self-compassion practices to include a warm nurturing voice. How you can practice a kind coach voice in your daily life. Links To Things I Talk About: Self-Compassion Workbook for OCD: https://www.amazon.com/dp/168403776X/ref=cm_sw_em_r_mt_dp_2JG8H4VWFSBMBJVQ4AD8 ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety...If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit – Episode 305. You guys, 305. That sounds like a lot of episodes to me. Oh my goodness. So exciting. All right. I am really feeling so connected to the message that I have with you today. It has been an ongoing lesson I have learned in my life. It has been something that I have had to fine-tune in my own self-compassion practice. And I know I’ve spoken about this before, but I wanted to come on and do a quick reminder of why the tone of your voice matters more than anything. When I say the tone of your voice, I mean like how you speak to yourself, and that would also include how you speak to other people. That both. Both are very, very important. I’m sure you know this from experience of talking to other people. When your tone is a little off, it tends to create some problems. Am I right? I definitely have some stories to tell you on that one. But there have been so many times over the summer and going now into the fall where I have had to really keep reminding my patients and myself. And I’m going to tell you a couple of stories here about my family where this has gotten so, so important. Why the tone of your voice matters more than anything? Because tone sets a scene for how things land. Here is an example. If I said to you-- let’s use last week’s example, we did a podcast on what does it actually mean to sit with your emotions. Now, as I talked about how frustrated I was about how-- sometimes we use this term and we don’t explain what it actually means. If the tone of my voice, as I said that, was like, “Oh my gosh, it’s so important that you use it in the right way,” I was saying those actual words. But if I’m using a tone that’s like, “You have to use it this way because you can’t use it this way!” that’s going to create inside a massive degree of anxiety and defensiveness and rejection from you guys. We can all agree. In fact, if you have read any of Dan Siegel’s work, he’s an amazing researcher, an amazing author – he talks about how the word “no” and how we say the word “no” can actually create a massive emotional approach or a response in people than if you were to say “yes” very kindly. Just a one-word difference. What I want to talk about here with you is tone and why tone needs to be a major part of your recovery. Let me tell you a story. The other day, for those of you who don’t know, I have this beautiful, young daughter who just started middle school. Yeah, get ready for the ups and the downs. It’s been a total ride since she started. But my husband was actually at the end of the day reflecting to me in a very compassionate way and he was saying, “Isn’t it interesting how you can say to her, ‘Get your bags, let’s go,’ and that can land so different than ‘Get your bags, let’s go!’” Same words, different tone. Five words, same five words, but those five words and the tone that we use can shift their experience and the way we feel as we express it. We were talking about-- and he was actually giving me a little bit. I’m not going to lie, he was giving me a little bit of feedback that my tone could be a little calmer. In the morning, things are stressful. I know I have some work to do. I’m not going to lie. I was like, “Okay. Yeah, you’re so right.” Coincidentally, I was already going to record this podcast, because so much of how we talk to ourselves is about motivating. I’m motivating her to “Get your bags, let’s go, come on. We’re going to move to the next step. We’re going to be late for school.” And it’s about how do we motivate ourselves. I’ve got some examples for you here and I want you to think about them and how they apply to you. These are personal examples, but I’m pretty certain you may or may not resonate with most of them. So, here we go. Using Self-Compassion To Increase Motivation The first one is how we motivate ourselves to get things done. So, what was shocking to me while I was in Australia, because things were much more calm and my workload was much less, is there were certain tasks I had to keep doing. Even though I was on vacation visiting with my family, I still saw my clients and I still had to respond to emails and so forth. But it was so interesting that when I sit to my desk, which I’m sitting at right now, I often use a tone, which is like, “You’ve got to write your email, get going!” Not that mean, but you hear what I’m saying. Maybe I’m going to be a little overdramatic in this today just for the sake of getting the message across. But like, “You’ve got to get your email done before you see your clients!” Whereas when I was in Australia, I had more space and I was like, “Okay, hun, you’ve got to get your emails done before you get and see your clients.” Same words, but the tone was so different. And so much of the motivating we deal with ourselves has a tone that is aggressive and unkind and bossy and anxiety-provoking and creates a defensive anxiety-driven experience. We all know when we are having anxiety, we actually then tend to build into that cycle even more. So, I want you to think about, how do you motivate yourself? You might even want to pause this and sit down and be like, “What specifically do I say and where’s the tone that gets me in trouble?” What’s the tone that brings on emotions that create more suffering for us? Another one, and this is true for a lot of my patients, this is where I pick up in them, is they know they have homework for therapy. And for those of you who are in therapy, usually, if you’re doing any kind of CBT, you get homework, so you have to get it done. And how you talk to yourself about that homework can determine whether you’re suffering or not. You could say, “I should get my homework done before I see my therapist!” or you could go, “Okay, I’m going to get my homework done before I see my therapist. When might I get that done?” Same topic, same motivation, same intention. The tone makes such a difference. Again, we’re talking about motivation. Using Self-Compassion To Better Appraise Events What about your appraisal of events? You could say, “That was really hard.” You’ve honored that you just did an exposure, let’s say, or you did your homework or you got your emails done, and then you go, “Wow, that was really hard.” That’s a lot different if you were really in a wrestle, “That was really hard! Urgh!” Because when we’re in that tone, we’re in, again, a resentful, angry tone. Not that there’s anything wrong with that. Again, there’s an important place for every tone. You’re allowed to be angry. You’re allowed to be frustrated. You’re allowed to be sad. You’re allowed to be resentful and all those things. I just want you to question your tone and be curious about your tone and ask, is it helpful? Is it effective for you? An example of this is, we’re talking about motivation, if you’re in the last mile of a marathon, you might need to take on a tone that’s very coaching, very like, “Come on, you could do it!” And you’re like, “Ah, just get it done!” I have a dear friend who is suffering with a lot of grief. She lost her father. When she’s playing her sports, she says, “I swear I can’t stop the whole time, and I use my anger to belt out the ball.” So, there is a great example. If it’s effective for you, go ahead and do it. But I want you to really question and be curious about your tone and really ask if it’s working for you. And then you have this great opportunity to start to play around with tones that work for you. Same goes for when we talk about it’s a beautiful day to hard things. A client of mine once mentioned to me that this really, really made her mad. She hated this term. She was like, “This is very annoying. I don’t want to do hard things. I know I can do them, but I don’t want to do them.” Again, you can absolutely use any tone you want, but check in on the tone you’re using. Does it motivate you? Does it give you a sense of inspiration? Does it move you towards the behavior you’re using? Is it kind? Absolutely the most important. Does it feel safe to use that tone? These are just questions to think about. One of the biggest ones is you made a mistake. You could say to yourself, “Okay, Kimberley, you made a mistake,” or you could say, “Kimberley, you made a mistake!” Same words, massive in different tone. Hugely different in the tone, same words. I keep saying same words. The tone is so much different and can really impact how much you suffer. For me, the one that actually-- I got it last, but the one that actually blew my mind the most is the saying, “Keep going.” I could say to myself, “Keep going. Keep going, Kimberley. Keep going. You’ve got this. Keep going. Keep going.” And that’s this idea of just one more, you can do one more. But if I were to be saying, “Keep going! Just keep going!” Same words, totally different effect. So, there’s some examples. You probably have dozens more, or the ones that are really, really different, but I really want, if you can implement, just checking in on your tone each day. You might find that you go leaps and bounds in your self-compassion practice. In fact, I found that the ones who mastered this idea, or not even mastered, just work towards having a kinder tone, tend to be people who end up embracing self-compassion and really reaping the benefits from it. Because again, this is why I’m saying, this is why the tone of your voice matters more than anything. It propels us towards healthier motivation. It propels us towards a bigger, wider self-compassion practice. It propels us away from having emotions that are brought on by this really mean tone, like more fear, shame, guilt, embarrassment, humiliation, irritability. When we use that tone, that really creates a really negative vibe for us. So, that is what I want you to take away. So, so important. All right. Before we finish up, let’s quickly go over the “I did a hard thing” one. This is from Sienna and they said: “In high school, I developed an eating disorder, and in college, I was diagnosed with anorexia nervosa. I’m currently one year out of college and weight restored, but eating is so difficult for me. I’m now in therapy for OCD, which my therapist and I realize, intersects with my eating disorder. It is very challenging for me to eat anything. I think I might be unhealthy and then continue to eating healthy foods that make me feel good. As a part of my ERP, I was assigned to drink kombucha once a day at lunch, and then continue eating healthy for the remainder of the day and to eat pizza once per week. These things scare me because of the pizza with my friends after a pool party, when I normally would have avoided the situation. I am so happy I was a part of my friend group in a way I previously couldn’t be and that I was able to face some of my fears.” Sienna, this is so good. Oh, I love it. You’re doing such hard things. And I love how you’ve identified the specifics, like eating unhealthy, but then going back to your other. I think that is such a great-- you’ve identified what the trigger is. That is so, so important, and it’s such an important part of exposure therapy. We talk about this a lot in ERP School, which is our signature course for OCD, which is, as you plan your exposures, you really want to be clear on the obsessions that you’re going to be targeting. Because once you’ve identified a good obsession and what you want to target, then you can create some really great exposures and some really specific exposures for it. So, so good. All right. Let’s finish up with the review of the week. It’s from Love Heart 2 and they went on to say: “Kimberley knows her stuff. I discovered Kimberley’s podcast a few months ago, and I really love listening to her Aussie-American accent as I am an Aussie in the US myself.” How fun, Love Heart 2. That makes me feel so close with you. “So it feels like a little piece of home. Secondly, she’s very informed on OCD, which I have had for a long time and anxiety. When you get down on yourself as a result of a mental illness, you need someone like Kimberley in your ear, reminding you that you can do hard work and that you are worth it.” Oh my goodness. Thank you so much for that review, Love Heart 2. If you haven’t left a review, please do so. It allows me to reach more people. When they see my podcast, it allows them to feel like they can trust what we’re saying. And that’s so important to me. The more people who feel that they can trust me, the more I can help them, and hopefully, I can bring just a little bit of joy into their day. So, thank you so much, Love Heart 2, and thank you so much, Sienna, for contributing to the “I did a hard thing” segment. All right, my loves, I’m going to sign off. Please do remember that the tone of your voice matters. It really, really does. Have a wonderful day.

SUMMARY:  Today we have Natasha Daniels, an OCD specialist, talking all about how to help children and teens with OCD and phobias.  In this conversation, we talk all about how to motivate our children and teens to manage their OCD, phobias, and anxiety using Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention (ERP), and other treatments such as self-compassion, mindfulness, and ACT. We also address what OCD treatment for children entails and what changes need to be made in OCD treatment for teens. In this episode, Natasha and Kimberley share their experiences of parenting children with phobias and OCD.   In This Episode: What does sitting with emotions mean?  How to sit with difficult feelings  How to sit with your sadness  How to sit with uncomfortable feelings,  Sit with the feelings  Links To Things I Talk About: ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety...If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 304.  Welcome back, everybody. It’s a delight to have you here with me today.  Oh, I’ve got so much I want to talk to you about and this is actually coming from an emotion of frustration, this episode, which every time I check in and I begin a podcast, I try to come from a place of fun. And am I feeling calm? And am I feeling completely connected to you, the listener? But today, just for fun, I’m coming to you from a place of frustration. And the frustration, promise, this is not going to be a vent episode – it’s actually a frustration in that I caught an error that I’ve made, and I think a lot of clinicians are making. And it’s not an error in that it’s bad or wrong or problematic. It’s just that I caught something in my own practice, and I was like, “Oh, hold up, we have to talk about this.” So, saddle in, get your cup of tea, settle in, because we’re going to have to have a conversation about wording. It might be really nuanced and I want you to take what’s helpful and leave the rest. I want you to think about it with an open, curious mind, and decide what’s best for you.  So, before we get into the show, as always, let’s start with the “I did a hard thing.” Let’s do it. This one is actually from someone that says-- the handle name is GottaCatchEmAll, and they said: “Thank you so much for your recent series on mental compulsions. Your podcast is truly a godsend and I’ve been listening nonstop ever since my friend shared it with me last month.” Now, for those of you who don’t know, the mental compulsion series was a six-part series that we created here on the podcast. It had so many amazing clinicians on. If you want access to that series, you can go back and listen to previous podcasts. Or, if you sign up for our newsletter, you’ll go to CBTSchool.com/newsletter. I will actually send you an amazing webpage, just one link where all the episodes are there, all the PDFs are there. It’s so pretty. I have to say it is so pretty, and it’s like a one-stop shop for that series. So, go over to the newsletter, CBTSchool.com/newsletter. Sign up for the newsletter. You’ll get an email from me every week. But on the front end, you will receive that link. I’m so proud of it. I love it. So, I digress, sorry. They went on to say: “I suffer from a plethora of different anxieties, OCD, scrupulosity, hoarding, body dysmorphia, perfectionism. So, basically a bunch of normal human things, right? Exactly. The other day, I told my therapist that dealing with all of these issues felt like playing a game of whack-a-mole in my head, except that instead of the typical game, the mole would pop up and then a zebra and a giraffe, and so on, in a quick succession throughout the course of the day. While sobbing, I told my therapist that I didn’t want to have a zoo in my head and I didn’t know how to treat so many issues simultaneously. Imagine my surprise when I heard a recent episode called Whack-a-mole Obsessions, it was a relief to discover that I wasn’t alone and weird or broken as I thought. I realized, instead of trying to resist or whack the zoo in my head, I could approach my anxieties and compulsions like they were different Pokemons that I could catch and train and carry around with me while I live the rest of my best life. Thank you, Kimberley, for putting on such an incredible content and for helping me and so many others navigate this difficult thing.” That is so good. Look at you working through that whack-a-mole ongoing struggle with different thoughts, different disorders, and so forth. I think so many of us resonate with this and you are definitely doing hard things. So, so, so cool.  All right. Real quick, before we get to the frustration that we’re all hanging out for, let’s just quickly do the review of the week. This one is a shorty from Inventedcharm, and they said: “It is a mental pick me up. I love listening when I need a mental pick me up. Kimberley’s voice is soothing, and she offers great tools for self-compassion and interviews other experts in the field of mental health.” So, thank you, Inventedcharm, and thank you, GottaCatchEmAll. Okay. So, here we go. I’m going to tell you a story of why I’m landing here on this episode with you today. So, once I got back from Australia, a lot of you know I spent five and a half weeks in Australia over the summer with my children. It was so beautiful. I can’t tell you how full my heart was when I returned. I was energized. I was the happiest I’ve ever been. And you know where this is going. Yeah, we do. I crashed big time. I just went through so much sadness. I missed my family. I was angry. I had so much grief. I was feeling, actually, if I’m going to be completely honest, quite a lot of resent towards even my husband, who I love and is such a wonderful human. But I was observing resent show up because I was like, “I don’t understand. I just want to be with my family and why can’t I have all the things I want?” So, all these emotions started showing up.  WHAT DOES IT MEAN TO SIT WITH EMOTIONS?  My therapist – of course, I talked with a therapist – was saying, “Everything, Kimberley, that you’re saying makes complete sense. Why don’t you practice sitting with your emotions?” And of course, I was like, “Yeah, that makes sense. I have given that advice myself.” And so, off I went right onto the roller coaster, or we could say the whack-a-mole to talk about the “I did the hard thing” segment, the whack-a-mole of emotions with the agenda of not numbing them like I often do. Sometimes when I work, I engage in these numbing behaviors where I just numb all of everything out by working. It’s something that I’ve overused as a coping skill, is when I work. So, I’m not doing that anymore. I’m not using any other problematic safety behaviors. I caught all these problems. So, it’s like, “I think really all you’ve got left to do is just sit with your emotions.” So, I went, “Okay, let’s do it. There’s no solution. There’s nothing I can do about this. Let’s just sit with it.” And I started to play with this idea of, okay, let’s talk about what does it mean to sit with your emotions. Now, this is where, again, I’m going to identify, I’ve given this advice and I’m going to say, I don’t think I’m going to give that advice anymore. Or if I do give it, and for any reason you don’t catch me doing this, you can always bring it to my attention, but I’m going to do my best, is I’m going to add another sentence to the whole “sit with your emotions” concept, because let’s say often you guys have heard me say, “Sit with anxiety, sit with your anxiety.” And that’s helpful because we know that doing compulsions with anxiety is a problem. If you resist or avoid or try and remove your anxiety, it’s going to create more problems. But where that gets in the way is it doesn’t mean you just sit there and do nothing but stare at the wall and just let the anxiety beat you into a pummel. No. I think that the mistake I’ll make, and I’m going to be completely transparent, I think the mistake I make is I’m assuming you guys know what I mean by that, and I’m assuming that you know, I mean, don’t just sit there and stare at the wall.  There were a couple of days where I was so overwhelmed with emotion that I did just sit there and be like, “Okay, I’m allowing this. I have to allow it. I’m sitting here. I’m allowing it. Oh man, this is hard,” until I was like, “Wait a second. This is not helpful. Just sitting here and letting it pummel me, that’s not the whole picture. There has to be tools and skills associated with it.” That’s where I’m talking about in regards to anxiety. It’s a great concept, but what do we actually mean when we say, “Sit with your emotions”? We mean, allow it, particularly when we’re talking about fear. We’re saying, don’t interfere with it. Don’t engage with it. Don’t wrestle with it. Don’t stir it up. And we’re also saying, don’t run away from it. We don’t thought suppress. So important.  So, I totally believe that sitting with emotions is an important concept, but we must, and I am sorry if I haven’t mentioned this and I haven’t gone a full explanation, we then must engage back into life. We must engage back into the things that we value. We must engage, even if we don’t like it. Sometimes you have to do the dishes. Sometimes you have to get out of bed. And sometimes we have to allow emotions, embrace emotions, bring on emotions in order to get up and do those things. But that’s just anxiety.  HOW TO SIT WITH DIFFICULT EMOTIONS?  Now, let’s talk about which emotions should you sit with and which ones shouldn’t you? Now, number one, there is no bad emotion. There’s no such thing as a bad emotion, a negative emotion, a problematic emotion. They’re all just neutral. And that’s huge to know. But as I was sitting in the chair of the client instead of being the therapist, and I was really going, “Okay, I’m not going to engage in these behaviors. I’m going to instead just allow them and sit with them,” I realized sometimes asking yourself to sit with an emotion, particularly ones like guilt and shame, that too isn’t completely helpful. We need to put an extra sentence on the end of that as well. So, we can say, “Sit with your emotion of shame, but also be aware of the stories it’s telling you, not taking it as a fact.” Because as I was noticing, so much shame showed up for myself in this specific situation. I was thinking, wait, if I told my client to sit with shame, but I hadn’t taught them the skill of diffusing from shame or observing the story of shame, they’re going to have shame and be like, “Oh yeah, it’s true. I am bad. I’m just going to sit with the fact that I’m bad.” So, no, no, no, no, no. That’s not what we mean, again, by sitting with emotions. We’re not saying we’re going to sit with them and accept them as fact.  Let’s talk about sitting with sadness and grief because, boy oh boy, did I have sadness and grief. And it would come in waves that punch me in the face. I’d be like-- and again, I want to validate grief. Doesn’t matter, it’s not just losing a human body. Nobody passed away. That’s definitely grief. But I was handling grief and loss of like, “Oh, I missed my family. I wish I was there. I wish I lived there. I wish I could just snap my fingers and be there. I wish the world was different. I wish COVID didn’t happen.” All these things. So, I just was getting these waves of sadness. And it was important as I was “sitting with sadness.” That’s okay. We want to do that. We want to allow it. We don’t want to interfere with it. We don’t want to run away from it. We want to embrace it. But we don’t want to thicken it with hopelessness as we sit there. We don’t want to thicken it with like, “Yeah, bad things are going to keep happening and there’s not hope.” That will only create more problems.  HOW TO SIT WITH SADNESS?  So, when we say “sit with your emotions,” particularly the one of sadness, we actually want to sit in sadness again with non-judgment, with curiosity, with awareness of other things. And when I did that, when I sat with my emotions and was curious and open, I noticed like LA’s got a beautiful, beautiful scene. The vibe is really cool. I love my house. I really do love my house. I love the fact that my house is surrounded by trees. I love my family. And I allowed me to be open to sadness and other parts of my life here. So, again, I’m bringing this up of just like in that moment of doing the action, I was thinking, oh my goodness, we need to make sure we expand our description of what it means to sit with your emotions.  If you need more step by step, in my book, The Self-Compassion Workbook for OCD, if you have OCD, I actually have a full chapter on managing strong emotions. And in that book, I actually did, I believe, a good degree of explanation. But I wanted to get on here and set the-- what do you say? Set you straight? That’s not right. Set the story straight. I don’t really know what that saying is, forgive me. But I wanted to be really clear and actually correct if I’ve ever said this term, “sit with your emotions.” It’s not a bad term. I actually almost called this episode “Why I’ll never say sit with your emotions again.” But the truth is, I won’t. I can’t hold that as true. So, I changed it to “What does it really mean to sit with your emotions,” and how can we add additional context to that statement so that it doesn’t mean you’re just indulging the emotion and all of the trash that some emotions can leave behind. And what I mean by trash, I’m not judging, it is like, with sadness comes hopelessness sometimes. So, we want to be careful not to engage with that and infuse too much with that. With shame comes a story that you’re bad, that you’re wrong, that you don’t have any worth. We don’t want to indulge or engage in that while we allow and experience the emotion of shame.  HOW TO SIT WITH ANGER?  Anger was another one. I went through these crazy waves of anger and talking with a therapist like, “Okay, you’re having your anger.” Of course, don’t lash out or say me unkind things, or catch yourself if you’re starting to feel highly dysregulated. And then just sit with your emotions. And I thought, wow, again, there’s that saying. But if I’m angry and I’m sitting with it, I could easily percolate on some pretty hateful thoughts. I could be sitting with and ruminating with that emotion. And that is not what we mean when we say “sit with your emotions.” So, I really wanted to just drop into this. If I were to sum up this whole episode, the thing I want you to think about the most is, there is no right way to manage an emotion and there is no right or wrong emotion. There is no-- and I talk with my patients all the time about this. There is no playbook on how this is supposed to go. The metaphor I often use is, it’s like any sport. Some of you may know, I’m learning tennis. I actually pretty suck at it, but that’s a whole nother story. The whole thing I’m learning is, and the reason that I suck, and I don’t say that in a judgmental way, I actually think it’s hilarious, is it’s all about being super flexible. So, I’m standing and my knees are bent and I’m holding my racket and I’m going left to right, left to right on my feet, and I’m getting ready for this constantly changing direction of a ball. And I have to stay really flexible. So, if the ball goes all the way to the right, I have to move my legs so I can move to the right. And then if next time it goes to the left, I have to be ready to make that maneuver.  HOW TO SIT WITH OTHER DIFFICULT EMOTIONS Same goes with emotions. Your emotions are going to flip flop and go from left to right and north to west, and it’s going to give you a run for your money. And we have to be able to adjust the strategy depending on what’s coming to us. And that’s true of emotions. In simple, we’re always going to observe it, allow it, acknowledge it. In some points, we have to be curious instead of being closed and judgmental. These are skills you can use with all of them. But as I’ve gone through some of the more difficult emotions today, sometimes we have to catch the themes that percolate and loop us into it when “sitting with emotions.” So, that’s the main thing I want to talk to you. Again, I’ll tell you, as I-- I was actually driving to the dentist and I called a very dear friend of mine, and I just said, “I actually just had a major epiphany. We can’t keep saying ‘sit with your emotions’ as clinicians. We have to make sure we add context to what that looks like, and it means not just sitting still and doing nothing, except focusing on the emotion.” So, if this resonates with you, I hope it does. It was such an important thing I wanted to talk with you about again. Does it mean it’s wrong? Absolutely not. If you’re a clinician or you hear this, or you’ve probably even heard it from me – if you’ve heard it, it doesn’t mean they’ve done anything wrong. I just want you to understand what it actually means when they say that and to add those extra sentences at the end and give context to like-- again, don’t interfere with them. Don’t run away from them. Allow them. Also, don’t calculate and ruminate on them either.  Sending you so much love. As always, this is really hard work. So, please do remember, it is a beautiful day to do these hard things. And I will add, for any of you who are writing out waves of emotion right now, I salute you. I have such deep respect for you because it’s no easy feat to choose an emotion, to choose to tolerate it and interrupt behaviors that are problematic and allow emotions to rise and fall. That is some pretty impressive work you’re doing. And I just want to give you a massive shout out because it’s not fun. It’s hard. It’s not easy. It’s skillful work. It takes some stamina to do it, and it’s exhausting. And so, if you’re doing even 10% of this work, I applaud you.  All right, my friends, I will see you next week. Have a wonderful, wonderful week. Again, please do go to CBTSchool.com/newsletter if you want access to that mental compulsions worksheet. And I’ll be seeing you in a week.

SUMMARY:  In this episode, I addressed a question that was asked of me by a loyal follower.  They asked, “What do I do if the present moment totally sucks? Like, what if I have a migraine , nausea , chills , pain?  Any suggestions ?!” This is such a great question and one we probably have all asked ourselves or our therapist at some point.   Links To Things I Talk About: ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor:This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety...If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 303. Welcome back, everybody. Thank you from the bottom of my heart for being here with me. Thank you for listening. Thank you for supporting me. I know how valuable your time is, and I know there are so many people that you could spend your time with, especially out on the podcast field. So, I am so, so grateful to have you here with me. Really, really, really I am. I hope that you find these episodes incredibly helpful. My hope is to give you bite-size tools so that you can get on with your life and live your best life. I hope this podcast is everything that you wanted to learn.  This week’s episode, I am totally, totally amped for. The reason being is, it was actually a response to a previous podcast where we talked about being present. Somebody had written back because they subscribe to my newsletter. If you haven’t subscribed to my newsletter, please do so. I will leave a link in the show notes, or you can go over to CBTSchool.com and sign up there. They had responded and said, “But Kimberley, what do I do if the present moment totally sucks?” And they went on to say, “I have a migraine or nausea or chills or pains.” And they said, “What are your suggestions?” I figured, this is probably the question you all have for me. I come on, I share with you tools. And then you guys are probably always going to have a question and this is a really common one.  WHAT TO DO IF THE PRESENT MOMENT TOTALLY SUCKS Today, I want to talk about what to do when the present moment totally sucks. Before we do that, let’s first do the “I did a hard thing” segment. This one is from Rachel and they said: “My thoughts get the best of me. I recently started teaching and I needed to stay long after the students go home. And I decided it just needs to be a busy time to distract me. I use your book to help me with any meditations and I just let my thoughts come and go. It was scary the first time, but now I’m used to it.” Thank you so much, Rachel. I’m so grateful my book can be of assistance. I think you’re doing some really, really hard work there. So, congratulations on that.  And then last of all, before we get into the bulk of the episode, let’s first share a review of the week and this is from Meldevs and they said: “I am so thankful to have found this podcast! Kimberley is such a compassionate, warm, honest, and insightful person for those struggling with anxiety disorders as I do. I have learned more listening to her than I have in my years of therapy. The way that she presents each and every podcast episode so that I feel challenged and understood. Thank you, thank you, thank you for being there for people struggling with anxiety!” Thank you, Meldevs. That is such a beautiful review, really. That brings me so much joy and I really, really appreciate all your reviews on the podcast, because it helps me to reach more and more people. Meldevs and Rachel, thank you so much for being a part of my community. Let’s get into the episode.  What do we do when the present moment totally sucks? Let’s break it down.  When we talk about being present, one of the biggest mistakes we make, and I talk with my patients about this all the time, is we assume that being present means everything feels great. I think we have in our mind that being present is when we are most mindful, when we are most at peace, when we’re most compassionate. And I’ll tell you honestly, that has not been my experience. Oh no. HOW TO BE PRESENT WHEN ANXIOUS Being present, the art of being present, the practice of being present in your most mindful sense has never meant being comfortable in my experience, especially as my experience with it as a clinician, especially as my experience of having my own mental illnesses and my own medical illnesses. No, it’s not that. Most of the time, when we need to be present are the times when things totally suck, when we’re in a great deal of distress. Because otherwise, if you’re not in distress, usually, you don’t have to be as present because often you naturally are.  So, let’s just remember that our brains, when we are uncomfortable, is wired to focus on that discomfort. That’s how we’ve survived all these years. And it’s going to focus on the pain because it is trying to send a message to you to get the pain to go away. But when we have something where the pain won’t go away, have it be migraine, like you said, nausea, chills, discomfort could be also anxiety or intrusive thoughts because we all know we can’t stop those. When we experience those, yes, naturally, you’re going to want to run away from it. But as a part of this team and as part of this community, you guys know and hopefully, I’ve taught you that running away from discomfort only makes it worse. Resisting the pain we feel and the suffering we feel only makes it worse and increases our suffering. So, what do we do? Friends, we settle in. I’ll give you a personal example of when I actually recently had COVID.  Some people bless your hearts. And also, I’m really still very mad at these people, but still, bless your hearts. I wish this was the case for everybody. But some people have very few symptoms when it comes to having COVID. I am not one of those people. When I have COVID and when I got COVID, I get bone pain. It is like the deepest pain in my bones. It goes right to the center of my bones and it is so painful. My daughter and my husband both had COVID as well. My daughter came in. And I, when I’m in this state where my bones hurt this bad, I’ve had it several times in my life. She said, “Mama, you’re tensing up. Your face is all squished.” I was holding my muscles tight. And thank goodness, because I was in so much pain that I actually needed somebody outside of my body to tell me this was happening because I just was so entrenched in the pain I was feeling that she said, “Mama, you’re all tense.” Thank goodness I’ve taught her that tensing up around pain actually makes it worse. Her and I have had many conversations around this.  STEP ONE: VALIDATE And so, I naturally was able to go, “Oh, okay, Kimberley, let’s pause.” Number one, validate. “Hun, you’re in a lot of pain.” You could even say, “This present moment totally sucks.” Or you could say, “Wow, I’m observing that you’re really uncomfortable right now.” So, if that’s you and your present moment really sucks, I’m strongly encouraging you first validating. The alternative would be you go, “It shouldn’t be this way.” But the truth is, it is this way. So, don’t go down the road of fighting it.  STEP TWO: STOP RESISTING THE PRESENT MOMENT The second piece is then check for where you are resisting the present moment and how much it sucks. Now I’m going to keep saying the word “sucks” really passionately because it does sometimes really suck, like really suck. And so, when it really sucks, it’s almost like the more it sucks, the more we have to soften around how much it sucks. If you have a migraine, the worse it is, the more you need to soften your brow and close your eyes and soften the environment that you’re in. The more you feel nausea, the more you feel your stomach nodding up. And some of you may feel that just by me mentioning it. The more you feel that, the more you need to soften around that physically by relaxing your muscles and softening your thoughts around it. Meaning now is not the time to beat yourself up for it. Now is not the time. Some people are going, “Yeah, but it’s my fault. I have nausea because I drank too much,” or “I ate too much,” or whatever it may be. Now is not the time to go through that. Now, the facts are, the present moment totally sucks. And so, let’s be gentle around it because our resistance makes it worse.  If you were like me and you have the chills and you’ve got literal, like feels like every bone in your body is broken, now is not the time to fight that and tense your muscles. Now is the time to soften. If you’re having a full-blown panic attack, first acknowledge, “Okay, I’m noticing I’m having a panic attack.” And then soften around it physically and cognitively in your thoughts. Don’t resist it.  Now, that being said, let me bring a very important concept to the table. And this actually just came up this morning. So, as many of you know, I have my online business, which is CBTSchool.com, and then I also have a private practice where we see clients. Because I can’t see all the clients that come to me, I have 10 amazing therapists who work for me and who I have trained and who I supervise every single week. We have a meeting every Monday, and we talk about cases. One of my staff was telling me today that one of her patients took what she said literally, which actually is pretty common. She was explaining to her patients that when you have anxiety and panic or discomfort, you sit in the discomfort or sit with the discomfort, or be with the discomfort. And this patient and client took it literally, which is fair. We have to be really descriptive and give lots of steps and explanations. And so, while they were feeling this discomfort, they literally sat in a chair and just stared and suffered. So, if I’ve ever said, sit with your discomfort, please don’t take it literally. And so, what I want to remember here and what I remind you of, I should say, is once we’ve acknowledged and we stop the resistance to it, we must then reengage in something we value. So, let’s use me as an example. I had COVID. I literally felt like every bone in my body was broken. That doesn’t mean I’m going to get up and go for a run. It doesn’t mean I’m going to get up and see patients because I’m actually in pain. I wasn’t able to. But what I can do is instead of putting my attention on how much it’s painful, I’m going to put my attention onto something else. And it could be as little or as minute as the sound of the leaves rustling outside, the sound of music, the, the smell of the cough medicine I had taken, the taste of the cough medicine I had taken, the touch of the blanket. So, you just get really in touch with that. And then you catch how your mind then keeps offering you thoughts that make you want to reengage back with the pain.  Now, again, I’ll give you another example. Most of you know, I have a chronic illness. I have postural orthostatic tachycardic syndrome. I am dizzy almost all the time. It’s under control now. I don’t faint nearly as much as I used to. But dizziness is actually a very normal part of my existence, particularly when I’m standing up. And so, my job is to allow it and then to catch when my brain starts to say, “It shouldn’t be this way. This isn’t fair. It’s not good. This is bad. It could be better. Your life could be better.” My brain offers me those thoughts and I choose not to entertain them. Now, I’m not perfect at this, and this is something I’ve been practicing for a long time, so please be gentle with yourself. My job and your job, when the present moment totally sucks, is to be an observer to our brain. And of course, as I said, at the beginning, it’s going to present to us all the problems and why this shouldn’t be the problem. And you just say, “Thank you for showing up. I totally get what you’re saying, brain. Thank you for being there for me, but I’m going to keep directing my attention to whatever it is in front of me.”  If you have anxiety and you’re having panic, you’re having high levels of anxiety, I’m going to say to you, ask yourself the question, what can I do or what would I be doing if anxiety wasn’t here right now? And go do those things. Don’t just sit in the discomfort. Only go engage back with life. Do the most that you can with your life WHILE you have anxiety. Now, let’s also address one other main issue. In no way am I saying to dump toxic positivity on yourself here. In no way am I saying things like, “Oh, you should be happy. The leaves are so beautiful.” Again, like I was saying to you, no, absolutely not. That is not what we’re talking about.  If you feel sad about this, if you feel down about it, if you feel a little discouraged or irritable, that’s okay. We can also be mindful and acknowledge, “Yeah, I’m feeling really frustrated with how I feel so terrible.” We’re not here when we’re mindful. We’re not here to say it shouldn’t be this way and just be happy about it. No, like I said to you, in my experience being present, my most mindful is actually when things totally suck. And I don’t try and change it that often. In fact, I just try to allow it, bring it in and then add other valuable things into my life.  Can it be positive? Absolutely, if you want it to be. But if the suffering you’re experiencing is depression or hopelessness or grief or panic, we don’t need to throw a bunch of positivity on there unless it’s really helpful to you. All I’m here trying to do is get you to not fight how painful it is because that usually makes it more painful. And also, we don’t want to thicken the pot of it by going, “You’re right. It does suck. It’s not fair,” and all those things. That can actually often-- we have research to show that that rumination actually makes our suffering worse. I know I said that was the last thing, but I have one more important thing to say, which is, please, please practice nonjudgment. If you’re going to be mindful, you have to practice nonjudgment. You can’t have mindfulness without nonjudgment. I have a whole episode on that. The whole point here with nonjudgment is, when we say this moment totally sucks, it’s actually a judgment. And I don’t want to take that from you. I don’t want to take that from you. It’s okay. You’re allowed to acknowledge it. But we also want to catch that how sometimes when we’re judgmental, this is good and this is bad, we actually train our brains to send out more anxiety hormones when we have that experience the next time, especially when we tell ourselves it sucks and it shouldn’t be there. So, keep that in mind.  Anytime I’m going through something difficult, and this is very true of my work that I did around dizziness, with my POTS, is I had to take all the judgment out of it to reduce my suffering around my dizziness. Because the more I judged it, the more I felt completely hopeless and depressed about the situation. The more I felt like, oh, I just don’t have an answer, there is no answer.  Again, I didn’t say, “Wow, I love dizziness. It’s so positive and wonderful.” I just said, it’s a sensation. I’m going to be gentle. I’m going to acknowledge it and allow it and lean into it, but not give it too much attention. And it’s neither good nor bad. And that was a conscious, intentional decision. Again, be careful that it doesn’t become toxic in that you’re pushing too much positivity on yourself, but again, it’s a balance. So, there it is. That is what I would encourage you to do when the present moment totally sucks. And as I said, the present moment, especially when you’re suffering, it will totally suck sometimes. But that doesn’t mean you’re going in the wrong direction. It doesn’t mean it’s going to stay that way forever. There’s another piece to catch.  I am just in love with you guys. I really am. What an amazing, amazing community. Please, if you want to be part of my community, you can go over to Instagram @YourAnxietyToolkit. You can listen to this podcast and go right back to the beginning and listen to the beginning ones. You can go over to Facebook. We actually have a private Facebook group called CBT School Campus. You’re welcome to come and join us there. Thank you. Just love you, love you, love you.  Have a wonderful day and I’ll talk to you next week.

In This Episode: What is the difference between a Panic Attack and an Anxiety attack?  What is the prevalence of Panic Disorder?  Are anxiety attacks dangerous?  Are Panic Attacks dangerous?  How does anxiety affect the body?  What anxiety does to your body when expereincing a panic attack?   What is the best treatment for panic disorder Links To Things I Talk About: Overcoming Anxiety and Panic Online Course Natasha’s Parenting Survival Online Program www.ATparentingsurvivalschool.com Natasha’s instagram @atparentingsurvival ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more.  Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). This is Your Anxiety Toolkit - Episode 302.  Welcome back, everybody. Today, we are talking about a question I get asked very commonly: Are panic attacks dangerous? Now I get this question a lot from clients who are just starting treatment. However, I will say I do get this question a lot on social media. People like doing the last-minute panic DM. What’s happened usually is they’ve experienced a panic attack or an anxiety attack, and then they have the thought, what if this panic attack is dangerous? What if this panic attack creates some illness in my body or is unhealthy for my body or unhealthy for my baby, if they’re pregnant. And so, from there, now they’re having anxiety about their anxiety and, as you guys know, then anxiety just takes off from there. So, I wanted to address this with you first. I’ve got a series of questions that I want to go through here with you. I will be looking a little bit at my notes because I wanted to make sure I got everything today.  Before we do that, let’s first do the “I did a hard thing” segment. This is a segment where you guys write into me and tell me the hard things that you’ve been doing – facing your fears, staring your fear in the face, or maybe it’s something not related to fear. It’s just something that you’ve been going through. So, go ahead and submit those to me anytime you would like. Let’s go over. This one is amazing. It says: “Honestly, Kimberley, you have changed my life in the last two weeks. I was in such a low place and coming across your podcast gave me so much power. I even faced my fear of heights last weekend and I went bungee jumping.” Love it. “That was frightening. And as I was falling, I screamed F-U-C-K,” but they said it in real life, excuse the language. “And I just thought, if I can do this, which is honestly terrifying, I can stop my mental rituals that are just so hard and scary.” This message is so good and it’s exactly the epitome of the work that we do and you do, which is when we face our fear, we realize how strong we actually are. And then we go on to face our fears again, which helps us to feel even more strong and courageous, which makes us do even harder things. And from there, our life turns away from getting smaller and smaller to getting bigger and bigger. So, I love this.  All right, let’s get to the show. So, we really want to pull apart, are panic attacks dangerous? But what’s interesting about this is, often when we talk about panic attacks, people start to talk about what’s called an anxiety attack. So, let’s first just pause and really talk about what is what. So, what is the difference between a panic attack and an anxiety attack? Let’s just go through that first so that we all know we’re talking about the same thing.  What Is The Difference Between A Panic Attack And An Anxiety Attack?  A panic attack or panic disorder is a disorder that is in the DSM, which is the Diagnostic Statistical Manual of Mental Disorders. That’s what we use to diagnose people. It usually involves a sudden onset of panic. It can last for minutes, sometimes longer than that or hours. For some people who are really struggling, it usually involves shaking or trembling or it may be heat flashing, hot flashes through your body. Some people experience a sense of detachment from their body. They may experience dizziness, sweating, heart pounding, maybe depersonalization and derealization, which we have episodes on if you want to go back and listen, trembling, sweating, weakness, feeling of extreme terror. Some people have numbness in their hands and feet, again, which is why they then question, is this dangerous? You can imagine, if you’re having any of these symptoms, it’s terrifying. It’s terrifying. But once we really get educated about what that is, then we can actually work with it. Now, as I said, when it comes to having panic disorder, you need to have had at least one of those panic attacks. And then that’s usually followed by one month or more of the person then fearing having another panic attack. And that can actually lead to some people having panic disorder with agoraphobia. Some have it with agoraphobia, which is where you feel like you can’t leave the house, and some do not.  So then the other part of this question is, what about an anxiety attack? Now, here’s the thing to remember. I asked quite a few clinicians, what do you think the difference between these is? And I actually got a ton of different answers, which I know isn’t super helpful for you guys, but some just basically said, “I don’t consider them any different at all.” Others said, yes, there is a difference in that an anxiety attack isn’t usually a disorder of its own, and it’s usually in relation to an actual threat. So, let’s say, panic disorder is very sudden, it’s often irrational, but not always. And so, it’s coming on very strong out of nowhere. However, an anxiety attack often gradually builds. It can last for several months. It can cause restlessness, sleep issues, fatigue, muscle, tension, and irritability. That though can all show up with panic disorder as well, but the main key thing that a lot of clinicians, and I’ve done some research online, is some people believe that it’s about what the trigger is. So, with an anxiety attack, if the trigger is an actual threat, like there is a dog running towards you and it’s going to bite you, or there is an actual threat in your society, a gun or weather issues, extreme weather, that that would be a trigger that would cause an anxiety attack and that’s how you would separate them.  Now, for the sake of today, I’m going to use them interchangeably. Whether it’s from a current stressor in your life that is actually a danger or whether it’s panic disorder in that it’s just sudden and out of the blue or related to a specific fear or phobia you have, I’m going to talk about them as if they’re the same, given that their symptoms are often the same. And really, what I want to look at today is about whether these symptoms are dangerous or not. What Is The Prevalence Of Panic Disorder?    Before we move on, let me quickly give you a little prevalence here, because I just wanted to normalize if you’re having panic, and I’m going to read directly here. The National Institute of Mental Health reports that approximately 2.7% of the adult population in the United States experience panic disorder each year. That’s pretty big. They went on to say, approximately 44.8% of those individuals experience a panic disorder that is classified as severe.  Now, I think that’s actually really interesting because anyone who’s had a panic attack is going to say it’s severe because a panic attack is 10 out of 10. So, I think that that’s actually-- I’m surprised. I would be surprised if it’s actually not way more than that. But what I’m guessing they’re also talking about here is the degree in which it impacts their functioning. Because a panic attack in and of itself, and we’ll talk about this here in a second, isn’t a problem. What can get in the way is it starts to make your life very, very small and can impact your functioning, your ability to have conversations, interact with people, go to work, go to school, sleep, eat, and so forth. So, really important that you get those points.  Are Anxiety Attacks And Panic Attacks Dangerous?  But then we want to move over to: Are these anxiety and panic attacks dangerous? So, let’s talk about that. Let’s look at those symptoms – chest pain, hot flashes, dizziness, pounding heart. Often when we experience those symptoms, we would make the assumption that something is terribly wrong with our body and we better get to the hospital pretty quick. Chest pain – what do you see often on advertisements and so forth? You can imagine, when you have those sensations, it makes complete sense that your brain is going to set off the alarm. I do encourage you all, if you’ve had these symptoms, go and see a doctor, explain to them what happened and have them do a check on you so that you are really clear that what you’re experiencing is a panic disorder or a panic attack or an anxiety attack. We all know the common TV show where they get rushed to the hospital and they’re having a heart attack. And then the doctor, in a comedic way, says, “You’re having a panic attack. It’s common.” It is true. Statistics show it. I think this is correct that the most admissions into an ER is panic attacks. Isn’t that so fascinating? So, it makes sense that people are afraid. But once you’ve had that clearance and I do encourage you to get clearance and just speak with your doctor always about that stuff, and if they’ve defined like you’re having a panic attack, then your job is actually, when you have those sensations, to not respond to them as if they are threats. If you respond to them as if they’re threats, you’re going to create more panic. We’ve got a whole ton of other episodes out about panic, so I’m not going to talk about too much there. But what I want to talk about is, are they dangerous? And the same goes for anxiety attacks.  What I’m going to tell you once and once only is, no, they’re not dangerous. Our body can withstand all of these symptoms many, many times. Lots of people who’ve been through very difficult times or had panic disorder can go on to live wonderful, healthy lives. But here is where I want to maybe address the elephant in the room. If you don’t follow me already, there is a chance you found this podcast because you saw the title and you were like, “Oh yes, I want to know if they’re dangerous.” And once you listen, you may actually feel compelled to come back and listen to this episode again and again to reassure yourself that they’re not. If that is the case, I’m going to strongly encourage you not to keep listening after you’ve listened to the first time.  Let me give you some information about that. When I see a patient for the first time, I do a lot of psychoeducation. I share with them, these are common sensations, this is normal if you’ve got panic. If you have these sensations, we’re going to treat them like we would treat panic symptoms. I would educate them if they’re concerned about the dangerousness. But then I would say to them, after today, we’re actually not going to keep revisiting these questions because what will happen is, the more you tend to these questions, the more you actually be fueling your panic disorder. Anytime you respond in a way that’s urgent and need to reduce your anxiety or your uncertainty, the chances are, you’re making the anxiety worse. So, I want to give you permission to go and see your doctor. I want you to get permission to share all of the details that you’re experiencing. Then I want you to give yourself permission to have your panic attacks without trying to solve whether they’re dangerous or not. Not tending to all of this, because the truth is, number one, nobody knows, number two, even I don’t know for certain, for every different person, and number three, the more you try and solve it, the more that you’re putting too much attention on this question that can actually keep you stuck in the cycle. How Does Anxiety Affect The Body?   Once we look at that, and that’s probably as far as I would go with my patients as well in terms of addressing that, often people have questions like, well, then what’s the impact of anxiety on my body? How does anxiety affect my body? How does panic impact my body? And again, I want to tread very gently because you deserve to have some psychoeducation about that, but we also want to be careful that we don’t spend too much time, again, tending to fears about what anxiety is doing to our body. Remember here, a lot of anxiety disorders is ultimately the fear of fear itself. Even though the content might be on something specific, it’s usually our resistance to having fear and experiencing fear and doing so without response or reaction.  So, does it impact the body? Yes and no. Meaning it does tend to make us increase sleep struggles. It makes it difficult to eat. There are many impacts that it can have on the body. But again, catch – the question, how does it impact my body – if that’s actually you saying, is this dangerous?  Think of it this way. When we ask questions and we pose questions to our mind, the words we choose and the emphasis we ask them can actually create more anxiety. If we say, “That’s so dangerous, we shouldn’t be doing that,” it’s true of anything. When you label anything as good and bad, you actually increase your resistance and your wrestle with it. If you say something is bad, you’re going to have anxiety about it next time.  And so, what we want to look at here is, yes, it does impact our body in terms of it’s exhausting and it creates struggles without regular functioning. So then what I would encourage you to do, instead of tending to back and forward on, is this anxiety good or bad for my body, what does it do to my body, does this anxiety impact my body in a healthy way – instead, put your attention on, what will help me overcome this anxiety in the long term? Anytime we ask for the short term, we’re always going to do something that’s a safety behavior or a compulsion, an avoidant behavior, a reassurance-seeking behavior. So, just keep asking yourself, what will help me in the long term overcome this fear? And often that involves not ruminating about whether it will be dangerous or not because when we ruminate, we get stuck. And when we get stuck, it makes the fears look bigger.  Isn’t it interesting, and I’m going to call myself out here, in that in my attempt to address the question, are panic attacks dangerous, my advice or my encouragement to you is to practice not trying to solve that question, i not giving attention to that question. Yes, you can get basic psychoeducation or you can go to your doctor and get a checkup, but anything beyond there, you’re always, and hear me if you can, if you can take one thing away from today’s episode, is really remember that anxiety is about willingness to tolerate discomfort and it’s about your willingness to be uncertain, especially if you have disorders like panic disorder, OCD, phobia, social anxiety, generalized anxiety. It’s almost always going to be, can I be uncertain? How can I be more uncertain? How can I practice riding the waves of uncertainty? And that’s very much the case with this specific question.  So, I hope that is helpful. Again, catch your urgency to listen to this over and over and do your best to acknowledge the thought that you’re having, treat it like a thought and not a fact, and then move on into the things that actually bring you value into your life because that is what recovery looks like.  Thank you so much for being here with me today. I am honored to have this special time with you. I hope that was helpful. Do please remember, it is a beautiful day to do hard things because this work is hard, but it is done in effort to really serve and nurture the future you. Even though it’s hard right now, we’re really tending to the wellness of the future you when we take on these really difficult concepts Have a wonderful day, everybody, and I will see you next week.

This is Your Anxiety Toolkit - Episode 301. Managing OCD Relapse (with Jazzmin Johnson)  Welcome back, everybody. I am covered in goosebumps. I literally, as we speak, just finished the recording of this episode. I wanted to come on and do the intro right away just because I’m so moved by this week’s guest. This week, we had Jazzmin Johnson. She’s a mental health advocate and she came on to talk about something she felt really, really passionate about, which is relapse, particularly related to relapse with anxiety disorders, even more particular and specific is with OCD. And she brought to the conversation the same struggles that I have seen my patients have over and over with relapse and how hard we can be on ourselves when we relapse and how difficult it can be to pull ourselves out of relapse. It’s a topic that I haven’t touched on nearly enough. And so, I’m just so grateful for her to come on and share her story and the steps she took to overcome any kind of relapse that she was experiencing, and identifying the difference between a lapse and a relapse I thought was really profound. I’m just so excited to share this episode with you. I actually had scheduled it to be out much later and I’m like, “No, no, no, we just have to get this out. This is so, so important.” So, I’m so thrilled. I’m not even going to do an “I did a hard thing” because this whole episode is Jazzmin explaining to us how to do hard things. So, I’m again impressed with how she’s handled it. So, let’s get straight to the show. I love you guys. I hope you can squeeze every ounce of goodness out of this episode. I think the main real message we took away is it’s a beautiful day to do hard things. So, enjoy the show. Kimberley: Welcome, everybody. I am so excited to have a special guest on the show that I’ve actually been wanting. We’ve been talking back and forth. I’m so excited to have Jazzmin Johnson on today. Thank you for being here, Jazzmin. Jazzmin: Thank you so much. I’m absolutely honored and really, really excited to chat. Can OCD Relapse?  Kimberley: Yeah. So, let’s dive in. We are going to talk about relapse, which is a topic I think you brought to my attention. I have not covered barely at all. So, let’s dive into that. But before we do that, can you give us a little background and fill us in up to where we’re at with relapse? Can OCD Relapse?  Jazzmin: Yeah, absolutely. So, my name is Jazzmin. I’m 28 years old. I was diagnosed with OCD when I was just freshly 23. So, it’s been a while. Looking back on my life, I’ve had OCD for a very long time, long before I was 23. So, definitely fun to look back on your life and the moments and say, “Oh, that was an interesting behavior and no one really caught that.” My story is I always love to tell it, but it started off with a really simple night of not sleeping, something that we think we’ve all experienced. And up until that point, I had assumed I was this rock-solid girl who was tough and I skateboarded on the weekends and just knew that nothing could touch me. And I remember having a hard night of sleep one night and my heart was beating really fast and I just felt really panicky. It was such a bizarre feeling for me. I remember at the time reaching out to my sister who also struggles with anxiety and OCD as well, and I just said, “Hey, have you ever dealt with this weird heart palpitation thing at night and you can’t relax?” And she just sent me a text in all caps and was like, “Yes, that’s anxiety.” And I think it was just this bonding moment where we were just like, “Oh, okay, I guess I’m like you like. Let’s do this.” But with that I think came a lot of fear too, because as someone who was assuming I was this rock-solid gal, who was tough and never stressed about anything, to have that identity switch that happened when I was told that I might have anxiety. As all of us know, listen to this, anxiety is a terrible feeling and it’s even harder when it really sticks around for a long time. I remember feeling like my body was buzzing all the time and I remember trying to explain it to my boyfriend and he was just like, “That’s really strange.” And I’m like, “You don’t understand. My whole body feels like it’s vibrating all the time and I just couldn’t sleep at night.” And so, I ended up reaching out to my mom and she helped me find a therapist, which I’m really grateful that my family is really pro helping people with mental health disorders. So, they knew exactly how to help me. So, I popped in with a therapist and was just like, “I don’t have anxiety. Why am I having anxiety? What’s going on?” And she just asked me if there were things that made me anxious. And I just remember telling her, “No, there’s no reason. My life is really good. I really enjoy where I’m at and I love my job and I love my boyfriend and I love my life. So, why am I feeling this way?” And she just said, “Well, have you talked to anybody about it?” And I remember telling her, “Yeah, my mom and my sister, and they’ve told me the things that make them anxious.” And so, now when I think about those things, I plan to be anxious in those scenarios too. And I just told her I was having a hard time figuring out what was causing this anxiety. And she just said-- I will remember these words forever because they started everything for me. But she said, “Maybe you just need to find yourself in all of this.” And so, I went home and was just like, “What does that even mean, how do you find yourself?” I was so lost. And at the time, I was thinking, okay, I’m 23 years old. What do I need to do? Do I need to eat, pray, love, and go to Italy and dump my boyfriend? And then that’s when that thought popped in my head. And I thought, what if I need to leave my boyfriend in order to not feel anxious anymore? And of course, that terrified me at the time. I’d been with my boyfriend for five years. We were high school sweethearts. I knew in my bones I would marry him one day. And the idea that the only way out of how I was feeling was to lose something that I really valued was just life-shattering. And so, I just spent so much time thinking to myself, no, that can’t be it. But OCD is the doubting disorder and I just hated this idea that what if that was the key to it all and it was something I didn’t want to do. And so, I fought it and I probably struggled with that thought for another three or four months. I spent every day thinking about it the first time I woke up in the morning. And it got to a point where my body and my brain was trying really hard to convince me to leave because it wanted this relief from this anxiety. So, I was almost trying to convince myself and arguing with my mind on why I need to leave. And it would jump from maybe I didn’t like the way he looked or he has a mustache this week and I don’t like mustaches, so maybe I need to leave. Or his jokes are really bad. I can’t be with someone whose jokes are bad. I mean, it’s almost comical to the point where the things that my brain was trying to do to get me out of this scenario that felt like anxiety was ruling at all. I remember going to therapy every week, and my therapist just said, “You’ve been talking about this for a long time and it sounds like you might be struggling with some obsessive thinking, and it might be OCD.” And that crushed me because at the time, I thought of OCD as flicking light, switches on and off, and I did not know what it was and that it could look different. So, I just got really scared and she just said, “Nope, we’re going to work through this. You’re going to be fine.” And so, we did my first exposure in that appointment and it was absolutely horrible and it was so hard, but we sat down and we mapped out what my life would look like for the next five years if I chose to leave. My life looked great. I was like, “I would move. I would go to LA and become a fashion designer,” whatever I was into at the time. And she was like, “You’d probably be okay. So, why is this so scary to you?” And I just told her, “I just don’t like this feeling of losing agency over my choices and feeling like anxiety was making those choices for me.” And that really made me spiral into a bit of a depression and just really struggled with feeling like I could do anything really. My therapist and I, we talked and I was prescribed antidepressant, which I owe my life to because that antidepressant gave me the strength to stand up against OCD for the first time in my life. And so, I started and I started just diving into the OCD community and listening to stories online, reading about it. Not just reading about people that were struggling, but people that had made it out or had worked through it and were doing really well. I just loved listening to specifically Stuart Ralph’s The OCD Stories podcast and your podcast really. I just loved hearing people’s stories about OCD, because I would listen to it on my way to and from work on my hour-long commute. And I would always smile when I was listening to these people’s poor traumatic stories, just because I could hear how different our obsessions were, yet we were all doing the same thing. There were so many similarities that I heard and I just felt such a sense of community and belonging. And so, I just really dove into that and was like, “Hey, let’s talk about this. Now, why isn’t anyone talking about relationship, anxiety, and relationship OCD?” I reached out to Stuart Ralph and he let me post a little blurb on his website about what I was going through and that started my advocacy journey. And so, now I just float through life and deal with what it throws at me. And of course, I struggle at times. OCD will always stick around, but I try really hard to always have all of my social media channels open for people that just want to talk. And I find that’s just such a good space to have for people when they just need someone to understand. So, that’s a brief, little rundown of my life with OCD so far.  Kimberley: I had goosebumps for quite a bit of that. It’s just like it gives me the chills in the best way and that you’ve gotten through so many bumps and windy corners and stuff. Then we come to here now. So, you’ve got this progression, this windy story and you arrive. And obviously, you’re doing pretty well. Tell me about this idea of relapse and what that means to you. How to Deal with OCD Relapse Jazzmin: Yeah. So, I look at lapses and relapses, in my opinion, a little differently. So, of course, in my journey, I had a few lapses. There were things that life happens and stress trauma happens. A few instances, I was really unfortunate to be in a space at my work where someone chose to take their life. And I was not at work, but I walked in about two minutes after it happened, because it happened at my work. I didn’t see anything, but just the feelings of the people around me just was really traumatic. And so, my OCD latched onto that for a while and that sense of safety that I felt and the fear of being in another instance or something else that would be traumatic. And of course, there’s been other moments in my life where really wild, crazy things have happened. And my OCD does always find something to latch onto for a short while. But usually, I’m able to notice a behavior and feel like, “Oh, that feels familiar. Uh-oh, I think I might be stuck again,” and then I can usually spot it. But this last spring, I had a bit of a relapse and I call it a relapse more than a lapse because it looped back into my old themes that I had worked through a lot. And it lasted for a really long time. And I really had a hard time finding that kind of pathway out. I couldn’t really find where on the cycle, the OCD cycle I was to where I could see where to get out. And so, at the time, I looked at relapses as failure and I think that’s one thing I really wanted to talk about. But I imagined that since I had come so far in my recovery, that when OCD shows its face again, I would know that it was OCD. I would see it and I’d be ready and I’d have my warrior gear on and I’d fight it and I’d carry on with my life. I think this last spring, just with the chaos that happened in my life, I learned that that’s not always the case. And sometimes it takes a little bit longer. But also, I think it always unlocks new layers to your recovery journey and healing that I think I needed to learn. So, I’m really grateful that it happened, which is so funny. I wish I could tell myself that four months ago and I was really in the thick of it, but yeah, I’m really grateful that I had that experience. OCD Relapse Story…or is that not the right wording?  Kimberley: Why do you think-- because I really resonate with what you’re saying and I think I’ve had, even in the last couple of weeks, some clients who’ve come back to treatment after doing really well with ERP and therapy. Can you tell us your OCD relapse story? Why do you think we consider it a failure to relapse? Where did that come from, do you think? Jazzmin: I think for me, I hear a lot about in the OCD community of just this idea of being fighters and warriors and we’re going into this battle. And once you’ve won the battle once, you feel not untouchable, but you just have that upper hand. And I think with every new theme that it throws at you, which it always will, it’s something new and it might take longer to recognize that, oh, this is the same thing. But for me, it felt like I was just losing a game, losing a battle, and that I knew how to fight. And I always would use this metaphor with my therapist that I felt like I had my toolkit with all of the things I had learned over the years, all of the exposures I can do and scripts and stuff I can write, but it felt like it was in a toolbox that was locked. Like I had to find the key before I could get to that toolbox. And when you’re feeling so terrible, you’re frantically searching to find that specific key. And I just found myself fumbling. And so, I think that idea of failure comes from just knowing better too. I felt like I knew better. I know what OCD looks like. I know this cycle like the back of my hand, yet, somehow it sneaks into my life again. I don’t realize it until either it’s too late and I’ve been doing compulsions for months maybe. And that is always a real letdown just in your personal self-esteem, and your idea of where you were in recovery can sometimes shift. And that’s scary because you think you’re through it or you’re better than that or that you know better. And then to find out maybe you were wrong, it’s really hard to sit with. Kimberley: Yeah. It’s an interesting reframe, isn’t it? We think of being a fighter and getting through it as if you won the battle and the battle is over. It can be a massive dent to your self-esteem would you say? Or tell me a little bit about, did it shift your perspective of yourself being a fighter for a while or were you able to be like, “No, no, this is the work”? How was that feel? Jazzmin: I think it’s a little different for me because at the time, I really considered myself an advocate. And I felt as an advocate, I guide other people and I help them through these things. And I remember a really specific moment with my husband after we had just met my baby niece for the first time. And the entire time we were visiting her, I was having intrusive thoughts probably every second and it was jumping themes. It was harm and then pedophilia and then harm again and harming myself. And I remember getting in the car with him as we left and just crying. And he just was like, “What’s going on? Talk to me.” And I just told him, “I’m so tired. I know what this is. I had those thoughts. I knew they were OCD. I knew the moment they showed their face, because why would I ever want to do that to my beautiful baby niece?” And yet, they still made me anxious. And I had made the story to myself that if an intrusive thought made me anxious, I’d already lost. So, my reaction to it was the first thing I could control. And when you get thrown a new theme, it knocks you down because you’ve never seen it before and it’s scary. I just remember crying to him and just explaining, “I am so frustrated with myself because I know what this is. I know what I’m doing and I can almost step outside of myself and see the cycle. I can draw it on a piece of paper. In fact, I did that often, and yet I couldn’t stop.” It was just a lot of disappointment in myself. I think as an advocate, you feel like you should know better and I helped people through this. In fact, there were times when I was in that relapse that people reached out to me for help. And I strapped on my booth and helped them and walked, talked them through it all and found them therapists and then was like, “Why can’t I do that for myself? Why am I so good at helping others and not giving myself the tools that I know are sitting right in front of me?” Kimberley: Yeah. I thought it was really interesting. You said like you were mad at yourself, or maybe I didn’t use that word correctly, for having anxiety about your thoughts. Oh my God, when did the expectations get so high? What are your thoughts about that? Jazzmin: I have no idea. It’s so funny too, because when I look back on the themes that I’ve always had, it’s always been around feeling anxiety. I have a fear of feeling anxiety. And that first thing I had was, maybe this will get rid of my anxiety. So, all of my obsessions were what’s the key to get rid of it. In fact, I often have an intrusive thought to this day that maybe my anxiety disorder is caused by the fact that I have hair and I need to shave my head to not feeling anxious anymore. And I have the best hair. I love my haircut. I have the best hair stylist, so I’m just like, “No, I don’t want to shave my head.” Kimberley: You don’t want to go all Britney Spears on yourself. Jazzmin: No. But it’s so funny to me how that works and the way-- yeah, I lost my train of thought there because we were laughing about Britney Spears, but-- Kimberley: But no, I think going back to what I was saying is I think you’re right. I think that we judge ourselves based on whether we’re anxious about something, like, “Oh, I shouldn’t be anxious about that.” But that’s just our brain doing its thing. Jazzmin: I was holding a newborn baby that I was related to for the first time in my whole life. Of course, I’m going to be terrified. I’m going to throw her against the wall. That’s a normal thing to feel really anxious about. But I think also when you’re in recovery, there’s a certain acceptance you have with anxiety. You learn that anxiety is going to be a part of my life and I’m going to accept it. And I’d always thought that I had done that. And then I remember doing ERP School this last spring. And you mentioned something about, I believe it’s willingness versus willfulness. Is that what it is? Kimberley: Yeah. Jazzmin: And I remember feeling angry with you when you mentioned that because I knew you were right. And I was like, “No,” because that was that missing piece that I had yet to figure out. I was always like, “Yeah, I get that I’ll have to feel anxious sometimes in my life. But I’m only feeling anxious and allowing myself to feel anxious because I hope that that will be the key to get rid of it.” So, it was just, that was always the way out. And for the first time, I had to realize that while I was allowing anxiety to happen, I wasn’t really welcoming it in a way. And so, that was what unlocked that little portion in my head. Kimberley: Okay. So, I just have a question. The therapist/educator in me is like, tell me more – you obviously took ERP School – what is it about? And I’m so happy that that was helpful. But I want to know, because you’re not alone. I love knowing when things make people mad because it means there’s a roadblock there. There’s a common human roadblock that we all get to. So, what about that made you mad? I’m so curious. Jazzmin: Yeah. I think in all honesty, it was a little bit of resistance because it was like, I knew that that was that next step and I really didn’t want to do that. Everything that I’ve ever done was to get rid of my anxiety. Even my OCD, all of my research, and all of the exposures that I worked on was only to get rid of that anxiety. And at the beginning of every video, you talked about, you said, “Hey, if that’s your goal, let’s reframe that.” And I was just like, “How do I do that? How does someone want to feel anxious?” I just really struggled with understanding how-- it’s such a terrible feeling. I hate it so much. How am I supposed to be happy to experience that? And I wasn’t sure how to connect those two.  I also was always looking for someone to just tell me how, like to give me steps and just say, “Hey, this is how you become willing to be anxious, or the willfulness, this is how you do it.” I remember talking to my therapist about it and I just said, “Kimberley was talking about this, and can you just tell me how to do that?” I was like, “How do I lean in? Is that something I should just tell myself? Is it something I need to write down?” And she just said, “I think it’s not something I can tell you. I think it’s a little more abstract than that.” And I just said, “Okay. So, you can’t give me a step-by-step on how to get out of this,” because that’s how I am. And she just said, “No, I think it’s a feeling.” It scared me more than it made me angry. And I think that’s why it made me angry because I knew that that was what I needed to do. So, that anger really comes from fear of just knowing what’s next and what I need to do. And it’s something I think I’ve put off for a very long time. Kimberley: Yeah. Listen, this week alone, I’ve had multiple of these conversations with my clients. I think it’s such a common roadblock for everybody. Like how often people who have recovered said, “When I stopped trying to not be anxious is when I actually got relief from my anxiety.” And it’s like what you resist, persist, is always this sort of thing. Jazzmin: Absolutely. Kimberley: I love that you told me that. Number one, I’m terrible. I always giggle when people say that my stuff made them mad because I’m like, “What happened?” But I think it’s such an important point, right? It’s such an important piece of the work. So, how would you encourage people to manage relapse or lapse? Jazzmin: Yeah, I think I was really lucky to have my sister by my side through this relapse, especially if someone who understands OCD. And encouragement was a huge thing in having a support system because I had my husband, I had my sister, I have grown a community on Instagram of people that know I have OCD and I don’t shy away from putting on my Instagram like, “I’m relapsing right now. Give me a minute. Let me figure this out.” And my comments are always flooded with like, “You got this. We believe in you. Hang in there if you need anything.” And so, I think that was a huge part of that healing for me, was just the support.  But I also think there’s a huge part about self-compassion that fits into this, about allowing yourself the opportunity to stumble. And I think it gives us its humanity. We’re going to fall and we’re going to trip and that’s going to happen. And also, life is not perfectly straight and boring where nothing bad ever happens. That’s what makes life exciting. So, I think there’s a big self-compassion piece to it all of just allowing yourself to be wherever you are. Kimberley: Is the self-compassion piece the work you’d, like you’d said, sometimes when we relapse? And I’ve had these conversations. It’s like, “Oh, there’s a layer of your therapy that you hadn’t done, or that this is a good thing for your long-term recovery.” Was the self-compassion work you had previously done or did you have to take on the self-compassion once you realized you had relapsed? Jazzmin: Self-compassion was not at all a part of my previous healing and it was something that I was really missing. I bought your book too, The Self-Compassion Workbook. I wrote through when I was on an airplane ride once. And again, it also made me frustrated because I remember you had me write like how I felt about me if my OCD was flaring up or what I thought to myself about the fact that these intrusive thoughts were present. And all of the things that I wrote were really nasty about myself like, “Why are you thinking that? Even if I know everyone has intrusive thoughts, people don’t have those ones or they don’t make them feel the way that mine make me feel. So, I’m not strong enough or I’m not doing well enough or I’m not as well as I thought I was.” And so, self-compassion was that layer of my healing that I don’t think I had reached yet but I think I really needed because again, I think I have that tough girl mentality and I want to be strong for everybody. And when it comes to doing that for myself, I fall short. So, I think it was really helpful to just learn, to give myself grace and to watch the way that I was speaking to myself when I was struggling and allowing myself to struggle, allowing myself to feel bad because that’s life.  Kimberley: Yeah. I love that you had support. I love that you had those people cheering you on, like clapping their hands, “You can do this.” What would you encourage people to do if they didn’t have that support? And in the same question, were you able to start to have that voice? Where you were like, “I can do it” and have that kind of coaching voice as well? Or was that not a part of your experience? Jazzmin: So, I think if anyone doesn’t have that support, the first thing I would encourage them to do was to find the community online because that’s how I mostly got that sport in the beginning, was just finding people that were struggling in a similar way. But also, I think a huge part of that self-compassion in your voice is to be that voice for yourself and to be an advocate for yourself in those moments. And so, yeah, I think there’s a part of just doing it for yourself in a way. And there was a second part of that question you asked. Kimberley: No, no, you answered it beautifully, because I think that is a piece of it too, is I have found for myself and I could be-- you may not feel this at all or the listeners may not feel this at all, but a huge part of my self-compassion journey was instead of going to other people to cheer me on, I had to learn to do it myself. Not to say you don’t deserve to go and get it. It’s not a problem if they cheer you on, that’s not a problem at all, but that was a huge piece of it. And I try to practice that with my patients as well, like can you cheer yourself on just a little, can you reframe that you’re strong while you suffer kind of thing. I think there’s so many reframes that we can make. Jazzmin: Yeah, absolutely. And I think back to the things that I did to encourage myself and I remembered one thing that I did is, I would have a full day of negative thoughts and negative intrusive thoughts and really struggling. And then maybe for two minutes out of that day, I would feel this overcome of like, “Hey, I got this. Wait a minute, I can do this.” And I’d always snap a selfie when I was feeling that. And so, over the course of this relapse, I have tons of these selfies and some of them I’m crying in and some of them I’m in the coffee shop or I’m in my car. And when I was really feeling down, I’d look back on that and I’d be like, “Hey, that’s the version of me that’s cheering me on right now.” And I would look back on those photos all the time and be like, “Hey, yesterday at 2:04 PM, I felt okay for a minute.” And even if it was just a minute, I’m going to trust that girl right there, because that’s who I am. Kimberley: Wow. That’s so cool. I love that. I’ve never heard that before. What an amazing way to capture you in that moment. I love that so much. Jazzmin: I think I put it in my phone, in my folders as reminders of hope. And I would look at those pictures whenever I needed it because I think seeing proof that you were there at one point too, it’s like, that was me and I could be there again. Kimberley: I love that so much. I actually think that that’s a piece of the tool belt or the toolkit that we need to have more of, like how can you remind yourself that you’re in the game and you’re doing the game. I love that so much. I remember many months ago, I did a podcast with Laura. I can link it in the show notes. She talked about, she did a collage of photos of her doing her exposures, even though she’s crying or even though-- and I just think that’s it, right? Just to remind ourselves that we’ve been there and we’ve gotten through it is so huge.  This goes back to the very beginning, but how do you-- is there a difference in how you respond depending on whether it’s a lapse, your version of a lapse or a relapse? For you, is the response and the tools you use the same or is it different?  Jazzmin: I think for me the tools are about the same. I would almost say I use less tools in my lapses and that’s always what causes them. So, I relax into this anxiety that I’m feeling and I let my guard down maybe a little bit and I start doing something. But generally, the way that I spot myself out of those cycles is to-- I quite literally will map out. I’m like, “What thought just made me anxious, and then what was my initial-- what did I feel like I needed to do to make myself feel better?” And then once I could take that step back, I could see what was going on. And I think my relapse was a little bit different because it reached that core fear of mine about feeling anxious forever or feeling like I wasn’t going to get rid of it. And so, I think it was a little harder to find that exit of that loop because it was something that I was so deeply engraved in my being that I’ve had for so long that I don’t think I ever really looked at. I always treated the surface of my obsessions and never really realized what is the core of this. It’s feeling anxious. It’s just this fear of anxiety. Kimberley: Yeah. And how are you doing now? Can you give me a realistic description on how to recover with OCD Relapse?  How to recover from OCD relapse Jazzmin: Yeah. I would say I’m doing really good right now. I’m actually 16 weeks pregnant. We found out we were pregnant back in May. And so, pregnancy is one big exposure because as someone who doesn’t like not knowing the future and is not great with uncomfortable sensations, that is pretty much all this pregnancy has been. But I remember explaining to a friend like sometimes when you’re pregnant, at least for me, I’ll just have these waves of sadness. Nothing is making me sad. I’m actually having the best day ever, and I’ll just have to go cry really hard for 10 or 20 minutes. And I was thinking to myself, this is something a couple years ago that would really scare me. I’d be really fearful of these feelings. And I have just come so far in my journey with anxiety and OCD that when I feel that way, I just surrender to it and I say, “Hey, babe, I’m going to go upstairs. Give me 10 minutes.” And I’ll just go hang out in the bathroom and let it out and wipe my tears away and just allow that I’m going to feel that way sometimes and it’s okay and I think so. So, right now, I’m doing really well and navigating, of course, pregnancy as much as I can as it’s super new. And of course, I have a lot of fears about being a mother and when those intrusive thoughts will show their face again, when I’m holding my baby, which I’m sure they will. But I’m really leaning into this idea that the version of me that will make it through that will be born in that moment. So, there’s nothing I can really do right now to make that intrusive thought not stick as much when it happens. All I can do is just trust that when it happens, if it happens in that moment, I’ll gain whatever resilience I need to work through it. And there’s a lot of self-trust that comes into that. And really trusting that I’ve got this and who knows, maybe I’ll stumble and I am fully allowing myself the opportunity to do that. So, I think that’s just been a big part of this journey for me, is allowing the unknown to just exist.  Kimberley: I love what you’re just saying. In fact, I have had clients who’ve actually written invitations to OCD like, “I welcome you to my baby’s birth,” or “I welcome you to my wedding,” and so forth. And so, I think that this is beautiful in sort of an insurance policy for relapses to say, “I’m inviting you to this big event,” which is what you’re doing. Jazzmin: Yeah. It’s like, “Let’s join me. I know you’re a part of my life and I want to see what are you going to throw at me. Let’s do this.” Almost like, “Let’s do this together. It’s not a fight and I don’t want you to go away, but I’m curious to see what you’re going to bring to the table and I’m looking forward to seeing how I handle it, learning whatever I need to learn in that moment.” Kimberley: See, you have a lot of willingness. Jazzmin: Now I do. Kimberley: You have got it. I’m so grateful to have you on and to share your story. This is so good. So good. Tell me-- let’s just wrap it up with like, okay, someone is in the depth of their relapse, they’re the lowest of the low. What words of wisdom do you have for them? Jazzmin: Feel it. I think that’s what I would say. I think when you’re in those lows, you’re always looking for that way out. And of course, naturally, you want a way out. There’s no way you want to be there forever. But I think just really leaning into this idea that the only way out is through and just really feel what you’re feeling and don’t be scared of it, because I think fear really holds us back from a lot of healing. Kimberley: So beautiful. Thank you so much for coming on. Jazzmin: Thank you so much. It’s so much fun. And I just want to say, I want to sing your praises for a minute. Your podcast and just you as a person are so kind, and I really found that just your content and just your presence was so comforting in the time of really darkness for me. And I think sometimes when you’re going through OCD, you have a lot of people that have that fight mentality and they’re like, “You got this. Just go at it, run at it.” And you just showed a level of gentleness in approaching that. And that was what really helped me find that self-compassionate voice. So, I just want to thank you from the bottom of my heart for the things that you do and what you do on here. It’s incredible. Kimberley: Oh, thank you. I’m covered in goosebumps. I can’t tell you-- I say this every time, is when you’re here talking to a microphone and no one’s there, sometimes you don’t really know who you’re touching and I just love hearing that. Thank you, because it really means so much to me that I could be there without even knowing that I’m being there. So, it brings me just so-- Jazzmin: Sometimes you just need to know. You need someone to tell you like, “Hey, what you’re going through is hard and it’s okay that it’s hard.” And I think that’s something you’ve always done for people, that we can do hard things. Kimberley: We can. It’s a beautiful day, right?  Jazzmin: Uh-hmm. Kimberley: Thank you, Jazzmin. You have been such an inspiration. If people want to follow you, where can they get ahold of you? Jazzmin: So, my Instagram is where I’m the most vocal. It’s Jazzmin Lauren. My name is weird. J-A-Z-Z-M-I-N. I have a jazz musician as a father. And I would say I’m not super vocal on big advocacy stuff on my social media. My goal is just to share my life as someone with OCD. So, my DMs are always open though. If you ever want to reach out and just say hi, or if you want help finding a therapist, I know how to do that and I’m always willing to help. So, yeah, you can find me there. Kimberley: You’re amazing. Thank you so much. Jazzmin: Thank you.

Welcome back, everybody. I am so excited to be here. This is my first recording since returning back from Australia, after having five and a half weeks in Australia with my family and I could not be more thrilled. I had the most incredible time. I tell you, my cup was overflowing by the time I left. My heart was full. I didn’t realize that my heart was very empty, even though I have so much love in my life and joy in my life, and in many areas of my life, my cup was so full. But I didn’t realize how much my heart needed to go home and actually just live in Australia for five and a half weeks and let my kids learn what it’s like to live in Australia and be in Australia. It was so wonderful. I’m just so incredibly grateful to have had that opportunity. That being said, I’m really also very, very sad to be back. However, I am making a choice to love-- how can I say it? Like love all of the parts of my life – the hard parts, the good parts, the easy parts, the parts that still don’t make sense to me. I’m making a point to love all the parts and feel all the parts and be gentle with all those parts. And I’m guessing you have some-- well, it may not be that exact experience. I’m guessing there’s some part of your life that you have to practice that with as well. And I strongly encourage it because it just opens up an opportunity for compassion and kindness and no more fighting in your mind. It’s just like, yes, it’s hard being an adult or a human. It’s hard, right? But again, it’s a beautiful day to do hard things. This week on this episode, I’ve actually been wanting to do this episode since I left, because this was one that I was almost going to record before I left and I just ran out of time. It’s funny, I do a lot of Googling for my job, not for reassurance reasons, but often will type in a keyword just to see who’s talking about certain topics and how I can talk about it better with my clients. And often when I type in “intrusive thoughts,” you know how in Google, it auto-populates what it thinks you’re going to ask? It often asks, is intrusive thoughts normal? Are they normal? And the other one that often comes up is, are intrusive thoughts dangerous? And so, I wanted to talk about that because if that’s one of the most Googled questions, well, let’s talk about it. Okay, let’s talk about it because it’s another common. It’s the question that we get asked with my staff. I have a private practice. We have 10 amazing therapists. It’s probably one of the most common questions people ask on their first session. So, let’s talk about it.  Okay. So, the first question is, are intrusive thoughts normal? Well, let’s first get a feel for what is an intrusive thought. Now an intrusive thought is a thought that is intrusive. Meaning you don’t want it. It happens automatically. It just pops into your mind. It’s usually repetitive. It’s usually distressing. Often it will go completely against your values, but not always. Sometimes it could just be a random benign thought, like if you know, we call them “earwigs” here in America. I don’t know what we call them in Australia, but it’s like where a commercial or a song just goes over and over in your mind. That’s actually technically an intrusive thought as well, even though it may not have the presence of anxiety.  But that’s what an intrusive thought is, and all humans have intrusive thoughts. They’re completely normal. Everyone has them. Even, you may have asked a close friend or a parent or somebody and say, “Hey, I have these intrusive thoughts sometimes, or really bizarre and strange. Do you have them?” And if they say no, I actually don’t believe them. What I’m guessing they’re actually saying is they have them, but they don’t distress them. But they do have them. We all have these thoughts that just randomly pop up in our mind that make absolutely no sense, that have absolutely no relation to what we’re doing. So, as you’re out to lunch with your friends, you might have this most bizarre thought. That’s what our brains do. They come up with some bizarre things, just like sometimes our brains have bizarre dreams.  So, when we’re talking about this question – the question being, are intrusive thoughts normal – the answer is yes. They’re very, very common. Now, the next question that often gets asked is a variation of this question, which is, what intrusive thoughts are normal? And I’m here to tell you all of them, every single one of them. When we talk about normal, we’re talking about what is average, what the average human experience is, and all of them are. Now let’s actually get straight to the weirdness, shall we? You’ll most likely find that you have these intrusive thoughts during the most peculiar times, like when you’re making love to somebody or having sexual relations with someone, while you’re making a phone call to talk to, or when you’re making eye contact with someone. Maybe it’s someone your boss, or someone who you normally wouldn’t have these thoughts about and you normally wouldn’t welcome these thoughts about – that’s when you’re going to probably have them. When you’re on a first date, when you’re changing a baby’s diaper, when you’re handing, let’s say, you’re working behind a cash register. As you hand the money to the person is when you’re likely to have the most bizarre or strange intrusive thought. That’s really, really common, so I want to normalize that for you. Now when I use the word “bizarre” or “strange,” that still has some judgment to it. So, I want to call myself out on that. Our job is to take judgment out of intrusive thoughts. The reason we often struggle with them is because we tell ourselves, “Oh, there are some thoughts that are good and some thoughts that are bad. And there are some intrusive thoughts that are good. And there are some intrusive thoughts that are bad.” And I’m here to tell you, or I’m here to remind you that there is no good or bad thoughts. They’re all just thoughts. There is no good or bad scenario in which you can have intrusive thoughts. Meaning it’s not bad to have intrusive thoughts during sexual intercourse, because we tell ourselves that, or it’s not good or bad to have thoughts when you’re with your baby or you’re at work with your boss or you’re doing homework, thinking about your teacher, or you’re thinking about someone you deeply love. There’s no right or wrong thoughts to have. They’re just thoughts. They’re thoughts. They’re projections that show up in our brain.  The only reason they become a problem is when we frame them as a problem that has to go away. And so, again, the main core message of today is, let’s not treat thoughts like problems. Let’s not treat the anxiety associated to it as a problem. And I do understand it’s painful. I do understand there’s a large degree of suffering there, but a lot of the time, the suffering comes from the fact that we’ve told ourselves, or we’ve put this expectation on ourselves that there’s a right and a wrong way to have intrusive thoughts, or there’s a right thought and a wrong thought to experience in your mind. Let’s not do that anymore. Let’s just let thoughts be like raining cats and dogs down on our mind, and we let it rain and rain, cats, and dogs in whatever form it is. Whatever thought and whatever content it is, we just let it come. Okay?  Now, let’s look at the other big question that people have that seem to be Googling, which breaks my heart, which is, when do intrusive thoughts become a problem? And I’m here again to tell you they’re never a problem. They’re never a problem. I don’t want you to think about intrusive thoughts or frame them as a problem.  Now, let’s get a little deep into that though, because it’s not as black as white as I’m saying it is. So, if you are someone who experiences intrusive thoughts, which we all do, and yours are associated with a large degree of suffering – anxiety, panic, uncertainty, dread, sadness, grief, like again, raining cats and dogs – it’s like you’re having intrusive thoughts and then all the emotions, rain, cats, and dogs around you too. Am I right? When you’re having that experience, I totally get that that is a large amount of suffering that you experience with the intrusive thoughts.  So, again, I don’t want you to feel like I’m gaslighting you or diminishing the suffering that you experience around your intrusive thoughts. But we will say that when we get really close and we get the magnifying glass really out and look, when we have the intrusive thought and you have the consequential or resultant anxiety and sadness and suffering, it really only becomes a problem. I don’t love the word problem, but I’m just going off the question. When we respond to that thought with criticism and punishment and self-judgment, and we beat ourselves up for having a brain that created and generated thoughts, that’s the real problem that I see.  So, when do they become a problem? They’re not, but they can become a problem if we then beat ourselves up because when we beat ourselves up, now we’ve got two problems. We’ve got the suffering of the intrusive thought and we’ve got now you’re beating yourself up and suffering even more.  Sometimes when we have those thoughts, we then go on to do other compulsions to try and get rid of those thoughts as if those thoughts were problems. So, we could see where this becomes a loop. If you have a thought and you tell yourself they’re wrong and that they’re a problem, you’re probably going to beat yourself up, which is doubled the suffering. And you’re probably going to do some pretty stretching, long painful behaviors to get rid of it, which is adding even more to your suffering. So, what we want to do is if we look at that like it’s a cycle, instead of judging and instead of responding with some kind of compulsive safety behavior, we can actually intervene at the thought at the top of this chain of reactions and go, “Okay, I’m having thoughts. I’m allowed to have them. I’m going to have them. Humans have them. They’re not a problem. I’m not going to treat them like a problem, even though my whole body wants to treat them like a problem. But I’m going to be really gentle and shift the way I respond from one of being critical and responsive to one of being accepting and compassionate.”  And the last question here is, are intrusive thoughts dangerous? That’s what I consider to be the most extreme framing of an intrusive thought, that thoughts are dangerous. And here I want to say to you, no, thoughts are not dangerous. Thoughts are thoughts. Now, again, let’s drop down a little bit deeper and look at this a little closer. You can have thoughts about dangerous things. That’s different. Meaning thoughts about unicorns aren’t dangerous. We can all agree with that unless you have a specific phobia about unicorns. We can laugh at that, but some people do. It’s like some people’s thoughts attack many areas in our lives. So, you can have a thought about a unicorn and we can all agree that that’s not dangerous. But for some reason, if we had a thought about hurting someone we love or dying, which might have the theme of dangerousness, we then go, “Oh no, that thought is more important because it’s about danger. It’s more important. My thoughts about what I’m going to have for lunch or my thoughts about will I be late for this meeting, that’s not a big deal. But my thoughts about harming people or hurting people or something bad having to myself, well, that’s a dangerous thought.” No, I’m actually going to say, that’s not a dangerous thought. That’s a thought about danger. Or if we go a little deeper, it’s a thought about a possibility of danger, not even an actual certainty.  And so, what I’m really wanting you to do as I walk you through these is to learn to have a different perception of thoughts, and learn to be mindful about the thoughts that we’re having. So, instead of having a thought and assuming that your thought is a fact, which thoughts are not facts, instead of doing that, we’re going to go, “Oh, I’m having a thought about such and such,” or “I’m having thoughts about these thoughts,” even to go even more deep into the mindful meta response.  So, here is where we shift our reaction, and what I’m going to offer you as I finish up this episode is double down here, if you can, on how you frame thoughts and how you perceive thoughts, and how you respond to thoughts. Make it your agenda for this week, month, or year or decade or life in that you start to practice observing thoughts and without framing them as a problem, dangerous, abnormal, as there’s something wrong with you because there’s nothing wrong with you. We all have these thoughts. Some of us have more than others, yes, but that still doesn’t mean there’s something wrong with you. Some have more suffering related to them, absolutely, but I still want to frame that it doesn’t make you a faulty, broken human. That’s not what this is about. Thoughts do not generate worth. Meaning if you have good thoughts, you have lots of worth, and if you have bad thoughts, you have very little worth. That’s not a thing. We just want to go back to thoughts being what gets projected in our mind and not give them all that power.  So, that’s the pieces that I want you to take. Take as much as you need from today. Some things may feel really true, like I’m speaking directly to you. Some may feel like, “Ah, that doesn’t land for me so much.” That’s okay. Take what you need. Consider what your experience of this conversation was, if you got triggered at some point or you feel really angry at some point or resistant or absolutely wonderful. Sometimes this can actually also start to become a compulsion in that you listen to this over and over to get reassurance that you’re not a bad person. So, check with that as well and ponder on it. Take what you need. Learn from it and what you needed to hear today.  Before we leave, let’s do the “I did a hard thing.” This one is short and sweet. This is from Natalie. Natalie said:  “I had pre-cancerous cervical cells removed yesterday and I was so anxious, but I did it.” So amazing, Natalie. I love this. Now, it’s short and sweet, but I actually think that’s a really, really hard thing. That takes some courage. So, I’m super, super proud of you for that. You should be so proud of yourself.  And then before we finish up, we have a review from Coronacouchpotato, and they said: “Brimming with resources. A friend referred me to this podcast and I am so grateful. I had received more helpful information in the past couple weeks listening to this podcast than I have in the past year or so in therapy. I tell everyone I can about this podcast and how it has changed my life. Thank you, Kim!” Oh my goodness. Coronacouchpotato, I cannot thank you enough for your review.  I will tell you a little story. I realized while I was away in Australia that I need to slow down enough to really be connected with the people who I am helping. Sometimes I think I go, go, go so fast, and I have this idea of helping all these people. I actually have to slow down and think about like, wow, it’s so cool that Coronacouchpotato and I are doing this together. And Natalie and I, we’re doing this together. And for you, even though I’m not saying your name, we’re doing this together. Isn’t that so cool?  Oh my gosh, it’s so beautiful. It’s so beautiful. And so, thank you, thank you, thank you for allowing me to be on this journey with you. I am honored. Thank you for trusting me. And if you would love to leave a review, I would love to feature it. So, go ahead and do that.  All right, folks, have a wonderful day. It is a beautiful day to have all the intrusive thoughts.  I’ll talk to you next week. Thank you again. Amazing for 300 episodes and I’ll talk to you soon.

This is Your Anxiety Toolkit - Episode 299.  Welcome back, everybody. 299, wow. That is amazing. I am so excited. I don’t know what it is about the word 99 that just makes me so joyful.  One of my favorite episodes is actually number 99, which was the only episode and the only time where I actually have a full conversation with my husband on the podcast, and we talked all about agoraphobia and panic disorder specifically related to flying. So, if you want to hear me and my husband have a good conversation about his experience, that was one of my favorite episodes of all time. But here we are, Episode 299, 200 episodes later, and we’re still going strong. No need to slow down. If anything, let’s speed it up a little. Shall we? Before we get started on this week’s episode, I am going to do the two segments that we do every week. First, I want to give you a little bit of a peek into where we’re going today. So, what we’re talking about is a question I get all the time, particularly when I’m talking about having a chronic illness. Specifically for those of you who have a chronic illness and have a mental illness as well, but also, this could be just for anyone because this is a human problem, this is not a mental health problem.  We’re talking about balancing exhaustion and when you have to “push through” and what do you choose? This has been a huge part of the work for me in my recovery from having postural orthostatic tachycardia syndrome. I feel like I’ve nailed this. To be honest, this is an area that I have learned very, very well, and it has saved my life literally in terms of I would be crashing and burning with tears and a major tantrum if it weren’t for my ability to balance, rest and push through. So, let’s talk about that in a second.  First of all, we’re going to do the review of the week. This is from Carsoccer27, and they say: “There are a lot of things that this podcast has helped me with. It’s a great toolbox in many of my anxiety triggers. I never knew where to start to help my anxiety. This podcast has helped me find my starting place and has helped me find my self-identity. Highly recommended!” Thank you, Carsoccer27. What a beautiful thing to say. To be honest, for someone to say that I’ve helped them find their self-identity, that is an amazing compliment. That sounds amazing to me. So, I’m so happy I’ve been able to walk along you in the journey of that. That’s just so cool. Okay. We now have an “I did a hard thing” from Anonymous. Anonymous said: “I did an exposure exercise. I get anxiety when I’m around people. So, it was hard for me to get groceries at the store, but I conquered my fear and got the groceries. And another important one is that I graduated college dealing with what I deal with.” Anonymous, I love this. What I love about this the most is you talk about your struggle to get the groceries while also adding graduating college. Two massive things. Two major accomplishments. And I’m so grateful for you that you shared that because I think some people have said to me like, “Groceries, everybody’s getting the groceries. I should be able to do that.” But I love that you’re celebrating how hard that was for you. We all need to do a better job of celebrating when we face a hard thing, whether bigger and small. Okay. So, let’s get into the episode. All right. Thank you first for Carsoccer27 and Anonymous. Let’s talk about balancing this push and rest. This balance between push and rest. If you could listen to me right now, you could see me. I’m swaying back and forth like a teeter-totter or a seesaw. It is a balancing act.  So, let’s just get the truth out. Having a mental illness or a medical illness is the most exhausting thing, and people will not get it. They will not get it until they’ve been through it. They don’t understand the degree of exhaustion that you are experiencing. So, I first want to just straight up validate you. It’s okay that they don’t get it. It doesn’t mean that you’re not validated and that you aren’t as exhausted as you are, because you do have to go through it to get it. So, let’s just be real about that.  Now, even though you are exhausted, you still are going to have to have times in your life where you have to push through to get stuff done. Anonymous is a great example of this. They push through despite going through anxiety the whole time, just push through, got through college. But what we have to be careful of here is this push through mentality. I’m actually right now reading a book by Ed Mylett and it’s called Max Out Your Life. I personally love it. It’s so inspirational. And as I’m listening to it on Audible, I’m like, “Yeah, let’s max out our life.” It’s so empowering and I just want to flex my muscles until I’m like, “Wait.” The anxious workaholic in me and the perfectionist in me wants to take that literally. And in the past, I have where I’m like, “Yeah, let’s max out our life. Let’s just push through and just push and push and push.” And then as I’ve said to you in the intro, I collapse and everything goes into a big pile of mush.  So, this is where we call it balancing. It’s a great idea and yet, it’s so empowering to hear that. But it’s not healthy to take on a high percentage of push through mentality. So, if you’re hearing this on social media and you’re reading books about it, listen with a little bit of a skeptical ear. Because you are already exhausted, pushing through more is probably going to tip the scales so that the scales tip over and you don’t recover at all. You’re actually in big trouble.  What we want to do today is we actually want to really learn the art – again, I’m swinging back and forth now – the art of balancing, the push through, and then making sure there’s time to rest. So, you do a little bit of a push through, you get through the class or you get the groceries or you pick up your kids or you go to a dinner that you don’t want to go to that exhausts you. And then you balance that with rest.  Now what I mostly hear my clients say is, “But Kimberley, I shouldn’t need to rest for that one thing. Everybody else is fine. I shouldn’t need to rest.” And this is where I’ll often say-- I look at them dead in the eyes. So, imagine I’m looking you dead in the eyes right now and I’ll say, “But whether other people are exhausted or not, you are and you have to radically accept it and you have to listen to your body.” It’s completely not even a calculation we need to take into consideration on how other people are handling it. You are exhausted. That’s the fact. And so, we do need to balance this teeter-totter, this seesaw of you push a little and you rest a little, you push a lot and you rest a lot. There’ll be times where you push a little and you still have to rest a lot. And that is, you’re doing it. The way I think of it is, if I rest enough today, I’ll have more energy for tomorrow so I can push through a little tomorrow, because you do. When I say push through, I mean, just get the things you value done. I’m not saying go hard and max out when you’re already exhausted. I actually don’t think that’s super helpful. I’ve fallen into that trap way too many times. The other thing here is, a lot of times, when we “push through,” meaning we have to. We have to show up for our kids and our partner and our boss and our parents and whatever, yourself. So, you’ve done that. And then when you go to rest, you look at Instagram and you watch some TV. There’s nothing wrong with going on Instagram and watching TV at all. I do it myself. But I want you to really just use this. Again, I love to ask questions. So, the question I’m going to ask you is, is that in fact restful? Does that actually fill your cup up, restore you? Because if you’re pushing through, you’re using up energy, you’re using up resources, you’re using up time, you’re using up your mental space. Does the resting that you’re doing actually restore you? If it’s no, I very much encourage you to take a look at what might be restorative for you.  Often people will say, “Nothing is restorative. Even when I rest, my anxiety is going through the roof.” And so, that’s where I would say, “Okay, if that’s the case, you may need to actually push through in terms of really double down with your treatment, really double down with your mindfulness, that’s the pushing through, so that you do learn how to rest.”  Often by the time a client comes to me or one of my staff, they’re already exhausted. They’re already depleted, because they’ve been trying to work through this disorder by themselves for a very long time. And so, when we say, “Buckle up, let’s get going with exposure therapy or we’re going to do mindfulness and we’re going to practice these skills,” they might be like, “Dude, I’m already exhausted. I don’t even have the capacity to do that.” And so, we’d say, “Yeah. This is an example of how we’re going to double down now, “push through” so that we can balance that exhaustion, so we can take away the thing that seems to be exhausting you.” So, again, it’s a push and a pull. It’s a little balance game. It’s like juggling, and juggling requires a rhythm and a balance and a practice and a consistency that you’ll have to find for yourself. But I strongly encourage you to spend some time looking at this because I think we hear too much about the push through on social media in society. And then on the flip side, we also have like, “Oh, you’re exhausted. You should rest.” And that’s true. But resting alone won’t get you better. So, it’s this dialectical two opposing things happening at the same time.  So, that’s what I want you to think about. An example for me, I’ll just give you a quick example. When I was really sick and my husband was working so much, I had to push through because I had to take care of two young children. I didn’t have a choice. What I did do, though, is when I was “pushing through” and even though I was so exhausted, I then challenged. While I’m pushing through, what am I doing that makes this more exhausting and how can I make it less exhausting?  So, an example, often with clients, they’ll say, “I have this test and I have to just push through, I have to study for it.” And I’ll say, “Okay, while you push through, and while you do that hard thing,” because pushing through is another word for just saying doing the hard thing, “as you do the hard thing, is there anything you can do to lessen the stress on your body? Could you maybe not tense your neck and shoulders so much? Could you breathe a little more? Could you take some more breaks? Could you have a bottle of water? Could you take little moments to breathe and do a little mindfulness or meditation exercise?”  So, the thing here is you can also be resting while doing little intervals of pushing through or doing the hard thing. For me, that was a crucial piece. While you’re pushing through, you’re letting go of stuff that doesn’t matter just to save yourself the exhaustion of taking that story on or that rule on or that expectation. While you push through, maybe lower your expectation. That might be helpful. Maybe lean in with a large degree of self-compassion and like, “Wow, Hun, you’re pushing through, you’re doing this hard thing. I’m going to be so gentle with you while you do this hard thing.” That’s so beautiful. Such a beautiful act of kindness. And then by doing that-- or when you’re exhausted and you’re resting and you’re feeling guilty for resting, you’d say, “Hun, you’re resting and this is so hard for you and this is triggering for you. Keep going. So brave. Keep going. I’m so grateful that you’re taking this time to rest for me.” Cool, right?  All right. That’s all I have for you today, guys. Just play with this. There has to be a balance. If this is still confusing for you, put it on paper, write down how many hours a day you push through and how many hours you rest, and just say, how can I increase the rest by 15-minute increments? What would that look like for me? What would that feel like for me? What would be helpful? Where can that be possible? How can that be possible? And maybe that 15 minutes will make a world of difference. It’s better than nothing. I’m going to take a deep breath with you. I’m going to hold my heart for you. I’m going to remind you that you’re stronger than you think, that the work you’re doing is important and amazing and inspiring, and don’t give up. Don’t give up. Keep tweaking and tweaking and taking baby steps and you will get there. You will get there.  All right, I’m going to send you so much love. Have a wonderful week. It is a beautiful day, it’s a beautiful week, it’s a beautiful month to do hard things. I’ll see you next week.

This is Your Anxiety Toolkit – Episode 298.  Welcome back, everybody. How are you? It is a beautiful summer day here in California. I love summer. It is very hot, but so happy to be here with you. I’m sitting in my office. I have a cup of tea. I have my little flowers next to me, and I’m just so grateful to have you here with me as well. Thank you for letting me be a part of your journey. I’m so honored. Really, I am. I know you have many options. It’s just an honor to be walking in this journey with you. Today, I want to talk to you about seven questions you can ask yourself every day. It doesn’t mean you have to ask all of them. They’re just my favorite seven questions. They’re questions I ask myself all the time, the questions I ask my patients all the time. They’re not groundbreaking in that they’re going to change your life, but they will definitely keep you on track. 100%. They’re what I call guidance questions. They’re questions that prompt you to go in the next best direction, take the next best step. So, I can’t wait to share those with you. Before I do, let’s do the review of the week. This is from Kendall Wetzel. She said: “Listening to her podcast and following her on Insta--” if you don’t follow me on Instagram, head over to Your Anxiety Toolkit on Instagram. She’s saying, “Following her on Insta has been so great for keeping me in check with my OCD. She’s gentle, positive, and awesome.” Thank you. “So thankful for this free resource.” Thank you so much, Kendall, for your amazing review. I love your reviews. Thank you for putting in the time to do that for me. It’s a gift. Thank you. All right. Before we get into the episode, let’s do the “I did a hard thing.” This is from Joy. Joy said today: “I told my boss I was resigning. It was a hard conversation to have and I overthought everything leading up to it.” Joy, I love that you shared that. We are human beings. We’re doing the best we can with what we have. But Joy goes on to say: “But I did it and it went well. This morning I woke up and I said it is a beautiful day to do hard things and that helped me to get through the day. Thank you.” Wow, Joy, love it. I mean, such a totally human response. Even though we overthink things, you still did it and that is all that matters. That is all that matters. That is all that matters. So amazing. All right. Let’s get into these seven questions. Shall we? All right. I’m actually going to do this pretty quickly, folks. I will leave the questions in the show notes. I strongly encourage you if you’re not driving to sit down and write them out and take some time today to journal on them. Again, it doesn’t have to be all of them. You can make it into a pretty PDF. You could print it out. You could make it into a daily journal, prompts. But these questions, I just sat down and I looked at my computer and I was like, “Okay, what are the questions I commonly ask my patients?” Now, of course, I always ask my patients, how are you doing? I also ask my patients like, how was your week? I didn’t include those questions. Of course, I ask the questions again as guiding questions that lead us towards the whole reason you’re here, which is to live the life you want to live and compassionately. Alrighty. So, here we go. Question #1: Does does this behavior line up with my values? So important. Often, I’ll just speak for myself, but I’m going to probably assume that you are just like me, given that we’re both human beings, but maybe not. Maybe you’re way more evolved than me. But often I find myself doing things that don’t line up with my values, because either society told me to do it or I’m on autopilot and I’m doing what I’ve just always done. And so, therefore, I just keep doing it and I catch myself doing it or I’m trying to avoid some emotion or some fear. So, the question is, does it line up with my values? Often it doesn’t. So, this is a question that guides me. I want you to think of it like your north star or your compass. These are compass questions as they guide you back on track. Does this line up with my values? If it’s a yes, proceed. If it’s a no, we might move our way down the other questions, or you might just want to reflect on that. Question #2: Does this behavior line up with my long-term goals? The thing around values is sometimes values will contradict each other. I really value being a good mom, but I also really value being a really good therapist. And sometimes I can’t meet both those values. I can’t be a really good therapist and a really good mom every single day. I can just do the best I can, but sometimes I have to go to work instead of being with my kids. Sometimes I have to be with my kids and I have to cancel a client. So, it’s hard. So, the question I ask myself is, does it line up with my long-term goals? Long-term goals. And I’m talking specifically here in regards to recovery. The last few weeks’ episodes are just about this, is getting clear on your goal, holding yourself accountable. Does this behavior line up with my long-term goals? Question #3: What is one thing I can do right now that lines up with my long-time goals and my values?  What’s the one thing, not the big thing? I struggle with this one so hard because I like to knock things out. It feels so good. It’s like a little adrenaline high, and I get discouraged when I can’t. So, I have to keep asking myself, just what’s the one little thing I can do right now in that direction? What’s the one thing? Don’t worry about the 17th thing. Just do the first, next best thing. Question #4: Is this behavior effective?  This is similar to the other questions. So, again, you might want to ask yourself all of these. You might get overwhelmed. But this is a question I often ask. I think I’ve mentioned in previous episodes, my 2022 goal is to be more effective. Sometimes I’m doing things and I’m like, “This is not an effective use of my time.” Again, you don’t always have to be effective. Sometimes we just do things for the pleasure of doing them or for the process of doing them, or for the joy of doing them. But is this actually reaching the goal? Is it effective? Sometimes my mom always to say, excuse me, if I kill this phrase, but she’d say, “You’re jumping over quarters to get to pennies.” She’s talking about saving money. You’re jumping over small amounts of money. Excuse me, you’re jumping over big amounts of money just to save small things. I told you I was going to kill that. I did the best I could. So, you’re jumping over quarters to get to pennies. If you live out of America, you’d say you’re jumping over 10 cents to get to a-- you’re jumping over 10 cents to get to 1 cent. But that’s true too. Are you doing one thing to reduce a little bit of discomfort when you could be doing something that would give you way better outcomes? This is very true of those of you who are doing compulsions. Sometimes we’re doing it and we’re like, “No, I just have to get this certainty. And if I get this certainty, well, then I’ll have relief.” But it’s like, okay, is that effective for your long-term plans? Yes. It reduces your short-term discomfort, but it actually increases your long-term discomfort. Question #5: How willing am I to be uncomfortable? This is the big one guys. If you’re going to ask yourself one question in your whole day, this is the one. How willing am I to be uncomfortable? Whether it be that you’re facing your fears on purpose, doing an exposure, how willing am I? Or whether it’s just doing something you have to do that you don’t want to do, like Joy told us this morning, she had to resign. Even if it’s something you have to do, how willing are you to be uncomfortable? How willing are you? Are you in resistance to the fact that this is happening? It’s happening. You’re anxious. You’ve got something hard to do. You can fight it or you can allow it. Question #6: Can I do this for another 10 seconds?  Oh, I love this one. I love it. I love it. I love it. Here we go. Can I do this for another 10 seconds? A client of mine once told me this. I think I’ve done an episode on this before, but it was a client of mine many, many, many years ago who said that they’d heard-- actually, I think it was like Grey’s Anatomy or some TV show. Well, maybe it was some research. They said anybody could do anything for 10 seconds. And so, they would say to themselves while they’re doing their exposure, “Can I do this just for another 10?” And when that 10 seconds is up, “Can I do it just for another 10 seconds?” You may increase it to 30 seconds, a minute, 10 minutes, an hour, or you may reduce it. “Can I do it for five seconds?” But it’s a great question. It really challenges this sort of-- we have these thoughts like I can’t do it anymore. But when you ask yourself, can I do it for another 10 seconds, well, then the script gets flipped. Question #7: How can I make this fun?  I mean this, even if it’s doing an exposure that is petrifying and 10 out of 10 anxiety, how can we make this fun? A part of you is probably throwing your phone against the wall and being like, “What the heck, Kimberley? None of this is fun. I don’t want to do these hard things. Go away.” And that’s fine. It’s a question you don’t have to ask if you don’t want, but I want you to ponder, how can you make it fun? How can you make the hard thing fun? So, as we look at these questions, these seven questions through the lens of it’s a beautiful day to do hard things-- let’s put it into sentences. It’s a beautiful day to do hard things that line up with your values, because that was question #1: Does it line up with my values? It’s a beautiful day to do things that-- excuse me, let me say it’s a beautiful day to do hard things that line up with my long-term goals. That’s question #2. It’s a beautiful day to do one hard thing. (Question #3) It’s a beautiful day to do hard things that are effective. (Question #4) How willing am I to do the hard thing? (Question #5) It’s a beautiful day to do hard things for 10 more seconds. (Question #6) And last one, it’s a beautiful day to do hard things, making it fun. So, how would I word that? It’s a beautiful day to do fun, hard things. I’m being silly now. But it’s true. I really want you to think about these. These are my favorite seven questions that I ask my patients. Try them on. See how they feel. If you like them, proceed. If you don’t, that’s fine. Just drop them. This is where you take what you need and leave what’s not helpful. I really want to remind you, this is not therapy. So, I’m not tailoring this specifically to your needs. So, if it doesn’t feel right, just leave it. Not everything is for everybody. All right. I love you. Have a wonderful day. It is a beautiful day to do hard things. Thank you so much for your support. Keep doing the hard things and I will talk to you next week.

This is Your Anxiety Toolkit - Episode 297.  Welcome back, everybody. How are you really? Just doing a quick check-in. I love the quick check-in, the drop down into your chest, the drop down into whatever discomfort you may be having. And just take it a minute to actually check-in. So important. How often are you doing this? Hopefully, multiple times every day.  All right. Today, we are talking about accountability, and this actually came, I was listening to something. I can’t remember even what it was, but someone was having a strong reaction to the word “accountability,” which words matter. They really, really do. But what I think is more important is the meaning in which we place on words. It’s a huge part of diffusing from what we tell ourselves all day. So, the whole point of today is to talk about this important treatment concept or recovery concept. And I’ll come back to why. But it’s so important. It’s so, so important. I’ve got a couple of different views about certain things, so you’ll have to hang with me each. Everyone is so important, but hang with me. Before we do that, let’s first do the review of the week. This is from Maggie Paulson. Maggie wrote: “I love this podcast. I’ve never been diagnosed with OCD, but I recognize that I have anxiety. This podcast has helped me to learn more about how my brain works, and her gentle and loving approach to treatment has helped me learn to handle my intrusive thoughts and my anxiety. To say that has improved the quality of my life is an understatement. I’m very grateful for Kimberley and her podcast.” Thank you, Maggie. You fill up my heart. Thank you so much for your reviews. All of you, even if you just click the five-star review or however many stars you think it deserves. You don’t even have to write a review. You can just give it stars, and that helps me. So, thank you so much.  All right, drum roll. We have the “I did a hard thing” segment. This is from Anonymous. Anonymous said: “Today, I manage not to lapse into a behavioral addiction that I’ve been struggling with for over a year. It’s very easy for me to use this addiction as a coping strategy for the stresses in my life. But I realized today that a good life free of this addiction is better than a good feeling that only lasts momentarily.” Oh my gosh, Anonymous, I want to give you a standing applause right now. “Although every day is going to be challenging when it comes to not lapsing into addiction, if I take each day as it comes and have the attitude that it’s a beautiful day to do hard things, I know I can live addiction free.”  So good. So good, Anonymous. Oh my gosh, lLet me read this line again. It says, “I realized today that a good life free of this addiction is better than a good feeling that only last momentarily.” So much wisdom in that sentence. Amazing. So much wisdom. That is true for all of us. Isn’t it? So true for all of us in that we just-- the real living we want, the real pieces on the other side of that hard thing. So, so true. Thank you so much, Anonymous, and thank you so much to Maggie Paulson for that amazing review.  All right, folks, here is something I want to first start with. So, we’re talking about, can you hold yourself accountable without being self-critical? That’s a really important question because, and the reason it’s so important for recovery is, unless you’re in an intensive treatment center, where you have services 24/7, chances are, you’re doing a lot of this hard work. You’re doing a lot of these “hard things” on your own. And in order to do a hard thing, you do have to be accountable. You have to generate. If you could see me, you can see me like my arms are moving like cogs are turning. You have to generate motivation to do these hard things, because the truth is, no one wants to do these hard things. That’s why they’re hard. I don’t blame you if you don’t want to do hard things today because hard things suck. I keep saying that lately and I mean it. It’s hard. I don’t want to discount and make this podcast out to be like, “Oh, it’s just easy. Just do these five mindful things and you’re going to be fine.” No, it’s hard work. You have to generate motivation and you have to generate accountability. The accountability is what gets you to do it, even though you don’t want to do it. And here is the point I want you to really take from this episode. Hopefully, this is a shorter episode, because I know I’ve been going a little longer lately. I’m a bit chatty. I’m chattier lately. I don’t know why. Here is the point. Being accountable is not synonymous with blame and harsh treatment. So, let me put that same concept into different words. Holding yourself accountable doesn’t mean the same as blaming yourself, beating yourself into doing the thing that you said you were going to do. That’s not accountability. Accountability is just holding yourself accountable to do the thing. Saying have some accountability doesn’t mean treat yourself terribly. And as I was saying at the beginning, I had heard something and I don’t even remember where. I’m assuming it was on Instagram. They were saying like, “Don’t tell me to be accountable. That’s just mean. That’s just mean that you would ask me to be accountable.” And I’m over here going, what? No, hun, someone somewhere you’ve picked up the idea or someone’s taught you that accountability means getting whipped and that isn’t true. That’s not true.  Accountability, we just last session, last episode did 196. It was about, what is your recovery goal? So, we got really clear about what do you want your life to look like. If you haven’t listened to that, please go back and listen to it. So, we got really clear on that. And accountability is saying, I love myself so much, and I love those recovery goals so much that I’m going to do this thing. That’s accountability. I value my well-being so much. I value that goal that I want for myself. I believe in myself so much that I’m going to do that thing. That hard thing. It’s not whipping and beating. It’s not mean words. It’s not saying get off your butt your lazy thing. That’s self-criticism. That’s not accountability. That’s just bullying. That’s self-bullying.  And so, what I want you to look at is, accountability is simply saying, I’m going to do the thing I said I’m going to do because I deserve it. I deserve the outcome, the dream, the goal, the life that lines up with my values. Accountability isn’t saying, push through no matter what, no matter how much pain you’re in, just like plow through it. Believe me. I’ve been there. I’ve been there. Sometimes you have to do that. I’m not going to say that that’s particularly even wrong because sometimes we do have to push through, but you don’t have to be mean. And it’s asking yourself, how willing am I to show up and do this hard thing so I can get this goal? Exactly like Anonymous said in this “I did a hard thing” segment. That’s accountability. Everything that Anonymous said is accountability. I should have actually-- sorry, Anonymous. I should have just read your “I did a hard thing” and said, “There you go, folks. That’s the episode. That’s what accountability looks like.” So, it’s accountability. Compassionate accountability will still get you across the finish line. Often when I talk to clients about roadblocks to self-compassion, they’ll say, “Well, I won’t get up and do it if I don’t beat myself up.” Is that you? Maybe I should ask that question. Does that resonate with you? Like, “I won’t get to the gym. I won’t exercise. I won’t do the exposure unless I beat myself up. That’s the only form of transportation to get myself to do the thing.”  If that’s the case, please make today the day that you start trying something else. I’ll tell you why real quick and then I’m going to finish up. Yes, there are times when being self-critical gets you to do the thing. And if that’s what it takes, it’s up to you. You get to choose. I’m not going to tell you what’s wrong. I’m not going to tell you you are wrong. I don’t want you to feel judgment about that from yourself or from me because we’re all doing the very best we can with what we have. So, that’s totally fine. But if you use that as your only way, the chances are, eventually, it’s going to burn you out. You’re going to start to feel so bad about yourself that you will give up. We’ve got all the research and science to back it.  So, it’s only short-lived. This is only going to work for a certain amount of time until it stops working. So, let’s use today to try something different. Let’s put eggs in different baskets. Let’s practice compassionate accountability.  Again, I’ll say it, compassionate accountability is doing the thing that you set out to do, because you love yourself and you love your goals so much that you’re willing to do the hard thing. That’s it. That’s it, friends. That’s all I got to say.  All right. I love you. Have a wonderful day. I just love you. I’m squeezing my fist. I just love you guys. Thank you for being a part of my community. Thank you for supporting me. I totally understand you have gazillions of options for podcasts and gazillions of people who are probably doing great things. Thank you for letting me be a part of your journey. It’s an honor. Really it is. Have a wonderful day.

In This Episode: The importance of having a specific recovery goal Why you need a recovery goal in order to gain traction with OCD and other anxiety disorders  What does your “recovery dream” look like?  What is getting in the way of your recovery goal?  Learn to live your life “as if” you had already reached your recovery goal.  Links To Things I Talk About: https://www.cbtschool.com/overcominganxiety ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more.  Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION  This is Your Anxiety Toolkit - Episode 296.  Welcome back, everybody. I am so fired up for this episode. Oh, I just love this stuff. I love it. I love it. I love it.  Okay. Let’s get started. First of all, let’s do an “I did a hard thing.” This one is epic. This one is from Fisher and they said:  “I have OCD, health anxiety, and panic disorder. And last year, I was diagnosed with POTS,” which is postural orthostatic tachycardia syndrome. That is the chronic illness that I have also. And they’ve said: “This was very overwhelming for me. I was petrified of exercising because of the exercise intolerance that comes with POTS and worrying that it was a life-threatening cardiac issue.” Oh, I am with you, Fisher. So, for those of you who don’t know what exercise intolerance is, it’s like it’s almost impossible to do exercise. When you stand up, you pass out. And when I’ve been triggered by POTS, it’s hard to even do a block around, walk around the block of my house.  “My doctor did all the cardiac tests to rule out any underlying issues before diagnosing me with POTS and recommended cardiac reconditioning to help me get started with recovery. My first barrier to overcome this was to trust in my physician and their diagnosis and follow their recommendation for exercise therapy. My second barrier was facing my fear of exercising. I can now say that I’m in my last week of the program after going twice a week for three months, along with exercising on my own at home. It’s been a struggle. There are some days where I flare up.” I hear you, Fisher. I totally get you. “And it seems impossible, but accessing self-compassion, budgeting spoon usage for the day, and moving things around to allow myself to rest have been invaluable tools to help me with the experience. A wise person told me after my diagnosis, the only predictable thing about living with a chronic illness is that it is unpredictable. So, I try to accept that uncertainty as a part of my life, living with anxiety and POTS.” Fisher, I just love you. You’re killing it here. “I have a lot of work to do in learning to live with my chronic illness and my OCD and health anxiety recovery, but I make a little progress each and every day. P.S. Would you consider doing an episode on coping with chronic illness that mirror anxiety symptoms like POTS? I’d love to hear the skills that have helped you and some of you recommend coping strategies. Thanks for all the hard work that you do on this podcast.” Fisher, I would love to have you on the podcast. I am going to write it in my notes to reach out to you because I think this is such an important topic, one that I myself have gone through, and thank you for writing this. You are doing badass, amazing hard work. So, yay. Thank you. You will hear from me. If you don’t hear from me, reach out, because I think that would be wonderful.  Okay. Let’s take a breath because that brought up a lot for me. I just feel such deep compassion for Fisher and all of you who are just doing the hard thing. So, so cool.  All right. Quickly, review of the week from Mosley23. They said: “I’ve been listening for several years and can say that this podcast has helped immensely to understand my OCD and anxiety. Kim and her guests have provided very helpful ideas, strategies, and encouragement that have been so key in helping me to get to a good place with my mental health. Could not recommend it more highly if you or someone you love have an anxiety disorder.” Thank you so much, Mosley23. Your reviews mean the world to me. The world really. Really, it’s so helpful. And again, if you give a review, and I know specifically what episode you’re talking about or what specific thing, it means then I can do more of that and help more people. So, yay.    All right. Let’s talk about recovery. It’s taking all of my energy not to bang my hands down on the table and be like, “Let’s do it.”  All right. So, I take walks every morning and I often listen to podcasts or audiobooks. I’m a big self-help, non-fiction kind of gal. And I’m often listening to these most motivating speakers and it gets me so fired up. This morning, I got so fired up because this is such a part of the work of being a clinician. We get trained on all the theory and the statistics and the diagnoses, but we don’t get taught very well how to help a client identify what is your recovery goal. What are you here for? And so, even though you, listener, loving beautiful person, human friend – even though you’re not here for therapy, because this is not therapy, I want you to be really intentional about your recovery goals.  Why is that important? Because, when you’re dealing with a mental health issue, you’ve already got a full-time job. You’re working your butt off to manage that. And sometimes we can put our attention so much on the disorder instead of making time and carving time and having a mindset towards, what do I want life to look like once I recover and how can I use that recovery goal to fuel the work I’m doing now while I’m in the trenches? So, what I’m not saying here is, list off 20 magical things that will happen to you in the future when you get rid of your anxiety disorder, because that just means now you have an additional list of things to check off and it’s overwhelming and anxiety producing. So, I’m not talking about just lists. I’m talking about getting clear on what you want life to be like, even if anxiety is there.  So, let me ask you. You guys know, I love questions. First question, what does your recovery dream look like? What do you wish it looked like? So, often when I ask that to clients, their first response is, they put their hand on the buzzer and they’re like, “Pick me.” I don’t want anxiety and I don’t want that to be your goal. So, the absence of an emotion is not a recovery goal. We need anxiety. If you didn’t have anxiety, you’d put your hand on the hot plate. You’d jam your hand in the door. We need anxiety. So, try not to make that your goal. I’m talking about specifically, zoom in and imagine that you are the ring camera on your house. What would be happening in your house, around your house, around your life? How would you be interacting with the world? That’s the stuff I’m really interested in knowing.  So, for me it’s like, okay, if I was in my fullest recovery, I would be with my kids. I would be helping my clients and my listeners and my followers. I would be a connected wife. I would be a wife that shows up for my husband, even when it’s tough and we’ve got stuff to work out. I’d be someone who still has good days and bad days. But the bad days I just keep showing up, like it’s a beautiful day to do hard things. I’d be that person. I’d embody “it’s a beautiful day to do hard things.” That’s what recovery would look like for me. It might not be that for you. And please don’t just use mine because mine is just for me. Make it specific for you and look at that, write it down. Because in those answers, in those questions and answers is all of the details in which you can start to implement today.  So, example being, if that was my recovery goal, what can I do today? I can get down on the floor and I can play with my kids, even if anxiety is there. I can go to my husband and say, “How are you? How are you really?” And practice staying in the moment and practice listening instead of letting my anxiety do all the talking. I still do the talking, but I’m listening to my partner, not to my anxiety. I’m practicing this and it’s not perfect. I might even suck at it. That’s fine. But I’m already working towards the recovery that I want, the life that I want, the dream that I want.  While I have anxiety, and if it’s there, I’m also going to bring myself into intention that my goal was to help people, to be of service, to show up for you guys and have a couple of giggles and be myself because that’s a huge goal for me, to be more myself, which means I have to share a few layers of professionalism and just show up as Kimberley, the imperfect, giggly, silly, goofy, all-over-the-place Kimberley. So, I’m working towards that, whether anxiety is there or not. And by practicing that, I’m already 20 steps towards the recovery goal because I got down-dropped into what was it that I was looking for? So, this is the work, guys. Don’t use this recovery list as a list of expectations that you tell you, you won’t ever get to. Instead, use it as a way to implement it today.  Now, what I just said is the perfect segue into identifying the next question I had in my prep for this. Are you living according to old stories or your recovery goal? Because often, if we’ve made mistakes in the past or we’ve struggled in the past or we have messed up in the past, as we’re engaging with our goals, we’re telling ourselves a story. What’s the point? Look at that, what I wrote down. Like, I want to show up for my followers and listeners. I want to be a wife that’s engaged and connected. I want to be a mom that’s on the floor playing with their kids. I want to be a therapist that is just pouring my heart into the people. So, that’s my list.  But if I’m living according to old stories, I’d go, “Yeah, that’s not going to happen because you totally screwed up with that one client that time, and you totally said something inappropriate to that one person and offended them and harmed them.” And so, you’re just, “Nah.” You think you don’t deserve to have that recovery or it’s just not possible for you, Kimberley. That’s what we call a fixed mindset. You’re living off of old stories. “No, I couldn’t do it in the past. I tried. So, there’s no point. There’s my recovery list. I’ll never get there.” That’s old stories.  And the whole point of me talking with you every week on doing the “I did a hard thing” segment isn’t just because-- well, yes, it’s because I love it. I ain’t going to lie. I love it so much. But the whole point I do that is so that you guys can see baby steps lead to medium size steps, leads to large steps. And you mess up and you totally screw up. I’ve done whole episodes about this in the past. Just recently actually. You mess up and then you go, “Okay, I’m going to just do one more.” It’s going to try one more time, and one more time. The whole AA approach, if you have an addiction, if you go to alcoholics anonymous is one more day. And there’s some research around that model because it helps you just to stay in the short term, doing today, not looking at the long term, and changing the story.  The next question I have is, are you really clear of what recovery will look like, and does that line up with your values? The reason I ask that, and that’s the final question of this episode, is when I ask my patients like, “Okay, let’s get a recovery plan together. What are your treatment goals? What do you want to look like once therapy is done? How would we define that?” Often, because they’ve been trained and conditioned from society to be this, they’re like, “Okay, so I want to have a house and I want a car and I want to have 100,000 followers on Instagram and I want to be a size blobbidy blah.” And it’s just like, whoa, whoa, whoa, whoa, whoa. Is that what society told you or is that actually what you want? Do you actually value those things? Are they coming from a place of getting other people’s approval or are they coming from a place of what really feels good to you, really feels good? What feels true to your values? Because yeah, it’s easy to say, “I want to have this many dollars in the bank,” or “I want to have achieved a certain thing.” That’s fine. I’m not against that. In fact, I love that kind of thing. I love goals. But I first want you to ask yourself, why? Why do you want that goal? Is it because you want approval or is it because you want to prove you’re worth? Because if it’s any of those two things, it’s probably going to be a painful process. Because, number one, you won’t get approval from other people that’s long-lasting because that depends on their mood and their values themselves, and you won’t get up to a place where you feel worthy because you’ve based that on a conditional relationship. The only way we can actually build self-worth is to drop all the conditions and recognize that you’re worthy right now, whether you reach this goal, this recovery goal or not. It’s not a condition. The thing to remember here is your worth doesn’t go up if you reach these goals. Please remember that. Your worth is the same whether you reach them or not. You’re a valuable, important human being that deserves love and kindness. So, just keep an eye on that. I’m sorry, I’m going on a little tangent there, but it’s so important as you embark on getting really clear. And I really want you to be really, really clear. I really do.  I’ll use a really ridiculous example, and mind me, I understand that this is a very privileged example, but my daughter is going off to middle school. She’s going to a school that’s very far away. And so, I have to engage in a carpool. We have a four-wheel-drive that we use to do all of the outdoor stuff that we do. So, I need a bigger car to fit seven people. And so, I’m trying to get really clear on values as I buy this car. I understand this is a ridiculous example, but let’s use it as an example. As I go to buy a car, what do I want to feel when I get in the car? What are the things that matter to me? Is it the brand? Do I have to drive a Mercedes Benz or is it the functions? Is it the way it makes me feel? Is it the color? Is it the way my kids feel? That will help me to make a decision. So, I drop down into, really what do I want? What’s important to me? Is it important for me to have technology or is it important for me to have ease? Is it important for me to have technology or pay less for this car? And so, it’s asking questions. Don’t go overboard here, but asking questions so I get really clear on what matters to me, what values matter in this decision.  So, again, I get the ridiculous privilege of that whole question, but they’re the questions I want you to ask about you, because you deserve that. When you make decisions about your recovery and your life, you want to ask the questions that are detailed so that you can pivot in those areas. It doesn’t have to be perfect, but get clear on what you want recovery to look like. Because if you don’t, you’ll probably find that you’re wavering around feeling directionless, not sure why you’re doing all these hard things, feeling like, what’s the point really? But when you know exactly what the outcome you want is, you’ll know exactly the point.  Okay. I love you. I love you. I love you. I love you. Thank you for being here. It is a beautiful day to do hard things. I hope that was helpful. I will talk to you guys next week, and have a wonderful, wonderful, wonderful, wonderful, wonderful day. By the time you hear this, I’ll be back in the United States from my trip. If you want to go back and listen to the old episodes, I encourage you to do that. All the goodness is right there in those early ones.  Have a wonderful day, everybody. Talk to you soon.

SUMMARY: Today we talk all about how to manage when your fears appear in your dreams.  This was a heavily requested topic, so I hope it was helpful for you. In This Episode: Why our fears and obsessions show up in our dreams What to do when your fears appear in your dreams  How to manage the distress when dreams feel “real”  Links To Things I Talk About: ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more.  Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION  This is Your Anxiety Toolkit - Episode 295. Welcome back, everybody. It is Episode 295, which sounds like a whole lot of episodes. It really, really does. Actually, it shocked me when I saw that number. Today, we are talking about when your fears show up in your dreams. I would say quite regularly, actually, a client, particularly morning clients will often say like-- I’ll be like, “How are you? How was your week?” And they’ll say, “Well, I’m just feeling really overwhelmed. I had the most bizarre dream last night and it’s hard to shake it off.” And so, I’m wondering, I’m guessing. I’ve had this experience, I’m guessing you have too. And I wanted to talk this episode about how we might respond to that situation and what we need to look out for when we have this situation, particularly if you have anxiety. That’s really the specific group of humans we’re speaking to today. And I’ll share a little bit more about that as we get going. All right, before we do that, let’s do the review of the week. This one is from FullWalrus and they said: “I found this podcast by Googling an issue I was having, and this just popped up.” FullWalrus, this makes me so happy. Thank you so much for Googling this and finding me because that means we’re doing a good job at being on the internet and helping people in that way. “I had kept away from podcasts about mental health in fear of being triggered or being told I was crazy after all, and that didn’t happen obviously. Kimberley is a gifted presenter and a therapist who introduced me to Buddhism and mindfulness in a way I’d never thought of before. For the first time, I feel like I actually have the tools to help me manage OCD, and this show is sure a beautiful compliment to any therapy you should be currently undergoing because we all need therapy. Thank you for everything, Kimberley. My life is forever changed and I am forever grateful.” Thank you, FullWalrus. What a wonderful, wonderful review. I just love hearing how I’m helpful. I love hearing what episodes are helpful and it’s really cool that I’m a really-- I love Buddhism. I find it to be exactly what I need every time I’m in a hard time. So, I’m so glad that I’m bringing that in a way that isn’t overwhelming or overpowering. So wonderful, wonderful, wonderful. This week’s “I did a hard thing” is coming to you from Holly. Holly says: “Last week, I went to court to obtain full custody of my son since his father has become a threat to him. This was extremely difficult seeing as we have been in an abusive past. My anxiety was the highest it’s been in a very long time, but ultimately, I knew I had to take action. I did my hard thing and I couldn’t be more proud of standing my ground and not succumbing to so many fears.” Holly, sending you so much love. This is 100% doing the hard thing. It’s so hard, because often we’re talking about irrational fears and so forth, but I love that you brought like I’m doing this real thing. This real thing. And I love when you guys share with me both you’re facing your fears related to your disorder, but also just facing fear about showing up and living according to your values and showing up for your family. And Holly, just so good. Thank you so much for submitting that “I did a hard thing” for our “I did a hard thing” segment. Okay. Let’s talk about dreams. So, again, often people will bring to my attention like, what do I do if my fears show up in my dreams, or even fears you didn’t have right. Like fears that you never considered during the day, but once you go to sleep, it gives it to you, sucks it to you, and whatnot. So, what do we do in this situation? Most people will report they wake up in a massive ball of sweat, high heart rate. It feels so real. It feels like it actually happened. And it takes some time for that to burn off. It really, really does. Some people say it even takes the whole day to burn off. And so, if that’s the case for you, you’re definitely not alone. Now, one thing to think about when we’re thinking about dreams is we’ve been fed this belief that dreams are like windows into our soul and that they must mean something, and that some people interpret dreams. In fact, I’ll tell you a story. I’m a clinician, I’m a CBT therapist. I use science-based treatment methods. And I do remember looking for a therapist several years ago actually and asking some colleagues. And one colleague, who knew me really well, referred me to this dream analyst. And I went for the first session. I was like, “This is not going to work for me,” mainly because of exactly what I’m going to tell you. Now, if you like dream analysis, 100% no judgment. The reason that I had a strong reaction to it is I was going through a very, very anxious time, and I knew that if I engaged in that behavior, it was going to trigger me in ways that I’ll share here very soon. The way I understand and the way I was trained and the way I’ve researched dreams is dreams, are just thoughts you have at night. So, if you’ve listened to this podcast, you’ll know that during the day, if you have a thought, I’m probably going to tell you, thoughts are thoughts. Don’t give them your attention. Don’t give them too much kudos. And so, dreams are no different. They’re just thoughts that you have while you’re asleep, and do your best not to give them a ton of importance, a ton of weight, a ton of value, because when you do that, you can get in trouble, particularly if they’re anxious thoughts. Now, let me say here, I am notorious for having the weirdest dreams. My husband often, when we first got married, would sit up in the morning and be like, “Tell me everything you dreamed,” because I dream about like, I once had this dream about turtles and we went scuba diving together. And me and these turtles, they were like cartoon turtles. We’re like going through these tunnels together. Ridiculous stuff. I’ve had dreams of going hot air ballooning with a giraffe, and I have had this dream many, many, many times. I would say tens of times. And so, yeah, sometimes dreams are just silly and crazy. But where they’ve got fear attached or danger attached or catastrophes attached, it can be really hard for us to not get caught up in them. So, the next question is, is it effective to interpret our dreams? My opinion is there’s nothing wrong with it, but here are the things to look out for. If you have a dream and it’s attached to your obsession and you’re interpreting your dream, it’s a chance that you’re doing compulsions to try and get certainty around that obsession. So, if you’ve already got the fear and the obsession, interpreting the dream actually maybe just reinforcing the fear, giving it too much importance, giving it too much value, and therefore feeding you back into a cycle where you’re going to keep having more of them, and you’re going to keep having anxiety about them, because you’re responding to them as if they’re important and dangerous. If they’re just random like you wake up, often people say, “I had a dream that a loved one died,” or “I had a dream that a loved one was in an accident or it was my fault or so forth.” If you have that, what I would encourage you to do is look at it curiously. For me, it’s either like a really silly cartoon style dream or it’s that I’m responsible for something, which just is a sort of, if I’m curious about that, I’m like, yeah, that makes sense. I tend to be hyper-responsible. I tend to take responsibility very seriously. So, that makes sense. But I’m not going to go and dig around more than that because now I’m digging around in the content of my fears and giving those fears way, way, way, way too much attention. Way too much attention. So, is it effective to interpret your dream? It depends. And I will say really clearly, if it is around your obsession, I strongly discourage you from doing it with one caveat, with one exception, which is unless it’s for the purpose of actually doing an exposure that’s scary. So, that would be the one time I would say, yes, it’s cool to interpret your dream. If you’re doing it on purpose in effort to actually induce the actual obsession and fear that you have so that you can practice tolerating the uncertainty and you can practice writing that wave of discomfort. We can and we do do exposures to the content of your dreams. So, again, if a client has a dream or you have a dream and it’s triggering you, whether it was a part of your old obsession or just a new one, you can choose if it’s really bothering you to do an exposure. You could do an exposure with imaginal exposures. We cover imaginal exposures in ERP School, which you can go and find out about at CBTSchool.com if you’re interested. ERP School is our online course that teaches you how to apply ERP to your obsessions. So, you could do an imaginal exposure where you write a story about your worst fear coming true and the consequences of that, and you read it over and over and over and you just allow the anxiety to rise and fall. You could do that. Or let’s say if it’s a fear like, not long ago, I had a dream about this one area of the corner of my kid’s school. It was like this really bad thing happened. So, if it’s really bothering me and I’m struggling with reducing my mental compulsions about that. Yeah, I might go into that corner and just sit there and read a book or just wait there for my kids or whatnot. So, yes, you can do exposures to the content of your dreams, particularly again, if they’re really strong, repetitious, and they seem to be persistent. What we can do in addition to that is apply a ton of mindfulness to the dream content itself. So, this is what this would look like. You wake up, whether it’s from the morning or from a nap. You’ve had a dream. It’s really overwhelming. It feels really real. It might even feel like you’re actually in the moment of this catastrophe or this event. And even though it feels real, we’re actually just going to be mindful of that. Now, what does mindfulness mean? Let’s do a quick recap. Mindfulness is being present with what’s actually happening. So, within that moment, what’s actually happening is things feel unreal, things feel strange, things feel scary. Your heart might be beating faster. You might be sweating. You might have a tummy ache. So, that’s what’s happening. We’re present with that, but we’re also present with what else is happening. Oh, the birds are chirping. I feel my pajamas against my skin. This is the taste of the coffee I’m drinking. I can smell the coffee as well. We’re just being very mindful of what else is happening, and we’re doing all of that nonjudgmentally. Key point: We’re doing all of this. We’re having the weird feeling. We’re having the anxiety. We’re smelling the coffee. We’re feeling our feet against the floor and we’re practicing not judging these things as good or bad, even though they might be uncomfortable. When we are acknowledging that they’re here, we’re allowing them. We’re being willing to experience them, not pushing them away, and we’re practicing being non-judgmental. Now you may need to do this, and this is often our clients will say, “Yeah, I did that, and then it kept bothering me.” And I’ll say, “Well, did you do it again? Could you do it a little longer?” And they’ll go, “Yeah, I did. But then it kept bothering me.” And I’ll joke with them. I try never to be condescending, but I’ll say, “But did you then do it again? Did you keep going?” And that’s the key to mindfulness. Mindfulness, we don’t do these behaviors to make the discomfort go away. We do them moment by moment, minute by minute, 10 seconds by 10 seconds, just to practice being in the presence of this discomfort and giving the discomfort zero of our tension. Now, the other thing we may want to do here is activate a behavior. So, if you’re feeling totally overwhelmed, totally anxious, everything feels like it really actually happened. A lot of clients will say somebody died in their dream and they actually cry and they’re experiencing grief as if it actually happened. That’s true too. That often happens. We would engage in behavioral activation of going, “If I didn’t have this feeling, what would I be doing?” Such a good question. If I didn’t have this experience, what would I be doing? And go and do that thing. So, if I didn’t have this dream, I’d be getting up and I’d probably go for a walk or I’d sit down and check my emails or whatever it may be. Make sure you do those things and try not to divert away from the behaviors you would’ve done had you not had this dream. That’s the response prevention piece. If you didn’t have this dream, would you be giving this content your attention? So, let’s say I had a dream about my child dying, which is devastating, the idea of it. So, when we say I wake up and I feel like it actually happened, my body is telling me it actually happened, even though maybe my child is right in front of me. Then how do I engage with the rest of the day? Am I ruminating about ways to prevent that from happening? Am I actually implementing behaviors to prevent it from happening? Because if I’m doing those things, I’m actually doing compulsions. I’m trying to solve a thought that I had, not an actual thing. And so, this is why this is so important that we understand that dreams are just thoughts you have at night or during sleep. That doesn’t mean that they’re important and they need to be analyzed and that it’s a sign of something to come, because we wouldn’t do that with an intrusive thought. We’re learning not to do that. So, when we have a thought, we’re learning not to go, “Oh my gosh, that must mean it’s a sign.” We’re learning to undo that reaction and going, “Yeah, thoughts are thoughts.” So, this is how I want you to maybe consider changing your response to dreams, especially scary dreams. Again, let me be really clear. If you love analyzing dreams and you find it helpful and you don’t find it loops you back into the anxious cycle, wonderful. No problem. I’m definitely not against dream analysis. But for those folks who were anxious, I just want you to know this information, keep it in your back pocket, or maybe even your front pocket for the times when you catch yourself engaging in behaviors that become ineffective. My word of 2022 is “effective.” I have it written everywhere. It’s a huge part of the decisions I make every day, every minute. Does this keep me in being effective? And so, it’s such a great question when we ask ourselves, is this behavior effective? It won’t always be, you don’t always have to be effective. But sometimes again, when you catch trends that are getting you to be ineffective, we want to see if we can make a change. Okay? So, that’s Episode 295: When your fears show up in your dreams. I hope it was helpful. Do not forget, it is a beautiful day to do hard things. This work is not easy, friends. This work is actually-- let’s just be real. This work sucks. It really, really does. It’s exhausting. It’s hard. It’s taxing. It beats you down. So, please be gentle. It is a beautiful day to do hard things. Please remind yourself of how brave and strong you are because you’re stronger than you think. And I will see you next week. Have a wonderful day.

SUMMARY:  Correcting thoughts can but a very helpful tool to use when you notice that you have lots of thought errors.  However, in some cases, correcting thoughts can become a compulsion.  In this episode, ask the question, “Can correcting thoughts become a compulsion?” And review what you can do to make sure you are not engaging too much in the content of your thoughts.  In This Episode: How to correct your thoughts and how this can help people who have errors in their thinking How to determine when it is helpful to correct your thoughts  How to determine when correcting thoughts is becoming a compulsion Links To Things I Talk About: Overcoming Anxiety and Panic https://www.cbtschool.com/overcominganxiety ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more.  Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION  This is Your Anxiety Toolkit - Episode 294.  Welcome back, everybody. What a special treat to have you here with me today.  Today, we are talking about when correcting your thoughts, we call it cognitive restructuring in therapy – when you correct your thoughts, when does that become compulsive? Or we could also say problematic. And so, we’re actually going to go into this today, and then I’m going to let you decide for yourself what is helpful and what’s not. But I hope today is really helpful. It’s a very, very, very important topic. It’s often one of the biggest mistakes therapists make, particularly those who are not trained in anxiety disorders and OCD, and ERP. It’s probably one of the biggest mistakes that they make. So, I want to really review this so that you can have the information in your back pocket and you can make the decisions for yourself. Before we do that, let’s first do the review of the week. This is from Cynthia Safell and Cynthia said: “I first was introduced to Kimberley’s clear and compassionate teaching style when I took the ERP school course for therapists.” This is wonderful, Cynthia. So, for those of you who don’t know, we have ERP School, which is a course where I teach you exactly how I would do ERP if you were my client. And then it turned out that a lot of therapists were taking this course. And so, we duplicated the course and I added a whole bunch of modules for therapists, so they can become excellent therapists for people with OCD as well. So, I am so delighted that Cynthia has written this review. She goes on to say: “In the past 3 weeks since taking the course, I recommended both the course and podcasts to my clients. So helpful. Thank you, Kimberley.” Wow, Cynthia, literally, that is the biggest compliment. Really, it is. If a therapist can trust me so much that they would recommend it to their clients, that is the biggest gift to me. And thank you so much for telling me that, because it just brings me so much joy and so much pride. So, thank you so much, Cynthia, for that amazing review.  Alright, before we move on to the bulk of the content of this episode, we also want to do the “I did our hard thing” segment. This is from Abby and Abby is over here doing some hard things. So cool. Let’s go. It says: “I have come on holiday. I’m terrified of flying. My anxiety was high. My thoughts were racing, but I did it.” So good, Abby. “I got on the plane and I got on holiday. It was scary, but I did it and I’m proud. Now to commit to the holiday first two days have been hard, but sitting with it and not letting it ruin my time.” Abby, this is so good. Not only did you get on a plane, but you’re doing all the hard things in addition, and that’s so good. What a treat for you. What a reward for you. You did the hard thing and now you’re on vacation. Isn’t that so cool? Thank you so much, Abby. And thank you so much, Cynthia, for being an amazing part of our community. Alright. So, let’s get down to it, shall we? So, I am a cognitive behavioral therapist. I love cognitive behavioral therapy. If you haven’t heard what that is, I’m assuming you have, but basically what that means is there is a cognitive component to treatment, which is focusing on your thoughts, and there is a behavioral component to treatment, which is where we focus on changing behaviors.  Now, in some disorders, we spend a little more time on cognitions and a little less time on behaviors. And in other disorders, we spend a little more time on behaviors and much less time on cognitions. So, I think it’s important for you to know that it depends on your disorder on how much cognitive restructuring or changing and thinking we do. And so, the whole point of today is to explore, is your cognitive restructuring, is changing and challenging your thoughts helpful for you and your set of symptoms? And you get to make that decision. I’m not here to tell you what’s right or wrong, but I do want to give you some guidance.  So, first of all, the big question that my staff bring to me when we’re in supervision, and this was actually inspired by a conversation we had during supervision, was what is the role of correcting distorted thoughts in treatment? So, if someone presents to me a distorted thought, a statement, they might say, “I’m an idiot,” or “What’s the point? I only ruin it and mess it up anyway,” or “I always make mistakes. I never do anything right.” I as the clinician and them as the client may benefit by pausing the session and checking in with them in how true is that statement. Is it really true that you never do anything right? Is it true that you are an idiot? Could we challenge that and could we start to have you practice changing the words you use towards yourself?  I am a massive, massive advocate for cognitive work because I think that in general, we walk around and we say a whole bunch of stuff that’s not true. I do it too. I actually have put-- in the last 18 months, I have put in massive amounts of time and energy into catching because I was finding I was saying a lot of sweeping generalizations like, “I feel terrible today.” Even though I didn’t feel well, it’s like, okay, I’m saying these words, “I’m so tired.” That was another big one I used to say every day. My husband would ask, “How are you, Kimberley?” “I’m so tired.” And it’s not that that thought was wrong or not true. I was really tired. But I had to check, is it helpful for me to keep saying this? Is there another way that I could maybe reframe this or present this or look at this? So, yes, there’s definitely a role in challenging and correcting errors in our thinking. And so, it’s important that we first look at what is a thought distortion or a cognitive distortion, or a thought error. It’s usually any thought that’s, number one, not true or not helpful, or keeps you responding in a way that isn’t beneficial. So, again, the thought for me is “I’m so tired.” It’s true. Is it helpful? No. Does saying that actually make me feel a little bombed and a little down? Yes. Could I maybe replace it with something else? That’s up to me. There’s no right or wrong.  I want to be really clear here in that when we talk about correcting thoughts, we are not saying toxic positivity, like, “Oh, I’m supposed to tell myself I feel fabulous because I don’t.” That’s not what this is about. We don’t do that kind of thing. We just make small little shifts depending on what feels helpful to you.  So, let’s go through a couple of scenarios. Does correcting thoughts help with depression? Now, based on the research, the treatment for depression is actually really balanced in terms of doing 50% cognitive work and 50% behavioral work. These numbers I’m throwing out aren’t science-based, but just in general, I want you to think about like, yeah, you have to do both. You have to look at correcting the lies that depression tells you, but you also have to look at your behaviors and how can you engage in behaviors that actually make you more fulfilled and happy and not feeling down.  So, yeah, with depression, we look at a lot of thoughts that are very critical, sweeping generalizations, we look at a lot of thoughts that discount the positive. I thought that’s like discounting the positive like, “Well, yeah, even though I got an A in that test, still, I’m probably going to fail my last year of college.” So, they discount the positive thing and they make another sweeping statement. So, we really want to make sure we’re correcting thoughts when it comes to depression. It’s really important because depression lies.  Do we correct thoughts when it comes to generalized anxiety? Well, yes, we can. But this is where this topic is so important, is you want to be careful. If you’re spending a lot of time correcting thoughts, there’s always room to correct your thoughts about things. But if you find that you’re trying to correct your thoughts just to reduce or remove your uncertainty, then it’s likely that it’s going to get you stuck in a loop where you have to keep doing that thought correction in a somewhat compulsive way to feel good. And so, what we want to do here is, yeah, we want to be mindful of our thoughts, and then we may choose whether we want to correct it or not, or whether we just want to observe that I’m having a thought. This goes for depression as well because mindfulness-based cognitive therapy is a huge, huge science-based treatment for depression. So, you’re going to see a trend happening here. So, we always want to observe the thought because it helps us to diffuse from the thought and see it in perspective. And then we can choose to correct it if it’s helpful in that moment. Maybe if you’ve never corrected it before, if it’s a new thought that it’s helpful for you to do a little thought work with. And then again, you’d still do the behavioral piece with generalized anxiety. So, if you’re having a lot of anxiety, you still want to work on not avoiding things and not seeking reassurance and not doing any self-critical behaviors, and so forth.  So, yes, what I would say is there is some benefit to correcting thoughts. The main thing with this is as long as it’s not the only tool you’re using, because if it’s the only tool you’re using, you’re going to be putting in a lot of work, a lot of time of the day correcting thoughts, and that’s probably going to take you away from living the life you want. Several episodes I did a podcast about your recovery plan and what’s getting in the way. The truth is, if you can identify the things you want to be doing when you’re recovered, once you’ve done that, you can start implementing that right away. So, I often will check in with myself because I’ve been doing a lot of work too. Okay, I could correct the thought right now, or I could just immediately throw myself into the behavior I want to live by. That’s according to my values. And then I make a decision. What would be most helpful? Should I explore this thought? Or would this be a wonderful time to do my paint by numbers? PS, I love Paint By Numbers. It literally got me through COVID. You have to try it. It’s the coolest thing and it’s so fun. But I ask myself like, do I want to just allow the thought to be there and go do the thing I love? Or would it be helpful for me to correct it? There’s no right answer. But if I’m trying to correct things that I’ve already corrected and that I already know the answer to, yeah, I probably am going to choose to do the Paint By Number, if I’m completely honest. I think that’s a more effective route. You are going to have to think about it and do a little cost-benefit analysis for yourself.  Then we are going to move over here, and this is very similar. Does correcting thoughts help with obsessive-compulsive disorder? You can see a progression here with depression. Yeah, we do quite a bit of it. Generalized anxiety, a little less because it can sometimes be very repetitive. When it comes to obsessive-compulsive disorder, guys, you have to be very careful about correcting thoughts. Because if you’re correcting thoughts to try and reduce or remove your uncertainty, it will most likely, and I would probably go as far to say, definitely turn into a compulsion that will keep you stuck. Because remember, the treatment of OCD and obsessive-compulsive disorder often involves leaning into discomfort, leaning into uncertainty, leaning into doubt, leaning into tolerating whatever experience of uncertainty and discomfort that you have.  So, here is what I say to my clients, and this is exactly what I said to my staff. One of my staff had said, “Okay, when do we correct thoughts and when don’t we then?” And here is the thing. If somebody is coming to me and they’re saying something that’s an error in thinking around their ability to cope with discomfort, I would 100% correct that. So, an example would be, if a client says to me, “I can’t handle my discomfort,” I will probably have them challenge that. I might even say, “How do you know? Could this be the first time that you actually do tolerate this discomfort or cope with this pain?” So, I would 100% challenge and correct thoughts around their coping.  But if someone has a thought, “What if I have a panic attack?” the truth is, trying to correct that is uncertain anyway. You’re not going to be able-- you can’t say, “No, I won’t,” because you don’t know that. You can’t say, “Yes, I will,” because you don’t know that. So, only correct thoughts around your struggle to cope. Never correct thoughts where you’re trying to reduce or remove your uncertainty. That would be my best advice to you.  Another point here is, if you find you’re correcting the same thought repetitively, chances are, it’s a compulsion or will turn into a compulsion. The reason that I push this so heavily is you’re going to-- here is where I really struggle the most, is you’re going to-- if you’re on Instagram, a lot of you come, listen, you follow me on Instagram. We have an Instagram account called Your Anxiety Toolkit. There are hundreds of accounts that tell you to correct every single thought you have, and I don’t agree with that. I do not agree with that. I think that that is terrible advice. Because number one, you could spend your whole day doing that, particularly if you’ve got bad anxiety or depression. Number two, you could spend your whole day doing the exact same behaviors you did last yesterday and last week that obviously didn’t reduce or remove your discomfort. And the third thing to remember here is we have scientific evidence specifically for obsessive-compulsive disorder, but also for generalized anxiety disorder, that most people who have these disorders, there is a certain set of things happening in their brain where cognitive restructuring just doesn’t stick. The part of their brain that allows them to correct things, there’s a weakness there or there’s this bad connection there, which means if this were to work, it would’ve worked already and they probably wouldn’t suffer because they would go, “Oh yeah, you’re right. That doesn’t make any sense.” And off they go.  It’s really frustrating because I know a lot of you see your partner or your friend who can quickly correct a thought or quickly do a quick Google search, quickly get reassurance and they’re fine. They get to move on. But the brain of an anxiety disorder is different, specifically the brain of someone with obsessive-compulsive disorder is different. And so, for you, you might get a moment of relief, but then you find the thought comes right back. And so, again, there’s no real point you can. Doing it is like whack-a-mole. If you do it,then discomfort goes away and then it comes back and you do it again. And now you’re just stuck, like weeding weeds that keep growing.  So, these are the things I want you to think about for yourself. I’m definitely not telling you what you have to do. Again, this is not therapy. But I want you to do a little inventory for yourself and just ask yourself what would be helpful and what’s not. The last question I have here for myself is, when does correcting thoughts help in recovery? Just like I said before, if it helps you in terms of reducing your self-criticism, increasing your sense of mastery over a task, or increases your ability to feel like you can cope, well then, I think it’s a helpful tool. I’ll give you an example of that.  I personally hate running payroll. Every month, I have these beautiful 10 and 11 staff. It’s actually more like 13, 14 beautiful staff who work for me. And at the first of every month, I have to run all this payroll stuff. And guys, to be honest, I suck at it. I’m terrible with numbers. I get all the numbers mixed up. It takes me twice as long as it would, but I really do value the importance of me knowing what’s happening in my business. So, I do it. I’m doing it. While I’m doing it, I have a lot of thoughts like, “I can’t do this, I don’t want to do this,” and a lot of like, “Ah, this is too hard” thoughts.  So, in that situation, I’m correcting my thoughts so that I can embody a sense of like, “No, I’m a really good boss and I’m trying to run a business that helps other people with their life.” And so, I correct my thoughts so that I can embody like, “No, this is important. I want and I’m choosing to do this. This is important for my staff. It’s important for me to get it right. And it’s worth the time.” So, in that situation, correcting the thoughts is really helpful because it helps me with that degree of anxiety. However, if I was having thoughts like, “What if you make a mistake? What if you make a mistake? What if you make a mistake?” correcting my thoughts to like, “You won’t make a mistake or that’s not even true. So, it’s not going to be helpful.”  So, again, let’s go back. When it will help is when it’s around your coping, when it’s around your capabilities. So, if you’re having a lot of thoughts like you suck and you can’t and you’re not good enough, you’re not strong enough, you’re not wise enough, you’re not courageous enough, yeah, you can correct that into more encouraging statements. But we don’t do it around uncertainties. We don’t do it around uncertainties. That will keep you stuck. Now the last thing I will say here before we wrap up is, is there a difference between education, reassurance, and assurance? So, let’s just break that down. If a client comes to me and they say, “Oh my gosh, I keep having these horrible intrusive thoughts. Something must be wrong with me,” through the lens of education, I might educate them and say, “Listen, everyone has intrusive thoughts. You’re just like everybody else and you shouldn’t be ashamed. And I really want you to understand that having intrusive thoughts is a normal part of having a really healthy working brain.” I consider that education. And you deserve to get education around things. So, if you have, let’s say, a new illness, it’s okay to go and get educated about the new illness. That’s not a compulsion. Now, there will be times where you educate yourself and you need to tweak what you know or learn something new, and that is also fine. The thing I would have you as we leave for this episode just continue to think about is the thing that we want to look out for is when it’s called reassurance, which is repetitive over and over attempts to reduce or remove a thought specifically related to your anxiety or your uncertainty. So, that’s the real thing I want you to think about and look out for. Take note. And the other thing I want you to remember is, please don’t beat yourself up if there are days when you do a lot of thought correction and it turns out to be a compulsion. You’re just a human being. There is no right or wrong. Often, I’ll say to a client, they’ll be like, “But what if I do correct a thought?” I’ll say, “You know what, you’re going to have ups and downs. So, try not to get too perfectionistic about this practice.”  There’s just these general ideas and you’ll know in your body if you’re doing it compulsively. A great and easy way to know if you’re doing something compulsively is, are you doing it with urgency? Are you doing it with an experience of resisting discomfort in your body? Are you doing it to reduce or remove a thought that you’re having? And are you doing it repetitively? Those are things where if you’re doing those things, you will know you’re probably doing a compulsion. And in fact, I encourage you to get really good at catching those things because then you will be one step closer to recovery.  Alright, my loves, that ends the episode on whether correcting thoughts is a compulsion or not. I’m going to let you really come to a conclusion on your own, or you can go and speak with your clinician and get to the bottom of that for yourself. Have a wonderful, wonderful day. It is a beautiful day to do hard things, and I will talk to you very, very soon, aka, next week. Have a good one, everyone.

This is Your Anxiety Toolkit - Episode 293. You guys, I’ve totally screwed up. Oh my God, it’s going to be one of those episodes where I laugh a lot. Maybe not. Who knows?  Alright, I totally screwed up. It’s funny because I have for months been thinking about doing an episode and reminding you guys mostly so I could remind myself that I’m a human being, that I’m going to make mistakes, and it’s one of the biggest lessons that I have had to learn over and over and over and over again. It’s really frustrating, you guys. I’m so frustrated by this fact that humans make mistakes. I don’t like it. It makes me mad. If only we could figure out a way where we don’t and we don’t disappoint people and we don’t screw up. If anyone has figured this out, let me know. Just shoot me an email, tell me your special secret, because I haven’t figured it out yet. So funny.  Okay. Before we get into it, this is actually pretty much a coincidence and I love when big coincidences happen, but the review of the week is actually from Flashcork. They’re writing a specific review on Episode 193, which I think is really cool because this is by coincidence 293. And they said: “This episode 193 is just what I needed to hear today. I’m stressed and anxious about my upcoming trip and experiencing racing thoughts. This will help me to manage those feelings and practice by shortening the leash.” Now, if you haven’t listened to this episode, it is probably one of my most favorite episodes. A lot of my patients and clients have said that this concept has helped them a lot. And so, really go back and listen to 193. If you want to practice being able to be in a place where you can manage those thoughts a little better, go back and check that out. It’s just a metaphor.  Flashcork says: “It makes sense because it has worked for me walking Sally, my Golden Retriever.” I make a reference to thoughts being like a dog on a leash. So, you can go back and listen to that anytime. That’s the review of the week. Thank you, Flashcork. So happy to have you join us.  The “I did a hard thing” is from Allison. Allison says: “I’m going to go on a job interview next week after applying to a different job, going through the grueling interviewing process and at the end not being successful. I’m working really hard to believe in myself, screw up my courage to attend this interview and be open-hearted about the new possibilities. It’s hard to pick yourself up and try again, but I’m doing the hard thing of trying again. I’m scared, but I’m proud of myself.” Allison, you are doing the work. And I’m actually going to take your advice today, Allison, because this is so perfect for the topic of today, which is like, yeah, sometimes we do screw up and we just have to get up and we have to try again. It’s so important. I’m so, so I’m impressed. I’m just so impressed with your courage and thank you so much for sharing that because I think we’ve all experienced it.  So, Allison, let me tell you my hard thing. I want to preface this with, I think in my-- if I’m being completely authentic with you guys, I think that I’ve somehow, for many years of my adulthood, without me realizing, and in not a super severe way either, it was a very secret underlying compulsion I think I’ve been doing for years that I didn’t even know I was doing until the last couple of years is I was trying to find a way, constantly striving to find a way that I could live in a world where I didn’t make a mistake. Now I understand I’m a human. I don’t think I’m a superwoman. But in my mind, I think I’ve had-- well, I know I have, let’s be honest. I think in my effort to control my emotions that I’ve engaged in these little nuanced secretive behaviors of constantly trying to find the formula where I don’t upset people and I don’t screw up. Let’s just take a minute because it’s funny for me to say that because how many times during the week with my clients and with you guys and everything I do is about self-compassion and letting go of control. And all along there was this nuanced little secret slither going through my life. And I think that number one, a part of this is true for a lot of people who have anxiety and are high functioning. Because I spoke to a couple of friends about this and they were like, “Yeah, to be--” when you have anxiety, to be high functioning, you have to put in place systems and procedures and routines to keep you going. And it makes sense that we often engage in other little behaviors that make us feel like we’re getting control when we don’t.  Everybody knows, I even spoke about it a couple of sessions ago, that I am so in love with calendaring. My life has changed since I’ve been more intentional about my calendar. I’m not compulsive about it at all. Because I’m managing two children and two businesses and a chronic illness, if I can be really intentional and effective with my schedule, I can go into the day. I never worry about what I have to get done anymore. Really, I don’t. It was the best change I ever made because I have a system where I write down what I need to do and I throw that list out because I immediately calendar the times that I’m going to do it. So, I know it’s going to get done because it’s in the calendar. And if I don’t get it done, I’ll reschedule it. And I know I’ll get it done. And through the process, I’ve actually built such trust with myself. I know. I know I used to worry that I won’t get things done. I never worry about that anymore because I’ve gotten really good at this process. You guys know what’s going.  This week is literally the only week of the year where the things on my calendar cannot be rescheduled because my beautiful daughter, who is a delight, she’s growing up to be this absolutely gorgeous human. I wish you could all meet her. She’s just so good. I know I’m biased, but she is just so wonderful. It’s her graduation. She’s graduating elementary school, you guys, and I’m going to have a middle schooler next year. So, the one thing this year-- because I’m my own boss. I can schedule what I want. The one thing I can’t miss is her graduation. And last week, you know what’s going to happen here I was prepping to present at this conference and I got on the call and then we were doing this rehearsal and she said, “Okay, great. I’ll see you next Friday.” And I was like, “No, no, no, no. It’s the week after.” And she said, “No, no, no it’s next Friday.” And I’m like, “No, no, it’s not. And I’m always right. It’s in my calendar.” And she’s like, “No, it’s really not. It’s next Friday. You agreed to it on this date.” And I realized she’s right. Now, I said to her, literally, “I cannot do it with this whole thing. I can’t do it. I’ve totally screwed up. This is not something I can reschedule.” And she was like, “Oh, okay.” So, she had to basically message a whole foundation. They had to change everything. They had to try and figure it out. This is where it was so humiliating, is they had to reach out to the person who was going after me, who is a very, very, very well-known person in the OCD community who I respect and don’t know. So, it’s like I have a relationship and had to ask him to reschedule his entire day because I screwed up.  Now, I know this is not a huge disaster. This is in the grand scheme of things. This is not a huge problem, but I felt so bad. Oh my God, it was so painful. I was in this meeting and to see their faces of just pure annoyance and frustration and anger of like, “What? You got the date wrong?” They were very kind, but I could tell they were annoyed.  And so, my question to you, because I love questions, is what do we do when we screw up? What do you do when you screwed up?  Now you might be thinking this isn’t a big deal. I want you to think about a time when you did screw up that’s a big deal for you, and I want you to ask yourself, what did you do when you screw up?  Immediately for me, this is the reason I wanted to really do this episode, is there was this interesting shift in me this time where-- because I haven’t screwed up this big in a couple of years. This was a pretty huge screw-up. I looked like a complete fall in something that was organized months ago, we’ve been talking about it, emailing back and forth. How did I miss this? I don’t know. But what was fascinating to me is, once upon a time, I would’ve said some very mean things to myself. Really, really mean. And I probably would’ve-- now that I’m noticing it is I would’ve responded, not just with self-criticism, but I would’ve tightened my belt even more with checking behaviors, rechecking, more controlling calendar, like compulsive calendaring. I would’ve overcorrected because I have been known to overcorrect. If you ask my partner, he’ll tell you I often used to overcorrect pretty bad. If I make a mistake, I would-- if I upset someone, I would go overboard trying to get them to like me again. Or I remember I used to-- if I was worried I offended someone, I would like to apologize over and over and over again. I don’t know if you’ve done any of these behaviors. You might want to gently say, “Kimberley, you’re not alone.” I’m kidding.  But this time what? I notice this shift in me where I was like-- what I say to my son all the time is, “Oh my gosh, I’m such a ding-dong.” I’ll say you’re such a ding-dong and he’ll say you’re such a ding-dong. It’s a funny thing. It’s lighthearted and it’s not critical. It’s just like, “Ding-dong. You’re such ding-dong.” And what was interesting is I responded by went, “Oh my gosh, I’m such a ding-dong,” but it wasn’t-- I said things that sounded critical, but it wasn’t. There was this giggle to it. There was this acceptance of my humanness to it. It was so playful in my response. And I mean, this is a big deal for me because I very much value the respect of the people in my field and I work really hard to get their respect. Not in a people-pleasing way, but it’s a very big value for me. And it was funny. I just went, “Oh my gosh, I’m so sorry. I’m a ding-dong.” And then I said, “What can we do to fix it?” It was just a very transactional thing. Whereas before I would’ve, “Oh my God. I’m so sorry. I’m such an idiot. I can’t believe I did this. You should fire me.” I would just go overcorrect.  So, let’s come here to the questions because I love the questions. If you’re driving, don’t do this. But if you’re not driving, I’d love for you to actually sit down with a notepad and just journal some of this out. So, when you screw up, what do you do?  The second question is, is it okay for you? Because it was fine for me, and I want you to actually check-in, is it okay for you to make jokes about yourself? Answer it honestly. If it’s a yes, that’s okay. It can be giggly, nothing too harsh. If no, take that and really follow that out when you do make a mistake.  Number three, is it helpful to apologize? Yes, of course. When we screw up, we should apologize. But how many times? And how do we apologize? Do we say it in a way that’s very factual, “I’m so sorry, this is a huge inconvenience for you”? Or do we say, “I’m sorry, I’m such a mess, screwed up person. I’ve ruined your day,” and make up a whole story about it? Because a lot of us do that when we screw up. Do you apologize over and over and over?  Catch how do you respond to try and make it up to them. And that’s a really big one. Because if you find that you’re trying to make it up to them that’s okay. But are you doing it because it equals the degree in which you screwed up or are you doing it just to remove the discomfort you feel about the fact that you’re a human being? Make sure it’s in proportion. So, if you, let’s say, forgot to text somebody about something, you wouldn’t need to buy them a $100 gift card. That’s going overboard. Maybe it depends on the situation, but we’re just making an assumption here. If you forgot someone’s birthday. Well, yeah, you probably need to take them out for dinner and do make a big deal about it. But do you need to do that four times this month or throw them a party that puts you out of pocket? No. Don’t try to make it up to people in a way that actually takes away from your well-being.  This is the next thing, is-- once I did this, I was really proud of myself. I’m not going to lie. I handled it pretty well, I think, and I was like, “Wow, I’ve made some pretty big growth in here obviously.” What was interesting is, once I hung up from them and I was like, “Oh dear.” I have all of these emotions, which I’ll talk to you here in a second about, I had to ask myself. The next question is, how long am I going to be on the hook for this, meaning from myself? How long am I going to hold myself on the hook? When am I going to let this one go? Because what I could have done is I could have said, “Okay, I made a mistake. It was not a good mistake there.” Obviously, I need to make some changes, but I’m going to beat myself up for the rest of the day. I’m going to ask yourself, how effective is that and is it in proportion with what happened, and is it effective? Really, does it make it less likely that you’ll do it again? The truth is, if I beat myself up all day, it’s not going to reduce the chances of this happening again, because it was a human mistake. And then the last question is, what can I do to resolve this if anything? But let me come back to the emotions because those questions are very much related to these emotions. When you make a mistake and whether-- let me pose a couple of things to you. It could be something you do to somebody else. It could be something you do to yourself. Meaning if you do a ton of compulsions and you are up all night and now, you’re exhausted, or it’s any mistake you make. You had a huge panic attack and you left the party of your best friend and she’s really mad at you because you left her birthday party. It could be that you were depressed and you just couldn’t show up for your friend this day. So, there are so many ways in which this plays out. It doesn’t just have to be with scheduling. When we upset other people or our behaviors impact other people, it’s normal to feel strong emotions. That’s normal. Often what we do is when we feel those strong emotions, we respond to them as if we need to squash them immediately, because we’ve told ourselves we can’t tolerate them. Guilt is probably one of the most common, shame being the second. There may be some anxiety related to it as well, or maybe some other emotions as well. But let’s take a look at those emotions and just quickly review how they may actually impact you.  So, when we feel guilt, guilt is usually you’ve done something wrong, and I had done something wrong. So, guilt was an appropriate emotion. But I always think of guilt-- I’ve done episodes on this in the past. I think of guilt as just a stop sign to ask you, is there anything I can do to fix this now or in the future? Again, just really logical. In this situation, yeah, I can reschedule. I can be honest. I can do what I can to apologize. But beyond that, there isn’t anything else. And so, any residual guilt I feel from there, I must just tolerate. I must compassionately ride the wave of guilt. Often, I see my clients, and I’ve done this myself, is if guilt is here, I’m going to beat myself up for it. No matter what, that’s the conditions. If guilt is present, I will beat myself up. And I want to invite you to have guilt and just be kind and let it ride. It’ll burn off like a candle. It’ll burn itself out and it’ll slowly dwindle away.  Guilt is “I did something bad.” Shame is “I am bad.” If you do something and you screw up, and you feel shame, your job is to check-in and recognize that mistakes don’t make you bad. Literally, no mistake. There is not a mistake you could tell me of that makes you bad. Even if there was an absolute catastrophe that happened, mistakes don’t make you bad. You’re a human being. You’re going to make them. And I know, like I said to you, if you figured out how not to be human, please email me. I’ll happily take your email into my inbox and I’ll apply your rules. But the truth is, I know none of you are going to email me because it’s not possible and we have to accept it. We have to accept it. I’m just joking really about the email.  And so, there is really no place for shame. If you feel shame, same as guilt, write it out compassionately. Give it very little of your attention. Don’t get into the content of what your shame is saying. Write it out and let it go. Meaning, like I said to you, there’s really no point in me dwelling on this because it’s done and I can’t do anything about it. All I can do is be kind to the feelings I’m feeling. Now, a lot of people will say, “Oh my gosh, I wrote this response on an email or call or I presented, or I was in a party, and now I feel nothing but anxiety because I totally made a mistake.” I’ve had people even say like, “Oh, I was at a party and I passed gas,” or “I said something stupid.” I mean, I could tell you some absolutely ridiculous stories.  Actually, let me tell you a quick, funny story, because I’ll come back to this, is recently, I attended this creative writing course, but it was actually a writing course for people who are business owners, and they were talking about getting really clear about you and the message you want to give and how to tell stories about it and so forth. And he was asking these questions about, who are you? And what’s something that the people closest to you would say? And I was thinking about it and I don’t think you guys know this about me, but I have, not in my professional life, but in my personal life, I have a way of the most bizarre things happening to me, like silly things. I always find myself in these situations where everyone is like, “Oh, only Kimberley would get put in that situation.” So ridiculous. I can’t even-- one day I think if I really let go, I’ll tell you some ridiculous stories. But if something really bizarre is going to happen, it always happens to me. And so, I just wanted to tell you that, because I want you guys to know that as the podcast is where I get a little more personal and bizarre things totally happen to me all the time. But let me go back.  So, let’s say you have anxiety. You’re having anxiety about something that happened, and you’re thinking like, “Oh my God.” And your brain is just telling you catastrophe after catastrophe, after catastrophe, all of the worst-case scenarios. The truth is, that’s your brain’s job. Its job is to tell you of all the catastrophes, but it doesn’t mean you need to respond as if they’re all true and happening. And so, again, we go back to these core questions, is how can I stay with the facts that it happened? How can I acknowledge that it is what it is and that I can’t solve it, I can’t make it go away? And how can I act in a way that doesn’t overcorrect again, not over-apologizing, not asking for reassurance, not avoiding those people, not saying too many jokes, and so forth? So, we want to catch that. We want to catch how we go into anxiety and respond in that compulsive way.  As I said to you at the beginning of this episode, I think that I was for many years doing this very nuanced compulsion of over-checking schedules and even being super neutral and kind to people so that I would never offend them. Stripping my personality down just so I would never harm them or never hurt them, which is not me being authentic, and I can see that now.  So, these are the things I want you to think about. And then once you identify these strong emotions – again, we’ve looked at guilt, we’ve looked at shame, we’re now looking at anxiety – the job is to ride them out, let the anxiety burn out on its own. We don’t need to tend to it. It happened because we’re human and we’re going to allow it to rise and fall on our own.  So, here is where I want you now to, number one, give yourself permission to be a human. Humans screw up. It’s a fact. It’s something we have to accept. How can we be in these situations and change the way we react so that we are not beating ourselves up and we’re not overcorrecting for the future?  The only last thing I’ll say here is, if you’re trying to control what people think about you, you’re never going to win because what they think is a reflection of them. So, here is the last point. I screwed up. It’s just a fact. I put other people out. My mistake is probably going to interrupt some people’s time next week. I don’t like that. That doesn’t line up with my values, but it is what it is. There’s not a lot I can do. But what they think about me is completely a reflection of them.  So, if let’s say this one person goes, “Oh my gosh, she is such an unorganized person and is horrible,” that really shows the degree in which they’re judgmental. Meaning they haven’t allowed me to show them that I’m more complex than that, that I have many other qualities, and so forth. If they were to say, “Oh my God, you’re fired, you’re terrible,” again, that’s not a fact either. And that’s a reflection of them and their struggle to be flexible and find solutions and so forth. Not that they’re bad, it’s just it’s more of a reflection on them because, in this situation, the people were very kind and they said, “We’ll work it out. We’ll see if we can reschedule you to be later on in the day,” and that it really was a reflection of how flexible they are.  So, I want you to really remember here that you making a mistake doesn’t make you good or bad. Their judgments about you doesn’t define whether you’re good or bad or that they’re good or bad. It’s just we’re doing the best we can and it’s just it is what it is.  So, that’s it, guys. We make mistakes. It’s terrible. I know it’s hard. It’s really painful, but can we hold space for the pain and the emotions associated and ride them out without beating ourselves up? That’s the real question.  Have a wonderful day, everybody.

SUMMARY: In this episode, we explore how to manage uncomfortable sensations. Many people do not struggle with intrusive thoughts and intrusive images, but instead, struggle to manage intrusive sensations. My hope is that this will give you some tools to manage these uncomfortable sensations and help you reduce how many compulsions you do to reduce or remove these feelings. In This Episode: What is an intrusive sensation? What is the difference between an uncomfortable sensation and an intrusive sensation. How to manage uncomfortable sensations such as rapid heartbeat, tingling limbs, numbness, lightheadedness, chest pain, etc. Links To Things I Talk About: ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com. CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors. Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 292.  Welcome back, everybody. Today, we are talking about something that I very rarely talk about that I should be talking about more because it’s like 20% of the conversations I have with clients. And I’ll explain to you why in just a second.  First, I’m going to do the review of the week. This one is from Linelulu. And they said: “Grateful. I am so grateful that I stumbled onto your podcasts. Your soothing voice enhances your messages as I am trying to understand more about anxiety, and panic attacks to be a better support for someone very close to me. Thank you!” You are so welcome, Linelulu. Thank you for that beautiful review. Please, I know I ask you every single episode. If you benefit from this podcast, this is one way that you can help me. So, if for any reason you feel like you have a few spare minutes, please do go and leave a review.  The last thing before we get talking about sensations is to do the “I did a hard thing” of the week, and this one is from Camille. Camille says: “I’ve been managing my dermatillomania,” which we also know is compulsive skin picking, “very well. However, I had a very stressful day and picked my skin pretty bad, in my opinion. I had a party to go to that night with a bunch of people. I didn’t know. And I almost didn’t go. But I pushed myself to go and no one said one thing about my skin. I’m so glad I went and got over the fact that my skin needs to be perfect in that instance.” Camille, this is so good on so many levels, that you showed up and you did the thing that you wanted to do. And ugh, it’s so good. And how wonderful that you had supportive friends. Again, we sometimes were really hard on ourselves and we think people notice everything about us, every flow, but how wonderful that they embraced you and no one said anything. So, thank you so much for Camille for putting in that “I did a hard thing.” I just love hearing you guys doing all the hard things. Now, why do we do this segment? Let’s just go back and look at that. So, most of you know that the thing I say all the time is “It’s a beautiful day to do hard things.” Our brains naturally default to this idea of like, “No, I shouldn’t do the hard thing. I should do the easy thing.” Marketing keeps telling us don’t do the hard thing, do the easy thing. Commercial advertising is always sharing the easy five-step way to do something. And we want to flip the script because while it’s good to have things be easy, when it comes to anxiety and these kind of conditions that we’re often talking about, it’s often important that you stare that scary, hard thing in the face.  Now, that is the perfect segue into this week’s episode about sensations. Now, at the beginning of the episode, I said it’s crazy that I haven’t done a lot of these episodes because sensations is 20% of the work. Now, why did I say that? In total, the clients that I see and that my staff see in our private practice, they’re coming to us for one of five reasons usually. They either have an intrusive thought that they don’t know what to do with, they have an intrusive feeling that they don’t know what to do with, they have an intrusive urge that they don’t know what to do with, they have an intrusive image that they don’t know what to do with, or they have an intrusive sensation that they don’t know what to do with. Five things.  99.9% of our patients and of the people that we help come with one of those five problems. It doesn’t matter what you call it. They’re coming with, “This is the experience that I’m having.” That’s so overwhelming and difficult and hard that then they go on to do behaviors to try and manage it, and we teach them how to manage those five things in a way that doesn’t require them to do the behaviors that cause them trouble.  So, let me give you a little more information about that. So, when we’re talking about sensations, we’re talking about-- let’s first get a definition. What is a sensation? A sensation is a physical feeling or a perception resulting from something that happens or that comes into contact with the body. So, really what we’re saying is a sensation is an experience you have in your body and it’s very specific. So often when I’ll say to a client, “Okay, how can I help?” they’ll say, “Well, I’m anxious.” And I’ll say, “Okay, tell me about your anxiety.” And they’ll then usually go on to say, “Well, I’m having these thoughts,” or “I’m having these feelings,” or “I’m having these urges. I’m having these images,” or “I’m having these sensations, and I don’t like it. They make me uncomfortable.” And when I have them, I do these again, like I said, behaviors that kept me into a ton of trouble. Meaning they’ve got big consequences.  So, often a sensation we consider to be an obsession, just like an intrusive thought, is an obsession. It’s as relevant. And it’s important if someone has anxiety for us to go, “Okay.” This is a common question. If you were my client, this is a common question I ask. I’ll say, “Imagine that I’m an alien and I’ve never, ever once in my life experienced anxiety, and I want you to tell me what it feels like because it doesn’t make any sense to me.” And often clients will struggle with this because they’ll be like, “Well, I just have anxiety.” And I’ll say, “No, we need to understand what specifically, how do you specifically know you’re anxious?” “Oh, I have tightening in my chest or I have shortness of breath, or I have a lump in my throat or I have these butterflies in my tummy.” So, immediately, once we get that, we’re like, “Okay, now we know what we’re dealing with. Okay, now we have specific sensations and now we can develop tools around them so that when you have them, you don’t either engage in avoidant compulsions or physical compulsions or mental rumination or reassurance or self-punishment.” So important.  Now, let’s slow down here a little and look at what that looks like for many of my patients and many of you. So, this is not scientific, what I’m about to tell you. This is really just coming off of my stream of consciousness and my experience as a clinician, is I’ve broken them down into four main sensations that my patients report to me. Again, this is not a clinical list. So, I want to preface. I don’t want to ever mislead you into thinking this is scientific. But often one of the sensations that people will feel are physical experiences of anxiety, like I listed. It could be butterflies in your tummy, tightness in your chest, as I just said, and I’ve listed them off.  The next one is specific sensations around what we call depersonalization and derealization. I’ve done full episodes on those in the past. So, go back and check them out. But this is the experience of this weird feeling. The sensation is like, everything feels strange. I feel like distorted, like I’m in a daydream. It feels very hazy and strange, or I feel like I’m outside of my body. Now while we have words to describe derealization and depersonalization, they are also at their most basic form of sensation, a basic sensation. So, I put that in its own category.  The next one is similar to anxiety and derealization and to personalization, but I’ve put them under the category of panic. Now, the reason that it’s so important for us to talk about sensations is, people who have panic disorder are very sensitive to the sensations that they have because panic is such a 10 out of 10 anxiety. So, it’s like can’t breathe, racing thoughts, major overwhelmed, dizzy, sweating. These are all sensations. These are all things that we perceive or we experience in our body.  And then the last one is physical pain. This is a sensation too. When you physically have pain, a tummy ache, that’s also a sensation.  Now, let’s talk about why I separated those, because I’ll give you a really perfect example of how this gets messy. Most of you know that I have postural orthostatic tachycardia syndrome, which is symptoms of dizziness, lightheadedness, headaches, stomach troubles. And often if you stand for too long, you faint. Now, what does that sound very similar to? You guys are probably laughing at me already. Anxiety. It looks exactly like anxiety except the fainting piece, dizziness, lightheadedness, stomach aches, headaches. So similar. And so, when we have, and this is where it gets difficult, when we have a chronic illness or if we have health anxiety, when we experience a sensation, sometimes we can’t figure out whether it’s real pain and real threat or if it’s anxiety.  The thing to remember here is the response needs to be similar. So, for me, when I had dizziness and lightheadedness, yes, of course, I’m not going to push myself to a place where I pass out, but I’m going to first stop and go, “Hmm, let me try to dip into these sensations. Instead of catastrophizing them as this is terrible and bad things are going to happen, I wonder what would happen if I just labeled them as a sensation.”  The thing here is, when we have sensations, and you’re having them right now, believe it or not. It could be an itch. It could be a muscle that’s sore from a workout you had, it could be a stomach ache because you just ate an amazing dinner and you just had a little more than you wish you had, or you’re having anxiety. We all have them. Where we often get into trouble is when we label them as good or bad. So, that’s the main point here first. Are you labeling your sensations as good or bad?  When I would have my POTS symptoms, I get dizzy. At the beginning, I go, “This is bad, this is bad. Bad things are happening,” which would then give me anxiety, which would make it worse. And now I’ve got this hot mess. Massive hot mess. Same for people with health anxiety. They have tightness in the chest and they go, “Oh my God, I’m dying. I’m having a stroke,” or “I’m having a heart attack.” And when we label it as bad, we get more anxiety, which makes it worse, and now we’re in a cycle. If you’re having a panic disorder and you’re starting to notice that small little tingle of anxiety coming up, this like whoosh of anxiety that whooshes over you when we have a panic attack, and you label this as, “Oh, this is bad, this is terrible. I got to get it to go away,” you can bet your bottom dollar, it’s actually going to feed you more anxiety. So, question whether you are labeling your sensations as good or bad. Now I’m guessing some of you are thinking, “Well, Kimberley, of course, I’m going to label it as bad. It is bad. It’s terrible. I don’t like it.” And I get you. But we’re here to learn. We’re here to grow. We’re here to recover. So, I want you to think beyond that judgment and look at first the judgment doesn’t help you. Whether it’s true or not, it’s not helpful. It makes it worse. So, let’s work at being nonjudgmental about the sensations that we have.  The response we have to your sensations can determine whether you get stuck in a cycle of having more discomfort. Let me rephrase that in a different way to make an even bigger point. The response you have to your sensations can determine whether you have anxiety about them in the future. Because if you treat the sensations today like they’re dangerous and harmful and they require immediate emergency, you’re training your brain to perceive those sensations as scary and bad and dangerous. And so next time you have them, your brain is going to send out a whole bunch more anxiety. So important.  I’ve had my share of panic attacks in my life, but when I have them and if I’m like, “Oh, dear God, please don’t,” I know my brain is going, “What, what, what? What’s wrong, Kimberley? Why are you telling me this is terrible? Okay, it is terrible. I’ll keep sending out anxiety.” But when I can respond by going, “Good one, brain. It’s cool. There’s no amount of sensations I can’t tolerate. It’s fine. I’m going to ride it out.” Again, we don’t know how to bypass it with positivity by going, “It’s great. I love it.” We’re not saying that. But we are saying if we can reframe the sensation as tolerable and manageable, you’re less likely to have anxiety about the sensation tomorrow. Now, I know a lot of you may be asking, “But how do I know when it’s something to just be uncertain and nonjudgmental about or when I should rush to the hospital and so forth?” Number one, you’ll know. But the other piece, I don’t want to discard you on that one because that’s hard to say, especially if you have anxiety, especially OCD and health anxiety. But the other thing is, for me, if I’m having it and I’ll use me as an example, if I’m having dizziness and lightheadedness, which could be anxiety or it could be my POTS, I just keep on the deferring. I keep on deferring like, “Okay, can I just stay with it nonjudgmental for another few minutes?” If I’m getting to feel really horrible, of course, I’m going to sit down and take a rest. I’m not going to push through and be unkind. But I just keep being curious. Could I it do a little longer? Could I have a little more? Could I be nonjudgmental for another few minutes?  It’s so important because when it comes to anxiety, the way in which we respond to the sensations is as important as how we respond to intrusive thoughts. Particularly like I said, if you’ve got depersonalization, derealization, panic disorder, physical pain, generalized anxiety, health anxiety, so important. If it’s social anxiety, it’s a big one because a lot of people with social anxiety have an aversion to the sensation of being flushed in their cheeks. But if you respond to your cheeks flushed as bad, you’re probably going to get more of it. It’s paradoxical. Now, here is one other point I want to make before we finish up, which is there is no sensation you can’t ride out. This was a huge one for me because I’ve had anxiety and I’ve had some pretty bad chronic illnesses. If I go into the day telling myself, “I won’t be able to handle it,” I usually have anxiety about the day. Have you noticed that? I know you can’t answer back, but I really want you to consider the question. Do you notice that in your experience? When you tell yourself “I can’t handle things,” does that actually then create more anxiety for you? And sometimes more depression too, if I can be completely honest.  Last week, we did a whole episode on depression. I think it’s really important to recognize that. Even I should say other sensations are like depression, that’s that sinking, dark, gray sensation that goes with having depression. I should put that there as the fifth type because that’s a sensation that can be scary too. Grief can be an experience that-- there are sensations associated with grief that feel intolerable. But when we tell ourselves we can’t tolerate them, we actually then create more anxiety and depression. So, these are things to think about when it comes to sensations.  Now, if you were in an office with me or one of my staff, we are most likely to say, at the end of the day, you’re going to have to say, “Bring it on.” Once you identify the sensation, it really comes to, do you avoid it or do you say it’s a beautiful day to do this hard thing, to experience this hard thing? And so, we would say, “Bring it on.” Now, in ERP School, we talk about this. I probably should do an episode on this. Let me just actually write myself a note to episode on this. If someone really comes to our office with a stronger aversion to certain sensations, we do what we call interoceptive exposures. We talk about this in ERP School. It’s an online course. But an interoceptive exposure is where we purposely expose you to the sensation that you’re avoiding.  So, examples might be, if you really don’t like dizziness and you’re doing things to avoid dizziness, we would sit you in our chair and we would spin you around 30 times and then we’d walk the hallway ways with you while you’re dizzy.  If you’re afraid of shortness of breath, we would give you a very small straw. One of those straws that you use to stir your coffee with, and we would have you practice breathing through that so that you, on purpose, tolerate the feeling of having shortness of breath.  If you really don’t like the feeling of shortness of breath, like tightness in your chest, we might wrap a bandage around your chest, so tight that it feels like you can’t breathe, just for a few minutes. We’re not here to torture you. But these are examples of interoceptive exposures that we do because not only are we like “Bring it on,” we’re like, “Let’s have more of it.” Let’s practice doing it so we can practice nonjudgment, we can practice non-aversion. We can practice saying I can handle this and learning that we can handle this is cool. So, so cool. That’s the thing.  So, depending on where you are and how severe you are in your aversion to sensations, there are multiple ways you can respond. I want you just to use this episode as an opportunity for you to check in, where are you in respect to your experience with sensations? Do you have aversion to them? How willing are you to feel them? Questions are my favorite, you guys. You know this about me. So, ask yourself these questions. So important.  All right. That is it for sensations. I hope that is helpful. I know I took you on a couple of meandering tangents there, but I hope you stayed with me. I love talking to you about this stuff and I hope that that did give you some clarity on how you may handle it in the future.  All right. I will see you next week. Have a wonderful, wonderful day, and don’t forget, it’s a beautiful day to do hard things. I’ll talk to you later.

SUMMARY:  A few months ago, I posted on social media and asked “What are your best tips for depression” and the response was incredible.  Hundreds of people weighed in and shared their best tips for managing depression with OCD and other anxiety disorders.   In This Episode:  Hundreds of people with depression shared what skills they use to manage OCD and depression  What skills can become compulsions  How to manage day-to-day depression when you are feeling hopeless (OCD hopelessness)  Links To Things I Talk About: Kimberley’s Instagram Page https://www.instagram.com/youranxietytoolkit ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit Episode 291. Welcome back, everybody. So, I want to set the scene here because things are shifting. Things have shifted. So, I am right now sitting in my office, which is in Southern California, in the United States. But as this launches and goes live, I will be in Australia for the summer. I think I’ve talked to you guys about this in previous episodes, but my husband and I made a decision that the children and I will go to Australia to see our family for the entire summer. Oh my goodness, what a huge undertaking, but we’re doing it and I am so excited. So, really, I’ve had to batch 10 episodes ahead of time.  Now, what I’ve done is I’ve done my best to make these the best episodes I can batch for you, like the things that seem to be coming up the most for my clients, the questions my staff seem to be asking the most, and the things that everyone seem to be really, really liking and appreciating on social media. And so, in preparation for today, I was thinking about what’s one of the most helpful, most enjoyed, and engaged posts on social media, because I do spend a lot of time over on Instagram. And by far, interestingly by far, my most popular post I have ever made in the whole history of me being on social media is tips on managing depression. What? I’m an OCD and an Anxiety Specialist, but yet my most popular post in the whole time I’ve been there is on managing depression. So, that’s what we’re talking about today.  Now, in order for me to do 10 posts, 10 podcasts, excuse me, in order, I’ve had to manage my time down to the minute because right now we are leaving in 18-- no, what is it? Not 18 days. It’s like 15 days. So, we’re leaving in 15 days. I have all of this in addition to the work because I usually just do these here and there. I’ve had to manage my time, and what I have relied on the most is managing my time using what we call “calendaring.” I talk a lot about this on my online course. If you go to CBT School, we have a whole course on managing time.  But the reason I also share that with you is as we talk about skills today, we’re going to be talking about cognitive skills and behavioral skills. And if you have depression, I strongly encourage you to go and sign up for that course. It’s not an expensive course. It’s jam-packed with how to schedule your time so that you can lessen the heavy load that you’re carrying or the time about the lists of things you have to do and get done. So, I do recommend you go check that out. Go to CBTSchool.com and I think it’s /time management. Yes, it is.  We’re about to get into the show. First of all, let’s do the “I did a hard thing.” This one is from Anonymous and it says: “I stopped driving and spending time with children because of OCD. But yesterday, I drove my little sister to school. I was scared, but I’m so proud of myself. Thank you, Kimberley.” This is so good. I can’t tell you how many people when they’re anxious, they stop driving. It’s actually a really common question I get on social media. It actually surprised me at first in that how common it is. It’s one of the first things people stop doing, is driving. So, Anonymous, amazing. You are just all for the correct courage and all for the bravery and I’m celebrating you right now. That is so, so amazing. Great, great job.  And one more thing, let’s do quickly a review of the week. This is from Robin. Robin says: “I’m not sure how to condense all of my happiness and thanks, but I’ll try. Was recommended to listen to your podcast by my therapist (who is just superb and I’m grateful she exists) and I instantly fell in love with your genuine desire to help which seeps through the sound waves. I am hooked on the real-life stories that I can connect to my own experience and have gotten my sister hooked as well who struggles with anxiety as I do. Thank you for your tools and support!” Thank you, Robin, for that amazing review. Please do go over. And if you listen to the podcast, leave a review. It does help me help other people and more than ever, that is my biggest mission.    Tips to Manage Depression (From Hundreds Who Have Been There)  All right, let’s do it. So, let me just give you a little bit deeper context here. So, what I did is I did a poll on social media. So, just to give you some context, I have around 75,000 followers on social media. So, I posted: “Please just give me your best tips for managing depression.” Hundreds of people wrote in and the reason-- I don’t give you the numbers because I’m bragging. I want you to know this is not just from me. This is from hundreds of people who weighed in, who’ve been there, who’ve had depression and they shared little nuggets of what has helped them. And I want to-- in fact, we actually had to split this post into two because there was just so many submissions that we couldn’t fit them all in one post. So, here we go.  The number one tip for managing depression and these aren’t in order, by the way, this is not the one that was most popular. This is just as we went through, these were the ones that seemed to be really coming up for the same a lot of people. The first one is-- this is going to be a fun one for you, is many people reported that having a dog or a cat or a pet helped them to feel like they had a purpose in the world, that they were there to take care of someone, and that that pet gave them an incredible amount of love.  I loved this one. What was interesting, I’ll give you feedback right away, is there was a little controversy and feedback around this. A lot of people were saying, “Please don’t encourage people to get a pet just because they’re depressed. Taking on a pet is a huge responsibility.” There was a little controversy, a little backlash, I would say, over that point. But I really do agree that those who do have a pet and can commit to taking on a pet have found that that’s really helpful for their mental health. Most people said having a pet is the most mindful they are in the day when they’re petting their pet, feeding their pet, cuddling with their pet, listening to their pet, and so forth. So, that I thought was an amazing, amazing tip or thing you could practice.  Number two, probably again, one of the most important from a clinical perspective is exercise. Now, yes, I know, it’s hard to exercise when you’re depressed, but we do have a ton of research to show that exercise is in fact as effective as an SSRI. Not to say you shouldn’t be on an SSRI. I actually am on all four meds. But exercise is an additional benefit. And so, I strongly encourage everyone to at least get out. It doesn’t have to be strenuous, but around 25 minutes was what most people who have depression said, that was the ideal amount. If you get to that point, you actually get more benefit, which I thought was really cool.  The next one is: Practice mindfulness. Now again, so helpful. If you have depression, usually, I’m going to guess, your mind tells you a lot of lies, a lot of horrible lies, a lot of absolute painful lies. And a big part of managing it is using what we call mindful-based cognitive therapy. And so, what we mean by that is, first, we are aware and we just observe thoughts as thoughts. We don’t take thoughts as facts. And then the cognitive therapy side is once we identify that we’ve had a thought, we may actually stop to correct it. So, if your brain says, there’s no point, you’re a waste of space or the future is going to be nothing but terrible or my life is nothing but terrible – when it tells us these lies, we can actually stop and go, “Okay, now, number one, that’s a thought and I’m going to observe that thought nonjudgmentally.” And then you can also go, “Okay, let’s actually check the evidence for that depressive thought. Hmm, do I bring purpose into the world? Is the world going to be terrible?” and look for maybe some holes in this theory and start to be curious about whether that’s in fact correct. It’s so important. Mindfulness. I personally think these two, the exercise and the mindfulness, are key, are major keys to managing depression. The next one that was suggested by a lot of people was to talk to family and friends, even if they don’t fully understand. And I loved that little caveat to go on. As much as depression makes you want to isolate and shut down, make sure that you are going and you’re just connecting with them. You’re talking with them, you’re sharing what you’re going through, even if they don’t understand, because the truth is they won’t. Even if they’ve been through what you’ve been through, they won’t fully get it. They’re not the ones getting fed the lies of depression like you are. Or if you’re a family member, I want you to understand it’s really not helpful to say to someone with depression, “I totally get what you’re going through,” because the chances are you don’t. But that doesn’t mean that we can’t relate on some level. That doesn’t mean we can’t connect and support each other. So, important. So, so important.  This one was an interesting one. And I want to-- some of these surprised me, but lots of people reported that attending couples therapy, couples counseling, if you’re in a relationship, was helpful for their depression. Now, I wonder if that is because maybe their relationship was a part of what’s very difficult for them, but I can see the benefit in that. I don’t talk about this very often, but I personally love couples counseling. I have no problem admitting that we’ve been to couples counseling before. It is thebomb.com. It is such a beautiful thing to do with your partner. Is it hard? Yes. Is it bumpy? Yes. But there’s something really cool about knowing that you’re showing up to the same place every week with the same goal, which is to strengthen your relationship. That in and of itself is just really, really cool. And a lot of people responded saying that that was really helpful for their depression, which I thought was really cool.  Next one, you guys aren’t going to be shocked by this, and I definitely wasn’t, which was to practice self-compassion. You guys, depression is nasty. It tells you nasty. I’m doing everything I can not to swear here, but it’s like BS. It tells you such nasty BS. And one of the best insurance policies against that, or one of the best defenders against that, or I should say offense, the offense against that is to practice compassion for yourself, to practice being kind and respectful and being tender to the suffering that you’re experiencing. Because believe me, I do know, I’ve experienced depression throughout different parts of my life. It’s horrible and it feels-- the only way I can explain it is you can’t understand it when you’re in depression because you’re in depression. But once you’re out of the depression, for me, it felt like someone had pulled this gray veil off my head that I didn’t even know was there until I’d come out of a depression by going to a lot of therapy and so forth. And I was like, “Whoa, I had no idea everything was under a gray veil until the gray veil was lifted.” So, that compassion piece is really important because I didn’t know the depression was there until the depression had lifted, if that makes any sense. And had I known it, I probably would’ve been much, much, much kinder to myself.  Next point, I love this. It’s very similar to what we talked about before, but it says, no matter how much you don’t want to, get up and move your body. Now, I could have easily put this under the category of exercise. But a lot of the comments weren’t-- this wasn’t talking about exercise. It was saying, stand up and stretch was one of them. Just stand up and swing your body around, move it around, get into the flow, let the blood flow around your body. And they were saying that that is a shift in mentality. It’s a shift in mindset. I know even today as I’m recording all these episodes, I’m going to need to practice this, because if I just stay here and I stare into this microphone and I’m looking at the screen, my brain is going to get a little distorted and strange. I’m going to have to go upstairs, shake it off, get a cup of tea, move around. And so, I love that they distinguish this separate from exercise. Next point, oh my gosh, this is gold right here. It says, do something you used to enjoy. Now, when we’re depressed, often nothing feels enjoyable. Even food isn’t enjoyable anymore, or company might not be enjoyable. The things you used to love, the vibe is gone. But what a lot of people were saying, and this is again from people who’ve had depression and managed it, is they were saying, whether or not you enjoy it now, continue to do the things you used to enjoy, but also spread out.  This is one thing I didn’t mention here, is a lot of people said, be curious about little things that you used to enjoy that you never really developed as a hobby. So, an example would be, I think somebody said something to the likes of like, I used to love hopscotch. Of course, they loved it when they were very, very little. So, as they got older, of course, they stopped playing hopscotch into their adulthood. But they were like, “I literally wrote down a list of everything I used to enjoy and I just did it, whether I’ve done it for 40 years or not.” So, little things. It doesn’t have to be grand things. It doesn’t have to be hobbies. It could be going, “I remember as a kid, I used to love boba or whatever.” Go and get some. Do the things you used to enjoy, even if they’re teeny tiny.  Another huge group of people said sunlight. Sunlight is a huge part of managing depression. Now, thank goodness for these, my community, because if I was putting together a podcast or managing depression, I would’ve completely forgotten about the people who have seasonal affective depression because I live in California and I wouldn’t have thought of that. But so many of my followers are from all around the world and hundreds of people responded saying, you have to get sunlight. You have to get exposure, UV lights. There are all these really cool exposure lights that you can talk to your doctor about getting. So, thank you to everyone who wrote this in because I would’ve forgotten that.  And for me too, what I will say is I work indoors a lot. I work at my desk a lot. Most of you know I am running two separate businesses at once. My private practice and CBT School. So, the days where I don’t just-- even if it’s go outside and sit in the sun while I have a cup of tea for 10 minutes, I do notice a shift in my mood. Again, don’t do too much. We don’t want you to get sunburn. We don’t want you to have too many exposures to UV rays. But I do believe there’s such a benefit for mental health.  Okay, next one. This one is amazing. So, many people wrote some variation of this, but we pulled it into this one point, which is write a list of “I can” statements. Meaning, when you’re depressed, depression will tell you can’t. “You can’t do that. You can’t do this. What’s the point of doing that? You can’t. Don’t do it. You won’t do it. Don’t do it.” And so, a lot of people were talking about writing a list of either your strengths or your characteristics or things that you can do. And I think that that is such an amazing shift – to write a list of I can’s. I can work out. I can call my friend. I can get some sun today. I can go to therapy. I can play with my dog. It’s very similar to the term “should.” That simple move of saying “I should exercise” to “I could exercise” like “I should be kinder to myself,” or you could say, “I could be kinder to myself,” those small shifts in sentences can make such a difference. So, I like either of those. Next one, appreciate the little things you do for yourself. You might start to see a trend here. When you’re depressed, the big stuff feels really hard. So, you got to zoom in on the little stuff. And they were saying, appreciate the little things you do for yourself. So, an example might be, “It’s really nice that you made yourself a cup of tea before you recorded these podcasts, Kimberley,” or “Wow, it was kind of you that you bathed today. Great job. Making sure you ate breakfast. Great job. Getting out of bed today.” Often with depression, we go, “Oh, that’s stupid. Why would I celebrate getting out of bed? Everyone gets out of bed. I’m such a loser because I can’t get out of bed.” I mean, that’s the mindset of someone with depression. And so, we want to shift that away from such critical voices and going, “Good job you got out of bed. That’s a big deal when you’re depressed. Good job on brushing your teeth when you’re depressed. That’s a big deal. Good job on saying no to that thing you didn’t want to do. That’s a big deal.” Really, really important.  I have three left. The third last one is, take your medication. Hundreds of people wrote this in and I just loved it. It filled me with joy because whether you choose to take medication or not is entirely your decision. But 10 years ago, I remember when I was-- 15 years ago when I was starting to do my internship, there was this article. I think it was like a USA Today article or something, and it was talking like, let’s take the stigma out of medication. And so, great. We’re starting to have those conversations. But to see now how the response was of like, “Just take your medication,” it just really made me feel joyful that maybe that means there’s a little less stigma about it, and I really hope that I help you to take the stigma out.  There’s absolutely nothing wrong with taking medication. In fact, I’ll tell you a quick story about myself, when I-- you’ll probably remember I went through a period in 2019 and 2020 where I was very, very sick and I had severe depression alongside it. And I remember the doctor saying, “Okay, we’ll prescribe you such and such for this condition and such and such. And we’ll prescribe you an SSRI for your depression.” And he didn’t really even ask if I was depressed, he just prescribed it. And I was like, “What? You didn’t even ask me if I was depressed.” And he goes, “No, no. Most people who have POTS,” I have pots, “they get depressed.” And I was like, “Huh, that’s interesting.” And I thought to myself, okay, I don’t-- for a second, I thought, no, I don’t really need it. But then I was like, “You know what? What a gift to give myself the help. If it’s going to help, I’m going to do it. What a gift.” Not that I’m at all encouraging you to take medication, but I just want to share with you my experience. I could have seen it as like, “Oh, I’m so bad. That’s weak and that’s lazy and I should try without it.” But I was like, “You know what? I’m really not well. I’m going to take all the help. And if one form of the help is to take a pill, I’m going to take a pill.” I’m not going to tell myself a story that that’s lazy. In fact, I’m going to say that’s pretty badass, that I would accept the help. I’ll get going. Sorry, I had to tell you that really important story from my perspective.  All right. Two to go. Second last one: Surround yourself with people who help keep sight of what’s important. This is important. If you’re depressed and you’re surrounded by people, whether it’s physically or on social media, people who are very materialistic or they are striving towards things that actually make your depression worse, find different people. You want to find yourself around people who strive for similar things that are aligned with your recovery.  I’ll tell you again a different story. As a business person, I love business. I really do. I love being a therapist, but if I wasn’t a therapist, I’d go to business school because I just love it. But I notice that if I’m hanging around with other people who are business-minded, it can get really icky and the messages can get really gross. And I can find myself falling into this trap of winning and wanting more. I was finding that I was starting to be hard on myself until I caught this and was like, “Whoa, I need to unfollow these people because this is not good for my mental health. I need to surround myself with people who have the same goals, like what’s important as their goal.” And that was really, really monumental for me. So, do an inventory of your friends, your family, your social media, your colleagues, and try to only surround yourself with people who support your recovery.  Last one is, when you’re having this feeling, don’t numb it out. I’m leaving this at the end. I probably should have put it at the front, but don’t numb it out. It’s okay. Sometimes you will need to turn your brain off and watch some TV. But if that’s all you’re doing to manage your depression, the chances are you’re going to get more depressed. That’s why I keep talking about scheduling and calendaring. Because often when we’re depressed, we want to just stay in bed and numb the feeling out. Sleep all day, watch TV just to numb the depression. But that only makes it worse. And this is the behavioral piece of managing depression, which is one of the gold standard treatments for depression is what we call time blocking or activity scheduling so that you schedule your day. Nothing heavy, nothing crazy. But you do that so that in doing that, you actually reduce your depression because you feel accomplished and you don’t feel like the day was a complete waste. Again, there’s a balance. You don’t want to overschedule, but you do want to engage in the day. You want to make sure that you’ve got things planned. So, don’t numb. Try to activity schedule.  If you need help with that, head over to CBTSchool/-- sorry, you’ll go to products and then there’ll be time management there, or CBTSchool/timemanagement. You can learn that in that course. It’s a really pretty cheap course and it’s pretty quick. It’s like a two-hour course and I walk you through exactly how I do it.  All right. So, that’s it. There are tips for managing depression. There’s like 12, maybe 15 of them. They’re from hundreds of people who have been there. I just love this community so much. If you haven’t followed me on social media, head over to Instagram under Your anxiety Toolkit, and I’ll be there. Thank you.  All right. Have a wonderful day. I will see you next week. Next week, we’re talking about sensations and anxiety and panic. So, I’ll see you there. Have a good one, everyone.

In This Episode, we discuss: Is it important that you stop doing all your compulsions? How can I practice Self-Compassion as you move through recovery? How can you balance facing fears and also being gentle on yourself? Links To Things I Talk About: ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION  This is Your Anxiety Toolkit - Episode 290.  Welcome back, everybody. 290, that sounds like a lot of podcast episodes. It’s funny. Sometimes I don’t think of it. If you have asked me on the street, I’d say, “Yeah, I’d have about maybe 110 in the can.” But 290, that is a lot of episodes. I do encourage you to go back and listen to them, especially the earlier ones. They’re my favorite. But no, go back, play around, check out the ones that you love. There’s probably some things there that you could probably go back and have a good giggle at. All right. We today are talking about a question that came from a student in one of my courses. I’ve found this question to be so important. I wanted to bring it in and have it be a podcast episode because I think this is a very important question and I think it’s something we can all ponder for ourselves. Now, before we go into it, I would like to give you the “I did a hard thing.” This is a segment where someone shares a hard thing that they’ve done. And I love the “I did a hard thing” segment probably as much as anything. This one is from anonymous and they said: “I have contamination OCD. And one thing I’ve avoided for a very long time is raw meat and eggs. Over the winter, I discovered that ERP is so much EASIER (and I use this term very loosely in capital letters) if my exposures are value-based.” This is so good, Anonymous. “So I decided that I wanted to be the mom that baked with her kids, anxiety be darned. I wanted my kids to have warm memories baking in the kitchen with their mom as the snow fell. So each week over the winter, we picked a new recipe, and over the weekend we made it as a family. The first time I cracked an egg, my husband took out his phone and took a picture. He was so proud. The exposure was still hard and I didn’t feel calmer at least while baking, but I tried my best to present and enjoy the time with my kiddos. Later, my son brought home A Joy Is book made at his school. Each page had something on it that brought him joy – fishing with dad, some are vacations. And there on the page.” Oh my God, Anonymous, I’m getting goosebumps. “There on a page was ‘making cookies from scratch with mom.’” Oh my God, I think I’m crying. Oh my goodness. I have goosebumps everywhere. “It is so hard to measure success with ERP sometimes, but that gets real, tangible evidence that I had accomplished something and it felt so good.” Holy my stars, Anonymous. This is incredible. Wow. This is what it’s all about, you guys. This is what it’s all about. For those of you who are listening, I don’t read these before the episode. I literally read them as just I pull them up and I read them. This one has taken my breath away. I just need a second. Oh my goodness, that is so beautiful. So beautiful. Thank you for sharing that. Oh my gosh, that is so perfect for this week’s episode. All right, here we go.   This week’s episode is about a question, like I said, is it okay to keep doing some of my compulsions? Again, this came from one of the courses that we have. We have two signature courses for OCD. One is ERP School, and then the other one is this Mindfulness School for OCD that teaches mindfulness skills. Now, the reason I love this question is, they’re asking me as if I am the expert of all things, OCD. And I want to let you in on a little truth here – I am not. You’re probably like, “What is happening? She’s been telling us that she’s an OCD specialist all this time. And now she’s telling me she’s not the expert.” I am not the expert of you. And I want to really make sure that is clear. Anytime someone says, “What should I do? What’s the right thing to do for me?” I try my best not to tell them that is best for them because I’m only telling them what I think is best for them. That doesn’t mean it’s the facts. So, I want to be very clear. I am not the expert in you. You are. You do get to make choices of your own. That being said-- and I’ll talk more about that here in a second. But that being said, let’s look at the question and just look at it from a perspective of just general concepts of OCD. Now, in the beginning of ERP School, we have a whole module that explains the cycle of obsessions and compulsions. I draw it out on a big sheet of paper, like this huge sticky note. And it’s actually really funny because I’m trying to squeeze myself into the frame of the video with this huge sticky note. When I think back to it, it makes me giggle. But here let’s take a look. The thing to remember here regarding this question is, if you have a fear and the fear is what we call egodystonic, meaning it doesn’t line up with your values, you know it’s a fear, and you know it’s probably irrational. If you have this fear and you respond to the fear as if it is dangerous and important and urgent, you actually are keeping your brain afraid of the fear. And you’re continually keeping your brain stuck in a cycle where your brain will set off the metaphorical fire alarm every time it has that fear. When you have fear and it doesn’t line up with your values and you have the insight to see that it’s irrational or that it’s keeping you stuck and it’s not effective for you and not responding anymore, your job is to practice changing your behaviors and your reaction to that thought so that you can train your brain not to set the fire alarm off next time. It may take several times or many times. But again, if you have a fear and you respond to it like it’s important, your brain is going to keep thinking it’s important. If you have a fear or an obsession and you keep responding to it with urgency, your brain is going to keep interpreting that fear as urgent, serious, dangerous, scary things. So, I’m always going to encourage my patients and my students to always check in on this one golden question, which is, what would the non-anxious me do? Or what would I do if I weren’t afraid of this thought? Or another question is, am I responding from a place of fear, generally? And if that’s the case, then I would encourage my patient to really work at reducing that compulsion because the compulsion keeps the cycle going. Now, that being said, still, again, I’m going to say, under no circumstances do I get to tell you what to do. Only you will know what’s right for you. And I have had clients, I will say, I’ve had clients where they’ve written out their hierarchy. They’ve gone all the way to the top. And there’s several things at the top where they’re like, “No, I’m actually going to keep these ones. These ones are ones that don’t interfere with my life too much. I’m comfortable. I’m not ready to face them yet. And so, no, I’m going to keep doing them.” And I respect that. Again. I am not the expert on everybody. Everyone gets to make their own value-based decisions. That’s entirely okay. I always say to them, going to the top of your hierarchy and cutting back on all of the compulsions is, think of it like an insurance policy on your recovery. It’s not going to completely promise you and guarantee that you won’t have obsessions in the future or you won’t have a relapse here or there. No. And that’s okay. That will happen. We’re going to actually have a conversation about that here in the next few weeks on the podcast. But you can help train your brain by marking off all those compulsions. So, what I’m going to leave you here with-- this is actually not going to be a long podcast, but what I’m going to leave you with is the actual answer to the question. Is it okay if I keep doing some of my compulsions? Yes, it’s okay. You don’t have to be perfect. You don’t have to win all the challenges. And for reasons that are yours, you get to make those decisions. And really that’s your personal decision as well, and-- we don’t say “buy,” we say “and.” And just keep in mind the nature of compulsions. Compulsions keep the cycle going. Just keep that in mind gently, in a tender place. Put it in your back pocket. And here is the question I’m going to leave you on, is ponder why you don’t want to stop this compulsion. What’s getting in the way? If you’re really honest with yourself, what’s the reason you want to keep doing it? Does doing it keep you aligned with your values? Is there a way to be creative and strategic in this situation where you can slowly reduce the compulsion, even if it’s a baby step? It’s so important just to be pondering and asking yourself questions. I have to always stop and say like, “Okay, Kimberley--” I call myself KQ. Everyone calls me KQ. “KQ, let’s get real. What’s really happening here.?” And I’m not doing it in a mean way. I’m having a heart-to-heart. What’s really happening? What’s really getting in the way? Are you being honest with yourself? And sometimes you have to have really honest conversations to be like, “Oh, I know. I’m totally giving myself stuck here.” And it might take some time before you’re ready, and that’s okay too. Okay? So, I want you to think about those things. Maybe even write the questions down. Go back and listen, or you can go to the transcript of this podcast. Write those questions down and go back and review them every now and then, because those are questions I ask my patients every single day. Every single day. And the questions I ask myself and the questions I ask my patients are often what defines how successful they are because we’re questioning the status quo. And that’s what gets them better. Before we finish up, let’s do the review of the week. This is from Robyncox and they said: “Thank you, Kimberley. I’m not sure how to condense all of my happiness and thanks but I’ll try. I was recommended to listen to your podcast by my therapist (who is just superb and I’m grateful she exists) and I instantly fell in love with your genuine desire to help which seeps through the sound waves.” I love that. “I am hooked on the real-life stories that I can connect to my own experience and have gotten my sister hooked as well who struggles with anxiety as I do. Thank you for your tools and support!” Thank you, Robin. Again, I love hearing your reviews and I just love hearing that I can be of service and help you and be a part of your day. I love knowing that people are like taking walks, listening to me and we get to have chats together. It’s beautiful. It’s really, really such an honor. All right. That’s it for Episode 290. That’s a lot of episodes, but I think we’re doing well. I will see you next week for Episode 291 and we will go from there. Oh, one thing to note. By the time you talk to me next time, I will be in Australia. We are going to spend the summer there this year and I could not be more excited. I’ll send you my love from there. Have a great day.

In This Episode: What is whack-a-mole obsessions?  Why do my obsessions keep changing?  What is the treatment for fears that keep changing?  Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more.  Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION  This is Your Anxiety Toolkit - Episode 289.  Welcome back, everybody. I am so happy to be with you again. I won’t lie. I’m still on a high (that rhymed) from the managing mental compulsion series. Oh my gosh, you guys, I am so proud of that series, that six-part series. If you didn’t listen to it, please do go back. I’ll probably tell you that for the next several podcasts, just because I am really still floating on the coattails of how amazingly, so wonderful that was. And it really seemed to help a ton of people, which is so fulfilling.  I do love-- it’s not because of the ego piece of it, I just do love when I know I’m making an impact. It’s really quite helpful to feel like you’re making an impact. And sometimes when I’m putting out episodes, I really don’t know whether they’re helpful or not. That’s the thing about podcasts compared to social media, is with social media, if you follow me on Instagram @youranxietytoolkit or Facebook, I can get a feel based on how many comments or how many likes or how many shares. But with podcast, it’s hard to know how helpful it is. And the feedback has been amazing. Thank you, everyone who’s left reviews. What a joy, what a joy.  What the cool thing is, since then, it’s actually created this really wonderful conversation between me and my therapist. So, for those of you who don’t know, in addition to me owning CBT School, I also own a private practice where myself and nine of my therapists were actually, now 10 extra therapists, in the process of hiring a new person. We meet once a week or more to discuss cases. And the cool thing about the mental compulsion series is it brought the coolest questions and conversations and pondering, what would this help this client? How would it help that client? These are the struggles my clients are having. Because as I kept saying, not every tool is for everybody. Some you’ll be like, “Yes, this is exactly what I needed,” and there’ll be other things where they might not resonate with you. And that’s totally fine. It doesn’t mean anything is wrong. That’s because we’re all different. But it’s really brought up a lot of questions. And so, now I’m actually going to hopefully answer some of those questions in the upcoming podcasts.  Today, we’re actually talking about what to do when your obsessions keep changing. Because we’re talking about mental compulsions and reducing those, and that’s actually the response prevention part of treatment, what’s hard to know, like what exposures do you do for somebody whose obsessions keep changing or their fears keep flip flopping from one to the other? One week, it’s this. Next week, it’s that. And then it’s funny because a lot of clients will say, “What was a 10 out of 10 for me last week is nothing now. And now all I can think about is this other thing. I was really worried about what I said to this one person. Now, all I can think about is this rash on my arm. And the week before that, I was really upset that maybe I had sinned,” or there was another obsession. Again, it’s just what we call Whack-A-Mole. We’re going to talk about that today.  But before we do that, we are going to do the “I did a hard thing” segment. This one is from Marisa. And Marisa is at the @renewpodcast. I think that might be her Instagram or their Instagram. Marisa said: “Last week I submitted my dietetic internship applications. It was a long, stressful process and anxiety definitely came up during it. And I was able to move through and do the hard thing. I kept reminding myself that the short-term discomfort of submitting the application was worth the long-term reward of hopefully getting a step closer to my goal of becoming a registered dietician through completing the internship. Even though there is still uncertainty and the outcome that I have to sit with while I wait to find out the results of my application, I have learned through my ERP work that I can sit with the discomfort and uncertainty. Thank you, Kimberley, for reminding me that it is a beautiful day to do hard things.” Marisa, I hope that you get in. I hope that you get all of the things that you’re applying for. This is so exciting. And yeah, you really walked the walk. This is exactly what we’re talking about when we do the “I did a hard thing” segment. It doesn’t have to be OCD-related or anxiety-related. It could be just hard things because life is hard for everyone. I love this. Thank you so much, Marisa.  If you want to submit your “I did a hard thing,” you may go to my-- it’s actually my private practice website where I host the podcast. If you go to KimberleyQuinlan-lmft.com and you go to the podcast link, right there, there is a link that says “I did a hard thing.” It’s actually KimberleyQuinlan-lmft.com/i-did-a-hard-thing/ okay? But it’s easier just to go, and I will try to remember to put this in a link in the podcast.  All right. One more piece of housekeeping before we get going is, let’s do the review of the week. This is from Sass, and Sass said: “I have had an eating disorder for many years and I spent my adult life trying to understand my compulsions and obsessions. When I found your podcast last summer, everything started to make sense to me. You have given me an understanding and acceptance I couldn’t get anywhere else. I look forward to your weekly podcast and enjoy going back and listening to the earlier podcasts as well. Thank you for all you do.” Sass, I get you. I was exactly in that position when I had my eating disorder. I didn’t understand it. I didn’t feel like people explained it in a way that made sense to me. And the obsessive and compulsive cycle really made sense to me. So, I am so grateful to have you, and I’m so grateful to be on this journey with you. Really, really, I am. Thank you for leaving that review.    Okay, let’s do it. Today, we are talking about Whack-A-Mole obsessions. Now, Whack-A-Mole obsessions is not a clinical term. Let’s just get that out of the way. There is nothing in the DSM or there’s no-- it’s not a clinical scientific term, but it is a term we use in the OCD community. But I think it’s true of the anxiety disorder community. Maybe even the eating disorder community as well, where the fears flip flop from one thing to the other. This may be true too if you have health anxiety. It might be true if you have generalized anxiety, social anxiety, where one day everything, it just feels like this fear is so intense and it’s so important and it must be solved today. It’s so painful. And then for no reason, it goes. And then it gets overshadowed by a different fear or obsession or topic.  And what can happen in treatment is you can start to treat one, doing exposure. This was actually one of the questions that came up through ERP School, which is our online course that teaches you how to create a plan for yourself to manage OCD. Some people will say, “Oh, I created a hierarchy. I followed the steps in ERP School. I started working on it and I did a few exposures and I did a few marginals. And boom, it just went away and then a new one came or the volume got turned down.” It could be that you addressed it a small amount, and then it went away and got replaced by another. Or it could be that you didn’t even get time to address it and it just went to a different topic. And this is really, really distressing for people, I’m not going to lie, because you’re just constantly whack-a-moling. You know the Whack-A-Mole game? You’re whack-a-moling things that feel super important, super scary, super urgent.  And so, what I want to do first is just validate and recognize this is not an uncommon situation. If this is happening for you, you are definitely not alone. And it doesn’t mean in any respect that you can’t get better. In fact, there’s a really cool tool, and I’m going to teach it to you here in a second, that you can use. We use it with any obsession. This is not special to Whack-A-Mole obsessions, but you can use it with any exceptions or if things keep changing. But first of all, I just want to recognize it is normal and it’s still treatable.  What do you do? The thing to remember here is, when you zoom out, and this is what we do as clinicians, our job as clinicians, and I say this to my staff all the time, is to find trends in the person’s behaviors and thinking. And what you will find is, when you’re having Whack-A-Mole obsessions, while the content may be different, when you zoom out, the process is exactly the same. You have a thought, a feeling, a sensation, or an urge that is repetitive, that is uncomfortable, that creates a lot of distress in your life. And of course, naturally, you don’t want that distress. That’s scary. And so, what you do is you do a compulsion to make it go away. It doesn’t matter what the content is. It doesn’t matter what the specific theory is. This is the same trend. And so, when we zoom out, we can see the trend, and then we can go, “Aha. Even though the content is the same, I can still intervene at the same point.” When we talk about this in ERP School, is the intervention point is at the compulsion.  And so, the work here is the content doesn’t matter. Your job is to catch and be aware, like we’ve talked a lot about mindfulness, is to be aware and identify, “Oh, I’m in the trend. I’m in the cycle.” While the one content has changed, the same behaviors are playing out. So, you catch that. You then practice being willing to be uncomfortable and uncertain about the content, because that’s the same too. The same cycle is happening. The thought and the fear create some anxiety, some sensations, and so forth.  And then we have an aversion to that. And then our job is to work at not engaging in that compulsion. So, that compulsion might be mental rumination. It might be doing certain behaviors, physical behaviors. It might be reassurance seeking. It might be avoidance. It might be self-punishment. It might be self-criticism. And your job is actually to go, “Okay, it really doesn’t matter.” And I really want to keep saying that to you. If the fear is, what if I have cancer? What if I’m going to hurt someone? What if I’m aroused by this? What if I have sinned? What if things are asymmetrical? What if I got some contaminant? What if I don’t love him enough? It doesn’t matter. What if it is not perfect? What if I fail? It doesn’t matter. I’ve just listed some, but if I didn’t list your obsession, please don’t worry. It’s for every one of these. The content for all of them are equally as important.  Sometimes what we do is we go, “Oh, that one is okay. But this one is really serious, and we have to pay attention to it.” And so, we have to catch that and go, “No, it’s all content. It’s all--” you could say, some people say it’s all spam, like the spam folder. Because when we get an email, we have emails that we really need to see – events, meetings coming up. And then we always have spam, the stuff that’s like, “Please send me money for Bitcoin,” or something. So, we put that in the spam folder. And so, your job is to catch the trends here, the patterns, and learn how to put those obsessions in the spam folder, no matter what the content. Now, this does require, and here’s the caveat, or I would say this is the deal-breaker, is it does require a degree of mindfulness in your part to be aware of what’s going on. And this is a practice, like a muscle that you grow. So, what it requires is you have to be able to catch that you are in the content. You have to be able to catch that you are in the cycle that keeps you stuck. And that does require you to be mindful again. And I get it. I’m not saying that you’ll ever be perfect at this because I don’t know anyone who is. There will be times when you’re so caught up in the content and you’ve been doing compulsions for an hour, two hours, two days, two months and you haven’t caught it. And you’re like, “Oops, wait. Oops, I didn’t catch that one.” That’s okay. We don’t beat ourselves up. Then we just go, “All right, I’m at the point where at least I’ve caught it. I’m aware that I’m in the content. I’m aware how this is playing out exactly the way that it played out yesterday, but with a different obsession.” And then you just move on from there. Don’t beat yourself up. But it does require you to strengthen the muscle of being able to catch that you’re in the content. And it’s what we call insight. It’s having the insight to recognize. Now, insight is something we can strengthen with practice. It’s not just one and done. It’s practice. It’s repetition. I have to do this all the time for myself. While I don’t have OCD, I do have anxiety and I will catch myself going down the rabbit hole with something until I’m like, “Wait, wait, wait, wait, wait, you’ve been here before. It looks exactly like what you did on Tuesday where you’re trying to figure out something that’s not in your control. Kimberley, this is not in your control. You’re trying to control something that isn’t even your business.” And I’ve seen that trend in me. And so, my job is to catch it. Once I can catch it, then I know the steps. I know, “Okay, I got to let this one go. I got to accept the discomfort on this one. I’m going to have to ride this wave of discomfort. I’m going to have to radically be kind to myself.” We know the steps. And once we can get those steps down, it’s about catching it. But this is what we do when the obsessions do keep changing.  Now, I’m not going to say this is easy because it’s not. And if you require help doing this, reach out to an OCD therapist or an anxiety specialist who knows ERP. Remember here, and I’m telling you this with the deepest, most absolute degree of love, is CBT School, the whole mission of CBT School is to provide you tools and resources for those who don’t have tools and resources. So, if you haven’t got a therapist and you’re finding this really, really helpful, but you’re still struggling, don’t be afraid. It doesn’t mean anything is wrong with you. It just means maybe you need some more professional help. Maybe you have a therapist and you’re listening into this just to get extra tools. Great. Take what you learn and then take what struggles you have and figure that out.  I really want to stress here, and the reason I bring that up is, when I say this, it isn’t as easy as it sounds and it does require sometimes having somebody else, this is why I go to therapy myself, is even though I know the tools, it’s really nice to have a second set of ears just going, “Wait a second. Sounds like you’re caught up in the content.” If it’s not a therapist, maybe you could have a loved one or even journaling I have found is really helpful in that when you journal it down, and I do this regularly, I then read it, not to judge it, but just to see what trends. And I get a highlighter and I just highlight like, where are the trends? Where am I seeing the same patterns playing out? And that’s where we intervene.  So, that’s Whack-A-Mole obsessions. That is what to do when your obsessions keep changing. I do hope that that was helpful, not just to validate you, but to give you some skills moving forward. I am so grateful to have you here. Don’t be afraid to let me know what you think. I love, again, getting your feedback via reviews. I urge you to join the newsletter. That will then allow you to reply and give me feedback that way. I love hearing from you all.  All right. I’m going to sign off and I’ll talk to you very, very soon.

SUMMARY:  Today, I share what to do when you get “bad” news.  This episode will share a recent situation I got into where I had to use all of my mindfulness and self-compassion tools.  Check it out! Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more.  Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two).   EPISODE TRANSCRIPTION  This is Your Anxiety Toolkit - Episode 288.  Welcome back, everybody. We literally just finished the six-week series on managing mental compulsions. My heart is full, as full as full can be. I am sitting here looking into my microphone and I just have a big, fat smile on my face. I’m just so excited for what we did together, and I felt like it was so huge. I have so many ideas of how I want to do something similar in the future with different areas. And I will. Thank you so much for your feedback and your reviews. I hope it was as helpful as it was for me, even as a clinician. I found it to be incredibly helpful, even as a supervisor, supervising my staff. I have nine incredible staff who are therapists, who help treat my clients and we constantly keep referring back during supervision of like, “Do you remember what Lisa said? Do you remember what Reid said? Listen, let’s consider what Jon said or Jon Hershfield said, or Shala Nicely said.” It was just so beautiful. I’m so grateful. If you haven’t listened, go back and listen to it. It’s a six-week series and ugh, it was just so wonderful. I keep saying it was just so wonderful. So, if you go back, I did an introduction, Episode 282. And then from there, it was these amazing, amazing experts who just dropped amazing truth bomb after amazing truth bomb. So, that’s that. Today, I am going back to the roots of this podcast. And I’m sharing with you-- for those of you who have been listening for a while, we usually start the episode with a segment called the “I did a hard thing” segment. This is where people write in and tell me a hard thing that they’ve done. If you go to my website, which is KimberleyQuinlan-lmft.com. There on the podcast page is a place to submit your “I did a hard thing.” And today’s “I did a hard thing” is from yours truly. I just had to share this story with you. I feel like it’s an important story to tell you guys, and I wanted to share with you that I’m not just talking the talk over here, I’m walking the walk. So, today’s episode is called When You Get Bad News. I’m just going to leave it at that. Before we get started, I would love to leave you and share with you the review of the week. This is from hannabanana3131, and they said: “Fantastic mental health podcast. Such an amazing podcast. I have learned so many useful tools for dealing with my anxiety and OCD. And Kimberley is such a loving, compassionate coach - I feel like she’s rooting for me every step of my healing journey,” and she’s left a heart emoji. Thank you so much, hannabanana. I love, love, love getting your reviews. It does help me so much. So, if you have a moment of time and the podcasts are helpful for you, that is the most helpful thing you can do back. When we get reviews, then when people who are new come over and see it, it actually makes them feel like they can trust the information we’re giving. And in today’s world, trust is important. There is so much noise and so many people talking about OCD and anxiety, and it’s easy to get caught up in nonsense stuff. And so, I really want to build a trust factor with the listeners that I have. So, thank you so much for doing that. Okay. It’s funny that hannabanana says, “I feel like she’s rooting for me,” because the “I did hard thing” is me talking about my recent experience of having a root canal. Worse than a root canal. So, let me tell you a story now. I’m not just telling you this story to tell you a story. I’m telling you this story because I want to sometimes-- when we do the “I did a hard thing” segment, it’s usually very, very short and to the point, but I’d actually like to walk you through how I got through getting some really bad news. So, let’s talk about it. And I’ll share. I’m not perfect. So, there were times when I was doing well and there was times when I won’t. So, for those of you who don’t know, which I’m guessing is all of you, I have very bad gums. My gums, I inherited bad gums. It comes in my family. I go in every three months for a gum routine where they do a deep cleaning or they really check my gums to make sure there’s not receding too much. And because of that, I take really good care of my teeth. And because of that, I usually have very little dental issues. I never had a cavity. I’ve never had any cracks or any terrible swollen problems. That just isn’t my problem. My problem is gums and it’s an ongoing issue that I have to keep handling. So this time, I go in, I get my x-rays, and the doctor comes in. And I have this really hilarious dentist who has not got the best bedside manner, but I do love him and he has been with me through some really tough times that when I found out I have a lesion on my brain, I fully broke down in front of him and he was so kind and gave me his cell phone number. He was just so lovely. But he comes in and he rubs his hands together and says, “What are we doing here today, Kimberley?” And he looks at the x-rays and I kid you not, he says, “Holy crap!” Literally, that was his response, which is pretty funny, I think. From there, I proceed to go into some version of a panic attack. I’m like, “What? What’s wrong? What do you see? What happened?” And I think that was pretty appropriate for me to do that. So, I want to validate you. When you get big news, it’s normal to go into a fight or flight, like what’s going on, you’re hypervigilant, you’re looking around. Now, he waited about 45 seconds to answer my question. I just sat there in a state of panic while he stared at the x-rays on the wall. And these 45 seconds, I think, was the longest 45 seconds of my life because he wouldn’t answer me. And I was just like, “Tell me what’s wrong. What’s wrong?” So, he turns around and he says, “Kimberley, you have a dead tooth.” And I’m like, “What? A dead tooth? What does that even mean?” And he says, “You have a tooth infection that is dormant. Do you have any pain? Do you have a headache? What’s going on?” And I’m like, “Nothing, nothing. I’m fine. Everything is fine.” And so, he proceeds to immediately in this urgent, panicky way, call in his nurses, “Bring me this, bring me that, bring me this, bring me that. Bring me this tool, bring me this chemical or medicine or whatever.” And they’re all poking at me and prodding at me and they’re trying to figure it out. And he’s like, “I cannot figure out what this is and why it’s here.” So, bad news. Just straight-up bad news. Now, the interesting thing about this is, it’s hard to be in communication with someone, particularly when they’re your doctor and they appear to be confused and panicking. Not that he was panicking, but he was acting in this urgent way. That’s a hard position to be in. And if you’ve ever been in a position like that, I want to first validate you. That’s scary. It is a scary moment that your trusted person is also panicking. Just like when you’re on an airplane and it’s really bumpy. But if you see that the air hostesses are giggling and laughing, you’re like, “Okay, it’s all good.” But when you see their faces looking a little nervous, that’s a scary moment. So, first of all, if you’ve been in that position, that’s really, really hard. What he then proceeded to tell me is, “Kimberley, this tooth has to come out. It has to come out immediately. We cannot wait. It’s going to cost a god-awful amount of money. And this has to happen right away.” Now in my mind, you guys know me, I am really, really strict about scheduling. I have a schedule. I’m not compulsive about it, but I run two businesses. I have a podcast, I have two children. I have a medical illness. I have to manage my mental illnesses all the time. So, I have to be really intentional with my calendar. So, this idea that immediately, everything has to change was a little alarming to me. But what I remember thinking, and this is one of the tools I want to offer you for today, is being emotionally flexible is a skill. And what we want to do in those moments, and this is what I practiced was, “Okay, Kimberley, this is one of those moments where your skills come in handy. Thank God for them.” How can you be flexible here? Because my mind wanted to go, “You got to pick up the kids and you’ve got to do this and you’ve got to a meeting tomorrow and you’ve got clients and you can’t do this. This can’t happen this week.” But my mind was like, “I’m going to practice flexibility.” In addition to that, when things change really quickly, we tend to beat ourselves up like, “Such and such is going to hate me. They’re going to be mad at me. They’re going to think I’m a loser for having to change the schedule.” And I just gently said to myself, “Kimberley, we’re going to be emotionally flexible here and we’re going to let everybody have their emotions about it.” So, the kids get to have their emotions about everything changing and my clients get to have their emotions about it too. And having to cancel the meetings, they get to have their emotions. Everyone’s allowed to have their emotions about the fact that many, many things are going to be canceled in the next few days. And that has been such a work of art for me, but it has been so beautiful for me to say, instead of me going, “No, no, no, I can’t do this,” because I don’t want them to have feelings and I don’t want them to think this about me, now I’m just like, everyone gets to have their feelings. They get to feel disappointed. They get to feel angry. They get to feel annoyed. They get to feel irritated. They get to feel sad. Everybody gets to feel their feelings about it because that’s a part of being a human. That’s one of the tools I want you to think about. Just play with these ideas. You’ve just come off the six-week series. These are some more ideas to play with. But then from there, I had about 36 hours where I had to wait for this surgery. And during that time, I had to have an x-ray where I was told, and this is the real bad news, is this infection, actually, this is gross. So, trigger warning, guys. The infection actually ate through a part of my jaw bone. I know. Isn’t that crazy? The infection was so bad and it was right at this area where I guess nerves come out of your jaw. There’s this tiny hole right at the front, around the sides where the nerves come out of your jaw and up into your lips and the infection spread and was all over that area. I know that is gross, but it’s also really scary. So, not only did I have to think about all of the changes, but he, the doctor, the dentist had made me very aware that this surgery has to go really well, and that if he pushes too hard or he pulls too hard with a tooth or he had to put in a-- there’s these words I don’t even know, but like a canal, like some kind of fixture so that he can create a new tooth because I had to have a tooth completely pulled out. He was like, “If I push it in too far, I actually may hit this nerve, which could be very, very bad.” So, this uncertainty felt horrible to me. And of course, I’m going to have these intrusive thoughts like, “What if I never get to speak again? What if I lose a feeling in my gums and what if he pushes hard and this is terminal? What if, what if, what if, what if?” And so, my skill here, and we’ve learnt this from managing mental compulsions, is bring it back to the present. Until there’s a problem, we don’t solve them. So, that’s what I kept doing. “It’s not happening now. Kimberley, it’s not happening now. It’s not happening now,” even though it’s a real threat, even though it’s going to be something I have to face, because sometimes our fears are like, “What if something happens?” But it’s just a what-if. There’s no actual event that you know for certain is going to happen. This was like, “Yeah, you’re going to do this in literally 30 hours and all of these risks are here.” You guys have probably got stories like this, where you’ve gone in for some brain surgery or any surgery where there’s a risk, but this risk was pretty huge. He was very concerned. I think appropriately concerned. So, here I am for 30 hours, managing this stuff where I’m like, “Okay, this could go really well or this could go really bad, like really, really bad.” I giggle just because it makes me nervous just to think about it. That’s a nervous giggle that you just heard me. I don’t know. I often giggle when I’m nervous. But it’s a big deal. So, I, in these moments, had to weigh up, go back to what Lisa Coyne was talking about. I was like, “Okay, values versus fear. Which one do I consult with?” I had reached out to the dentist to say, “You know what, let’s just not do this. I’m not in any pain. Let’s just keep it there. Let’s just not.” And his response was like, “That’s not even an option. If you’ve already got this much damage, this could get worse and be very, very problematic.” So, I didn’t even have the option to back out. I had to do this. And so, as I proceeded forward, I had to keep being aware like what Jon Hershfield talked about and Dr. Grayson and Dr. Reid Wilson, and Shala. I had to really allow all the intrusive thoughts to come like, “Yup. Possible. Yup, that’s possible too. Yup, that’s possible too. Maybe it does. Maybe it will. Not going to give it my attention right now. I see you’re back again. Good one, bro. Hi there, I see you. I fully accept the uncertainty.” That was me for l30 hours, literally bringing in every tool I have. The cool thing is it was a hugely busy week. And because I have been really doubling down on my mindfulness skills over the last few months, that actually really helped. Every time I noticed that I was getting anxious, I was like, “Okay, what does the keyboard feel under my fingers?” I have these fiddles that I play with and I’m like, “Okay, what does this feel like? This rubber feel like, or this metal feel like, and so forth?” So, that was really helpful. The day of the surgery, I go in and I’m fully anxious. I’m going to the bathroom. I’m needing to pee. I feel dizzy. I’m not allowed to be on my medication. Oh, and that’s the other thing, is this maybe the-- what do you call it? The silver lining. Just a little update for you guys, is there is a small chance, because this infection has been here for a long time and we haven’t actually detected it yet, that it may be the reason for all my POTS symptoms. As some of you may know, I have postural orthostatic tachycardia syndrome. It is a chronic illness related to dysautonomia. It causes me to faint and have headaches and nausea and dizziness and blood pooling and it’s the worst. And there is a chance that that might be why. So, I’m half scared and half excited all day, which is a lot to handle. But as the day is moving forward, I’m getting more and more nervous and I start to feel the urge to start to seek reassurance. I start to observe the urge to Google. I start to observe the urge to ask the doctors many, many, many, many questions. And when I say it, I’m saying that very intentionally. I observed the urge, which is I didn’t do those behaviors. I just noticed the urge that kept showing up. “Ooh, let’s try and get this anxiety to go away. Ooh, let’s try and get that anxiety to go away.” Knowing that when it’s my turn to sit in that chair, I will ask specific questions. So, I’m not saying you can’t ask your doctors questions, but that was key for me, was to observe the urge to seek reassurance, observe the urge to go into avoidance. I’m not going to make this story too much longer, but what I will say, I want to tell you the funniest part of this story. I’m in the doctor’s office because I had to go in for this very fancy x-ray that does all your nerves because he was afraid he was going to hit one. He’s showing me the x-ray and I’m literally looking at it. He’s showing me cross-sections of my jaw. And you guys, it was so scary. You can see the hole that it’s created. You can see the infection and how it’s deteriorated the bone. It was so scary. And so, he puts his hand on my-- and I’m like, at that point, “Is there any way we could get away with not doing this? Because this is really scary.” He puts his hand on my hand, he says, “I’m going to go and take care of all of these last patients I have so I can give you 100% of my attention and I will be back.” You guys, this is the funniest thing ever. So, the dental nurse is there watching me. My heart is through the roof. My blood pressure is all over the place. She stands in front of me and she says, “Miss Kimberley, don’t be worried. We’ve watched all the YouTube videos.” And I swear to you, every piece of panic that I had went out the window for that small second and I laughed so hard. She said, “In fact, that’s where the doctor is right now. He’s just going to watch the YouTube video one more time.” And I just died laughing. Now for some of you, that may have actually been really anxiety-provoking. But for me, it was exactly what I needed. I needed someone to make this so funny. And it was so funny. I swear to you, every time I think of it, the way she says it in her accent was the most hilarious thing ever. It was so perfectly timed. The delivery was perfect and I burst out laughing. He comes back in-- this is the end of the story. I’m not going to drag it out for too much longer. I promise. But he comes back in, and I just wanted to share with you, because I know last week with Lisa, I had a really emotional moment, and I think it was really tied to this. As he was putting in the IV – because I had to be knocked out. He said he couldn’t take a risk of me moving. So, he knocked me out for the surgery – tears just rolled out of my eyes. And I wasn’t going to be ashamed of it. And what came up for me was, I said, “Please, sir.” I said “Sir,” which I think is so funny, because I know him by his first name. “Please, sir. Please just take care of me.” And for me, tears were rolling down my face, but that was an act of compassion for myself. Instead of me saying-- because I know two years ago, or even six months ago, I probably would’ve said, “Please, don’t kill me,” or “Promise me nothing bad would happen.” But there was this act of compassion that just flowed out of me, which was like, “Please, sir. Please take care of me.” And it was coming from this deep place of finally in my life, being able to ask to be taken care of. And I’ve been working on this, you guys, for about a year, is having the ability to actually ask for help has been something I’ve really sucked at and it’s something I’ve worked so hard at. And for me, that was groundbreaking, to ask for help. Now you could say it was me pleading with him, but it wasn’t. It was me. It was an act of compassion. It was an act of saying, “I’m scared. I’m not asking you to take my fear away. I’m just asking you to hold me in a place of kindness and compassion and nurturing and care.” And that for me was profound. So, I just wanted to share that with you. I know that it might not be as skills-based as some of the other episodes, but I love sharing with you hard things and I love sharing with you that I’m a human, messy human who’s doing the best they can and is imperfect too. But I just wanted to give you a step-by-step one. It’s okay if it’s hard and there are skills that you can use and we can get through hard things. It’s a beautiful day to do hard things, I always say that. And so, I wanted to just record this and share with you the ups and the downs of my week and help you maybe if there’s a time where you’ve gotten bad news on ways that you might manage it. Now, what I do want to end here with is, I understand my privilege here. I understand my privilege of getting bad news and being able to get medical care and have a lovely dentist and a lovely nurse who makes funny jokes. And sometimes the news doesn’t end well, and I get that. I want to honor you that there is no right way to get bad news. And the grief process of getting bad news is different for everybody. This was more of an anxiety process, but I want to honor to you that if you’re going through some hard thing in your life where you’ve gotten bad news, I want to also offer you the opportunity to grieve that and I want to honor that this is really, really a hard thing to go through. So, I really want to make sure I make space for you with that because my experience is not your experience, I’m sure. So, that’s it, guys. That’s what to do when you get bad news. That’s my experience of getting bad news and I hope it’s been helpful. We are embarking on some shifts here with the podcast. I am so inspired to be more focused on just delivering the tools to you and being a safe place for you and being a bright, shiny light for you. And so, I’m doing a lot of exploring on how I can do that. So, if you ever-- again, please do feel-- if you want to give some thoughts, please do reach out, send me an email. If you’re not on my newsletter list, please do go and sign up. I’ll leave you a link in the show notes, or you can go to CBTSchool.com and sign up for the newsletter and you can reply there as well or you can leave a review. All right. I love you guys. Have a wonderful day. It is a beautiful day to get bad news and do the hard thing. I love you. Have a great day.

SUMMARY:  In this episode, we talk with Lisa Coyne about ACT For mental compulsions.  Lisa Coyne addressed how to use Acceptance and Commitment therapy for overcoming mental compulsions. We cover how to identify your values using a fun little trick! In This Episode: How to use Acceptance & Commitment Therapy to manage mental compulsions How to practice Willingness in regards to reducing mental rituals and mental rumination  A fun little Value Based tool for identifying your values.  How to be curious instead of thinking in a limited way.  Links To Things I Talk About: Stuff thats Loud Stop Avoiding Stuff  https://www.newenglandocd.org/ ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two).   EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 287.  Welcome back, everybody. I am so excited. We are at Episode 6 of this six-part series of how to manage mental compulsions. You guys, we could not end this series with anyone better than Dr. Lisa Coyne. I don’t know if you’ve heard of Lisa Coyne. I bet you, you probably have. She is the most wonderful human being.  I have met Lisa, Dr. Lisa Coyne multiple times online, never in person, and just loved her. And this was my first time of actually getting to spend some really precious time with her. And, oh my gosh, my heart exploded like a million times. And you will hear in this episode, you will hear my heart exploding at some point, I’m sure. I am so honored to finish out the six-part series with Lisa. This series, let me just share with you how joyful it has felt to be able to deliver this as a series, as a back-to-back piece of hope. I’m hoping it has been a piece of hope for you in managing something really, really difficult, which is managing mental compulsions. Now, as we finish this series up, I may or may not want to do a recap. I’m not sure yet. I’m going to just see where my heart falls, but I want to just really first, as we move into this final part of the series, to remind you, take what you need. You’ve been given literally back-to-back some of the best advice I have ever heard in regards to managing mental compulsions. We’ve got world-renowned experts on this series. You might have either found it so, so educational and so, so helpful while also feeling sometimes a little bit like, “Oh my goodness, there’s so many tools, which one do I use?”  And I really want to emphasize to you, as we finish this out, again, so beautiful. What a beautiful ending. I almost feel like crying. As we finish it out, I really want to remind you, take what you need, take what’s helpful, or – well, I should say and – try all of them out. Practice with each of the skills and the concepts and the tools. See what happens when you do. Use them as little experiments. Just keep plugging away with these skills and tools. Because number one, they’re all evidence-based. I very carefully picked the experts on this series to make sure that we are bringing you evidence-based, really gold standard treatment. So, that’s been a priority. Just practice with them. Don’t be hard on yourself as you practice them. Remind yourself, this is a long-term journey. These are skills I still practice. I’m sure everyone who’s come on the show, they are still practicing them. And so, I really want to send you off with a sense of hope that you get to play around with these. Be playful with them. Some of them will be we’ve giggled and we’ve laughed and we’ve cried. So, I want you to just be gentle as you proceed and you practice and remind yourself this is a process and a journey.  That being said, I am going to take you right into this next part of the six-part series with Dr. Lisa Coyne. This is where we bring it home and boy, does she bring it home. I feel like she beautifully ties it all up in a ribbon. And I hope it has been so helpful for you. Really, I do. I want this to be a resource that you share with other people who are struggling. I want to be a resource that you return to when you’re struggling. I want it to be a place where you feel understood and validated. And so, thank you so much for being a part of this amazing series. That being said, let’s get over onto the show, and here is Dr. Lisa Coyne. ------ Kimberley: I literally feel like I’m almost in tears because I know this is going to be the last of the series and I’m so excited. I had just said this is going to bring it home. I’m so excited to have Dr. Lisa Coyne. Welcome. Lisa: Thank you. It’s so nice to be here with you, Kim. Hi, everyone. What is a Mental Compulsion? Do you call it a Mental Compulsion or a Mental Ritual?  Kimberley: Yes. So, first of all, the question I’ve asked everybody, and I really am loving the response is, this is a series on managing mental compulsions, but do you call them mental compulsions, mental rituals, rumination? How do you conceptualize this whole concept? Lisa: I would say, it depends on the person and it depends on what they’re doing. I call them any number of things. But I think the most important thing, at least for me in how I think about this, is that we come at it from a very behavioral perspective, where we really understand that-- and this is true for probably all humans, but especially so for OCD. I have a little bit of it myself, where I get caught up in the ruminations. But there’s a triggering thought. You might call it a trigger like a recurrent intrusive thought that pops up or antecedent is another word that we think of when we think of behavior analysis. But after that thought comes up, what happens is the person engages in an on-purpose thing, whatever it is that they do in their mind. It could be replacing it with a good thought. It could be an argument with yourself. It could be, “I just need to go over it one more time.” It could be, “I’m going to worry about this so I can solve it in advance.” And that part is the part that we think of as the compulsion. So, it’s a thing we’re doing on purpose in our minds to somehow give us some relief or safety from that initial thought.  Now the tricky part is this. It doesn’t always feel like it’s something we’re doing on purpose. It might feel so second nature that it too feels automatic. So, part of, I think, the work is really noticing, what does it feel like when you’re engaging in this activity? So, for me, if I’m worrying about something, and worry is an example of this kind of doing in your mind, it comes with a sense of urgency or tightness or “I just have to figure it out,” or “What if I--” and it’s all about reducing uncertainty really.  So, the trick that I do when I notice it in me is I’ll be like, “Okay, I’m noticing that urgency, that tension, that distress. What am I up to in my head? Am I solving something? Is that--” and then I’ll step back and notice what I’m up to. So, that’s one of my little tricks that I teach my clients. Kimberley: I love this. Would you say your predominant modality is acceptance and commitment therapy? What would you say predominantly you-- I mean, I know you’re skilled in so many things, but what would you-- Lisa: I would say, it’s funny because, yeah, I guess you would. I mean, I’m pretty skilled in that.  I’m an ACT trainer. Although I did start with CBT and I would say that for OCD, I really stick to ERP. I think of it as the heart of the intervention, but we do it within the context of ACT. ACT for Mental Compulsions  Kimberley: Can you tell me what that would look like? I’m just so interested to understand it from that conceptualization. So, you’re talking about this idea. We’ve talked a lot about like, it’s how you respond to your thoughts and how you respond and so forth. And then, of course, you respond with ERP. What does ACT look like in that experience? I’d love to hear right from your mouth. Lisa: Okay. All right. So, I’m going to do my best here to just say it and then we’ll see if it sounds more like ACT or it sounds more like ERP. And then you’ll see what I mean when I say I do both of them. So, when you think about OCD, when you think about anxiety, or even maybe depression where you’re stuck in rumination, somebody is having an experience. We call it a private event like feeling, thought, belief that hurts, whatever it is. And what they’re doing is everything that they can to get away from that. So, if it’s OCD, there’s a scary thought or feeling, and then there’s a ritual that you do.  So, to fix that, it’s all about learning to turn towards and approach that thing that’s hard. And there’s different ways you can do that. You can do that in a way where you’re dialing it in and you’re like, “Yeah, I’m going to do the thing,” but you’re doing everything that you can to not feel while you’re doing that. And I think that’s sometimes where people get stuck doing straight-up exposure and response prevention. It’s also hard.  When I was a little kid, I was really scared to go off the high dive. I tell my clients and my team the story sometimes where it was like a three-meter dive. And I was that kid where I would be like, “I’m going to do it. All the other kids are doing it.” And I would climb up, I’d walk to the end of the board, freak out, walk back, climb down. And I did this so many times one day, and there’s a long line of other kids waiting to get in the water. And they were pissed. So, I got up and I walked out to the end of the board and I was like, “I can’t.” And I turned around to go back. And there was my swim coach at the other side of the board with his arms crossed. I was like, “Oh no.” Kimberley: “This is not the way I planned.” How do you apply Acceptance & Commitment Therapy for OCD and Mental Compulsions?  Lisa: And he is like, “No, you’re going.” And I went, which was amazing. And sometimes you do need that push. But the point is that it’s really hard to get yourself to do those really hard things sometimes when it matters. So, to me, ACT brings two pieces to the table that are really, really important here. You can divide ACT into two sets of processes. There’s your acceptance and mindfulness processes, and then there’s your commitment and valuing processes, which are the engine of ACT, how do we get there?  So, for the first part, mindfulness is really paying attention on purpose. And if you want to really learn from an exposure, you have to be in your body, you have to be noticing, you have to be willing to allow all of the thoughts and sensations and whatever shows up to show up. And so, ACT is ideal at shaping that skillset for when you’re in the exposure. So, that’s how we think of it that way.  And then the valuing and commitment is, how do you get yourself off that diving board? There has to be something much more important, bigger, much bigger than your fear to help motivate you for why to do this hard thing. And I think that the valuing piece and really connecting with the things that we most deeply care about is part of what helps with that too. So, I think those two bookends are really, really important. There’s other ways to think about it, but those are the two primary ways that we do ERP, but we do it within an ACT framework. Using Values to manage Mental Compulsions Kimberley: Okay. I love this. So, you’re talking about we know what we need to do. We know that rumination isn’t helpful. We know that it creates pain. We know that it keeps us stuck. And we also know, let’s jump to like, we know we have to drop it ultimately. What might be an example of values or commitments that people make specifically for rumination, the solving? Do you have any examples that might be helpful?  Lisa: Yeah. I’m just thinking of-- there’s a bunch of them, but for example, let’s take, for example, ROCD, relationship OCD. So, let’s say someone’s in a relationship with a partner and they’re not sure if the right partner is. Are they cheating on me? Are they not? Blah, blah, blah, blah. And it’s this like, “But I have to solve if this is the right person or not. Am I going to be safe?” or whatever the particular worry is. And so, one of the things that you can do is once folks notice, they’re trying to solve that. Notice, what’s the effect of that on your actual relationship? How is that actually working? So, there’s this stepping back where an ACT, we would call that diffusion or taking perspective self-as-context, which is another ACT, acceptance, and mindfulness piece. And first of all, notice that. Second of all, pause. Notice what you’re up to. Is the intent here to build a strong relationship, or is the intent to make this uncertainty go away? And then choose. Do I want to work on uncertainty or do I want to work on being a loving partner and seeing what happens? Because there’s so much we’re not in charge of, including what we’re thinking and feeling. But we are in charge of what we choose to do. And so, choosing to be present and see where it goes, and embracing that uncertainty. But the joyfulness of it, I think, is really, really important. So, that would be one example.  Kimberley: I love that example. Actually, as you were saying, I was thinking about an experience of my own. When your own fears come up around relationship, even you’re ruminating about a conversation or something, you’ve got to stop and be like, “Is this getting in the way here of the actual thing?” It’s so true. Tell me about this joy piece, because it’s not very often you hear the word joy in a conversation about mental compulsions. Tell me about it. Lisa: Well, when you start really noticing how this is working, and if you’re willing to step back from it, let it be, and stay where you are in that uncertainty, all sorts of new things show up. Stuff you never could have imagined or never could have dreamed. Your whole life could be just popping up all of these possibilities. In that moment you stop engaging with those compulsions, you could go in a hundred different directions if you’re willing to let the uncertainty be there. And I think that that’s really important.  I want to tell a story, but I have to change the details in my head just for confidentiality. But I’m thinking of a person who I have worked with, who would be stuck and ruminating about, is this the right thing? I could make decisions and how do I-- for example, how do I do this lecture? My slides need to be perfect and ruminating, ruminating, ruminating about how it works. And one day they decided, “Okay, I’m just going to be present and I’m just going to teach.” And they taught with a partner. And the person themself noticed like, “Wow, I felt so much more connected to my students. This was amazing.” And the partner teaching with them was like, “I’ve never seen you so on. That was amazing.” They contacted this joy and like, “This is what it could be like.” And it’s like this freedom shows up for you. And it’s something that we think we know. And OCD loves to know, and it loves to tell you, it knows the whole story about everything. And it’s more what you get back when you stop doing the compulsions if you really, really choose that. It’s so much more than just, “Oh, I’m okay. I noticed that thought.” it’s so much more than that. It’s like, yes, and you get to do all this amazing stuff.  Kimberley: Right. I mean, it’s funny. I always have my clients in my head. When someone says something, I’m imagining my client going, “But like, but like...” What’s the buts that are coming? Lisa: And notice that process. But see, that’s it. That’s your mind, that’s their minds jumping back in being like, “See, there it is again.” Kimberley: Yeah. Lisa: And what if we just don’t know? Using Curiosity to Stop Mental Compulsions  Kimberley: And this is what I love about this. I agree with you. There have been so many times when I’ve dropped myself out of-- I call it being heady and I drop into my body and you get this experience of being like, “Wow.” For me, I can get really simple on like, “Isn’t it crazy that water is clear?” I can go to that place. “Water is clear. That is incredible.” You know what I mean? It’s there to go to that degree. But then, that’s the joy in it for me. It’s like, “Wow, somebody literally figured out how to make this pen work.” That still blows my mind.  Lisa: I had a moment. I started horseback riding again for the first time in literally-- I’ve ridden on and off once a year or something, but really riding. And actually, it was taking classes and stuff for the first time in 30 years. And they put me in this class and I didn’t know what level it was. I just thought we were just going to walk around and trot and all that stuff. Plus, she starts setting up jumps. And I was like, “Oh my God, this is old body now. This is not going to bounce the way it might have been.” It’s what means all these 15-year-olds in the class. Kimberley: Wow. Lisa: I’m third in line and I’m just on the horse absolutely panicking and ruminating like, “Oh my God, am I going to die? Should I do this? What am I going to do? Should I tell her no? But I want it and I don’t know what I’m going to--” and my head was just so loud. And so, the two girls in front of me go. And then I look at the teacher and I go, “Are you sure?” It’s literally the first time I’ve ever done in 30 years. She just went-- she just looked at me. And I noticed that my legs squeezed the horse with all of the stuff rolling around in my head. And I went over the jump and it was, I didn’t die. It was really messy and terrifying. Oh my God, it was so exciting and joyful. And I was so proud of myself. That’s what you get-- Kimberley: And I’ve heard that from so many clients too.  Lisa: It’s so awesome.  Kimberley: I always say it’s like base jumping. It’s like you’ve got to jump. And then once you’ve jumped, you just got to be there. And that is true. There is so much exhilaration and sphere that comes from that. So, I love that. What about those who base jump or squeeze the horse and they’re dropping into discomfort that they haven’t even experienced before, like 10 out 10 stuff. Can you walk me through-- is it just the same? Is it the same concept? What would you advise there? Lisa: So, I think it’s important to notice that when that happens, people are not just experiencing physical sensations and emotions, but it’s also whatever their mind is telling them about it. And I think this is another place where ACT is super helpful to just notice, like your mind is saying, this is 10 out of 10. What does that mean to you? That means like, oh my gosh. And just noticing that and holding it lightly while you’re in that 10 out of 10 moment, I think, is really, really helpful.  So, for example, I have a really intense fear of heights where I actually freeze. I can’t actually move when I’m on the edge of something. And I had a young client who I’ve worked with for a while. And as an exposure for her, but also for me as her clinician to model, we decided. She wanted me to go rock climbing with her, which is not something I’ve ever done, ever, and also fear of heights. So, I kept telling myself, “Fear of heights, this is going to suck. This is going to be terrible. This is going to be terrible.” And there was also another part of me interested and curious.  And so, what I would say when you’re in that 10 out of 10 moment, you can always be curious. So, when you’re like, “Oh my gosh, I’m really scared,” the moment you’re unwilling to feel that is the moment it’s going to overwhelm you. And if you can notice it as a thought, “I’m having the thought, I don’t think I can handle this. I don’t think I’m going to survive this,” and notice it and be curious, let’s see what happens. And so, for me, I noticed interestingly, even though I’m terrified of heights, I wasn’t actually scared at all. And that was a shocker, because I was full sure it was going to be the worst thing ever.  And so, notice the stories your mind tells you about what an experience is going to be and stay curious. You can always be curious. And that’s going to be, I think, your number one tool for finding your way through and how to handle those really big, unexpected, and inevitable surprising moments that happen in life that are really scary for all of us. Kimberley: Right. And when you say curious, I’m not trying to get too nitpicky on terms, but for me, curiosity is, let’s experiment. I always think of it like life is a science experiment, like let’s see if my hypothesis is true about this rock climbing. Is there a way that you explain curiosity? Lisa: Yeah. Well, that’s part of it, but it’s also part like what you were describing. Isn’t water cool? It’s more than, is this true or not true? That’s so narrow. You want, “No, really? What does this taste like?” And that’s the mindfulness piece. Really notice all of it. There’s so much. And when you start doing that, you’ll find-- even if you do it outside of exposure, for example, as practice, you start to notice that the present moment is a little bit like Hermione’s purse in Harry Potter, where you think it’s this one thing, and then when you start to expand your awareness, you notice there’s tons of cool stuff. So, in these big, scary moments, what you might see is a sense of purpose or a sense of, “Holy crap, I’m handling this and I didn’t think I could. Wow, this is amazing,” or “I’m really terrified. Oh my gosh, my nose itches.” It could be anything at all.  But the bottom line is, our bodies were meant to feel and they were meant to experience all the emotions. And so, there is no amount of emotion or fear or anything that we are not built to handle. Emotions are information. And to stay in the storm when it’s such a big storm, when OCD is ramping you up, it teaches the OCD, “Actually, I guess I get to stand down here eventually, I guess I don’t need to freak out about this so much. Huh, interesting. I had no idea.” I don’t know if that’s helpful or not.   Kimberley: No, it’s so helpful. It is so helpful because I think if you have practiced curiosity, it makes sense. But for someone who maybe has been in mental compulsions for so long, they haven’t really strengthened that curiosity muscle. Mindfulness for Mental Compulsions Lisa: That’s so true. So, start small. Don’t start in the storm. Start with waking up in the morning and noticing before you open your eyes, what do you hear? How do the covers feel? Do you hear the birds outside your window? Start with that. And start in little moments, just practicing during the day. Start a conversation with someone you care about, and notice what your mind is saying in response to them, what it’s like to notice their face. Start small, build it up, and then start practicing with little tiny, other kinds of discomfort. Sometimes we’ll tell people like impatience. When you’re waiting in line or in hunger or tiredness, any of those, to just bring your full awareness to that and be like, “What is it like inside this moment right now?” And then you can extend that to, “Okay. So, what if we choose to approach this scary thing? What if we choose to just for a few seconds, notice what it feels like in this uncertain space?” And that’s how you might begin to bring it to rumination, be curious about what was the triggering thought. And then before you start ruminating or before you start doing mental rituals, just notice the first thought, and then you don’t have to answer that question. And there’s different ways to handle that, but curiosity is the beginning. And then stopping the compulsion is ultimately, or undoing it or undermining it in some way is going to be the other important piece. Kimberley: I’d love to hear more about commitment. I always loved-- when I have multiple clients, we joke about this all the time. They’ll say, “I had these mental compulsions and you would be so proud. I was so proud. I was able to catch it and pull myself back into the present. And yes, it was such a win. And then I had another thought and you’d be so proud of me. I did the same thing. And then I had another thought and...” Lisa: You’re like, “Was that the show that you just did right there?” It’s sneaky, huh. Kimberley: And so, I’d love to hear what you’re-- and maybe bring it from an ACT perspective or however you would. It’s like you’re chugging away. “I’m doing good. Look at me go.” But OCD can be so persistent. Lisa: It’s so tricky.  Kimberley: And so, is that the commitment piece, do you think? What is that? How would you address that?  Lisa: So, if I’m getting your question right, you’re asking about, what do we do when OCD hijacks something that you should do and turns it into a ritual? Is that what you’re asking?  Kimberley: Yes. Or it just is OCD turns up the volume as like, “No, no, no, no. You are going to have to tend to me or I’m not going to stop,” kind of thing. Lisa: Yes. That is a commitment piece. And it’s funny because there’s different ways that I think about this, but it’s almost like a little child who has a tantrum. If you keep saying yes, every time they make the tantrum bigger, it’s going to end up being a pretty big tantrum. And OCD loves nothing more than a good tantrum. Kimberley: So true. Lisa: And so, the thing you have to do is plan for that and go, “Yeah, it’s going to get loud. Yeah, it’s going to say whatever it needs to say, and it’s going to say the worst thing I can think of.” And I have had my clients call this all sorts of different things like first-order thoughts, second-order thoughts, just different variations on the theme where it’s going to ramp up to hook you in. And so, really staying very mindful of that and making a promise to yourself.  One of my clients who helped us a lot in teaching but also in writing stuff that’s loud, Ethan, I think said it in this really elegant way. He said, make a promise to yourself. That really matters, even if it’s small. It doesn’t matter how big it is. But one of his first ones was, under no circumstances, am I going to do X the compulsion? And keep that promise to yourself because if you-- anybody who ever woke up and didn’t want to get out of the bed in the morning because, “Ah, too tired, it’s too early. I don’t really want to go to the gym.” If you know you’re in that conversation with yourself about, “Well, maybe just one more minute,” you’ve already lost. And so, this is a good place again for that ACT piece of diffusion. Noticing your mind or your OCD or your anxiety is pulling you into, “Ah, let’s just see if we can string you along here.” And so, what needs to happen is just move your feet and put them on the floor. Don’t get into that conversation with yourself. And having that commitment piece, that promise to myself with the added value piece, that really matters. And one other thing that’s sometimes helpful that I have-- I’ll use this myself, but I also teach my clients, remembering this question: If this is a step towards whatever it is that’s really important, am I willing to allow myself to feel these things? Am I willing? And remembering that as a cue. We’re not here. It’s never about this one exposure. It’s about, this is a step towards this other life that you are fighting for. And every single step is an investment in that other life where you’re getting closer and you’re making it more possible, and just remembering that. I think that that’s a really important piece. A Values Tool YOU NEED!  Kimberley: Yeah. It actually perfectly answered the question I had, which is, you’re making a commitment, but what to? And it is that long-term version of you that you’re moving towards or the value that you want to be living by. Would you suggest-- and I’ve done a little bit of work on the podcast about values. Maybe one day we can have you back on and you can share more about that, but would you suggest people pick one value, three values? How might someone-- of course, we all have these values and sometimes OCD can take things from us, or anxiety can take those things from us. How would you encourage someone to move in that direction? Lisa: Well, actually, do you want to do a fun thing? Kimberley: I do. Lisa: Okay. So, let’s do-- Kimberley: I never would say no to that. I would love to. I’m really curious about this fun thing. Lisa: All right. So, do you like coffee or are you a tea person or neither? Kimberley: Let’s go tea. I’m an Australian. If I didn’t say tea, I would be a terrible Aussie.  Lisa: They’ll kick you off. All right. So, Kim, think about in your life a perfect cup of tea, not just a taste, but a moment with someone maybe you cared about or somewhere that was beautiful or after something big or before something big, or just think about what was a really, really amazing important cup of tea that you’ve had in your life. Kimberley: Oh, it’s so easy. Do I tell you out loud?  Lisa: Yeah. If you want to, that’d be great.  Kimberley: I’ll paint you guys a picture. So, I live in America, but my parents live in Australia and they have this beautiful house on a huge ranch. I grew up on a farm. And we’re sitting at their bay window and you’re overlooking green. It’s just rolling hills. And my mom is on my left and my dad is on my right. And it’s like milky and there’s cookies. Well, they call them biscuits. So, yeah. That’s my happy place right there. Lisa: And I could see it in your face when you’re talking about it. So, where do you-- does that tell you something about what’s really important to you?  Kimberley: Yes. Lisa: What does it tell you? Kimberley: Family and pleasure and just savoring goodness, just slowing down. It’s not about winning a race, it’s just about this savoring. And I think there’s a lot-- maybe something there that I think is important is the green, the nature, the calm of that. Lisa: Yeah. So, as you talk about that, what are you noticing feeling? Kimberley: Oh my God, my heart just exploded 12 times. My heart is filled. That was the funnest thing I’ve ever done in my whole life. Funnest is not a word. Lisa: What if you could build your life around moments like that? Would that be a well of life for you? Kimberley: I think about that nearly every time I make tea, actually. Lisa: That’s how you would help your clients, and that’s one way to think about values. Kimberley: Wow. That is so cool. I feel like you just did a spell on me or something. Lisa: You just connected with the stuff that’s really important. So, when you think about if I had a hard thing to do, what if it was a step towards more of that in your life? Kimberley: Yeah. Lisa: You see?  Kimberley: It’s so powerful. I’ve never thought that. Oh my God, that was gold. And so, that’s the example. Everyone would use that, coffee or tea. Lisa: There you go. Just think about it. And it’s funny because we came up with this in our team, maybe three months ago. We keep piloting just new little values exercise, but it’s so funny how compelling it is. just thinking about-- gosh. Anyway, I could tell you about mine, but you get the point.  Kimberley: And you know what’s so funny too and I will say, and this is completely off topic, there’s a social media person that I follow on Instagram. And every time she does a live-- and for some reason, it’s so funny that you mentioned this, I love what she talks about, but to be honest, I’m not there to watch her talk. The thing that I love the most is that she starts every live with a new tea and she’ll pause the water in front of you. It’s like a mindfulness exercise for me. To be honest, I find myself watching to see whether she’s making tea. Not that this is about tea, but I think there’s something very mindful about those things that where we slow down-- and the water example, she’s pouring it and she’s watching the tea. And for some reason, it’s like a little mini-break in the day for me.  Lisa: I totally agree. It’s like the whole sky, the cloud, and the tea and the-- Kimberley: Like Thich Nhat Hanh. Lisa: Yes. I can’t remember the quote, but exactly.  Kimberley: Yeah. Oh my gosh, I love that example. So good. Well actually, if you don’t mind, can you tell us your tea? Because I just would love to see if there’s a variation. So, what would yours be? Lisa: It was funny because I think I did coffee the first time I did this, but then recently I just did a workshop in Virginia and I was like, “Oh my gosh, tea.” And what came to mind was, when I took my 17-year-old daughter tracking in the Himalayas to Nepal, because I wanted her. She was graduating from high school and I wanted to show her that you could do anything and she really wanted to go. We both really wanted to go to Ever Space Camp. And every morning after trekking nine, 10, 11 hours a day where you’re freezing cold, you’re exhausted, everything’s hurting, and it’s also amazing and beautiful, the guides would knock at our door and there would be two of them. And one of them would have a tray of little metal cups. And then the other one would say, “Tea? Sugar? Would you like sugar?” And they would make you, they would bring you, and this was how you woke up every morning, a steaming cup of tea. Sometimes the rooms were 20 below zero. And you’d get out of bed and you’d be so grateful for that warm cup of tea. And that was the tea I remembered. Kimberley: Right. And then the values you pulled from that would be what? Lisa: That moment, it was about being with my daughter and it was about showing her, modeling courage and modeling willingness and just adventure and this love of being in nature and taking a journey and seeing, “Could we do this? And what would it be like?” And just sharing the experience with her. It’s just beautiful. And the tea is right in the center of that. So, it’s almost not even about the tea, but it’s that moment. It’s that time and that experience. So amazing. Kimberley: So amazing. Thank you. I’m deeply grateful. That just filled my heart.  Lisa: I’m so glad. I feel so honored that you have had experience. I love that so much. Kimberley: I did. I always tell my clients or my kids or whoever is at-- when I was a kid, my mom, every afternoon when I came home from school, she’d say, “What’s the one thing you learn at school today?” And so still, there’s always one thing I learn and I always note it like that’s the one thing I learned today and that was it. What an amazing moment.  Lisa: I’m so glad.  Kimberley: Okay. I love this. So, we’ve talked about mindfulness and we’ve talked about commitment. We’ve talked about values and we have talked about the acceptance piece, but if we could have just one more question around the acceptance piece. How does that fit into this model? I’m wondering.  Lisa: It’s funny because I always feel like that acceptance piece, the word, it means to so many people, I think, tolerance or coping or let’s just make this okay. And it doesn’t mean any of those things. And so, I’ve moved more into thinking of it and describing it as, it’s like a willingness. What is under the hood of acceptance and am I willing? Because you cannot like something and not want something and also be willing to allow it. And it’s almost like this-- again, it involves curiosity about it. It involves squeeze the horse with all the stuff. Get the feet on the floor, even though you’re having an argument that’s in your head. And so, sometimes people think about it as a feeling and sometimes it is, but a lot of times, it’s willingness with your feet. When you think about moms and infants in the middle of the night, I don’t think there was ever a moment when I was like, “Oh yeah, the baby’s crying at 4:00 in the morning. I’m so excited to get up.” I’m feeling in my heart, no. It’s like you’re exhausted and it’s like the last thing you want to do and 100% you’re willing to do it. You choose. And so, that’s the difference. And so, I think people get tangled up, not just thinking of it as tolerance, but also waiting for a feeling of willingness to happen. And that’s not it. It’s a choice. Kimberley: It’s gold. Lisa: Yeah, seriously. I mean, it’s the same thing. I learn it every day. Trust me, when I fall out of my gym routine or my running routine and I’m off the willingness, and then I’m like, “Yeah, that’s not it.” And I have to come back to it. So, it’s something we all struggle with. And I think that’s really important to know too, but ultimately, it’s a choice, not a feeling. Kimberley: Okay. That was perfect. And I’m so happy. Thank you, number one. This is just beautiful for me and I’m sure the gifts just keep going and flowing from this conversation. So, thank you.  Lisa: Thank you for having me. Kimberley: Tell me where people can hear more about you and know your work? Lisa: Well, we’re at the New England Center for OCD and Anxiety in Boston. We have recently opened in New York City and in Ireland. So, if anybody is in Ireland, call us, look us up. Kimberley: Wow. Lisa: Yeah. That’s been really fun. And there’s a few books we have. There’s Stuff That’s Loud written by Ben Sedley and myself. There’s our newest book called Stop Avoiding Stuff with Matt Boone and Jen Gregg. And that’s a fun little book. If anybody’s interested in learning about ACT, it’s really written-- the chapters are each standalone and they’re written so that you could read them in about two minutes, and that was on purpose. We wanted something that was really pocket-sized and really simple with actionable skills that you could use right away. And then I have a new book coming out actually really soon. And no one knows this. Actually, I’m announcing this on your show. And I am writing it with my colleague, Sarah Cassidy-O’Connor in Ireland. We are just doing the art for it now and it’s a book on ACT for kids with anxiety and OCD.  Kimberley: When is this out? Lisa: Good question. I want to say within the year, but I don’t remember when. Kimberley: That’s okay.  Lisa: But look for it and check out our website and check out Stuff That’s Loud website. We’ll post it there and let folks know. But yeah, we’re really excited about it. And it’ll be published by a UK publisher. So, it’s really cute. So, I think the language will be much more like Australia, UK, Ireland for the US, which is really fun because I have a connection to Ireland too. But anyway, there you go.  Kimberley: It’s so exciting. Congratulations. So needed. It’s funny because I just had a consultation with one of my staff and we were talking about books for kids. And there are some great ones, but this ACT work, I think as I keep saying, there’s skills for life.  Lisa: It really is. Kimberley: So important. How many times I’ve taught my child, even not related to anxiety, just the ACT skill, it’s been so important. Lisa: Yeah. Mine too. I think they’re so helpful. They were just really helpful with flexibility in so many different areas. Kimberley: Right. I agree. Okay. This is wonderful. Thank you for being on. Like I said, you brought it home.  Lisa: We’ll have our cups of tea now. Kimberley: We will Lisa: So nice to talk to you, Kim.  Kimberley: Thank you. Lisa: Thank you.

SUMMARY: In this week's podcast, we talk with Dr. Reid Wilson.  Reid discussed how to get the theme out of the way and play the moment-by moment game.  Reid shares his specific strategies for managing mental compulsion. You are not going to want to miss one minute of this episode. Covered in This Episode: Getting your Theme out of the way The importance of shifting your additude Balancing “being aggressive” and implementing mindfulness and acceptance How to play the “moment by moment” game Using strategy to achieve success in recovery OCD and the 6-moment Game Other tactics for Mental compulsions Links To Things I Talk About: Reid’s Website anxieties.com https://www.youtube.com/user/ReidWilsonPhD?app=desktop DOWNLOAD REID’s WORKBOOK HERE  Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 286. Welcome back, everybody. I am so excited. You guys, we are on number five of this six-part series, and this six-part series on Managing Mental Compulsions literally has been one of the highlights of my career. I am not just saying that. I’m just flooded with honor and pride and appreciation and excitement for you. All the feedback has been incredible. So many of you have emailed me or reached out to me on social media just to let me know that this is helping you. And to be honest with you, I can’t thank you enough because this has been something I’ve wanted to do for so long and I’ve really felt that it’s so needed. And it’s just been so wonderful to get that feedback from you. So, thank you so much. The other plus people I want to be so grateful for are the guests. Each person has brought their special magic to how to manage mental compulsions. And you guys, the thing to remember here is managing mental compulsions is hard work, like the hardest of hard work. And I want to just honor that it is so hard and it is so confusing and it’s such a difficult thing to navigate. And so, to have Jon talking about mental compulsions and mindfulness and Shala talking about her lived experience and flooding, and Dr. Jonathan Grayson talking about acceptance last week. And now, we have the amazing Reid Wilson coming on and sharing his amazing strategies and tools that he uses with his patients with mental rumination, mental compulsions, mental rituals. Literally, I can’t even explain it. It’s just joy. It’s just pure joy that I get to do this with you and be on this journey with you. I’m going to do this quick. So, I’ll just do a quick introduction. We do have Dr. Reid Wilson here. Now we’ve had Reid on before. Every single guest here, I just consider such a dear friend. You’re going to love this episode. He brings the mic drops. I’m not going to lie. And so, I do hope that you squeeze every little bit of juice out of this episode. Bring your notepad, get your pen, you’re going to need it, and enjoy. Again, have a beautiful day. As I always say, it is a beautiful day to do hard things. Let’s get onto the show. Kimberley: I am thrilled to have you, Dr. Reid Wilson. Reid: Thanks. Glad to be here. Kimberley: Oh my goodness. Okay. I have been so excited to ask you these questions. I am just jumping out of my skin. I’m so really quite interested to hear your approach to mental compulsions. Before we get started, do you call them mental compulsions, mental rituals, mental rumination? How do you-- Reid: Sure. All of the above doesn’t matter to me. I just don’t call it “pure obsessions, pure obsessionals” because I think that’s a misnomer, but we can’t seem to get away from that. Kimberley: Can you maybe quickly share why you don’t think we can get away from that? Do you want to maybe-- we’d love to hear your thoughts on that. We haven’t addressed that yet in the podcast. Reid: Well, typically, we would call-- people write to me all the time and probably do that too, say, “I’m a pure obsessional.” Well, that’s ridiculous. Nobody’s a pure obsessional. What it really is, is I have obsessions and then I have mental compulsions. And so, it’s such a misnomer to be using that term. But what I mean is, how we can’t get away from it is it’s just gotten so completely in the lexicon that it would take a lot of effort to try to expel the term. Getting the theme out of the way Kimberley: Okay. Thank you for clearing that up, because that’s like not something we’ve actually addressed up until this time. So, I’m so grateful you brought that up. So, I have read a bunch of your staff. I’ve had you on the show already and you’re a very dear friend. I really want to get to all of the main points of your particular work. So, let’s talk first about when we’re managing mental compulsions. We’ll always be talking about that as the main goal, but tell me a little bit about why the theme, we’ve got to get out of the way of that. Reid: Right. And my opinion is this is one of the most important things for us to do and the most difficult thing to accomplish. It’s really the first thing that needs to be accomplished, which is we have to understand. And you’re going to hear me say this again. This is a mental health disorder and it’s a significant disorder. And if we don’t get our minds straight about what’s required to handle it, we’re going to get beaten down left and right. So, of course, the disorder comes into the mind as something very specific. Focusing on the specific keeps us in the territory of the disorders control. So, we need to understand this is a disorder of uncertainty. This is a disorder of uncertainty that brings distress. So, we have that combination of two things. If we’re going to treat the disorder, we cannot bring our focus on our theme. But the theme is very ingrained in everyone.  I talk about signal versus noise, and this is how I want to help people make that transition, which is of course, for all of us in all humanity, every worry comes into the prefrontal cortex as a signal. And we very quickly go, “Oh yeah, well, that’s not important. I don’t need to pay attention to that.” And we turn it over to noise and let go of it and keep going. With OCD, the theme, the topic, the checking, and all the mental rituals that we do are perceived and locked down as signals. And if we don’t convert them into noise, we are stuck.  What I want the client to do is to treat the theme as nothing, and that is a big ask. And not only do we have to treat the theme as nothing, we have to treat it as nothing while we are uncertain, whether it’s nothing or not. So, in advance of an obsession popping up, we really need to dig down during a no problem time and get clear about this. And then we do want to figure out a way to lock that down, which includes “I’m going to act as though this is nothing,” and it has to be accomplished like that. Go ahead. Kimberley: No. And would you do the same for people, let’s say if they had social anxiety or health anxiety, generalized anxiety? Would you also take the theme out of it? Reid: Absolutely. But if the theme is in the way, then we need to problem-solve that. So, if we go to health anxiety, okay, I’ve got a new symptom, some pain in the back of my head that I’ve never had before. I have to decide, am I going to go into the physician and have it checked out or am I not? Or am I going to wait a few days and then do it? With that kind of anxiety and fear around health, we have to get closure around “I don’t need to do anything about this.” Sometimes I use something called “postponing.” So, with social anxiety, it can-- I mean, with health anxiety, it can work really well to go, “Well, I’m having this new symptom, do I have to immediately go in and see the physician and get it checked out? Can I wait 24 hours? Yes, I can. I’ve already been diagnosed with health anxiety. So, I know I get confused about this stuff. So, I’m going to wait 24 hours.” So, what does that give us then? Now I have 24 hours to treat the obsession as nothing because I don’t need to focus on it. I’ve already decided, if I’m still worried tomorrow, I’m making an appointment, we’re going in. That gives me the opportunity to work on this worry as an obsession because I’ve already figured it out. The reason we want to do that so diligently is we have to go up one level of abstraction up to the disorder itself. And that’s why we have to get off of this to come up here and work on this. Kimberley: This is so good. And you would postpone, use that same skill for all the themes as well? I’m just wanting to make sure so people clarify. Reid: Well, sure. I mean, postponing is a tactic. I wouldn’t say we can do postponing across the board because some people have-- it really depends on what the obsession is and what the thinking ritual is as to whether we can use it. But it’s one of them that can be used. Shifting your attitude  Kimberley: Amazing. Tell me about-- I mean, that requires a massive shift in attitude. Can you share a little bit about that? Reid: Yeah. And if you think about-- I use that term a lot around attitude, but we’ve got some synonyms in attitude. What is my disposition toward this? Have I mentioned mental health disorder? What do I want my orientation to be? How do I want to focus on it? And we want to think about really attitude as technique, as skill set. So, what we know is the disorder wants some very specific things from us. It wants us to be frightened by that topic. It wants us to have that urge to get rid of it and have that urge to get rid of it right now. And so, that begins to give us a sense of what is required to get better. And that again is up here.  So, why do you do mental counting? Why do you do rehearsal mentally? Why do you try to neutralize through praying? When you look at some of those, the functions of some of those or compulsions and urge to do the compulsions, it is to fill my mind so I don’t get distracted again, it is to reassure myself, it is to make sure everything is going to be okay. It is to get certain. And so, when we know that that is the drive of the disorder, we begin to see, what do we need to do broadly in general? And that is, I need to actually operate paradoxically. If it needs me to do this, feel this, think this, I’m going to do everything I can to manipulate that pattern and do the opposite. It wants me to take this theme seriously, I’m going to work on-- and really it has to be said like that. I’m going to work on not taking it seriously. So, that’s the shift. If we can get a sense of the attitude and the principles that go along with all of that, then moment by moment, we’ll know what to do in those moments. Do you need to be aggressive with OCD and intrusive thoughts?  Kimberley: We’ve had guests talking about mindfulness and we will have Lisa Coyne talking about act and Jon Grayson talking about acceptance, and you really talk more about being aggressive. How do you feel about all of those and where do they come together, or where are they separate? How would you apply these different tools for someone with mental compulsions? Reid: Yeah, sure. Mindfulness is absolutely a skill set that we need to have. Absolutely. We are trying to get perspective. We’re trying to get some distance. We would like to detach. That’s what we’re trying to do. But what are we trying to be mindful of? We’re trying to be mindful of the belief that this topic is important. We’re trying to be mindful of the need to ritualize that is created by the theme. So, the end game is mindfulness and detachment. That’s where we’re going. My opinion is, the opening gambits, the opening moves, it’s very difficult to go from a frightened, terrified, scared, and slide over to neutral and detached. It’s just difficult.  And so, I think initially, we need to be thinking about a more aggressive approach, which is I’m going to go swing in this pendulum from, “I can’t stand this, this is awful.” I’m going to swing over right past mindfulness over to this more aggressive stance of, “I want this, let’s get going. I’m taking this theme on.” The aggressiveness is a determination of my commitment to do the work.  And here’s the paradox of it. I’m going to address on the disorder by sitting back. My action is to go, “I’m okay. This is all right.” And that’s a mindful place to get to. But you have to know we’re going after this big, aggressive bully, and it requires an intense amount of determination and you have to access your determination over and over and over again. You don’t just get determined and it’s steady. So, we just got to keep getting back to that. “No, no, I want to do this work. I want to get my outcome picture. I want to have my mind back. I want to go back to school. I want to be able to connect with my family in a loving way, with having one-third of my mind distracted. I want that back very strongly. And therefore, If I have to go through this work to get there, I want to go through this work.” We can maybe talk more about what that whole message of “I want this” means, but here it is, which is, “I want this” is a kind of determination that’s going to help drive the work. Kimberley: Yeah. Let’s go there because that is so important. So, tell me about “I want this.” Tell me about why that is so important. So, you’ve talked about “I want to get better and I want to overcome this,” and so forth. Tell me more about the “I want this comfort.” Reid: Well, let’s think about-- you really only have two choices in terms of your reaction to any present moment, either I want this moment, so I’m present to this moment, or I don’t want this moment. It’s very simple in that way. When I don’t want this moment, I’m now resisting this present moment. And what that means practically speaking is, now I’ve taken part of my consciousness, part of my mind that is available for the treatment and I’ve parked it. I’ve taken it offline and actually provoking myself, sticking myself with, “Are you sure you want to do this? Is this really safe? Don’t you think-- maybe we could do this later and not now.” So, there’s a big drive to resist that we need to be aware of. Have I mentioned this yet? This is a mental health disorder that is very tough to treat. I want 100% of my mental capacities available to do the treatment. I’ll never have all of that because I’m always going to have some form of resistance, but I need to get that resistant part of me on the sideline not messing with me, and then let me go forward all like that.  One of the confusions sometimes people get around this work when I talk about it is it’s not, “Oh, I want to have another obsession right now,” or “I want to have an urge to do my compulsion right now. I want that.” No. What we’re talking about is a present moment. So, if my obsession pops up, if it pops up, I want it. If I’m having that urge to do my compulsion, I want it. And why is that? Because we have to go through it to get to the other side. I have to be present to both the obsessions and the urges to do the compulsions in order to do the treatment. So, that’s the aggressive piece. “Come on, bring it on. Let’s get going. I’m scared of this.” Of course, I don’t want-- Kimberley: I’m just going to ask. Reid: I don’t want to feel it. I don’t want to, but I’m clear that to do the treatment, it requires me to go through the eye of the needle. If you’re like I am, there’s plenty of days when you don’t want to go to the gym. You don’t really want to work out or sometimes you don’t even want to go to bed as early as you should, but if we want the outcome of that good rest, that workout, then we manifest that in the moment and get moving. We’re disrupting a pattern. When I talked about postponing, it’s a disruption of this major pattern. If we insert postponing into these obsessions and mental compulsions are impulsive, I have that obsession and I pretty immediately have that urge to do the compulsion. And then I begin doing my mental compulsion. If we slide something in there, that’s what mindfulness does go, “Oh, there it is again. Oh, I’m doing it.” Even if you can’t sustain that, you’ve just modified for a few moments, the pattern that you’ve had no control over. So, that’s where we want to be going. And you know how I sometimes say it is, my job is to-- as the client is to purposely choose voluntarily to go toward what scares the bejesus out of me. I don’t know if you have bejesus over there in California, but in North Carolina, we got bejesus, and you got to go after it. Kimberley: I think in California, it’s more of a non-kind word. Reid: Ah, yes. Okay. Well, we won’t even spell it. The Moment By Moment Game  Kimberley: That’s okay. So, I have questions. I have so many. When you’re talking about this moment, are you talking about your way of saying the moment-by-moment game? Is that what you’re talking about? Tell me about the moment-to-moment game. Reid: Sure. I’m sure people hearing this the first time would go, “Well, don’t be-- you’ve lost rapport with me now because you called it a game.” But I’ve been doing this for 35 years, so it’s not like I am not aware of the suffering that goes on here. The only reason to call it a game is simply to help structure our treatment approach. Kimberley: That’s interesting, because I think of a game as like you’re out to win. There’s a score. That’s what I think of when I-- Reid: That’s what this is. That is actually what this is.  OCD and the 6 Moment Game  Kimberley: I don’t think of it as a game like Ring A Rosie kind of stuff. I think of it as like let’s pull our socks up kind of stuff. Is that what you’re referring to? Reid: We’ve got this mental game that we are-- we’ve been playing this game and always losing. So, we’re already engaged in it. We’re just one down and on the losing end, on the victim end. So, when I talk about it as moment by moment, I want to have, like we’ve been talking about, this understanding of these sets of principles about what needs to happen. It wants me to do this, I’m going to do the opposite, this is paradoxical and so forth. And then we need to manifest it moment by moment. So, how do we do this? I will really talk about six moments and I’ll quickly go through the first three because the first three moments are none of our business. We can’t do anything about them.  So, moment #1 is just an unconscious stimulus of the obsession, and that’s all. That’s all it is. Moment #2 is that obsession popping up. And moment #3 is my fear reaction to the obsession because obsessions are frightening by their construct. And so, now I’ve got those three moments. As I’m saying, we can’t do anything about those three moments. These three moments are unconsciously mediated. They are built right on into the neurology.  Now we’ve got in my view three more moments. So, moment #4 is really the foundation of what we do now, what we do next, which is a mindful response. And it is just stepping back in the moment. Suddenly the obsession comes up and I’m anxious and I’m worried about it and I’m having the urge to do the compulsion. And what I want to train myself to do, which can take a little time sometimes, is when I hear my obsession pop up. The way I just described it right there is already a stepping back. When I recognize that I’ve started to obsess and sometimes it takes a while to even recognize it, I want to step back in that moment and just name it. They have that expression, “Name it to tame it.” So, it’s the start of that. So, I’m stepping back in that moment going, “Oh, I’m doing it again,” or, “Oh, there it is.” Now, the way I think about it, if I can do that and just step back and name it, I just won that moment because I just inserted myself. I insinuated myself into the pattern. OCD doesn’t want you anywhere near this at this moment. It doesn’t want you to be labeling the obsession an obsession. It wants you to be naming the fearful topic of it. So, I’m going to step back in that moment. And if I can accomplish that, great, I’ve won that moment.  If I can go further in that moment, of course, in the end, we want to be able to do that, moment #5 is taking the position of, “I’m treating this as nothing. There is my obsession. I’m treating it as nothing.” And there’s all kinds of things you can say to yourself that represent that. “This is none of my business. Oh, there it is trying to go after me. Not playing. I’m not playing this game.” Because it really is a game that the disorder has created. And what we’re saying is, “Look, I’m not playing your game anymore. I’m playing my game. And this is what my game looks like.” I’m going to notice it when it pops up, the obsession and the urge to do my compulsion, and I’m going to go, “Not playing,” whatever way I say it.  And then moment #6, and this is a controversial moment for others. Moment #6, I’m going to turn away from it. I’m going to just redirect my attention, because this is nothing, but it’s drawing my attention. I’m going to treat it as nothing by engaging in some other thought or action that I can find. And even if I can refocus my attention for eight seconds, even if it pops right back up again like, “Where are you going? This is important. You need to pay attention to it,” even if I turn away for eight seconds, I’ve won that moment because I’m no longer responding to this over here.  Now, why I say this is controversial for some folks is it sounds like distraction. It sounds like, “Oh, you’re not doing exposure. You’re just telling the person to distract themselves. And that’s opposite of what we want to be doing.” I don’t see it that way.  Kimberley: No, I don’t either. I think it’s healthy to engage in life.  Reid: And if we think about, what we’re really trying to do is to sit with a generic sense of uncertainty, then this allows us to do it because, in essence, the obsession is a kind of question that is urging you to answer. And when you turn away, engage in something else, you are leaving that question on the table. And that is exposure to pure uncertainty. I just feel like in our field, in exposure, we’re doing so much to ask people to expose themselves to the specifics and drill down about that as a way to change neurology. And we know that’s really the gold standard based on all the research that has been done. But I think it really adds a degree of distress focusing on that specific that maybe we can circumvent.  Kimberley: Do you see a place for the exposure in some settings? I mean, you’re talking about being aggressive with it. Does that ever involve, like you said, staring your fear in the face purposely? Reid: Well, yeah. And how do you do that? Well, what you do is you either structure or spontaneously step into circumstances that would tend to provoke the obsession. So, do something that I’ve been avoiding for fear that thought is going to come up or anything that I have been blocking or avoiding out of fear of having the obsession or anything that tends to provoke the obsession. I want to step into those scenes. So, step into the scene, but the next move isn’t like, “Okay, come on obsessions. I need to have an obsession now.” No. If you step into the scene that typically you have an obsession with and you don’t have the obsession, well, that’s cool. That’s fine. That’s progress. That’s great. Now you got to find something else to step into it with. However, most people with thinking rituals, it goes on most of the day anyway. So, we’re going to have a naturalistic exposure just living the day.  Kimberley: The day is the exposure. Reid: And for people who are structuring it and you know you’re about to step into a scene where you have the obsession, you can, in that way, be prepared to remind yourself, cue yourself ahead of time what your intention is. The more difficult practice is moving through your day and then getting caught by it. So, you get caught by it and then you start digging to fix the content and it takes a little more time to go, “Oh, I’m doing it again.” We’re doing exposure. This is exposure. You have to do exposure. I’m just saying that there’s a different way to do it instead of sitting down and conjuring up the obsession in order to sit with the distress of the specific. Kimberley: I’m going to ask you a question that I haven’t asked the others, just because it’s coming up specifically for me. Some clients or some of my therapist clients have reported, “Okay, we’re doing good. We’re doing good. We’re not doing the mental compulsion.” And the obsession keeps popping up. “Come on, just a little. Come on, let’s just work it out.” And they go, “No, no, no, not engaging in you.” And then it comes back up. “No, no, no, not engaging in you.” And much of the time is spent saying, “Not today, not today,” or whatever terminology. And then they become concerned that instead of doing mental compulsions, they’re just spending the whole time saying, “Not today, not today.” And they’re getting concerned. That’s becoming compulsive as well. So, what would you say? Are you feeling like that’s a great technique? Where would you intervene if not? Reid: Well, I think it’s fine if it is working like we’re describing it, which is not today, turning away, engaging in something else. So, we’ve got to be careful around this “not today” thing if you forget to do-- Kimberley: The thing Reid: Moment #6, which is find something else to be engaged in. Then you’re going to be-- it’s almost, again, you’re trying to neutralize, “Oh, this is nothing.” So, we want to make sure that we really complete the whole process around that. And the other way that we-- again, mindfulness and acceptance, the way we can get to it is we have the expression of front burner and back burner. So, we want to take the obsessiveness and the urges and just move them to the back burner, which means they can sit there, they can try to distract you, they can try to pull your attention. So, here you are at work and you’re really trying to do right by the disorder, but you’re trying to work, and it’s still coming over here trying to get to you. You’re going to be a little distracted. You’re not going to be performing your work quite as well as you would if your mind were clear. And that is the risk that you need to take. That is the price that you need to pay. And that’s why you need to have that determination and that perspective to be able to say, “Geez, this is hard. This is what I need to be doing.” You have to talk to yourself. You have to. We talk to ourselves all day long. This is thinking, thinking, thinking. So, we know people with thinking rituals are talking about the urges and so forth. And we’ve got to redirect how we talk about it in the moment. Kimberley: Okay. So good. What I really want to hear about is your ideas around rules.  Reid: Sure. And again, nobody seems to talk about rules. I’m a very big component or a proponent of rules. And here’s one reason. What are thinking rituals all about? It’s all about thinking, thinking, thinking, thinking, thinking. What do we need to do in the treatment strategy? Well, first off, the disorder is compelling me to fill my mind with thoughts in order to feel safe. I need to come up with a strategy and tactics that reduce my thinking. Then if I don’t reduce my thinking, I’m not going to get stronger. One of the ways to reduce my thinking is to say, “I don’t need to think about this anymore. I’ve already figured out what I need to do.” So, during no problem times, during therapeutic times, whether you’re sitting with your therapist or figuring this out on your own, you come up with literally what we’ve been talking about, “What I need to do when an obsession takes place? And then here’s what I’m going to do next.” Kimberley: So, you’re making decision-- Reid: I’m going to turn my attention. I’m sorry, go ahead. Make Decisions Ahead of Time Kimberley: Sorry. You’re making decisions ahead of time. Is that what you mean? Reid: Absolutely. You’re making decisions. This is rules of engagement. So, we’re not talking about having to get really specific moment by moment. We’re talking about thinking rituals. So, it’s rules of engagement. Well, simply put, initially, the rule of engagement has to do with those six moments we talked about, which is, okay, when this pops up, this is how I’m going to respond to it. So, we want to have that. All that we’ve talked about decide that ahead of time. And then as I would say, lock it down, lock it down. And now the part of you who is victim to the disorder, when the obsessiveness starts again, when the urge to do the compulsion starts again, I want to have all of me stand behind the rules, because if we don’t have predetermined rules, what is going to run the day? What’s going to win the day? What’s going to win the day in the moment is the disorder shows up. The victim side, the victim to the disorder is also going to show up and it’s going to say, those rules that I was talking about before, “This seems like a bad idea. I don’t think in this circumstance that’s the right thing to do.” So, if we don’t lock it down and we don’t have a hierarchy, which is, what I was saying, we’re not killing off the side of us that gets obsessive and is being controlled by the disorder. But we are elevating the therapeutic voice, “I’ll do that again with my hands.”  This is a zero-sum game. So, if I bring my attention to what I’ve declared what I need to do now, then by default, my attention toward that messages of my threatened self are going to diminish. And this is what I’ve been talking about with you around determination. You have to be so determined, because it’s so tantalizing. Even if they say this isn’t going to take me very long to complete this mental ritual, and then it’ll be off my plate, and I won’t have to be scared about the outcome of not doing this, why wouldn’t I do that? So, that’s what we’re really competing against in those moments of engagement. Thinking Strategically Kimberley: Right. So good. I’m so grateful for what you’re sharing. Okay. I want to really quickly touch on, and I think you have, but I want to make sure I’m really clear in terms of thinking strategically. It sounds like everything you just said is a part of that thinking strategic model. I love the idea that you come into the day, having made your decisions upfront with the rules. You’ve got a plan, you know the steps in the moment. Thinking strategically, tell me if that’s what that is or if there’s something we’ve got to add to it. Reid: Yeah. So, yes, all that you just said is that, that we’re understanding the principles of treatment based on the principles of what the disorder has intended for us. And then we’re trying to manifest those principles in, how do we act in the moment? How do we engage in that in the moment? The other thing we want to think about in terms of how I think about strategic treatment is we’re looking for the pattern and messing with the pattern. So, I talked earlier about postponing. We insert postponing into the pattern. It’s much easier to add something to a pattern than to try to pull something away. So, if we add postponing or add that beat where I go, “Oh, there’s my obsession,” now we’re starting to mess with the pattern. I’ll give you a couple of-- these are really tactics. Let me tell you about a couple of others and these seem surprisingly ridiculous. Okay, maybe not surprisingly ridiculous.  Kimberley: Appropriately ridiculous.  Reid: I’m sure you experience this. I experience a lot where people go, “Look, I’d love to do what you’re saying, but these obsessions are just pounding away at me all day long. I can’t interrupt them. I can’t do it.” What I would like people to be focused on is, what can we do to make keeping the ritual, keeping the obsession more difficult than letting it go? So, we talked about postponing. That doesn’t quite do what I’m saying right now. One of the things I’ll have people do is to sing it. I know, and I’m not going to demonstrate. Kimberley: Please. I will.  Reid: And here’s what you do. If I can’t stop my obsessions, I can’t park them, then when I notice – there’s moment #4 – when I notice my obsessions-- and we can do this in a time-limited-- I’m a cognitive therapist, so we do behavioral experiment. So, we can just do an experiment. We can go, “Okay, for the next three days, three weeks, three hours, whatever we decide, anytime I notice the obsession coming up, instead of saying it urgently and anxiously in my mind, I must sing it.” It just means lilting my voice. “Oh my gosh, how am I ever going to get through this? I don’t count the tiles on the ceiling. I’m not sure I can really handle what’s going to happen next. Oh my gosh, I feel so anxious about--” you see why I don’t demonstrate. Kimberley: Encore, encore. Reid: SO, it’s just lilting the voice like that. A couple of things are going on. One is obviously we’re disrupting the pattern. But just as important, who in their right mind, having a thought that is threatening, would sing it? So, simply by singing my obsession instead of stating it, I’m degrading the content, I’m degrading the topic. And so, that’s why I would do it. And again, that’s what we were saying. You got to lock it down. You got to go signal versus noise. This is noise. It’s acceptable to me to be doing this. This is very difficult. With such a short period of time, I don’t drill that home as much as I might. This is really, really hard, but it is an intervention. So, singing it is one thing that I will sometimes have some people do. And the other one is to write it down. And this means literally carrying a notepad with you and a pen throughout your day. And anytime your obsession starts to pop up, you pull that notepad out and you start writing your obsession. And I’m not saying put it in an organized paragraph fashion or a bulleted list or anything like that. We’re talking about stenographer in the courtroom. I want to, in that moment, when I start obsessing, to step back, pull out my notepad, because I said for the next three days, I’m going to do this, and then I’m going to write every single thing that’s popping up in my mind.  Kimberley: So, it’d be like, “What if you want to kill her? You might want to kill her. There’s a knife. I noticed a knife. Do I want to kill her with a knife? Am I a bad person?” Reid: Oh, it’s harder than that. It’s harder than that, Kimberley, because you’re not only saying, “Do I want to kill her? There’s the knife. Oh, what did I just say?” Now I got to write, “Oh, what did I just say? Oh, the knife. Oh, the knife. Do I want to kill her with the knife?” So, every utterance, we’re not saying every utterance. And so, there’s going to be a message of, “Did I just say that right? Now I can’t remember what I said. Damn it, damn it.” All of that. Now, again, a couple of things are happening. I’m changing modes of communication. The disorder wants me to do this by thinking. You and I know, you can have an obsessive thought a thousand times in a day. You can’t write it a thousand times. So, now we’re switching from the mode of communication that serves the disorder to a mode of communication that disrupts it. And if I really commit myself to writing this, after a while, now I’m at a choice point. Now when obsession pops up later and I go, “Oh, I’m obsessing again. Well, I can either start writing it,” or “Maybe I can just let it go right now because I don’t want to write it. It’s just so much work. Okay, let me go distract myself.” So, all of a sudden, we’ve done exposure and response prevention without the struggle, because I don’t want to do what I have agreed to do locked down, which is write this.  So, it empowers. Writing it, just like singing it, empowers me to release it, especially people with thinking rituals. The whole idea of using postponing around the rituals, singing the obsession if I need to, writing down the obsession as tactics to help break things up, and then just keep coming back to what’s our intention here. This is a mental health disorder. I keep getting sucked into the topic. I don’t think I can-- here’s I guess the last thing I would say on my end is, this is it, which is, I don’t know if this is going to work. I don’t know how painful whatever is coming next is going to be by not doing my ritual. I am going to have faith. I mean, this is what happens. You have to have faith and a belief in something and someone outside of your mind, because your mind is contaminated and controlled by the disorder. You can’t keep going up into your thinking and try to figure out how to get out of this wet paper bag. You’re just not-- you can’t. So, you got to have faith and trust. And that’s a giant leap too. Because initially, when we do treatment with people, however we do it, they’ve got to be doing something they don’t know is going to be helpful.  When people start doing the singing thing or the writing down thing, for instance, after a while, they go, “Wow, that really worked. Okay, I’m going to do that some more.” And that’s what we need. Initially, you just have to have faith and experiment. That’s why we like to do short experiments. I don’t say, “Hey, do this over the next 12 weeks and you’ll get better.” I go, “Look, I know you think this over here, I’m thinking it’s this over here. How about we structure something for the next X number of minutes, hours, days, and just see what you notice if you can feel like you can afford to do that.”  Kimberley: So good. I’ve just got one question and then I’m going to let you go. I’m going to first ask my question and then I want you to explain, tell us about your course. When you sing the song, I usually have my staff sing it to a song they know, like Happy Birthday or Auld Lang Syne, whatever it may be. You are saying just up and down, “No, no, no,” that kind of thing. Is there a reason for that? Reid: Well, I don’t want people to have to make a rhyme. I don’t want them to have to-- Kimberley: It’s just for the sake of it. Reid: I’m totally fine with what you’re saying. Okay, I’m going to-- you can figure it out. It’s like going, “Okay, anytime I hear my obsession come up, I’m going to make my obsession the voice of Minnie Mouse. So, I’m going to degrade it by having to be a little mouse on my shoulder, anything to degrade it.” If you’ve got to set little songs or you ask your client what they would put it to, then yeah. And then in the session, we’re talking about the therapist, demonstrate it and have them practice it with you in order to get it. Kimberley: Right. I’ve even had clients who are good at accents, like do it in different accents. They bring out-- Reid: You’ve got a good one. You’re really practicing that Australian accent. Kimberley: Very. I practiced for many years to get this one. All right. You talk about the six-moment game. I’ve had the joy of having taken that course. Can you tell us if that’s what you want to tell us about, about where people can hear about you and all the good stuff you’ve got? Reid: Sure. Well, I would start with just saying anxieties.com. It’s anxieties, plural, .com. And that’s my website, a free website. It’s got every anxiety disorder and OCD. You’ve got written instruction around how to do some of the work that we’re talking about. And then I’ve got tons of free video clips that people can watch and learn a bunch of stuff. I laid out, in the last two years, a four-hour course, and I filmed it. And so, it is online now. I take people all the way through what I call OCD & the 6-Moment Game: Strategies and Tactics, because I want to empower people in that way. So, I talk about all the stuff that you and I are rushing over right now. It’s got a full written transcript as an eBook, a PDF eBook. I’ve got a workbook that lets people figure out how to do these practices on their own. All of that. In fact, you can get-- I can’t say how to get it at this moment. Maybe you can post something, I don’t know. But I will give anybody the workbook, that’s 37 pages, and it takes you through a bunch of stuff. No cost to you, send it to anybody else you want.  So, I feel like that, first off, we don’t have enough mental health professionals to treat the people with mental health disorders in this world today. And so, we need to find delivery systems. That will help reach more people. And I believe in Stepped Care. And Stepped Care is a protocol, both in physical medicine and in mental health, which says that first step of Stepped Care and treatment is self-help. And I call it self-help treatment, because the first step is relatively inexpensive, empowering the patient or the client, and giving them directions about how to get stronger. And a certain percentage of people, that will be enough for them. And so, all of us who have written self-help books and so forth, that’s our intention. And now, I’m trying to go one step beyond self-help books to be able to have video that gives people more in-depth.  What I want is for that first step, the principles that are in that first step, go up to the next step. So, if a self-help course or a book or whatever is not sufficient to finish the work, then you go up one level to maybe a self-help group or a therapeutic group and work further there. And if you can’t complete your work, then go up the next step, which is individual treatment, the next step, which is intensive outpatient treatment, the next step, mixture medications, and so forth. And so, if we can carry a set of principles up, then everybody’s on the same page and you’re not starting all over again. So, I focus on step one. I’m a simple guy. Kimberley: I’m focused on step one too, which is what you’re doing with me right now, which makes me so happy. I’m so grateful for you for so many reasons. Reid: Well, I’m happy to be doing this, spending time with you. It’s great. And trying to figure out how to deliver the information concisely. It’s still a work in progress. Thank you for giving me an opportunity. Kimberley: No, thank you. I’ve loved hearing about all of these major points of your work. I’m so grateful for you. So, thank you so much for coming on again. I didn’t have a coughing fit during this episode like I did the last one. Reid: Nothing to make fun of you about. Kimberley: Thank you so much, Reid. You’re just the best. Reid: Well, great constructing this whole thing. This is what I’m talking about too, is to have a series of us that eventually everybody will see and work their way down and get all these different positions and opinions from people who already do this work. And so, that’s great. You have a choice, so that’s great. Kimberley: Love it. Thank you. Reid: Okay. Talk again sometime.

SUMMARY: In this weeks podcast, we talk with Dr Jon Grayson about managing mental compulsions. Jon talks about how to use Acceptance to manage strong intrusive thoughts and other obsessions. Jon addressed how to use acceptance with OCD, GAD and other Anxiety disorders. Covered in This Episode: What is a Mental Compulsion? What is the difference between Mental Rumination and Mental Compulsions? How to use Acceptance for Mental Compulsions How to practice acceptance when the intrusive thoughts are so strong. Links To Things I Talk About: Jon’s Book Freedom from Obsessive Compulsive Disorder: A Personalized Recovery Program for Living with Uncertainty Jon’s Website https://www.laocdtreatment.com/ ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com. CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors. Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit Episode - 285. Welcome back, everybody. We are on episode three of the six-part series. And if you have listened to the previous episodes, I am sure you are just full of information, but hopefully ready to hear some more. Today, we have Dr. Jonathan Grayson. He’s here to talk about his specific way of managing mental compulsions. As you may know, if you’ve listened before, I strongly urge you to start and go in order. So, first, we started with Mental Compulsions 101. That was with yours truly, myself. Then Jon Hershfield came in. He talked about mindfulness and really went in, gave some incredible tools. Shala Nicely, again, gave some lived experience and really the tools that worked for her. And I have just been mind-blown with both of their expertise. And it doesn’t stop there. We have amazing Dr. Jonathan Grayson today talking about all of the ways that he manages mental compulsions and how he brings specific concepts to help a client be motivated and lean into that response prevention and to reduce those mental compulsions. I am again blown away with how amazing and respectful and kind and knowledgeable these experts are. I just am overwhelmed with joy to share this with you. Again, please remember this should not replace professional mental health care. We are here at CBT School, who is the host of this series. We’re here to provide you skills and tools, and resources specifically if you don’t have access to those resources. That is a huge part of our mission. So, even though we have ERP School – and that is an online course, you can take it from your home – we wanted to offer this freely because so many people are seeming to be misunderstanding mental compulsions, and it’s an area I really have been excited to share with you in this free series. So, I’m not going to yammer on anymore. I’m going to let you hear the amazing wisdom of Jonathan Grayson. Have a wonderful day. Kimberley: Welcome. I am so honored to have you here, Jon Grayson. Jonathan: It is always a pleasure. Kimberley: Okay. So, I actually am really, really interested to hear your point of view. As we go through a different episode, I actually am learning things. I thought I knew it all, but I’m learning and learning. So, I’m so excited to get your view on managing mental compulsions or how you address them. My first question is, do you call them mental compulsions, mental rituals, rumination? How do you frame it? Jonathan: I’m never really too big on jargony, but mental compulsions are mental rituals. And I think that’s trying to-- and I think the thing about mental rituals is some people don’t know they have them. I mean, some people know, but some people will describe it as, “I just obsess, I don’t have rituals.” but then when you listen, they do. And the ritual part is trying to reassure themselves or convince themselves that whatever it is they’re worrying about isn’t. So, they have both the fear part like, “Oh my God, what if this is true? But wait, here’s why it’s not true. Now I know that’s not really true. But what if it is true?” So, that is what I would call mental compulsion or rituals. Kimberley: Right. How do you-- let’s say you’re sitting across from a patient or a client they are doing either predominantly mental compulsions or that’s a huge part of the symptoms that they have. How would you address in your own way, teaching somebody how to manage mental compulsions? Jonathan: I think there’s two answers to the question because I never have, and one has to do with what is the content, because I believe every set of mental rituals – I believe it for all forms of OCD, whether there’s a very strong behavioral component or it’s all mental – it has its own set of arguments that we’re going to use. Of course, when I talk about arguments, I know this will be a shock to you, but to me, it always has to do with coping with uncertainty, because I think the purpose of mental compulsions is to deny reality. That is, there is something I don’t want to be true and I keep trying to convince myself it’s not true.  Now often it’s a low probability. But low probability is not no probability. Sometimes I have clients a little confused, saying like, “I tell myself it’s low probability,” and they actually feel better. Is that okay? And the answer is, it depends. If I’m trying to convince myself, I don’t have to worry about it because it’s a low probability, no, that’s a ritual. If I’m just saying it’s a low probability, I mean, way actually with OCD, it’s very easy because people don’t mind saying it’s low prob they. They like saying it’s low probability, but they don’t want the last sentence to be “But it might happen.” So, it’s like, as long as you’re answering “It might happen,” then you’re dealing with reality because everything is a low probability, even if it’s really small.  So, one part has to do with the content. And I think for every set of obsessions, there is, what is the content they’re doing? I think in a more general way, the goal of treatment is basically accepting that low probability things might happen. I was recently saying to people that I hope the probability of nuclear war is no worse than that. It was as bad as likely as a worldwide pandemic. Some people would freak out like, “You think there’s going to be a war?” First of all, I know anything, but they were missing the point. It’s like, no, I really mean it’s as likely as a pandemic, which means it’s not likely. However, the thing about the pandemic, low probability things can happen. So yeah, we’re probably okay. And so, the thing about acceptance that everyone hates is acceptance is second best. We spend so much time talking about how great acceptance is and I really think it’s a disservice in some respects to not point out what acceptance means because it almost always is. Here’s something you don’t want that you might have to live with. If I lose a loved one, we start in denial. And for me, denial is defined as I’m comparing life to a fantasy. I have a woman in a bad relationship and she thinks he really loves the guy, but it’s like, he’d be so good if only he would change X, Y, and Z. And of course, if he changed X, Y, and Z, he would be someone else. So, they’re in love with a fantasy. And when somebody dies, the fantasy is life would be better if they were here. It’s a fantasy because that’s never happening again. So, we have to get them to the point.  And of course, the thing, the reason I mentioned death is it points out a really important thing about acceptance. You don’t get to just decide, “I’m going to accept.” I lose a loved one. I don’t care how or where you are. You’re starting in denial because you’re missing them and you want them there. And after about a year, if you’ve gone through mourning, you accept it. It’s not like you don’t care they’re gone. You can still cry. You can still miss them. But when you’re doing something you’re enjoying and in the present not comparing to what it would be with that person.  So, acceptance, I’m pretty sure, always sucks. However, it’s better than fantasy because the fantasies never happen. So, it doesn’t matter if it’s likely or unlikely. It’s just a matter that this is your fear and the thing that’s hard for people to deal with fear is to cope with it. You’re going to say, “How would I try to live with the worst happening?” And people’s initial response to something is, “Yeah, but I don’t want that.” There are multiple reasons that we need to do acceptance. If I’m correct about denial, that’s comparing reality to fantasy. Well, not acceptance means what I want will never happen. So, for me to want that there’s no possibility something will occur is probably not true. I don’t care if it means that maybe this reality doesn’t exist and I’m going to wake up, and some of the things that discover I’ve created all of reality, there’s nothing. I don’t know that that’s likely, but I can’t prove it’s not likely.  So, I think people go in circles. And you can hear it. The thing about the pandemic, you could hear the regular population denial. Because when I say it’s comparing reality to fantasy, a lot of times that sounds cool. And people don’t quite get what it means, but here are statements of denial early in the pandemic, “Well, this can’t go on more than a few weeks.” Honestly, at the beginning, I was like, “Of course, it’s going on for a few weeks. They have to have a vaccination. They’re telling us that’s two years down the road. This is going on for a long time.” Kimberley: I was in team two weeks. Jonathan: Yeah. “It can’t last. I can’t take it.” Saying “I can’t take it,” although you’re expressing the feeling like “I really hate this,” but including in the words “I can’t take it” is a fantasy as if you have a choice. And in a way, luckily, most people who say they can’t take it didn’t kill themselves. It’s proved that they can’t take it. They took it. They kept going on. It’s like, they didn’t want to imagine continuing to live that way. So, acceptance is like, “Yeah, this is going to happen. Yes, it can keep going.” How will you try to cope with the worst? And go on, I’ll shut up. You look like you want to say something. Kimberley: No, no. I’m following you. I’m really enjoying this. I actually wrote down the word “cope” right at the beginning because I think that that’s such a keyword here. To stay out of the fantasy, would you say that’s true? Jonathan: Well, yes. The worst might-- I mean, I always feel like if I’m doing therapy and if somebody has intolerance of uncertainty, they don’t like uncertainty, I have to treat that problem. And what I mean by that is we have a lot of therapists who impose their own feelings on the client. If I have a therapist that I have somebody who’s socially anxious and saying, “I’m afraid if I go in a room, some people won’t like me.” Almost every therapist is going to say, “Oh, well, that’s the fact, they might not like you.” But that same patient is like, “I’m afraid if I touch the doorknob, I’m going to get sick.” “Oh no, that won’t happen.” Well, that’s not the issue. Now therapist is-- if I have a problem of threat estimation, that’s fine, but that’s not it. I don’t want to know that it’s a low probability, I want no probability. So, we have to deal with the fact that this is what the person’s afraid of. This is what they fear.  Somebody will say, “Well, but they don’t have cancer issue. Why should they worry about it?” But let’s face it. If they did have cancer, the focus would be coping with the fact they’re dying. And if they’re afraid of having cancer, I’d say the treatment is the same. Now, the only great thing is they probably won’t have cancer, so it’s not a fear they will have to probably deal with. They want to have the second part of it like, “And I’m dying.” But to be more prepared-- and I think what you’ve done wisely, like hearing that, yes, what you’ve done wisely is you’re talking about the fact that this is not just a nosy problem. This is a problem for everyone, coping with uncertainty.  I hate to do a plug. It’s okay. It’s a while away. Actually, Liz McIngvale and I, we’re working on a book, talking about-- well, the book is partially-- and we’ll be doing some talks on it. We’re saying that ERP is not the gold standard of treatment for OCD. And we’re going to say that it’s not the gold standard because it’s lacking the gold. It really needs to be ERP plus gold. But that’s awkward because I like to be calling these initials. So, we want to use initials. Do you happen to know the chemical symbol for gold? Kimberley: F-- no. FE is copper.  Jonathan: No, that’s iron.  Kimberley: Iron.  Jonathan: Yeah. AU. Kimberley: AU. Jonathan: The gold standard of treatment-- Kimberley: Like Australia. Jonathan: Well, no. ERP plus AU. AU as in Accepting Uncertainty. Kimberley: Oh, my trap. Jonathan: Yeah. It took me a while to work that around.  Kimberley: Now you sure it’s not Australia.  Jonathan: But our point is what we want to write. We want to write a book that’s not only about helping therapists deal with every presentation of OCD and how you deal with the uncertainty problem, but we’re also arguing that it’s a book for everyone that people can learn from OCD, a disorder that intolerance uncertainty is like the core. Because I always feel that our clients who get better, they’re not normal. They are better than normal because they’re coping with uncertainty, because the average person really doesn’t do that. Well, I mean, in the pandemic, you got to see how bad non-sufferers are. So, I think the core of coping with mental obsessions is this. Well, what if the worst happens? And so many people, “I don’t want to think it,” and that leaves us stuck because we’re not stupid. If you say to somebody-- if you get a phone call from police and they say your spouse has died, your first response is you’re just in this shock and you’re just like frozen. And for a lot of things that are bad, that’s the way people stop thinking. It’s like, “I don’t want to think about it.” The thing is, if the police make that call, something happens next. And life goes on.  And back for clients, I often ask that in a sneaky way. What if this did happen? What would be next? What if he did have-- the doctor says, “Yeah, it can,” so I freak out. What does that look like? “I’d be screaming.” You’re in the doctor’s office, screaming. How long are you going to do that? And then you’re going to go home and you need dinner. What do you do the next day? And even though we’re going through something that sounds terribly scary, people oddly feel better after that. Now, this is first session. It’s not like they’ve done treatment, but they feel better because a statement that is true, you can’t do what you won’t imagine. And I don’t mean this as you would say, in the flowers and unicorns kind of way that you can do anything you can imagine. I do not mean that. But if you won’t even imagine it, you can’t do it. So, what would you do in X situation where it’s like, no. Well, it’s like the world is ending. When we imagine it, it’s not like it’s good. But it’s like, oh, because the feeling that accompanies acceptance is a down, depressing feeling like, “Oh, that could happen.” However, it’s not frantic. Denial is frantic. “That can’t happen. No, no.” Again, everything at least has some low probability. Some things are higher. You could have cancer, yes. Your family could die. Those things are like, they’re there. So, it’s not like I get the choice. So, the statement of denial is frantic. The statement of acceptance is depressing, but it’s not frantic. And so, I don’t care how bad the disaster is. How would you try to cope? Because in most realities, that’s what you’re going to do. And I could pause at this moment because I don’t know if this would be the point where I would then be shifting to, well, what are the mental compulsives we’re talking about here? Because I think again, each one has its own set of arguments. You’ve heard my general thing. In some ways I think I’m reasonably good at applying it to myself. I think there’s some areas I haven’t been tested in. So, that’s nice. I hope I could be-- I know what I want is possible because I’ve seen people do it. Would I be one of those good people? I can only hope. But at least because I know people have done it, I know it’s possible. I like to believe-- go on, you. Yes. Kimberley: What does that look like? Can you paint me a picture of a client who does well using this strategy at managing mental compulsions? Jonathan: A client that I-- there’s a podcast on that, the OC stories, he was afraid of going crazy. And he had had this from age 19 to his late forties. And he had ERP, but ERP was always focused likely and we’re going to focus on going crazy and all this stuff. Know whatever explicit just said to him, the goal of treatment is for you to risk going crazy. I told him that the first session and he began to cry because he’s been spending more than 30 years trying to avoid this. And I’m saying, “Oh yeah, this might happen.” And many people really are able to accept. And I never talk about accepting uncertainty. I talk about learning to accept uncertainty. Because really, if I can talk to you-- if it’s just a decision, we’re done the first session. But most people are convinced of recession. It took about three months to help convince him. And he kept going back and forth. And so, convincing him, we went through a number of things to work on it.  So, I’m describing it quickly, so it sounds simple. But remember, three months. The first reason, and this is true of almost all rituals, mental compulsions, regardless, you don’t have a choice. All your rituals do not prevent you from going crazy. He’s avoiding places because you’ve got an anxiety attack there, so I’m not going to go there. It’s like, sorry, it’s a biological process that you’re going crazy. That’s doing nothing. So, one is, your rituals don’t work. Two, for pretty much anything, you don’t have a choice. Uncertainty is the fact of life. We talked about what it would look like and he went crazy. And we were going-- and we talked about, well, what’s going to happen? Where are you going to go? He went through all these things. And because he’s logical, at some point it’s like, it could happen.  And at that point, he’s then able to spend the other work, which is not fun, which is then imagining going crazy and looking at all the things that scare the heck out of him so he could begin to function again. We wanted to treat going crazy, the way most people do this is not their problem. Treat, getting main paralyzed and disfigured in a car crash. We all know it’s possible. Our brilliant plan is generally, I hope it doesn’t happen. I’m not dealing with it until I’m bleeding out, crushed under the metal. To say, “I’m not going to be in a car accident today,” it’s like, really? I can’t say that. So, our goal is to get whatever uncertainties in life there are to be like that. And it doesn’t matter whether I’m afraid of going crazy. I’m afraid that I’m going to be a pedophile. I’m going to slice and dice my wife tonight. I’m going to flunk the test. These people don’t like me. It doesn’t matter what it is. It’s still always the same. I mean, we can talk about odds, but not as simply reassurance because, again, it’s reassurance if I want to know it’s low odds, but if I want it to not be possible, it’s not reassuring. It’s like, it’s probably not this, but it might be how we deal with it is that way.  The other thing that we look at is, how does it work for you to fight against this uncertainty? What are you losing? And of course, the more pathological the problem is, the worse it is. So, if I have OCD, it could be destroying my life. I’m not only hurting myself, I’m hurting my family. Let’s go how you’re really torturing everybody. And sometimes I think, in that case, we’re looking for reasons to get better. I always like people to look at all the harm they’re doing to themselves and their family. And I think in a brilliant way, just to plug you, I think your book, your new book really partially addresses that because the self-compassion part isn’t just like, okay, be nice to yourself, stop suffering. It’s like, if you’re going to love yourself, what kind of life do you want to make for yourself? What are your values going to be? Because I think we transform this process of coping into something more than simply confronting fear. It becomes something for myself. And secondarily, not as preferable, but sometimes easier to get to – it becomes not only confronting a fear, it becomes an act of love. Because you know what, I’m going to stop being a pain in the ass to my family. I’m now going to put all of us first.  And so, we’re really going to have-- what are my values, and how does this interfere with my values? And again, it doesn’t have to be as major as I’m dysfunctional, torturing my family with something OCD for any worry. Everybody’s going to be happier if I can cope with my worries better. I mean, my family’s going to be happier because they love me. It’s really nice to see me not freaking out because they don’t have-- because you want to help and there’s no way to help. So, for me to be better and calmer and coping is nice for them. It’s certainly nice for me, and isn’t that what I would prefer in life? And so, when, when my life depends on me having a worry that’s not allowed to happen, I don’t get to enjoy things.  Another coping thing I do that’s smaller is I will ask people to notice what they’re enjoying, no matter how, whatever level, even 5%. I think many times people will say, “Everything sucks, I don’t enjoy anything because of this problem.” Now that’s not entirely true because in the course of interviewing them, there are a few times I’ll get them to laugh for three seconds. And I admit if laughing three seconds were the goal, wow, that’d be great. But three seconds of laughter isn’t much compared to a life of misery. But the thing is, they don’t even notice that ever. The entire experience has been horrible and it’s like-- and to get them to notice not what it should be, but what it was.  I once did this with a guy. I sent him to the movies and I said, “Watch the movie, just tell me whatever you enjoyed. I don’t care how little.” And he came back and he said, “It didn’t work. Everything was horrible.” I’m like, “Okay, now tell me about the movie.” So, he was describing the movie to me, it was a war movie, and it is clear, this guy liked the climax. So, I’m like-- Kimberley: Isn’t that funny? The way our brain works? Jonathan: Yeah. And I said, “That was pretty cool, that climax. Are you sorry you saw that?” “No.” I said, “Okay, you didn’t do my assignment. Notice whatever you enjoyed. I don’t care that it’s not as good as it should have been. You clearly like that.” And it makes a difference because it means a two-hour experience that he comes away believing he had nothing. It would be a slight change to go like, “I enjoyed a little bit of that.” I try to tell people, think of it as like a little while of enjoyment that you don’t notice exists, and we want to expand those. And most people would recognize that in a way, what we’re talking about is a little bit of mindfulness. Like, okay, it sucks. I’m not arguing it doesn’t suck, but a lot of mindfulness. It isn’t like, I’m going to put you in a happy land. It’s like, we were trying to do AND, not OR. The beginning of the pandemic, Kathy and I, we’re out on our pandemic walk. And she said to me, “This would be such a great day if all this wasn’t going on.” I said, “You’re wrong, Kathy.” We should let you and your listeners know. You don’t know this, but your husband does. Being married to a psychologist is not necessarily fun. Kimberley: So true. Jonathan: It is a beautiful day. We’re walking together, it’s beautiful. We’re together, it is beautiful. It is a beautiful day AND it sucks that there’s a pandemic.  Kimberley: So true.  Jonathan: Not OR, it’s AND. In a sense, mindfulness is teaching us to live in that world of AND. This is awful AND I can still enjoy stuff, as opposed to it’s either or. And again, some people go like, “Well, that’s awful.” And that’s perfectly true, because we’re going back to what is acceptance. Acceptance sucks. It’s the second-best life. However, what’s really great about the second-best life, the first best doesn’t exist. So, it’s like, yeah, it’s second-best, but it’s this or nothing. So, I think those are a lot of the principles of doing it and I think to do it, it’s like, why would I take this risk? It’s not a risk, but essentially, it’s like, why would I accept living like this, whatever this is? And I don’t have a choice. What am I losing by not living like this? Am I hurting my family? What would life be like if I could be okay with this? Depending who you are, that’s an incredibly amazing change or it’s a minor change. I mean, if I’m a very competent worrier and very successful, we’re talking about way more peace. But if I’m competent, I’m interfering with my life and taking up a lot of time, we’re now making major changes in the quality of life. And as you know, I can obsess or worry about anything from like, “I need to be the best.” And I always ask people, what is so good about best? Because God forbid, you should be mediocre. God forbid, you should be a happy mediocre person than the best person. And so, for some-- Kimberley: Well, that’s still a piece of denial, isn’t it? They have this idea that the best is no pain. Jonathan: Yeah. Kimberley: There’s no pain at the top. Jonathan: Yeah. Right. And generally, there’s some other assumption that-- I don’t know. Somehow, I’m deficient of, I’m not best. So, it’s like the only way I can know. It’s another set of issues. What is it that I fear that I have to cope with? Not being best. Okay, I get you want to be best. Why? Well, best is best. I mean, it’s nice, I guess. When I think about being well-known, I generally think of being well-known as icing. That is, what makes my life great? For me, I love what I’m doing, and what I’m doing is, besides talking a lot because I love talking, but I like working with people, and I just really enjoy it. I have no plans on retiring because I like this too much. That’s almost all year round. Being famous and well-known, that’s about six days a year when I go to conventions. And I say, it’s like icing to indicate I am weak enough. I’ll admit I’m weak enough to really enjoy it. But I also recognize it is nothing. It doesn’t have any substance. And the thing about fame, you’re always going to lose it. You’re never famous enough. And there’s a poem by Shelly that I think really characterizes it. It describes a traveler in an ancient land. It’s come across a huge fallen monument and it’s describing the magnificence of what this had been. And he comes to the base of the statue where these words are written: “My name is Ozymandias, King of Kings; Look on my Works, ye Mighty, and despair!” That’s fame. It’s empty I can gorge, but it doesn’t mean anything because what I enjoy is what I actually do. It’d be sad if my life was like, it’s good six days a year when I can feel it. Kimberley: Right. And I think what’s important, particularly for the sufferer, is you still have uncertainty in your life. Jonathan: I don’t know any way to be certain, so I know nothing. Kimberley: Right. You know what I was reflecting on, and this is just me reflecting, is last year, maybe it was the beginning of this year, I gave myself the exercise to catch the mini toddler tantrums that showed up in my mind. Jonathan: I love that term. Great. Did you make that up? Kimberley: I think I did because it-- Jonathan: Take credit. It’s great. Love it. Kimberley: It feels like a toddler tantrum in my mind. Jonathan: It’s perfect. It’s that “But I don’t want that.” I love it. Oh, I love it. Go on. Kimberley: Yeah. I did a whole podcast about it last year because I was just noticing toddler tantrum after toddler tantrum, and I regulate myself really well. But it was showing up. And then as you’re talking, I’m thinking about how that was me resisting acceptance. That toddler tantrum is probably where I have the option to pull out of rumination and be present when I can catch it and be like, “Okay, you’re totally in denial. You’re in a fantasy land.” And so, that really speaks to me as a way to catch when you’re up in that place of rumination. Jonathan: That’s perfect. Kimberley: Yeah. For me, that was really powerful. I love that you brought that up because I think that is the bridge. I’m totally out of acceptance when I’m in a toddler tantrum. Jonathan: Right. Because when you get better, as you’re describing, you can deal that pull of like, “This is what it is. No, no, no.” You can feel that pull back and forth because you don’t get completely lost and it’s like, ah. Kimberley: Yeah. It was such a visual. I could see it tantruming out. “No, no, no.” And so, I love that you brought that in particularly in this way, like I said, of catching the compulsion. So, thank you. That actually consolidated-- Jonathan: I’m just now obsessing about how I’m going to work this in. We’ll give you credit. Kimberley: You do. The Kimberly Quinlan “toddler tantrum,” I’m very well-known for it now. No, I am so thankful for you for bringing all this up. Is there-- because I want to be respectful of your time, is there anything else that you want to address when it comes to conceptualizing or managing mental compulsions? Jonathan: I think that I’m afraid I have to be patient. Again, thinking about death, I don’t get to accept just because I want to. You have some people who try to accept like, “I’m accepting and I’m accepting it.” It’s like, yeah, sorry. I can be working towards learning it. I think sometimes people have an insight. An insight is not like you suddenly know some new piece of information. Insight is something that you basically knew, suddenly it’s true. I had somebody have that the other day when that’s hurting and they felt like it was trivial trying to explain to me what happened, but I already had this concept. I said, “I know. It’s like, you’ve always known you feel like going wrong.” “No, you don’t get it. It’s really true.” So, it was very cool.  And so, I think it’s a gradual process where I get better at it. And because life is completely uncertain in every which way, there’s always opportunities to practice it, better personal. And you may scare other people. And one client who was very scared of a lot of things, especially of one of their pets dying. As they got uncertain and told, and then they could talk about it pretty calmly with people, “Oh yeah, I think she’s going to die at some point.” And people would be horrified. She could sound so calm, but she was like, not that she likes it and she really doesn’t want it to happen, but she could also think about it and think about life after that. And I think some people mistakenly will say something like, “Oh my God, you’re making life complete miserable. All you’re thinking about is all these nightmares that can happen all the time. That’s terrible.” That’s crazy because-- I thought I’d use a clinical term. Because what happens when I accept uncertainty?  Somebody else has said this. Unfortunately, I haven’t made it up. I become, in a positive way, hopeless future. And what I mean by hopeless is the way most people who aren’t scared of the car crash, or it’s not like, I’m okay with a car crash. It’s like, what can I do? And when I become hopeless about control, that is when I get to live in the present because I’m no longer in the past or the future. Let’s face it. The truth is that’s all we have. The past of great memories or terrible memories, the future’s hopes, all we have is the present, this moment, my entire life and your entire life with each other. Everything else we like might not be there at this moment. So, I get to have the only thing there is, which is the present. And again, I can’t just decide because you see people do this, “I’m going to live in the present. I’m going to enjoy the present now. Enjoy the present.” It’s like, I have to learn to give things up.  To steal from this woman who wrote this book of compassion: “To be kind to myself, to let myself learn, to not expect it all at once.” Again, if we were talking OCD, I don’t know why we were talking about that. If we were talking about OCD, every particular variation has its own uncertainties to cope with. Scrupulosity, how do I learn to believe in a God and simultaneously admit I might be wrong? How do I live in a world where probably I’m not going to slice and dice Kathy tonight? But if I do, how would I try to-- what would I do the next step? When my son was 16 and going out on dates. And of course, he would never be home on time. And Kathy always wanted to call him. And I wouldn’t let her call him not to be nice to him, but I knew as she knew, his cell phone would be on. So, calling somebody you’re worried about in their cell phone on is not going to be comforting. So, she’d go like, “Well, when can I call him?” So, I’d make this mental calculation. Okay, he should be home now. I think he’ll be home in these many minutes. And let me add another half hour and say, you can call him dead. And she could for some reason, which is unusual, she would then go to sleep. And I would go there and I think, “Huh, he’s probably okay. He’s probably not doing anything terrible. Probably nothing terrible is happening to him. But tonight could be the night that our lives change and everything is screwed up forever.” And then I would go to sleep. That’s just the truth. Kimberley: Yeah. It’s powerful. I’ll be calling you, and my kids are teenagers, saying “Coach me, coach me.” Jonathan: Yeah. And I will give you the following advice. It gets so much easier when they’re 23.  Kimberley: Yes, I know. Jonathan: Until your acceptance is, “Oh yeah,” you’re screwed till then. Kimberley: It’s true. I’m so grateful for you and your time and all your wisdom. I feel like I’m sitting and just absorbing it all for myself, which I’m loving.  Jonathan: Thank you. Kimberley: Tell us, I know you’ve been on the podcast before, but tell us where people can hear more about you and your work. You obviously have a new book, which I did not know about. Jonathan: Well, we are working on it and we’re at the stage of working it, not procrastinating. We’re at the stage of doing a bunch of presentations on the idea, because I’ve just seen so many treatments fail because it didn’t address uncertainty. Although I always focus on certainty, it really is-- the bottom part of dealing with that is coping with life. It transcends OCD. So, I don’t know. What would you like to know about me? Kimberley: Where can people find you? Jonathan: Where can people find me? Easily on the internet. Website is a laocdtreatment.com. But I think my name plus OCD tends to come up a lot.  Kimberley: Your book? Jonathan: I have a book. It’s Freedom From OCD. I think there are a lot of good OCD books. Of course, I like mine because I agree with it most. But it’s a little scary when people read it before they see me because it is almost my entire repertoire minus maybe about 40 minutes. I feel like I’m going to be repeating myself, but somehow that doesn’t seem to be a problem. Apparently, hearing it out loud is different than reading it.  Kimberley: Well, and that’s the whole point, right? I have the same situation as people need to hear it more than once too, in some cases. Not as a form of reassurance, but I think we all need to hear it. Even me today having a little light bulb moment I think is really cool, even though I’ve heard that before. So, I will have your website and your work in the show notes. Jonathan: Very kind. Kimberley: Thank you so much for being here and sharing. Jonathan: I don’t know if you figured it out yet. I know I’ve told you this, but I’ll just repeat it. Probably if you asked me to come on, the answer will always be yes. So, thank you. Kimberley: I’m so happy. No, I remember you saying that last time. Like I said to you, before we started recording, I have wanted to do this series for quite a while. And I had you right there going. I already put you on the list because I already knew. You told me you would say yes. Jonathan: And so, apparently, I’m not dishonest or not that dishonest. Kimberley: Not at all. When I texted to ask you, I actually already had you on the list and scheduled you in. Jonathan: It was a confidence that you could well have. Kimberley: Yeah. I’m so grateful. And yes, we will definitely have you on. It’s always a pleasure. Jonathan: All right. Okay. Take care. Thank you very much.

SUMMARY:  In this weeks podcast, we have my dearest friend Shala Nicely talking about how she manages mental compulsions.  In this episode, Shala shares her lived experience with Obsessive Compulsive Disorder and how she overcomes mental rituals. In This Episode: How to reduce mental compulsions for OCD and GAD. How to use Flooding Techniques with Mental Compulsions Magical Thinking and Mental Compulsions BDD and Mental Compulsions Links To Things I Talk About: Shalanicely.com Book: Is Fred in the Refridgerator? Book: Everyday Mindfulness for OCD ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 284. Welcome back, everybody. We are on the third video or the third part of this six-part series on how to manage mental compulsions. Last week’s episode with Jon Hershfield was bomb, like so good. And I will say that we, this week, have Shala Nicely, and she goes for it as well. So, I am so honored to have these amazing experts talking about mental compulsions, talking about what specific tools they use.  So, I’m not going to take too much time of the intro this time, because I know you just want to get to the content. Again, I just want to put a disclaimer. This should not replace professional mental health care. This series is for educational purposes only. My job at CBT School is to give you as much education as I can, knowing that you may or may not have access to care or treatment in your own home. So, I’m hoping that this fills in a gap that maybe we’ve missed in the past in terms of we have ERP School, that’s an online course teaching you everything about ERP to get you started if you’re doing that on your own. But this is a bigger topic. This is an area that I’d need to make a complete new course. But instead of making a course, I’m bringing these experts to you for free, hopefully giving you the tools that you need.  If you’re wanting additional information about ERP School, please go to CBTSchool.com. With that being said, let’s go straight over to this episode with Shala Nicely.  Kimberley: Welcome, Shala. I am so happy to have you here. Shala: I am so happy to be here. Thank you for having me. Kimberley: Okay. So, I have heard a little bit of your views on this, but I am actually so excited now to get into the juicy details of how you address mental compulsions or mental rituals. First, I want to check in with you, do you call them mental compulsions, rituals, rumination? How do you address them? Shala: Yeah. All those things. I also sometimes call it mental gymnastics up in your head, it’s all sorts of things you’re doing in your head to try to get some relief from anxiety. Kimberley: Right. So, if you had a patient or a client who really was struggling with mental compulsions, whether or not they were doing other compulsions as well, how might you address that particular part of their symptomology? Shala: So, let me answer that by stepping back a little bit and telling you about my own experience with this, because a lot of the way I do it is based on what I learned, trying to manage my own mental rituals. I’ve had OCD probably since I was five or six, untreated until I was 39. Stumbled upon the right treatment when I went to the IOCDF Conference and started doing exposure mostly on my own. I went to Reid Wilson’s two-day group, where I learned how to do it. But the rest of the time, I was implementing on my own. And even though I had quite a few physical compulsions, I would’ve considered myself a primary mental ritualizer, meaning if we look at the majority, my compulsions were up in my head. And the way I think about this is I think that sometimes if you have OCD for long enough, and you’ve got to go out and keep functioning in the world and you can’t do all these rituals so that people could see, because then people will be like, “What’s wrong with you? What are you doing?” you take them inward. And some mental compulsions can take the place of physical compulsions that you’re not able to do for whatever reason because you’re trying to function. And I’d had untreated OCD for so long that most of my rituals were up in my head, not all, but the great majority of them.  Exposure & Response Prevention for Mental Compulsions So, when I started to do exposure, what I found was I could do exposure therapy, straight up going and facing my fears, like going and being around things that might be triggering all I wanted, but I wasn’t necessarily getting better because I wasn’t addressing the mental rituals. So, basically, I’m doing exposure without response prevention or exposure with partial response prevention, which can make things either worse or just neutralize your efforts. So, what I did was I figured out how to be in the presence of triggers and not be up in my head, trying to do analyzing, justifying, figuring it out, replaying the situation with a different ending, all the sorts of things that I would do over and over in my head. And the way I did this was I took something I learned from Jonathan Grayson and his book, Freedom From OCD. I know you’re having him on for this series too. And he talked about doing all this ERP scripting, where you basically write out the worst-case scenario, what you think your OCD thinks is going to happen and you write it in either a worst-case way or an uncertainty-focused way. And what I did was after reading his book, I took that concept and I just shortened it down, and anything that my OCD was afraid of, I would just wrap may or may not surround it.  So, for instance, an example that I use in Is Fred in the Refrigerator?, my memoir, Taming OCD and Reclaiming My Life was that I used to-- when I was walking through stores like Target, if I saw one of those little plastic price tags that had fallen on the ground, if I didn’t pick it up and put it out of harm’s way, I was afraid somebody was going to slip and fall and break their neck. And it would be on some security camera that I just walked on past it and didn’t do anything. So, a typical scrupulosity obsession. And so, going shopping was really hard because I’m cleaning up the store as I’m shopping. And so, what I would do is I would either go to Target, walk past the price tag. And then as I’m just passing the price tag, I would say things. And in Target, I obviously couldn’t do this really out loud, mumble it out loud as best, but I may or may not cause somebody to kill themselves by they’re going to slip and fall on that price tag because I didn’t pick it up. I may or may not be an awful, terrible rotten human being. They may or may not catch me and throw me into jail. I may or may not rot in prison. People may or may not find out what a really bad person I really am. This may or may not be OCD, et cetera, et cetera, et cetera.  And that would allow me to be present with the obsessions, all the what-ifs – those are basically what-ifs turned into ‘may or may nots’ – without compulsing with them, without doing anything that would artificially lower my anxiety. So, it allowed me to be in the presence of those obsessive thoughts while interrupting the pattern of the mental rituals. And that’s really how I use ‘may or may nots’ and how I teach my clients to use ‘may or may nots’ today is using them to really be mindfully present of what the OCD is worried about while not interacting with that content in a way that’s going to make things worse. So, that’s how I developed it for myself. And I think that-- and that is a tool that I would say is an intermediary tool. So, I use that now in my own recovery. I don’t have to use ’may or may nots’. It’s very often at all. If I get super triggered, which doesn’t happen too terribly often, but if I get super triggered and I cannot get out of my head, I’ll use ’may or may nots’.  But I think the continuum is that you try to do something to interrupt the mental rituals, which for me is the ’may or may nots’. You can also-- people can write down the scripts, they can do a worst-case scenario. But eventually, what you’re trying to get to is you’re trying to be able to hear the OCD, what-ifs in your head and completely ignore it. And I call that my shoulders back, the way of thinking about things. Just put your shoulders back and you move on with your day. You don’t acknowledge it.  What I’ll do with clients, I’ll say, “If you had the thought of Blue Martian is going to land on my head, I mean, you wouldn’t even do anything with that thought. That thought would just go in and go out and wouldn’t get any of your attention.” That’s the way we want to treat OCD, is just thoughts can be there. I’m not going to say, “Oh, that’s my OCD.” I’m not going to say, “OCD, I’m not talking to you.” I’m not going to acknowledge it at all. I’m just going to treat it like any other weird thought that we have during the day and move on.  Your question was, how would you help somebody who comes in with mental rituals? Well, first, I want to understand where are they in their OCD recovery? How long have they been doing these mental rituals? What percentage of their compulsions are mental versus physical? What are the kind of things that their OCD is afraid of? Basically, make a list or a hierarchy of everything they’re afraid of. And then we start working on exposure therapy. And when I have them do exposures, the first exposure I do with people, we’ll find something that’s-- I start in the middle of the hierarchy. You don’t have to, but I try. And I will have them face the fear. But then I’ll immediately ask them, what is your OCD saying right now? And they’ll tell me, and I’ll say, “I want you to repeat after me.” I have them do this, and everyone that I see hates this, but I have them do it. Standing up with their shoulders back like Wonder Woman, because this type of power pose helps them. It changes the chemistry of your body and helps you feel more powerful.  OCD thinks it’s very powerful. So, I want my clients to feel as powerful as they can. So, I have them stand like Wonder Woman and they repeat after me. Somebody could-- let’s just say we are standing near something red on the floor. And I’ll say, “Well, what is your OCD saying right now?” And they’ll say, “Well, that’s blood and it could have AIDS in it, and I’m going to get sick.” I’ll say, “Well, that may or may not be a spot of blood on the floor. I may or may not get sick and I may or may not get AIDS, but I want to do this. I’m going to stay here. OCD, I want to be anxious, so bring it on.”  And that’s how we do the exposure, is I ask them what’s in their head. I have them repeat it to me until they understand what the process is. And then I’m having them be in the presence of this and just script, script, script away. That’s what I call it scripting, so that they are in the presence of whatever’s bothering them, but they’re not up in their head. And anytime something comes in their head, I teach them to pull it down into the script. Never let something be circulating in your head without saying it out loud and pulling it into the script.  I will work on this technique with clients as we’re working on exposures, because eventually what we’ll want to do is instead of going all over the place, “That may or may not be blood, I may or may not get AIDS, I may or may not get sick,” I’ll say, “Okay, of all the things you’ve just said, what does your OCD-- what is your OCD scared of the most? Let’s focus on that.” And so, “I may or may not get AIDS. I may or may not get AIDS. I may or may not have HIV. I may or may not get AIDS,” over again until people start to say, “Oh, okay. I guess I don’t have any control over this,” because what we’re trying to do is help the OCD habituate to the uncertainty. Habituate, I know that’d be a confusing word. You don’t have to habituate in order for exposure to work due to the theory of inhibitory learning, but we’re trying to help your brain get used to the uncertainty here. Kimberley: And break into a different cycle instead of doing the old rumination cycle.  Shala: Yes. And so then, I’ll teach people to just find their scariest fear. They say that over and over and over again. Then let’s hit the next one. “Well, my family may or may not survive if I die because if I get a fatal disease and I die and my family may or may not be left destitute,” and then over and over. “My family may or may not be left destitute. My family may or may not be left destitute, whatever,” until we’re hitting all the things that could be circulating in your head.  Now, some people really don’t need to do that scripting because they’re not up in their head that much. But that’s the minority of people. I think most people with OCD are doing something in their head. And a lot of people aren’t aware of what they’re doing because these mental rituals are incredibly subtle at times. And so, as people, as my clients go out and work on these exposures, I’ll have them tell me how it’s going. I have people fill out forms on my website each day as they’re doing exposures so I can see what’s going on. And if they’re not really up in their head and they don’t really need to do the ‘may or may nots’, great. That’s better. In fact, just go do the exposure and go on with your life. If they’re up in their head, then I have them do the ’may or may nots’. And so, that’s how I would start with somebody.  And so, what I’m trying to do is I’m giving them what I call a bridge tool. Because people who have been mental ritualizing for a long time, I have found it’s virtually impossible to just stop because that’s what your mind is used to doing. And so, what I’m doing is I’m giving them a competing response. And I’m saying here, instead of mental ritualizing, I’d like you to say a bunch of ’may or may nots’ statements while standing up and say them out loud while looking like Wonder Woman. Everybody rolls their eyes like, “Really?” But that’s what we do as a bridge tool. And so, they’ve lifted enough mental weights, so to speak, with this technique that they can hear the OCD and start to disengage and not interact with it at all. Then we move to that technique. Flooding Techniques for Mental Rumination Kimberley: Is there a reason why-- and for some of the listeners, they may have learned this before, but is there a reason why you use ’may or may nots’ instead of worst-case scenarios? Shala: For me, for my personal OCD recovery journey, what I found with worst-case scenario is I got too lost in the content. I remember doing-- I had had a mammogram, it had come back with some abnormal findings. I spent the whole weekend trying to do scripting about what could happen, and I was using worst-case scenario. Well, I end up in the hospital, I end up with breast cancer, I end up dead. And by the end of the weekend, I was completely demoralized. And I’m like, “Well, I don’t bother because I’m going to be dead, because I have breast cancer.” That’s where my mind took it because I’ve had OCD long enough that if I get a really scary and I start and I play around in the content, I’m going to start losing insight and I’m going to start doing depression as a compulsion, which is the blog we did talk about, where you start acting depressed because you’re believing what the OCD says like, “Oh, well, I might as well just give up, I have breast cancer,” and then becoming depressed, and then acting like it’s true. And then that’s reinforcing the whole cycle.  So, for me, worst-case scenario scripting made things worse. So, when I stayed in the uncertainty realm, the ‘may or may nots’ that helped because I was trying to help my brain understand, “Well, I may or may not have breast cancer. And if I do, I mean, I’ll go to the doctor, I’ll do what I need to do, but there’s nothing I can do about it right now in my head other than what I’m doing.” Some people like worst-case scenario and it works fine for them. And I think that works too. I mostly use ’may or may nots’ with clients unless they are unable through numbing that they might be doing. If they’re unable to actually feel what they’re saying, because they’re used to turning it over in their head and pulling the anxiety down officially, and so I can’t get a rise out of the OCD because there’s a lot of really little subtle mental compulsions going on, then I’ll insert some worst-case scenario to get the anxiety level up, to help them really feel the fear, and then pull back into ’may or may nots’. But there’s nothing wrong with worst-case scenario. But for me, that was what happened. And I think if you are prone to depression, if you’re prone to losing insight into your OCD when you’ve got a really big one, I think that’s a risk factor for using that particular type of scripting.  Magical Thinking and Mental Compulsions  Kimberley: Right. And I found that they may or may not have worked just as well, except the one thing, and I’m actually curious on your opinion on this and I have not had this conversation, is I find that people who have a lot of magical thinking benefit by worst-case scenario, like their jinxing compulsions and so forth, like the fear of saying it means it will happen. So, saying the worst-case is the best exposure. Is that true for you? Shala: I have not had to use it much on my own magically. I certainly had a lot of magical thinking. Like, if I don’t hit this green light, then somebody’s going to die. But I think the worst-case scenario, I could actually work well in that, because if you use the worst-case scenario, it can make it seem so ridiculous that it helps people let go of it more easily. And I think you can do that with ’may or may nots’ too. I’ll try to encourage people to use the creativity that they have because everybody with OCD has a ton of creativity. And we know that because the OCD shares your brain and it’s certainly the creative stuff And to one-up the OCD, you use the scripting to be like, “Gosh, I may or may not get some drug-disease and give it to my entire neighborhood. I may or may not kill off an entire section of my county. We may or may not infect the entire state of Georgia. The entire United States may or may not blow up because I got this one disease. So, they may or may not have to eject me off the earth and make me live on Mars because I’m such a bad person.” This ‘may or may not’ is in all this crazy stuff too, because that’s how to win, is to one up the OCD. It thinks that’s scary, let’s go even scarier. But the scary you get, it also gets a little bit ridiculous after a while. And then the whole thing seems to be a little bit ridiculous. So, I think you can still use that worst-case stuff with may or may not. Kimberley: Right. Okay. So, I mean, I will always sort of-- I know you really well. I’ve always held you so high in my mind in just how resilient and strong you are in doing this. How might you, or how do you help people who feel completely powerless at even addressing this? For you to say it, it sounds very like you’re just doing it and it’s so powerful. But for those who are really struggling with this idea of like, you said, coming out of your head, can you speak to how you address that in session if someone’s really struggling to engage in ’may or may nots’ and so forth? Shala: Yeah. Well, thank you for the kind words, first off. I think that it’s really common for people with OCD by the time they get to a therapist to feel completely demoralized, especially if they’ve been to multiple therapists before they get to somebody who does ERP. And so, they feel like they’re the victim at the hands of a very cruel abuser that they can’t get away from. And so, they feel beaten down and they don’t know how to get out of their heads. They feel like they’re trapped in this mental prison. They can’t get out. And if somebody is struggling like that, and they’re doing the ’may or may nots’ and the OCD is reacting, which of course, it will, and coming back at them stronger, which I always warn people, this is going to happen. When you start poking at this, the OCD is going to poke back and poke back even harder, because it wants to get you back in line so it can keep you prisoner.  So, what I’ll often do in those situations, if I see somebody is really feeling like they have been so victimized, that they’re never going to be able to get over this, is the type of script I have them do is more of an empowerment script, which could sound like this: “OCD, I’m not listening to you anymore. I’m not doing what you want. I am strong. I can do this.” And I might add some ’may or may nots’ in there. “And I want to be anxious. Come on, bring it on. You think that’s scary? Give me something else.”  I know you’re having Reid Wilson on as part of this too. I learned all that “bring it on” type stuff and pushing for the anxiety from him. And I think helping people say that out loud can be really transformative. I’ve seen people just completely break down in tears of sort of, “Oh my gosh, I could do this,” like tears of empowerment from standing up and yelling at their OCD.  If people like swearing, I also just have them swear at it, like they would really swear at somebody who had been abusing them if they had a chance, because swearing actually can make you feel more powerful too, and I want to use all the tools we can. So, I think scripting comes in a number of forms. It’s all about really taking what’s in your head, turning it into a helpful self-talk and saying it out loud. And the reason out loud is important for any type of scripting is that if you’re saying it in your head, it’s going to get mixed up with all the jumble of mental ruminating that’s going on. And saying it out loud makes it hard for you to ruminate. It’s not impossible, but it’s hard because you’re saying it. Your brain really is only processing one thing at a time. And so, if you’re talking and really paying attention to what you’re saying, it’s much harder to be up in your head spinning this around.  And so, adding these empowerment scripts in with the ’may or may nots’ helps people both accept the uncertainty and feel like they can do this, feel like they can stand up to the OCD and say, “You’ve beaten me enough. No more. This is my life. I’m not letting you ruin it anymore. I am taking this back. I don’t care how long it takes. I don’t care what I have to do. I’m going to do this.” And that builds people up enough where they can feel like they can start approaching these exposures. Kimberley: I love that. I think that is such-- I’ve had that same experience of how powerful empowerment can be in switching that behavior. It’s so important. Now, one thing I really want to ask you is, do you switch this method when you’re dealing with other anxiety disorders – health anxiety, social anxiety, panic disorder? What is your approach? Is there a difference or would you say the tools are the same? Shala: There’s a slight difference between disorders. I think health anxiety, I treat exactly like OCD. Even some of the examples I gave here were really health anxiety statements. With panic disorder-- and again, I learned this from Reid and you can ask him more about this when you interview him. But with pain disorder, it’s all about, I want to feel more shorter breath, more like their elephant standing on my chest. I want my heart to be faster. But I’m doing this while I’m having people do exercises that would actually create those feelings, like breathing through a little bit of cocktail straw, jogging, turning up a space heater, and blowing it on themselves. So, we’re trying to create those symptoms and then talk out loud and say, “Come on, I want more of this. I want to feel more anxious. Give me the worst panic attack you’ve ever had.” So, it’s all about amping up the symptoms.  With social anxiety, it’s a little bit different because with social anxiety, I would work on the cognitions first. Whereas with OCD, we don’t work on the cognitions at all, other than I want you to have a different cognitive relationship with your disorder and your anxiety. I want you to want the anxiety. I want you to want the OCD to come and bother you because that gives you an opportunity to practice. That’s the cognitive work with OCD. I do not work on the cognitive work on the content. I’m not going to say to somebody, “Well, the chance you’re going to get AIDS from that little spot of blood is very small.” That’s not going to be helpful  With social anxiety, we’re actually working on those distorted cognitions at the beginning. And so, a lot of the work with social anxiety is going to be going out and testing those new cognitions, which really turns the exposures into what we call behavioral experiments. It’s more of a cognitive method. We’re going out and saying, “Gosh, my new belief, instead of everybody’s judging me, is, well, everybody is probably thinking about themselves and I’m going to go do some things that my social anxiety wouldn’t want me to do and test out that new belief.” I might have them use that new belief, but also if their anxiety gets really high and they’re having a hard time saying, “Well, that person may or may not be judging me. They may or may not be looking at me funny. They may or may not go home and tell people about me.” But really, we’re trying to do something a little bit different with social anxiety. Kimberley: And what about with generalized anxiety? With the mental, a lot of rumination there, do you have a little shift in how you respond? Shala: Yeah. So, it’s funny that the talk that Michelle Massi and others gave at IOCDF-- I think it was at IOCDF this year about what’s the difference between OCD and GAD is they’re really aligned there. I mean, I treat GAD very similarly the way I treat OCD in that people are up in their heads trying to do things. They’re also doing other types of safety behaviors, compulsive safety behaviors, but a lot of people GAD are just up in their head. They’re just worried about more “real-life” things. But again, a lot of OCD stuff can be real-life things. I mean, look at COVID. That was real life. And people’s OCD could wrap itself around that. So, I treat GAD and OCD quite similarly. There are some differences, but in terms of scripting, we call it “worry time” in GAD. It’s got a different name, but it’s basically the same thing. Kimberley: Right. Okay. Thank you for answering that because I know some folks here listening will be not having OCD and will be curious to see how it affects them. So, is that the practice for you or is there anything else you feel like people need to know going in, in terms of like, “Here is my strategy, here is my plan to target mental rituals”? What would you say? Shala: So, as I mentioned, I think the ’may or may nots’ are bridge tool that are always available to you throughout your entire recovery. My goal with anybody that I’m working with is to help them get to the point where they can just use shoulders back. And the way that I think about this is what I call my “man in the park” metaphor. So, we’ve all probably been in a park where somebody is yelling typically about the end of the world and all that stuff. And even if you were to agree with some of the things that the person might say from a spiritual or religious standpoint, you don’t run home and go, “Oh my gosh, we got to pack all our things up because it’s the end of the world. We have to get with all of our relatives and be together because we’re all going to die.” We don’t do that. We hear what this guy’s saying, and then we go on with our days, again, even if you might agree with some of the content. Now, why do we do that? We do that because it’s not relevant in our life. We realize that person probably, unfortunately, has some problems. But it doesn’t affect us. We hear it just like when we might hear birds in the background or a car honking, and we just go on with our day. That’s how we want to treat OCD. What we do when we have untreated OCD is we run up to the man in the park and we say, “Oh my gosh, can I have a pamphlet? Let me read the pamphlet. Oh my gosh, you’re right. Tell me more, tell me more.” And we’re interacting with him, trying to get some reassurance that maybe he’s wrong, that maybe he does really mean the end of the world is coming soon. Maybe it’s going to be like in a hundred years. Eventually, we get to the point where we’re handing out pamphlets for him. “Here, everybody, take one of these.” What we’re doing with ’may or may nots’ is we’re learning how to walk by the man in the park and go, “The world may or may not be ending. The world may or may not be ending. I’m not taking a pamphlet. The world may or may not be ending.” So, we’re trying to not interact with him. We’re trying to take what he’s saying and hold it in our heads without doing something compulsive that’s going to make our anxiety higher. What we’re trying to do is practice that enough till we can get to the point where we can be in the park with the guy and just go on with our day. We hear him speaking, but we’re really-- it’s just not relevant. It’s just not part of our life. So, we just move on. And we’re not trying to shove him away. It’s just like any other noise or sound or activity that you would just-- it doesn’t even register in your consciousness. That’s what we’re trying to do.  Now I think another way to think about this is if you think-- say you’re in an art gallery. Art galleries are quiet and there are lots of people standing around, and there’s somebody in there that you don’t like or who doesn’t like you or whatever. You’re not going to walk up to that person and tap on their shoulder and say, “Excuse me, I’m going to ignore you.” You’re just going to be like, “I know that person is there. I’m just going to do what I’m doing.” And I think that’s-- I use that to help people understand this transition, because we’re basically going from ’may or may nots’ where we’re saying, “OCD, I’m not letting you do this to me anymore,” so we are being really aggressive with it, to this being able to be in the same space with it, but we’re not talking to it at all because we don’t need to, because we can be in the presence with the intrusive thoughts that the OCD is reacting to, just like the presence of all the other thousands of thoughts we have each day without interacting with them. Kimberley: That’s so interesting. I’ve never thought of it that way.  Shala: And so, that’s where I’m trying to get people because that is the strongest, strongest recovery, is if you can go do the things that you want to do, be in the presence of the anxiety and not do compulsions physical or mental, you don’t give anything for OCD to work with. I have a whole chapter in my memoir about this after I heard Reid say at one of the conferences, “We need to act as though what OCD is saying doesn’t matter.” And that was revolutionary to me to hear that. And that’s what we’re trying to do both physically and mentally. Because if you can have an obsession and focus on what you want to focus on, do what you want to do, you’re not giving OCD anything to work with. And typically, it’ll just drain away. But this takes time. I mean, it has taken me years to learn how to do this, but I went untreated for 35 years too. It may not take you years, but it may. And that’s okay. It’s a process. And I think if you have trouble trying to do shoulders back, man in the park, use ’may or may nots’. You can use the combination. But I think we’re trying to get to the point where you can just be with the OCD and hear it flipping out and just go on with your day. OCD, BDD, and Mental Rituals  Kimberley: In your book, you talk about the different voices. There is a BDD voice and an OCD voice. Was it harder or easier depending on the voice? Was that a component for you in that-- because the words and the voice sound a little different. I know in your memoir you give them different names and so forth, which if anyone hasn’t read your memoir, they need to go right now and read it. Do you have any thoughts on that in terms of the different voices or the different ways in which the disorders interact? Shala: That’s a really great question because yes, I think OCD does shift its voice and shift its persona based on how scared it is. So, if it’s a little bit scared, it’s probably going to speak to you. It’s still going to be not a very nice voice. It might be urgent and pleading. But if it’s super scared, I talk about mine being like the triad of hell, how my OCD will personify into different things based on how scared it is. And if it’s super scared and it’s going to get super big and it’s going to get super loud in your head because it’s trying desperately to help you understand you’ve got to save it because it thinks it’s in danger. That’s all its content. Then I think-- and if you have trouble ignoring it because it’s screaming in your head, like the man in the park comes over with his megaphone, puts it right up against your ear and starts talking, that’s hard to ignore. That’s hard to act like that’s not relevant because it hurts. There’s so much noise.  That’s when you might have to use a may or may not type approach because it’s just so loud, you can’t ignore it, because it’s so scared. And that’s okay. And again, sometimes I’ll have to use that. Not too terribly often just because I’ve spent a long time working on how to use the shoulder’s back, man in the park, but if I have to use it, I use it. And so, I think your thought about how do I interact with the OCD based on how aggressive it’s being also plays into this. Kimberley: I love all this. I think this is really helpful in terms of being able to be flexible. I know sometimes we want just the one rule that’s going to work in all situations, but I think you’re right. I think that there needs to be different approaches. And would you say it depends on the person? Do you give them some autonomy over finding what works for them, or what would you say?  Shala: Absolutely. If people are up in their heads and they don’t want to use ’may or may nots’, I’ll try to use some other things. If I really, really think that that’s what we need right now, is we need scripting, I’ll try to sell them on why. But at the end of the day, it’s always my client’s choice and I do it differently based on every client. For some clients, it might be just more empowering statements. For some clients where it’s more panicky focused, it might be more about bringing on your anxiety. Sometimes it might be pulling self-compassion in and just saying the self-compassion statements out loud. So, it really does vary by person. There’s no one-size-fits-all, but I think, I feel that people need to have something to replace the mental ritualizing with at the beginning that they’ve been doing it for a long time, just because otherwise, it’s like, I’m giving them a bicycle, they’ve never ridden a bicycle before and I won’t give them any training wheels. And that’s really, really hard. Some people can do it. I mean, some people can just be like, “Oh, I’m to stop doing that in my head? Okay, well, I’ll stop doing that in my head.” But most people need something to help them bridge that gap to get to the point where they can just be in the presence with it and not be talking to it in their heads. Kimberley: Amazing. All right. Any final statements from you as we get close to the end? Shala: I think that it’s important to, as you’re working on this, really think about what you’re doing in your head that might be subtle, that could be making the OCD worse. And I think talking and being willing to talk about this to therapists about putting it all out there, “Hey, I’m saying this to myself in my head, is that helpful or harmful?” Because OCD therapy can be pretty straightforward. I mean, ERP, go out and face your fears, don’t do rituals. It sounds pretty straightforward. But there is a lot of subtlety to this. And the more that you can root out these subtle mental rituals, the better that your recovery is going to be.  And know too that if you’ve had untreated OCD for a long time, you can uncover mental rituals, little bitty ones, for years after you get out of therapy. And that’s okay. It doesn’t mean you’re not in recovery. It just means that you are getting more and more insightful and educated about what OCD is. And the more that you can pick those little things out, just the better your recovery will be. But we also don’t want to be perfectionistic about that like, “I must eliminate every single mental ritual that I have or I’m not going to be in a good recovery.” That’s approaching your ERP like OCD would do. And we don’t want to do that. But we do want to be mindful about the subtleties and make sure to try to pull out as many of those subtle things that we might be doing in our heads as possible.  Kimberley: Amazing. Thank you. Tell us-- again, first, let me just say, such helpful information. And your personal experience, I think, is really validating and helpful to hear on those little nuances. Tell us where people can hear about you and the amazing projects you’ve got going on. Shala: You can go to ShalaNicely.com and I have lots of free blog posts I’ve written on this. So, there are two blog posts, two pretty extensive blog posts on ’may or may nots’. So, if you go on my website and just search may or may not, it’ll bring up two blog posts about that. If you search on shoulders back or man in the park, you’ll find two blog posts on how to do that technique. I also have a blog post I wrote in the last year or so called Shower Scripting, which is how to do ERP, like just some touch-up scripting in the shower, use that time. So, I would say go to my website and you can find all sorts of free resources. I’ve got two books. You can find on Amazon, Everyday Mindfulness for OCD, Jon Hershfield and I co-wrote. And we talk about ‘may or may nots’ and shoulders back and some of the things in there just briefly. And then my memoir, Is Fred in the Refrigerator?: Taming OCD and Reclaiming My Life, is also on Amazon or bookstores, Audible, and that kind of thing.  Kimberley: I wonder too, if we could-- I’m going to put links to all these in the show note. I remember you having a word with your OCD, a video? Shala: Oh yes, that’s true. Kimberley: Can we link that too? Shala: Yes. And that one I have under my COVID resources, because I’m so glad you brought that up. When the pandemic started, my OCD did not like it, as many people who have contamination OCD can relate to. And it was pretty scary all the time. And it was making me scared all the time. And eventually, I just wrote it a letter and I’m like, “Dude, we’re not doing this anymore.” And I read it out loud and I recorded it out loud so that people could hear how I was talking to it.  Kimberley: It was so powerful. Shala: Well, thank you. And it’s fun to do. I think the more that you can personify your OCD, the more you can think of it as an entity that is within you but is not you, and to recognize that your relationship with it will change over time. Sometimes you’re going to be compassionate with it. “Gosh, OCD, I’m so sorry,” You’re scared we’re doing this anyway. Sometimes you’re going to be aggressive with it. Sometimes you just ignore it. And that changes as you go through therapy, it changes through your life. And I think that recognizing that it’s okay to have OCD and to have this little thing, I think of like an orange ball with big feet and sunglasses is how I think about it when it’s behaving – it makes it less of an adversarial relationship over time and more like I have an annoying little sibling that, gosh, it’s just not going to ever not be there, but it’s fine. We can live together and live in this uncertainty and be happy anyway. Kimberley: I just love it. Thank you so much for being here and sharing your experience and your knowledge. It’s so wonderful. Shala: Thank you so much for having me.

SUMMARY: Covered in This Episode: What is a Mental Compulsion?  What is the difference between Mental Rumination and Mental Compulsions?  How to use Mindfulness for Mental Compulsions How to “Label and Abandon” intrusive thoughts and mental compulsions  How to use Awareness logs to help reduce mental rituals and mental rumination  Links To Things I Talk About: Links to Jon’s Books https://www.amazon.com/ Work with Jon https://www.sheppardpratt.org/care-finder/ocd-anxiety-center/ Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more.  To learn about our Online Course for OCD, visit https://www.cbtschool.com/erp-school-lp. Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free, and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION I want you to go back and listen to that. That is where I walk you through Mental Compulsions 101. What is a mental compulsion, the types of mental compulsions, things to be looking out for. The reason I stress that you start there is there may be things you’re doing that are mental compulsions and you didn’t realize. So, you want to know those things before you go in and listen to the skills that you’re about to receive. Oh my goodness. This is just so, so exciting. I’m mind-blown with how exciting this is all for me. First of all, let’s introduce the guest for today. Today, we have the amazing Jon Hershfield. Jon has been on the episode before, even talking about mental compulsions. However, I wanted him to status off. He was so brave. He jumped in, and I wanted him to give his ideas around what is a mental compulsion, how he uses mental compulsion treatment with his clients, what skills he uses. Little thing to know here, he taught me something I myself didn’t know and have now since implemented with our patients over at my clinic of people who struggle with mental compulsions. I’ve also uploaded that and added a little bit of that concept into ERP School, which is our course for OCD, called ERP School. You can get it at CBTSchool.com.  Jon is amazing. So, you’re going to really feel solid moving into this. He gives some solid advice. Of course, he’s always so lovely and wise. And so, I am just so excited to share this with you. Let’s just get to the show because I know you’re here to learn. This is episode two of the series. Next week we will be talking with Shala Nicely and she will be dropping major truth bombs and major skills as well, as will all of the people on the series. So, I am so, so excited.  One thing to know as you move into it is there will be some things that really work for you and some that won’t. So, I’m going to say this in every episode intro. So, all of these skills are top-notch science-based skills. Each person is going to give their own specific nuanced way of managing it. So, I want you to go in knowing that you can take what you need. Some things will really be like, yes, that’s exactly what I needed to hear. Some may not. So, I want you to go in with an open mind knowing that the whole purpose of this six-part series is to give you many different approaches so that you can try on what works for you. That’s my main agenda here, is that you can feel like you’ve gotten all the ideas and then you can start to put together a plan for yourself. Let’s go over to the show. I’m so happy you’re here. ----- Kimberley: Welcome, Jon. I’m so happy to have you back. Jon: Hi, Kimberley. Thanks for having me back. Difference Between Mental Compulsions and Mental Rumination  Kimberley: Okay. So, you’re first in line and I purposely had you first in line. I know we’ve had episodes similar to this in the past, but I just wanted to really get your view on how you’re dealing with mental compulsions. First, I want to check in, do you call them “mental compulsions” or do you call it “mental rumination”? Do you want to clarify your own idea? Jon: Yeah. I say mental compulsions or mental rituals. I use the terms pretty interchangeably. It comes up at the first, usually in the assessment, if not then in the first post-assessment session, when I’m explaining how OCD works and I get to the part we say, and then there’s this thing called compulsions. And what I do is I describe compulsions as anything that you do physically or mentally to reduce distress, and this is the important part, specifically by trying to increase certainty about the content of the obsession.  Why that’s important is I think we need to get rid of this myth that sometimes shows up in the OCD community that when you do exposures or when you’re triggered, you’re just supposed to freak out and deal with it, and hopefully, it’ll go away on its own. Actually, there are many things you can do to reduce distress that aren’t compulsive, because what makes it compulsive is that it’s acting on the content of the obsession. I mean, there might be some rare exceptions where your specific obsession has to do with an unwillingness to be anxious or something like that. But for the most part, meditation, breathing exercises, grounding exercises, DBT, certain forms of distraction, exercise – these can all reduce your physical experience of distress without saying anything in particular about whether or not the thought that triggered you is true or going to come. So, once I’ve described that, then hopefully, it opens people up to realize, well, it could really be anything and most of those things are going to be mental. So then, we go through, “Well, what are the different mental ways?” We know the physical ways through washing hands and checking locks and things like that. But what are all the things you’re doing in your mind to convince yourself out of the distress, as opposed to actually working your way through the distress using a variety of distress tolerance skills, including acceptance? Kimberley: Right. Do you do the same for people with generalized anxiety or social anxiety or other anxiety disorders? Would you conceptualize it the same way? Mental Compulsions for General Anxiety Disorder vs OCD  Jon: Yeah. I think for the most part, I mean, I do meet people. Some people who I think are better understood as having generalized anxiety disorder than OCD, and identifying with that concept actually helps them approach this problem that they have of dealing with uncertainty and dealing with worry and dealing with anxiety on close to home, regular everyday issues like finance and work and health and relationships and things like that. And there’s a subsection of that people who, if you treat it like OCD, it’s really helpful. And there’s a subsection if you treat it like OCD, they think, “Oh no, I have some other psychiatric problem I have to worry about right now.” I’m a fan of treating the individual that the diagnostic terms are there to help us. Fundamentally, the treatment will be the same. What are you doing that’s sending the signal to your brain, that these ideas are threats as opposed to ideas, and how can we change that signal? Exposure & Response Prevention for Mental Compulsions  Kimberley: Right. I thank you for clarifying on that. So, after you’ve given that degree of psychoeducation, what do you personally do next? Do you want to share? Do you go more into an exposure option? Do you do more response prevention? Tell me a little bit about it, walk me through how you would do this with a client. Jon: The first thing I would usually do is ask them to educate me on what it’s really like to be them. And so, that involves some thought tracking. So, we’ll use a trigger and response log. So, I keep it very simple. What’s setting you off and what are you doing? And I’ll tell them in the beginning, don’t try too hard to get better because I want to know what your life is really like, and I’ll start to see the patterns. It seems every time you’re triggered by this, you seem to do that. And that’s where they’ll start to reveal to me things like, “Well, I just thought about it for an hour and then it went away.” And that’s how I know that they’re engaging in mental review and rumination, other things like that. Or I was triggered by the thought that I could be sick and I repeated the word “healthy” 10 times. Okay. So, they’re doing thought neutralization. Sometimes we’ll expand on that. One of the clinicians in my practice took our thought records and repurposed them as a mental behavior log. So, it’s what set you off. What did you do? What was the mental behavior that was happening at that time? And in some cases, what would’ve been more helpful? Again, I rely more on my patients to tell me what’s going on than on me to tell them “Here’s what’s going on,” so you get the best information. Logging Mental Rituals  Kimberley: Right. I love that. I love the idea of having a log. You’re really checking in for what’s going on before dropping everything down. Does that increase their distress? How do they experience that? Jon: I think a lot of people find it very helpful because first of all, it’s an act of mindfulness to write this stuff down because it’s requiring you to put it in front of you and see it, which is different than having it hit you from inside your head. And so, that’s helpful. They’re seeing it as a thought process. And I think it also helps people come to terms with a certain reality about rumination that it’s not a hundred percent compulsion in the sense that there’s an element of rumination that’s habitual. Your mind, like a puppy, is conditioned to respond automatically to certain things that it’s been reinforced to do. And so, sometimes people just ruminate because they’re alone or sitting in a particular chair. It’s the same reason why people sometimes struggle with hair-pulling disorder, trichotillomania or skin picking. It’s these environmental cues. And then the brain says, “Oh, we should do this now because this is what we do in this situation.” People give themselves a really hard time for ruminating because they’ve been told to stop, but they can’t stop because they find themselves doing it.  So, what I try to help people understand is like, “Look, you can only control what you can control. And the more that you are aware of, the more you can control. So, this is where you can bring mindfulness into it.” So, maybe for this person, there’s such a ruminator. They’re constantly analyzing, figuring things out. It’s part of their identity. They’re very philosophical. They’re not thinking of it as a compulsion, and many times they’re not thinking of it at all. It’s just happening. And then we increased their awareness, like, “Oh, okay. I got triggered. I left the building for a while. And then suddenly, I realized I was way down the rabbit hole, convinced myself that’s something terrible. So, in that moment I realized I’m supposed to stop, but so much damage has been done because I just spent a really long time analyzing and compulsing and trying to figure it out.”  So, strategies that increase our awareness of what the mind is doing are extraordinarily helpful because imagine catching it five seconds into the process and being able to say, “Oh, I’m ruminating. Okay, I don’t need to do that right now. I’m going to return my attention to what I was doing before I got distracted.” Kimberley: Right. I love the idea of this, the log for awareness, because a lot of people say, “Oh, maybe for half an hour a day.” Once they’ve logged it, they’re like, “Wow, it’s four hours a day.” I think it’s helpful to actually recognize this, like how impactful it is on their life. So, I love that you’re doing that piece. You can only control what you can control. What do you do with the stuff you can’t control? Jon: Oh, you apply heavy doses of self-criticism until you hate yourself enough to never do it again. That’s the other mental ritual that usually happens and people realize, “Oh, I’ve been ruminating,” and they’re angry at themselves. “I should know better.” So, they’re angry at themselves for something they didn’t know they were doing, which is unfair. So, I use the term, I say, “label and abandon.” That’s what you do with all mental rituals. The moment you see it, you give it a name and you drop it. You just drop it on the floor where you were, you don’t finish it up real quick. You don’t analyze too much about it and then drop it. You’re just like, “Oh, I’m holding this thing I must not hold,” and you drop it. Label and abandon. What people tend to do is criticize then label, then criticize some more and then abandon. And the real problem with that is that the self-criticism is in and of itself another mental ritual. It’s a strategy for reducing distress that’s focused on increasing certainty about the content of the obsession. The obsession, in this case, is “I’m never going to get better.” Now I know I’m going to get better because I’ve told myself that I’m being fooled and that I’ll never do that again. It’s not true. But then you wash your hands. They aren’t really clean either. So, none of our compulsions really work. Self-Compassion for Mental Compulsions  Kimberley: Doesn’t have to make sense.  Jon: Yeah. So, I think bringing self-compassion in the moment to be able to recognize it and recognize the urge to self-criticize and really just say like, “Oh, I’m not going to do that. I caught myself ruminating. Well done.” Same thing we do when we meditate. Some people think that meditation has something to do with relaxation or something to do with controlling your mind. It’s actually just a noticing exercise. Your mind wanders, you notice it. “Oh, look at that, I’m thinking.” Back to the breath. That’s a good thing that you noticed that you wandered. Not, “Oh, I wandered, I can’t focus. I’m bad at meditating.” So, it’s really just changing the frame for how people are relating to what’s going on inside.  One, eliminating self-criticism just makes life a lot easier. Two, eliminating the self-criticism and including that willingness to just label the thought pattern or the thought process and drop it right where it is. You can start to catch that earlier and earlier and earlier. So, you’re reducing compulsions. And you’ll see that the activity, the neutralizing, the figuring it out, the using your mental strength against yourself instead of in support of yourself, you could see how that’s sending the signal to the brain. “Wait, this is very important. I need to keep pushing it to the forefront.” There’s something to figure out here. This isn’t a cold case in a box, on a shelf somewhere. This is an ongoing investigation and we have to figure it out. How do we know? Because they’re still trying to figure it out. Kimberley: Right. How much do you think insight has to play here or how much of a role does it play? Jon: Insight plays a role in all forms of OCD. I mean, it plays a role in everything – insight into our relationships, insight into our career aspirations. I think one of the things I’ve noticed, and this is just anecdotal, is that the higher the distress and the poorer the distress regulation skills, often the lower the insight. Not necessarily the other way around. Some people have low insight and aren’t particularly distressed by what’s going on, but if the anxiety and the distress and the discomfort and disgust are so high that the brain goes into a brownout, I noticed that people switch from trying to get me to reassure them that their fears are untrue to trying to convince me that their fears are true. And to me, that represents an insight drop and I want to help them boost up their insight. And again, I think becoming more aware of your mental activity that is voluntary – I’m choosing to put my mind on this, I’m choosing to figure it out, it didn’t just happen. But in this moment, I’m actually trying to complete the problem, the puzzle – becoming more aware that that’s what you’re doing, that’s how you develop insight. And that actually helps with distress regulation. Kimberley: Right. Tell me, I love you’re using this word. So, for someone who struggles with distress regulation, what kind of skills would you give a client or use for yourself? Jon: So, there are many different skills a person could use. And I hesitate to say, “Look, use this skill,” because sometimes if you’re always relying on one skill and it’s not working for you, you might be resistant to using a different skill. In DBT, they have something called tip skills. So, changing in-- drastic changes in temperature, intense exercise, progressive muscle relaxation, pace breathing. These are all ways of shifting your perspective. In a more global sense, I think the most important thing is dropping out of the intellectualization of what’s happening and into the body. So, let’s say the problem, the way you know that you’re anxious is that your muscles are tense and there’s heat in your body and your heart rate is elevated. But there are lots of circumstances in your life where your muscles would be tense and your heart rate will be up and you’ll feel hot, and you might be exercising, for example.  So, that experience alone isn’t threatening. It’s that experience press plus the narrative that something bad is going to happen and it’s because I’m triggered and it’s because I can’t handle the uncertainty and all this stuff. So, it’s doing two things at once. It’s dropping out of the thought process, which is fundamentally the same thing as labeling and abandoning the mental ritual, and then dropping into the body and saying, “What’s happening now is my hands are sweaty,” and just paying attention to it. Okay, alright, sweaty hands. I can be with sweaty hands. Slowing things down and looking at things the way they are, which is not intellectual, as opposed to looking at things the way they could be, or should be, or might have been, which again is a mental ruminative process. Kimberley: Right. Do you find-- I have found recently actually with several clients that they have an obsession. They start to ruminate and then somewhere through there, it’s hard to determine what’s in control and what’s not. So, we want to preface it with that. But things get really out of control once they start to catastrophize even more. So, would you call the catastrophization a mental rumination, or would you call it an intrusive thought? How would you conceptualize that with a client? They have the obsession, they start ruminating, and then they start going to the worst-case scenario and just staying there. Jon: Yeah. There’s different ways to look at it. So, catastrophizing is predicting a negative future and assuming you can’t cope with it, and it’s a way of thinking about a situation. So, it’s investing in a false project. The real project is there’s something unknown about the future and it makes you uncomfortable and you don’t like it. How do you deal with that? That’s worth taking a look at. The false project is, my plane is going to crash and I need to figure out how to keep the plane from crashing. But that’s how the OCD mind tends to work. So, one way of thinking about catastrophizing is it’s a tone it’s a way-- if you can step back far enough and be mindful of the fact that you’re thinking, you can also be mindful of the fact that there is a way that you’re thinking. And if the way that you’re thinking is catastrophizing, you could say, “Yeah, that’s catastrophizing. I don’t need to do that right now.”  But I think to your point, it is also an act. It’s something somebody is doing. It’s like, I’m going to see this through to the end and the hopes that it doesn’t end in catastrophe, but I’m also going to steer it into catastrophe because I just can’t help myself. It’s like a hot stove in your head that you just want to touch and you’re like, “Ouch.” And in that case, I would say, yeah, that’s a mental ritual. It’s something that you’re doing.  I like the concept of non-engagement responses. So, things that you can do to respond to the thought process that aren’t engaging it directly, that are helping you launch off. Because like I said, before you label and abandon. But between the label and abandon, a lot of people feel like they need a little help. They need something to drive a wedge between them and the thought process. Simply dropping it just doesn’t feel enough, or it’s met with such distress because whenever you don’t do a compulsion, it feels irresponsible, and they can’t handle that distress. So, they need just a little boost.  What do we know about OCD? We know that the one thing you can’t do effectively is defend yourself because then you’re getting into an argument and you can’t win an argument against somebody who doesn’t care what the outcome of the argument is. The OCD just wants to argue. So, any argument, no matter how good it is, the OCD is like, “Great, now we’re arguing again.” How to Manage Mental Compulsions  Kimberley: Yeah. “I got you.” Jon: Yeah. So, what are our options? What are our non-engagement response options? One, which I think is completely undersold, is ignoring it. Just ignoring it. Again, none of these you want to only focus on because they could all become compulsive. And then you’re walking around going, “I’m ignoring it, I’m ignoring it.” And then you’re just actually avoiding it. But it’s completely okay to just choose not to take yourself seriously. You look at your email and it’s things that you want. And then in there is a junk mail that just accidentally got filtered into the inbox instead of the spam box, and mostly what you do is ignore it. You don’t even read the subject of it. You recognize that in the moment, it’s spam and you move on as if it wasn’t even there. Then there’s being mindful of it. Mindful noting. Just acknowledging it. You take that extra beat to be like, “Oh yeah, there’s that thought.” In act, they would call this diffusion. I’m having a thought that something terrible is going to happen. And then you’re dropping it. So, you’re just stepping back and be like, “Oh, I see what’s going on here. Okay, cool. But I’m not going to respond to it.” And then as we get into more ERP territory, we also have the option of agreeing with the uncertainty that maybe, maybe not. “What do I know? Okay. Maybe the plane is going to crash. I can’t be bothered with this.” But you have to do it with attitude because if you get too involved in the linguistics of it, then it’s like, well, what’s the potential that it’ll happen? And you can’t play that game, the probability game.  But it is objectively true that any statement that begins with the word “maybe” has something to it. Maybe in the middle of this call, this computer is going to explode or something like that. It would be very silly for me to worry about that, but you can’t deny that the statement is true because it’s possible. It’s maybe. So, just acknowledging that, be like, “Okay, fine. Maybe.” And then dropping it the way you would if you had some thought that you didn’t find triggering and yet was still objectively true.  And then the last one, which can be a lot of fun, can also be overdone, can also become compulsive, but if done well can make life a little bit more fun, is agreeing with the thought in an exaggerated humorous, sarcastic way. Just blowing it up. So, you’re out doing the OCD. The OCD is very creative, but you’re more creative than the OCD. Kimberley: Can you give me examples? Jon: Well, the OCD says your plane is going to crash. He said, your plane is going to crash into a school. Just be done with it, right? And that kind of shock where the bully is expecting you to defend yourself and instead, you just punched yourself in the face. He’s like, “Yeah, you’re weird. I’m not going to bother you anymore.” That’s the relationship one wants with their OCD. Kimberley: That’s true. I remember in a previous episode we had with, I think it was when you had brought out your team book about saying “Good one bro,” or “brah.” Jon: “Cool story, brah.” Yeah.  Kimberley: Cool story brah. And I’ve had many of my patients say that that was also really helpful, is there’s a degree of attitude that goes with that, right? Jon: Yeah. And because again, it’s just a glitch in the system that, of course, you’re conditioned to respond to it like it’s serious. But once you realize it is, once you get the hint that it’s OCD, you have to shift out of that, “Oh, this is very important, very serious,” and into this like, “This is junk mail.” And if you actually look at your junk mail, none of it is serious. It sounds serious. It sounds like I just inherited a billion dollars from some prince in Nigeria. That sounds very important. I Kimberley: I get that email every day pretty much.  Jon: Yeah. But I look at it and immediately I know that it’s not serious, even though the words in it sound very important.  Kimberley: Yeah. So, for somebody, I’m sitting in the mind of someone who has OCD and is listening right now, and I’m guessing, to those who are listening, you’re nodding and “Yes, this is so helpful. This is so helpful.” And then we may finish the episode and then the realization that “This is really hard” comes. How much coaching, how much encouragement? How do you walk someone through treatment who is finding this incredibly difficult? Jon: I want to live in your mind. In my mind, let that same audience member is like, “This guy sucks.” Kimberley: My mind isn’t so funny after we start the recording. So, you’re cool. Jon: Who is this clown? Again, it’s back to self-compassion. I’m sure people are tired of hearing about it, but it’s simply more objective. It is hard. And if you’re acting like it shouldn’t be hard or you’re doing something wrong as a function, it’s hard because you’re doing something wrong, you’re really confused. How could that be? You could not have known better than to end up here. Everything that brought you here was some other thought or some other feeling, and you’re just responding to your environment. The question is right now where you have some control, what are you going to do with your attention? Right now, you’re noticing, “Oh man, it’s really hard to resist mental rituals. It’s hard to catch them. It’s hard to let go of them. It’s hard to deal with the anxiety of thinking because I didn’t finish the mental ritual. Maybe I missed something and somebody’s going to get hurt or something like that because I didn’t figure it out.”  It is really hard. I don’t think we should pretend that it’s easy. We should acknowledge that it’s hard. And then we should ask, “Okay, well, I made a decision that I’m going to do this. I’m going to treat my OCD and it looks like the treatment for OCD is I’m going to confront this uncertainty and not do compulsions. So, I have to figure out what to do with the fact that it’s hard.” And then it’s back to the body. How do you know that it’s hard? “Well, I could feel the tension here and I could feel my heart rate and my breath.” So, let’s work with that. How can I relate to that experience that’s coming up in a way that’s actually helpful? The thing that I’ve been thinking about a lot lately is this idea that the brain is quick to learn that something is dangerous. Something happens and it hurts, and your brain is like, “Yeah, let’s not do that again.” And you might conclude later that that thing really wasn’t as dangerous as you thought. And so, you want to re-engage with it. And you might find that’s really hard to do, which is why exposure therapy is really hard because it’s not like a one-and-done thing. You have to practice it because the brain is very slow to learn that something is safe, especially after it’s been taught that it’s dangerous.  But that’s not a bad thing. You want a brain that does that. You don’t want a brain that’s like, “Yeah, well, I got bit by one dog, but who cares? Let’s go back in the kennel.” You want a brain that’s like, “Hold on. Are you sure about this?” That whole process of overcoming your fears, I think people, again, they’re way too hard on themselves. It should take some time and it should be slow and sluggish. You look like you’re getting better, and then you slip back a little bit, because it’s really just your brain saying, “Listen, I’m here to keep you safe, and I learned that you weren’t, and you are not following rules. So, I’m pulling you back.” That’s where that is coming from. So, that’s the hard feeling. That’s the hard feeling right there. It’s your brain really trying to get you to say, “No, go back to doing compulsions. Compulsions are keeping you safe.” You have to override that circuit and say, “I appreciate your help. But I think I know something that you don’t. So, I’m going to keep doing this.” And then you can relate to that hard feeling with like, “Good, my brain works. My brain is slow and sluggish to change, but not totally resistant. Over time, I’m going to bend it to my will and it will eventually let go, and either say this isn’t scary anymore or say like, ‘Well, it’s still scary, but I’m not going to keep you from doing it.’” Kimberley: Right. I had a client at the beginning of COVID I think, and the biggest struggle-- and this was true for a lot of people, I think, is they would notice the thought, notice they’re engaging in compulsions and drop it, to use your language, and then go, “Yay, I did that.” And then they would notice another thought in the next 12 seconds or half a second, and then they would go, “Okay, notice it and drop it.” And then they’d do it again. And by number 14, they’re like, “No, this is--” or it would either be like, “This is too hard,” or “This isn’t working.” So, I’m wondering if you could speak to-- we’ve talked about it being “too hard.” Can you speak to your ideas around “this isn’t working”? Jon: Yeah. That’s a painful thought. I think that a lot of times, people, when they say it isn’t working, I ask them to be more specific because their definition of working often involves things like, “I was expecting not to have more intrusive thoughts,” or “I was expecting for those thoughts to not make me anxious.” And when you let go of those expectations, which isn’t lowering them at all, it’s just shifting them, asking, well, what is it that you really want to do in your limited time on this earth? You’re offline for billions of years. Now you’re online for, I don’t know, 70 to 100 if you’re lucky, and then you’re offline again. So, this is the time you have. So, what do you want to do with your attention? And if it’s going to be completely focused on your mental health, well, that’s a bummer. You need to be able to yes, notice the thought, yes, notice the ritual, yes, drop them both, and then return to something.  In this crazy world we’re living in now where we’re just constantly surrounded by things to stimulate us and trigger us and make us think, we have lots of things to turn to that aren’t necessarily healthy, but they’re not all unhealthy either. So, it’s not hard to turn your attention away from something and into a YouTube video or something like that. It is more challenging to shift your attention away from something scary and then bring it to the flavor of your tea. That’s a mindfulness issue. That’s all that is. Why is one thing easier than the other? It’s because you don’t think the flavor of your tea is important. Why? Because you’re just not stimulated by the firing off of neurons in your tongue and the fact that we’re alive on earth and that we’ve evolved over a million years to be able to make and taste tea. That’s not as interesting as somebody dancing to a rap song. I get that, but it could be if you’re paying a different kind of attention. So, it’s just something to consider when you’re like, “Well, I can’t return to the present because it doesn’t engage me in there.” Something to consider, what would really engage you and what is it about the present that you find so uninteresting? Maybe you should take another look. Kimberley: Right. For me, I’m just still so shocked that gravity works. Whenever I’m really stuck, I will admit, my rumination isn’t so anxiety-based. I think it’s more when I’m angry, I get into a ruminative place. We can do that similar behavior. So, when I’m feeling that, I have to just be like, “Okay, drop away from, that’s not helpful. Be aware and then drop it.” And then for me, it’s just like, “Wow, the gravity is pulling me down. It just keeps blowing my mind.” Jon: Yeah. That’s probably a better use of your thought process than continuing to ruminate. But you bring up another point. I think this speaks more closely to your question about when people say it’s not working. I’m probably going to go to OCD jail for this, but I think to some extent, when you get knocked off track by an OCD trigger, because you made me think of it when you’re talking about anger. Like, someone says something to you and makes you angry and you’re ruminating about it. But it’s the same thing in OCD. Something happens. Something triggers you to think like, “I’m going to lose my job. I’m a terrible parent,” or something like that. You’re just triggered. This isn’t just like a little thought, you’re like, “Oh, that’s my OCD.” You can feel it in your bones. It got you. It really got you.  Now, you can put off ruminating as best you can, but you’re going to be carrying that pain in your bones for a while. It could be an hour, could be a day, could be a couple of days. Now, if it’s more than a couple of days, you have to take ownership of the fact that you are playing a big role in keeping this thing going and you need to change if you want different results. But if it’s less than a couple of days and you have OCD, sometimes all you can do is just own it. “All right, I’m just going to be ruminating a lot right now.” And I’m not saying like, hey, sit there and really try to ruminate. But it’s back to that thing before, like your brain is conditioned to take this seriously, and no matter how much you tell yourself it’s not serious, your brain is going to do what your brain is going to do. And so, can you get your work done? Try to show up for your family, try to laugh when something funny happens on TV, even while there’s this elephant sitting on your chest. And every second that you’re not distracted, your mind is like, “Why did they say that? Why did I do that? What’s going to happen next?” And really just step back from it and say like, “You know what, it’s just going to have to be like this for now.” What I see people do a lot is really undersell how much that is living with OCD. “I’m not getting better.” I had this happen actually just earlier today. Somebody was telling me, walking me through this story that was just full of OCD minds that they kept stepping on and they kept exploding and they were distressed and everything. And yet, throughout the whole process, the only problem was they were having OCD and they were upset. But they weren’t avoiding the situation. They weren’t asking for reassurance and they weren’t harming themselves in any way. They were just having a rough time because they just had their buttons pushed. It was frustrating because they wouldn’t acknowledge that that is a kind of progress that is living with this disorder, which necessarily involves having symptoms.  I don’t want people to get confused here and say like, “This is as good as it gets,” or “You should give up hope for getting better.” It’s not about that. Part of getting better is really owning that this is how you show up in the world. You have your assets and your liabilities, and sometimes the best thing to do is just accept what’s going on and work through it in a more self-compassionate way. Kimberley: Right. I really resonate with that too. I’ve had to practice that a lot lately too of accepting my humanness. Because I think there are times where you catch yourself and you’re like, “No, I should be performing way up higher.” And then you’re like, “No, let’s just accept these next few days are going to be rough.” I like that. I think that that’s actually more realistic in terms of what recovery really might look like. This is going to be a rough couple of days or a rough couple of hours or whatever it may be. Jon: Yeah. If you get punched hard enough in the stomach and knock the wind out of you, that takes a certain period of time before you catch your breath. And if you get punched in the OCD brain, it takes a certain amount of time before you catch your breath. So, hang on. It will get better. And again, this isn’t me saying, just do as many compulsions as you want. It’s just, you’re going to do some, especially rumination and taking ownership of that, “Oh man, it’s really loud in there. I’ve been ruminating a lot today. I’ll just do the best I can.” That’s going to be a better approach than like, “I’m going to sit and track every single thought and I’m going to burn it to the ground. I’m going to do it every five seconds.” Really, you’re just going to end up ruminating more that way. Kimberley: Right. And probably beating yourself up more. Jon: Exactly. Kimberley: Right. Okay. I feel like that is an amazing place for us to end. Before we do, is there anything you feel like we’ve missed that you just want people to know before we finish up? Jon: I guess what’s really important to know since we’re talking about mental compulsions is that it’s not separate from the rest of OCD and it’s not harder to treat. People have this idea that, well, if you’re a compulsive hand-washer, you can just stop washing your hands or you can just remove the sink or something like that. But if you’re a compulsive ruminator about whether or not you’re going to harm someone or you’re a good person or any of that stuff, somehow that’s harder to treat. I’ve not found this to be the case. Anecdotally, I haven’t seen any evidence that this is really the case in terms of research. You might be harder on yourself in some ways, and that might make your symptoms seem more severe, but that’s got nothing to do with how hard you are to treat or the likelihood of you getting better. Most physical rituals are really just efforts to get done what your mental rituals are not doing for you. So, many people who are doing physical rituals are also doing mental rituals and those who aren’t doing physical rituals. Again, some people wash their hands. Some people wash their minds. Many people do both. A lot of this stuff, it has to do with like, “I expect my mind to be one way, and it’s another.” And that thing that’s making it another is a contaminant, “I hate it and I want to go away and I’m going to try to get it to go away.” And that’s how this disorder works. Kimberley: Right. It’s really, really wonderful advice. I think that it’s actually really great that you covered that because I think a lot of people ask that question of, does that mean that I’m going to only have half the recovery of someone who does physical compulsions or just Googles or just seeks reassurance? So, I think it’s really important. Do you feel like someone can overcome OCD if their predominant compulsion is mental? Jon: Absolutely. They may even have assets that they are unaware of that makes them even more treatable. I mean, only one way to find out. Kimberley: Yeah. I’m so grateful to you. Thank you for coming on. This is just filling my heart so much. Thank you. Jon: Thank you. I always love speaking with you. Kimberley: Do you want to share where people can find you and all your amazing books and what you’re doing? Jon: My hub is OCDBaltimore.com. That’s the website for the Center for OCD and Anxiety at Sheppard Pratt, and also the OCD program at The Retreat at Sheppard Pratt. And I’m on Instagram at OCDBaltimore, Twitter at OCDBaltimore. I don’t know what my Facebook page is, but it’s out there somewhere. I’m not hard to find. Falling behind a little bit on my meme game, I haven’t found anything quite funny or inspiring enough. I think I’ve toured through all of my favorite movies and TV shows. And so, I’m waiting for some show that I’m into to inspire me. But someone asked me the other day, “Wait, you stopped with the memes.” Kimberley: They’re like, nothing’s funny anymore. Jon: I try not to get into that headspace. Sometimes I do think that way, but yeah, the memes find me. I don’t find them. Kimberley: I love it. And your books are all on Amazon or wherever you can buy books, I’m imagining. Jon: Yes. The OCD Workbook For Teens is my most recent one and the second edition of the Mindfulness Workbook for OCD is also a relatively recent one. Kimberley: Amazing. You’re amazing. Thank you so much. Jon: Thank you.

SUMMARY: Welcome to the first week of this 6-part series on Mental Compulsions.  This week is an introduction to mental compulsions.   Ove the next 6 weeks, we will hear from many of the leaders in our feild on how to manage mental compulsions using many different strategies and CBT techniques.  Next week, we will have Jon Hershfield to talk about how he using mindfulness to help with mental compulsions and mental rituals. In This Episode: What is a mental compulsion? Is there a different between a mental compulsion and mental rumination and mental rituals? What is a compulsion? Types of Mental Compulsions Links To Things I Talk About: How to reach Jon https://www.sheppardpratt.org/care-finder/ocd-anxiety-center/ ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com. CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors. Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 282 and the first part of a six-part series that I am overwhelmed and honored to share with you – all on mental compulsions. I have wanted to provide a free resource on mental compulsions for years, and I don’t know why, but I finally got enough energy under my wings and I pulled it off and I could not be more excited. Let me tell you why. This is a six-part series. The next six episodes will be dedicated to managing mental compulsions, mental rituals, mental rumination. I will be presenting today the first part of the training, which is what we call Mental Compulsions 101. It will talk to you about all the different types of mental compulsions, give you a little bit of starter training. And then from there, it gets exciting. We have the most incredible experts in the field, all bringing their own approach to the same topic, which is how do we manage mental compulsions? We don’t talk about mental compulsions enough. Often, it’s not addressed enough in treatment. It’s usually very, very difficult to reduce or stop mental compulsion. I thought I would bring all of the leaders, not all of them, the ones I could get and the ones that I had the time to squeeze into this six-part series, the ones that I have found the most beneficial for my training and my education for me and my stuff. I asked very similar questions, all with the main goal of getting their specific way of managing it, their little take, their little nuance, fairy tale magic because they do work magic. These people are volunteering their time to provide this amazing resource. Welcome to number one of a six-part series on mental compulsions. I hope you get every amazing tool from it. I hope it changes your life. I hope you get out your journal and you write down everything that you think will help you and you put it together and you try it and you experiment with it and you practice and you practice because these amazing humans are so good and they bring such wisdom. I’m going to stop there because I don’t want to go on too much. Of course, I will be starting. And then from there, every week for the next five weeks after this one, you will get a new take, a new set of tools, a new way of approaching it. Hopefully, it’s enough to really get you moving in managing your mental compulsion so you can go and live the life that you deserve, so that you can go and do the things you want without fear and anxiety and mental compulsions taking over your time. Let’s do this. I have not once been more excited, so let’s do this together. It is a beautiful day to do hard things and so let’s do it together. Welcome, everybody. Welcome to Mental Compulsions 101. This is where I set the scene and teach you everything you need to know to get you started on understanding mental compulsions, understanding what they are, different kinds, what to do, and then we’re going to move over and let the experts talk about how they personally manage mental compulsions. But before they shared their amazing knowledge and wisdom, I wanted to make sure you all had a good understanding of what a mental compulsion is and really get to know your own mental compulsions so you can catch little, maybe nuanced ways that maybe you’re doing mental compulsions. I’m going to do this in a slideshow format. If you’re listening to this audio, there will be a video format that you can access as well here very soon. I will let you know about that. But for right now, let’s go straight into the content. Who is Kimberley Quinlan? First of all, who am I? My name is Kimberley Quinlan. A lot of you know who I am already. If you don’t, I am a marriage and family therapist in the State of California. I am an Australian, but I live in America and I am honored to say that I am an OCD and Anxiety Specialist. I treat all of the anxiety disorders. I also treat body-focused repetitive behaviors, and we specialize in eating disorders as well. The reason I tell you all that is you probably will find that many different disorders use mental compulsions as a part of their disorder. My hope is that you all feel equally as included in this series. Now, as well as a therapist, I’m also a mental health educator. I am the owner, the very proud owner of CBTSchool.com. It is an online platform where we offer free and paid resources, educational resources for people who have anxiety disorder orders or want to just improve their mental health. I am also the host of Your Anxiety Toolkit Podcast. You may be watching this in a video format, or you may actually be listening to this because it will also be released. All of this will be offered for free on Your Anxiety Toolkit Podcast as well. I wanted to just give you all of that information before we get started so that you know that you can trust me as we move forward. Here we go. What is a Mental Compulsion? First of all, what is a mental compulsion? Well, a mental compulsion is something that we do mentally. The word “compulsion” is something we do, but in this case, we’re talking about not a physical behavior, but a mental behavior. We do it in effort to reduce or remove anxiety, uncertainty, some other form of discomfort, or maybe even disgust. It’s a behavior, it’s a response to a discomfort and you do that response in a way to remove or resist the discomfort that you’re feeling. Now, we know that in obsessive-compulsive disorder, there are a lot of physical compulsions. A lot of us know these physical compulsions because they’ve been shown in Hollywood movies. Jumping over cracks, washing our hands, moving objects – these are very common physical compulsions – checking stoves, checking doors. Most people are very understanding and acknowledge that as being a part of OCD. But what’s important to know is that a lot of people with OCD don’t do those physical compulsions at all. In fact, 100% of their compulsions are done in their head mentally. Now, this is also very true for people with generalized anxiety. It’s also very true for some people with health anxiety or an eating disorder, many disorders engage in mental compulsions. Mental Compulsion Vs Mental Ritual? For the sake of this series, we use the word “mental compulsion,” but you will hear me, as we have guests, you will hear me ask them, do you call them “mental compulsions”? Some people use the word “mental ritual.” Some people use the word “mental rumination.” There are different ways, but ultimately throughout this series, we’re going to mostly consider them one and the same. But again, just briefly, a mental compulsion is something you do inside of your mind to reduce, remove, or resist anxiety, uncertainty, or some form of discomfort that you experience. Let’s keep moving from here. What is a Compulsion Now, who does mental compulsions? I’ve probably answered that for you already. Lots of people do mental compulsions. Again, it ranges over a course of many different anxiety disorders and other disorders, including eating disorders. But again, generalized anxiety, social anxiety, phobias, health anxiety, post-traumatic stress disorder. Some of the people with that mental disorder also engage in mental compulsions. Predominantly, we talk a lot about the practice of mental compulsions for people with obsessive-compulsive disorder. The thing to remember is it’s more common than you think, and you’re probably doing more of them than you guessed. I’m hoping that this 101 training will help you to be able to identify the compulsions you’re doing so that when we go through this series, you have a really good grasp of where you could practice those skills. Now, often when people find out they’re doing mental compulsions, they can be very hard on themselves and berate and criticize themselves for doing them. I really want to make this a judgment-free and punish-free zone where you’re really gentle with yourself as you go through this series. It’s very important that you don’t use this information as a reason to beat yourself up even more. So let’s make a deal. We’re going to be as kind and non-judgmental as we can, as we move through this process. Compassion is always number one. Do we have a deal? Good. Types of Mental Compulsions Here is the big question: Are there different types of mental compulsions? Now, I’m going to proceed with caution here because there is no clear differentiation between the different compulsions. I did a bunch of research. I also wrote a book called The Self-Compassion Workbook For OCD. There is no specific way in which all of the psychological fields agree on what is different types of mental compulsions. There are some guidelines, but there’s no one list. I want to proceed with caution first by letting you know this list that we use with our patients. Now, as you listen, you may have different names for them. Your therapist may use different terminology. That’s all fine. It doesn’t mean what you have done is wrong or what we are doing is wrong. To be honest with you, this would be a 17-hour training if I were to be as thorough as listing out every single one. For the sake of clarity and simplicity, I’ve put them into 10 different types of mental compulsions. If you have ones that aren’t listed, that doesn’t mean it’s not a mental compulsion. I encourage you to just check in. If you have additional or you have a different name, that’s totally okay. Totally okay. We’re just using this again for the sake of clarity and simplicity. Here we go. 1. Mental Repeating The first mental compulsion that we want to look at is mental repeating. This is where you repeat or you make a list of individual items or categories. It can also involve words, numbers, or phrases. Often people will do this for two reasons or more, like I said, is they may repeat them for reassurance. They may be repeating to see whether they have relief. They may be repeating them to see if they feel okay. They may be repeating them to see if any additional obsessions arise, or they may be repeating them to unjinx something. Now, that’s not a clinical term, so let’s just put that out there. What I mean by this is some people will repeat things because they feel like the first time something happened, it was jinx. Like it will mean something bad will happen. It’s been associated with something bad, so they repeat it to unjinx it. We’ll talk more about neutralizing compulsions here in a second, but that’s in regards to mental repeating. You may do it for a completely different reason. Don’t worry too much as we go through this on why you do it. Just get your notepad out and your pencil out and just take note. Do I do any mental repeating compulsions? Not physical. Remember, we’re just talking about mental in this series. 2. Mental Counting This is where you either count words, count letters, count numbers, or count objects. Again, you will not do this out loud. Well, sometimes you may do it out loud in addition to mental, but we’re mostly talking about things you would do silently in your head. Again, you may do this for a multitude of reasons, but again, we want to just keep tabs. Am I doing any mental counting or mental counting rituals? 3. Neutralization Compulsions or Neutralizing Compulsions What we’re talking about here is you’re replacing an obsession with a different image or word. Let’s say you are opening your computer. As you opened the computer, you had an intrusive thought that you didn’t like. And so in effort to neutralize that thought, you would have the opposite thought. Let’s say you had a thought, a number. Let’s say you’ve had the number that you feel is a bad number. You may neutralize it by then repeating a positive number, a number that you like, or a safe number. Or you may do a behavior, you may see something being done and you have a negative thought. So then, you recall a different thought or a prayer, it could be also a prayer, to undo that bad feeling or thought or sensation. Now, when it comes to compulsive prayer, that could be done as a neutralization. In fact, I almost wanted to make prayer its own category, because a lot of people do engage in compulsive prayer, particularly those who have moral and scrupulous obsessions. Again, not to say that all prayer is a compulsion at all, but if you are finding that you’re doing prayer to undo a bad thought or a bad feeling or a bad sensation or a bad urge – when I say bad, I mean unwanted – we would consider that a neutralization or a neutralizing compulsion. 4. Hypervigilance Compulsions Now again, this is the term we use in my practice. Remember here before we proceed that hypervigilance is an obsession, meaning it can be automatic, unwanted, intrusive, but it can also be a compulsive behavior. It could be both or it could be one. But when I talk about the term “hypervigilance compulsions,” this is also true for people with post-traumatic stress disorder, is it’s a scanning of the environment. It’s a scanning, like looking around. I always say with my clients, it’s like this little set of eyes that go doot, doot, doot, doot really quick, and they’re scanning for danger, scanning for potential fear or potential problems. They also do that when we’re in a hypervigilance compulsion. We may do that with our thoughts. We’re scanning thoughts or we’re scanning sensations like, is this coming? What’s happening? Where am I feeling things? You may be scanning and doing hypervigilance in regards to feeling like, am I having a good thought or a bad thought or a good feeling or a bad feeling? And then making meaning about that. You may actually also be hypervigilant about your reaction. If let’s say you saw something that usually you would consider concerning and this time you didn’t, you might become very hypervigilant. What does that mean? I need to make sure I always have this feeling because this feeling would mean I’m a good person or only good things will happen. The last one again is emotions, which emotions and feelings can sometimes go in together. Hypervigilant compulsion is something to keep an eye out. It could be simple as you just being hypervigilant, looking king around. Often this is true for people with driving obsessions or panic disorder. They’re constantly looking for when the next anxiety attack is coming. 5. Mental Reassurance We can do physical reassurance, which is looking at Google, asking a friend like, are you sure nothing bad will happen? We can do physical, but we can also do mental reassurance, which is mentally checking to confirm an obsession is not or will not become a threat. This is true for basic like we already talked about and some checking and repeating behaviors. You may mentally stare at the doorknob to make sure it is locked. You may mentally check and check for reassurance once, twice, five times, ten times, or more. If the stove is off or that you are not having arousal is another one, or that you are not going to panic. You may be checking to get reassurance mentally that your fear is not going to happen. Again, some people’s fear is fear itself. The fear of having a panic attack is very common as well. Again, we’re looking for different ways that mentally we are on alert for potential danger or perceived danger. 6. Mental Review We’ve talked a lot about behaviors that we’re doing in alert of anxiety. Mental review is reviewing and replaying past situations, figuring out the meaning of internal experiences, such as, what is the meaning of the thought I had? What is the meaning of the feeling I had? What is the meaning of that sensation? What does that mean? What is the meaning of an image that just showed up intrusively and repetitively in my mind? What is the meaning of an urge I have? This is very true for people with harm obsessions or sexual obsessions. When they feel an urge, they may review for hours, what did that mean? What does that mean about me? Why am I having those? And so the review piece can be very painful. All of these are very painful and take many, many hours, because not only are you reviewing the past, which can be hard because it’s hard to get mental clarity of the past, but then you’re also trying to figure out what does that mean about me or the world or the future. So, just things to think about. To be honest, mental review could cover all of the categories that we’ve covered, because it’s all review in some way. But again, for the sake of clarity and simplicity, I’ve tried to break them up. You may want to break them up in different ways yourself. That is entirely okay. I just wanted to give you a little category here on its own. 7. Mental Catastrophization This is where you dissect and scrutinize past situations with potential catastrophic scenarios. Now, I made an error here because a lot of people do this about the future as well. But we’ll talk about that here in a little bit. Mental catastrophization, if you have reviewed the past and you’re going over all of the potential terrible situations. This is very true for people who review like, what did I say? Was that a silly thing to say? Was that a good thing to say? What would they think about me? Mental catastrophization is reviewing the past, but is also the future and reviewing every possible catastrophic scenario or opportunity that happened. Whether it happened or not, it doesn’t really matter when it comes to mental compulsions. Usually, when someone does a mental compulsion, they’re reviewing maybe’s, the just in case it does happen, I better review it. 8. Mental Solving Very similar, again, which is anticipating future situations with or without potential what-if scenarios. Very similar to catastrophization compulsions. This is where you’re looking into the future and going, “What if this happens? What if that happens? What if this happens? Well, what if that happens?” and going through multiple, sometimes dozens of scenarios of the worst-case scenarios on what may or may not happen. Again, it usually involves a lot of catastrophizing. But again, these are all safety behaviors. None of this means there’s anything wrong with you or that you’re bad or that you’re not strong. Remember, our brain is just trying to survive. In the moment when we are doing these, our brain actually thinks it’s coming up with solutions, but what we have to do, and all of the guests will talk about this, is recognize. Most of the time, the problem isn’t actually happening. We’re just having thoughts that it’s happening. Again, this is reviewing thoughts of potential what-if scenarios. 9. Mental Self-Punishment I talk a lot about this in my book, The Self-Compassion Workbook For OCD. Mental self-punishment is a compulsion, a mental compulsion that is not talked about enough. One is criticizing, withholding pleasure, harshly disciplining yourself for your obsessions or even the compulsions that you’ve done. Often, we do this as a compulsion, meaning we think that if we punish ourselves, that will prevent us from having the obsession or the compulsion in the future. The fact here is beating yourself up actually doesn’t reduce your chances of having thoughts and feelings and sensations and behaviors or urges. But that is why we do them. It’s to catch when you are engaging in criticizing or withholding or punishing compulsions. 10. Mental Comparison Again, not a very common use of compulsions, but this is one I like to talk about a lot. Most of my patients with OCD and with anxiety will say that they know for certain that they compare more than their friends and family members who do not have anxiety disorders. I’ve put it here just so that you can catch when you are engaging in mental comparison, which is comparing your own life with other people’s life, or comparing your own life with the idea that you thought you should have had for your life. So, an idea of how your life was supposed to be. This is a compulsive behavior because it’s done again to reduce or remove a feeling or a sensation or a discomfort of anxiety or uncertainty you have around your current situation. It’s really important to catch that as well because there’s a lot of damage that can be done from comparing a lot with other people or from a fantasy that you had about the way your life should or shouldn’t look. Again, we will talk about this in episodes, particularly with Jonathan Grayson. He talks a lot about this one. I just wanted to add that one in as well. They’re the main top 10 mental compulsions. Again, I want to stress, these are not a conclusive list that is the be-all and end-all. A lot of clinicians may not agree and they may have different ways of conceptualizing them. That is entirely okay. I’m never going to pretend to be the knower of all things. That is just one way that we conceptualize it here at our center with our staff and our clients to help patients identify ways in which they’re behaving mentally. Something to think about here, though, is you may find some of your compulsions are in more than one category. You might say, “Well, I do mental comparison, but it’s also a self-punishment,” or “I do mental checking, but it’s also a form of reassurance.” That’s okay too. Don’t worry too much about what section it should be under. Again, it’s very fluid. We want you just to be able to document. It doesn’t matter what category it is particularly. I really just wanted this 101 for you to do an inventory and see, “Oh, wow, maybe I’m doing more compulsions than I thought.” Because sometimes they’re very habitual and we are doing them before we even know we’re doing them. I just want to keep reminding you guys it’s okay if it looks a little messy and it’s okay if your list is a little different. The main question here as we conclude is: How do I stop? Well, the beauty is I have the honor of introducing to you some of the absolute, most amazing therapists and specialists in the planet. I fully wholeheartedly agree with that. While I wish I could have done 20 people, I picked six people who I felt would bring a different perspective, who have such amazing wisdom to share with you on how to manage mental compulsions. Now, why did I invite more than one person? Because I have learned as a clinician and as a human being, there is not one way to treat something. When I first started CBT School, I was under the assumption that there is only one way to do it and it’s the right way or the wrong way. From there, I have really grown and matured into recognizing that what works for one person may not work for the next person. As we go through this series, I may be asking very, very similar questions to each person. You will be so amazed and in awe of the responses and how they bring about a small degree of nuance and a little flare of passion and some creativity of each person and bring in a different theme. I’m so honored to have these amazing human beings who are so kind to offer their time, to offer this series, and help you find what works for you. As you go through, I will continue reminding you, please keep asking yourself, would this work for me? Am I willing to try this? The truth is, all of them are doable for everybody, but you might find for your particular set of compulsions specific tools work better. So trial them, see what works, be gentle, experiment. Don’t give up. It may require multiple tries to really find some little win. Please, just listen, enjoy, take as many notes as you can, because literally, the wisdom that is dropped here is mind-blowing. I’ve been treating OCD for over a decade and I actually stopped a few things after I learned this and went straight to my staff and said, “We have to make a new plan. Let’s implement this. This is an amazing skill for our clients. Let’s make sure we do it.” Even I, I’m a student of some of these amazing, amazing people. How do I stop? Stay tuned, listen, learn, take notes, and most importantly, put it into practice. Apply. That’s where the real change happens. Now, before we finish, please do note this series should not replace professional healthcare. This or any product provided by CBT School should be used for education purposes only, so please take as much as you can. If you feel that you need more support, please reach out to a therapist in your area who can help you use these tools and maybe pick a part. Maybe there’s a few things that you need additional help with, and that is okay. Thank you, guys. I am so excited to share this with you. Have a wonderful day.

SUMMARY:  This episode addresses some common questions people have about anxiety and arousal. Oftentimes, we are too afraid to talk about anxiety and arousal, so I thought I would take this opportunity to address some of the questions you may have and take some of the stigma and shame out of discussing anxiety and how it impacts arousal, orgasm, intimacy, and sexual interactions. In This Episode: How anxiety and arousal impact each other (its a cycle) Arousal Non-Concordance and how it impacts people with anxiety and OCD How to take the shame out of arousal struggles Understanding why anxiety impacts orgasms and general intimacy Links To Things I Talk About: Article I wrote about OCD and Arousal Non-Concordance https://www.madeofmillions.com/articles/whats-going-ocd-arousal Come as You are By Emily Nagoski, PhD Come as You Are Workbook By Emily Nagoski, PhD ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com. CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors. Go to CBTschool.com to learn more. Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 281. Welcome back, everybody. How are you? It is a beautiful sunny day here in California. We’re actually in the middle of a heatwave. It is April when I’m recording this and it is crazy how hard it is, but I’m totally here for it. I’m liking it because I love summer. Talking about heat, let’s talk about anxiety and arousal today. Shall we? Did you get that little pun? I’m just kidding really. Today, we’re talking about anxiety and arousal. I don’t know why, but lately, I’m in the mood to talk about things that no one really wants to talk about or that we all want to talk about and we’re too afraid to talk about. I’m just going to go there. For some reason, I’m having this strong urge with the podcast to just talk about the things that I feel we’re not talking about enough. And several of my clients actually were asking like, “What resources do you have?” And I have a lot of books and things that I can give people. I was like, “All right, I’m going to talk about it more.” So, let’s do it together. Before we do that, let’s quickly do the review of the week. This one is from, let’s see, Jessrabon621. They said: “Amazing podcast. I absolutely love everything about this podcast. I could listen to Kimberley talk all day and her advice is absolutely amazing. I highly recommend this podcast to anyone struggling with anxiety or any other mental health professional that wants to learn more.” Thank you so much, Jess. This week’s “I did a hard thing” is from Anonymous and they say: “I learned it’s okay to fulfill my emotions and just allow my thoughts and it gave me a sense of peace. Learning self-compassion is my hard thing and I’m learning to face OCD and realize that it’s not my fault. I’m learning to manage and live my life for me like I deserve, and I refuse to let this take away my happiness.” This is just so good. I talk about heat. This is seriously on fire right here. I love it so much. The truth is self-compassion practice is probably my hard thing too. I think that me really learning how to stand up for myself, be there for myself, be tender with myself was just as hard as my eating disorder recovery and my anxiety recovery. I really appreciate Anonymous and how they’ve used self-compassion as their hard thing. Let’s get into the episode. Let me preface the episode by we’re talking about anxiety and arousal. If I could have one person on the podcast, it would be Emily Nagoski. I have been trying to get her on the podcast for a while. We will get her on eventually. However, she’s off doing amazing things. Amazing things. Netflix specials, podcasts, documentaries. She’s doing amazing things. So, hopefully, one day. But until then, I want to really highlight her as the genius behind a lot of these concepts. Emily Nagoski is a doctor, a psychology doctor. She is a sex educator. She has written two amazing books. Well, actually, three or four. But the one I’m referring to today is Come as You Are. It’s an amazing book. But I’m actually in my hand holding the Come as You Are Workbook. I strongly encourage you after you listen to this podcast episode to go and order that book. It is amazing. It’s got tons of activities. It might feel weird to have the book. You can get it on Kindle if you want to have it be hidden, but it’s so filled with amazing information. I’m going to try and give you the pieces that I really want you to take away. If you want more, by all means, go and get the workbook. The workbook is called The Come as You Are Workbook: A Practical Guide to the Science of Sex. The reason I love it is because it’s so helpful for those who have anxiety. It’s like she’s speaking directly to us. She’s like, it’s so helpful to have this context. Here’s the thing I want you to consider starting off. A lot of people who have anxiety report struggles with arousal. We’re going to talk about two different struggles that are the highlight of today. Either you have no arousal because of your anxiety, or you’re having arousal at particular times that concern you and confuse you and alarm you. You could be one or both of those camps. So let’s first talk about those who are struggling with arousal in terms of getting aroused. So the thing I want you to think about is commonly-- and this is true for any mental health issue too, it’s true for depression, anxiety disorders, eating disorders, dissociative disorders, all of them really. But the thing I want you to remember, no matter who you are and what your experience is, even if you have a really healthy experience of your own sexual arousal and you’re feeling fine about it, we all have what’s called inhibitors and exciters. Here is an example. An inhibitor is something that inhibits your arousal. An exciter is something that excites your arousal. Now you’re probably already feeling a ton of judgment here like, “I shouldn’t be aroused by this and I should be aroused by this. What if I’m aroused by this? And I shouldn’t be,” and so forth. I want us to take all the judgment out of this and just look at the content of what inhibits our arousal or excites our arousal. Because sometimes, and I’ll talk about this more, sometimes it’s for reasons that don’t make a lot of sense and that’s okay. Let’s talk about an inhibitor, something that pumps the brakes on arousal or pleasure. It could be either. There’s exciters, which are the things that really like the gas pedal. They just really bring on arousal, bring on pleasure, and so forth. We have the content. The content may be first mental or physical, and this includes your health, your physical health. For me, I know when I am struggling with POTS, arousal is just barely a thing. You’re just so wiped out and you’re so exhausted and your brain is foggy. It’s just like nothing. That would be, in my case, an inhibitor. I’m not going to talk about myself a lot here, but I was just using that as an example. You might say your anxiety or your obsession is an inhibitor. It pumps the brakes on arousal. It makes it go away. Worry is one. It could also be other physical health, like headaches or tummy aches, or as we said before, depression. It could be hormone imbalances, things like that. It’s all as important. Go and speak with your doctor. That’s super important. Make sure medically everything checks out if you’re noticing a dip or change in arousal that’s concerning you. The next one in terms of content that may either excite you or inhibit you is your relationship. If your relationship is going well, you may or may not have an increase in arousal depending on what turns you on. If your partner smells of a certain smell or stench that you don’t like, that may pump the brakes. But if they smell a certain way that you do really like and really is arousing to you, that may excite your arousal. It could also be the vibe of the relationship. A lot of people said at the beginning of COVID, there was a lot of fear. That was really, really strong on the brakes. But then all of a sudden, no one had anything to do and there was all this spare time. All of a sudden, the vibe is like, that’s what’s happening. Now, this could be true for people who are in any partnership or it could be just you on your own too. There are things that will excite you and inhibit your arousal if you’re not in a relationship as well, and that’s totally fine. This is for all relationships. There’s no specific kind. Setting is another thing that may pump the brakes or hit the gas for arousal, meaning certain places, certain rooms, certain events. Did your partner do something that turned you on? Going back to physical, it could also depend on your menstrual cycle. People have different levels of arousal depending on different stages of their menstrual cycle. I think the same is true for men, but I don’t actually have a lot of research on that, but I’m sure there are some hormonal impacts on men as well. There’s also ludic factors which are like fantasy. Whether you have a really strong imagination, that either pumps the brakes or puts the gas pedal in terms of arousal. It could be like where you’re being touched. Sometimes there’s certain areas of your body that will set off either the gas pedal or the brakes. It could be certain foreplay. Really what I’m trying to get at here isn’t breaking it down according to the workbook, but there’s so many factors that may influence your arousal. Another one is environmental and cultural and shame. If arousal and the whole concept of sex is shamed or is looked down on, or people have a certain opinion about your sexual orientation, that too can impact your gas pedal and your brakes pedal. So, I want you to explore this, not from a place of pulling it apart really aggressively and critically, but really curiously and check in for yourself, what arouses me? What presses my brakes? What presses my gas? And just start to get to know that. Again, in the workbook, there’s tons of worksheets for this, but you could also just consider this on your own. Write it down on your own, be aware over the next several days or weeks, just jot down in a journal what you’re noticing. Now, before we move on, we’ve talked about a lot of people who are struggling with arousal, and they’ve got a lot of inhibitors and brake pushing. There are the other camp who have a lot of gas pedal pushing. I speak here directly to the folks who have sexual obsessions because often if you have sexual obsessions, the fact that your sexual obsession is sexual in nature may be what sets the gas pedal off, and all of a sudden, you have arousal for reasons that you don’t understand, that don’t make sense to you, or maybe go against your values. I’ve got a quote that I took from the book and from the workbook of Emily Nagoski. Again, none of this is my personal stuff. I’m quoting her and citing her throughout this whole podcast. She says, “Bodies do not say yes or no. They say sex-related or not sex-related.” Let me say it again. “Bodies do not say yes or no. They say sex-related or not sex-related.” This is where I want you to consider, and I’ve experienced this myself, is just because something arouses you doesn’t mean it brings you pleasure. Main point. We’ve got to pull that apart. Culture has led us to believe that if you feel some groinal response to something, you must love it and want more of it. An example of this is for people with sexual obsessions, maybe they have OCD or some other anxiety disorder, and they have an intrusive thought about a baby or an animal. Bestiality is another very common obsession with OCD or could be just about a person. It could be just about a person that you see in the grocery store. When you have a thought that is sex-related, sometimes because the context of it is that it’s sex-related, your body may get aroused. Our job, particularly if you have OCD, is not to try and figure out what that means. It’s not to try and resolve like, does that mean I like it? Does that mean I’m a terrible person? What does that mean? I want you to understand the science here to help you understand your arousal, to help you understand how you can now shift your perspective towards your body and your mind and the pleasure that you experience in the area of sexuality. Again, the body doesn’t say yes or no, they say it’s either sex-related or not sex-related. Here’s the funny thing, and I’ve done this experiment with my patients before, is if you look at a lamp post or it could be anything, you could look at the pencil you’re holding and then you bring to mind a sexual experience, you may notice arousal. Again, it doesn’t mean that you’re now aroused by pencils or pens. It’s that it was labeled as sex-related, so often your brain will naturally press the accelerator. That’s often how I educate people, particularly who are having arousal that concerns it. It’s the same for a lot of people who have sexual trauma. They maybe are really concerned about the fact that they do have arousal around a memory or something. And then that concerns them, what does that mean about me? And the thing to remember too is it’s not your body saying yes or no, it’s your body saying sex-related or not sex-related. It’s important to just help remind yourself of that so that you’re not responding to the content so much and getting caught up in the compulsive behaviors. A lot of my patients in the past have reported, particularly during times when they’re stressed, their anxiety is really high, life is difficult, any of this content we went through, is they may actually have a hard time being aroused at all. Some people have reported not getting an erection and then it completely going for reasons they don’t understand. I think here we want to practice again non-Judgment. Instead, move to curiosity. There’s probably some content that impacted that, which is again, very, very, normal. this is why when I’m talking with patients – I’ve done episodes on this in the past, and we’ve in fact had sex therapists on the podcast in the past – is they’ve said, if you’ve lost arousal, it doesn’t mean you give up. It doesn’t mean you say, “Oh, well, that’s that.” What you do is you move your attention to the content that pumps the gas. When I mean content, it’s like touch, smell, the relationship, the vibe, being in touch with your body, bringing your attention to the dance that you’re doing, whether it’s with a partner or by yourself, or in whatever means that works for you. You can bring that back. There’s another amazing book called Better Sex Through Mindfulness, and it talks a lot about bringing your attention to one or two sensations. Touch, smell being two really, really great ones. Again, if your goal is to be aroused, you might find it’s very hard to be aroused because the context of that is pressure. I don’t know about you, but I don’t really find pressure arousing. Some may, and again, this is where I want this to be completely judgment-free. There’s literally no right and wrong. But pressure is usually not that arousing. Pressure is not that pleasurable in many cases, particularly when it’s forceful and it feels like you have to perform a certain way. Again, some people are at their best in performance mode, but I want to just remind you, the more pressure you put on yourself on this idea of ending it well is probably going to make some anxiety. Same with test anxiety. The more pressure you put on yourself to get an A, the more you’re likely to spin out with anxiety. It’s really no different. So, here is where I want you to catch and ask yourself, is the pressure I put on myself or is the agenda I put on myself actually pumping the brakes for me when it comes to arousal? Is me trying not to have a thought actually in the context of that, does that actually pump the brakes? Because I know you’re trying not to have the thought so that you can be intimate in that moment and engaged in pleasure. But the act of trying not to have the thought can actually pump the brakes. I hope that makes sense. I want you to get really close to understanding what’s going on for you. Everyone is different. Some things will pump the brakes, some things will pump the accelerator. A lot of the times, thought suppression pumps the brakes. A lot of the times, beating yourself up pumps the brakes. A lot of the time, the more goal, like I have to do it this way, that often pumps the brakes. So, keep an eye out for that. Engage in the exciters and get really mindful and present. A couple of things here. We’ve talked about erections, that’s for people who struggle with that. It’s also true for women or men with lubrication. Some people get really upset about the fact that there may or may not be a ton of lubrication. Again, we’ve been misled to believe that if you’re not lubricated, you mustn’t be aroused or that you mustn’t want this thing, or that there must be something wrong with you, and that is entirely true. A lot of women, when we study them, they may be really engaged and their gas pedal is going for it, but there may be no lubrication. And it doesn’t mean something is wrong. In those cases, often a sex therapist or a sex educator will encourage you to use lubrication, a lubricant. Again, some people, I’ve talked to clients and they’re so ashamed of that. But I think it’s important to recognize that that’s just because somebody taught us that, and sadly, it’s a lot to do with patriarchy and that it was pushed on women in particular that that meant they’re like a good woman if they’re really lubricated. And that’s not true. That’s just fake, false. No science. It has no basis in reality. Now we’ve talked about lubrication. We’ve talked about erection. Same for orgasm. Some people get really frustrated and disheartened that they can’t reach orgasm. If for any reason you are struggling with this, please, I urge you, go and see a sex therapist. They are the most highly trained therapists. They are so sensitive and compassionate. They can talk with you about this and you can target the specific things you want to work on. But orgasm is another one. If you put pressure on yourself to get there, that pumps the brakes often. What I want you to do, and this is your homework, is don’t focus on arousal. Focus on pleasure. Focus on the thing that-- again, it’s really about being in connection with your partner or yourself. As soon as you put a list of to-dos with it is often when things go wrong. Just focus on being present as much as you can, and in the moment being aware of, ooh, move towards the exciters, the gas pedal things. Move away from the inhibitors. Be careful there. Again, for those of you who have anxiety, that doesn’t mean thought suppress. That doesn’t mean judge your thoughts because that in and of itself is an inhibitor often. I want to leave you with that. I’m going to in the future do a whole nother episode about talking more about this idea of arousal non-concordance, which is that quote I use like “The bodies don’t say yes or no, they say sex-related or not sex-related.” I’ll do more of that in the future. But for right now, I want it to be around you exploring your relationship with arousal, understanding it, but then putting your attention on pleasure. Being aware of both, being mindful of both. Most people I know that I’ve talked to about this-- and I’m not a sex therapist. Again, I’m getting all of this directly from the workbook, but most of the clients I’ve talked to about this and we’ve used some worksheets and so forth, they’ve said, when I put all the expectations away and I just focus on this touch and this body part and this smell and this kiss or this fantasy, or being really in touch with your own body, when I just make it as simple as that and I bring it down to just engaging in what feels good – sort of use it as like a north star. You just keep following. That feels good. Okay, that feels good. That doesn’t feel so great. I’ll move towards what feels good – is moving in that direction non-judgmentally and curiously that they’ve had the time of their lives. I really just want to give you that gift. Focus on pleasure. Focus on non-judgmentally and curiously, being aware of what’s current and present in your senses. That’s all I got for you for today. I think it’s enough. Do we agree? I think it’s enough. I could talk about this all day. To be honest, and I’ve said this so many times, if I had enough time, I would go back and I would become a sex therapist. It is a huge training. Sex therapists have the most intensive, extensive training and requirements. I would love to do it. But one day, I’ll probably do it when I’m 70. And that will be awesome. I’ll be down for that, for sure. I just love this content. Now, again, I want to be really clear. I’m not a sex therapist. I still have ones to learn. I still have. Even what we’ve covered today, there’s probably nuanced things that I could probably explain better. Again, which is why I’m going to stress to you, go and check out the book. I’m just here to try and get you-- I was thinking about this. Remember, I just recently did the episode on the three-day silent retreat and I was sitting in a meditation. I remember this so clearly. I’m just going to tell you this quick story. I was thinking. For some reason, my mind was a little scattered this day and something came over with me where I was like, “Wouldn’t it be wonderful if I didn’t just treat anxiety disorders, but I treated the person and the many problems that are associated with the anxiety disorder? Isn’t that a beautiful goal? Isn’t that so? Because it’s not just the anxiety, it’s the little tiny areas in our lives that it impacts.” That’s when I, out of me, as soon as I finished the meditation, I went on to my-- I have this organization board that I use online and it was arousal, let’s talk about pee and poop, which is one episode we recently did. Let’s talk about all the things because anxiety affects it all. We can make little changes in all these areas and little changes. Slowly, you get your life back. I hope this gives you a little bit of your sexual expression back, if I could put it into words. Maybe not expression, but just your relationship with your body and pleasure. I love you. Thank you for staying with me for this. This was brave work you’re doing. You probably had cringy moments. Hopefully not. Again, none of this is weird, wrong, bad. This is all human stuff. Finish up, again, do check out the book. Her name is Emily Nagoski. I’ll leave a link in the show notes. One day we’ll get her on. But in the meantime, I’ll hopefully just give you the science that she’s so beautifully given us. Have a wonderful day. I’ll talk to you soon. See you next week. Please do leave a review. It helps me so much. If you have a few moments, I would love a review, an honest review from you. Have a good day.

In this week’s podcast episode, we are reflecting on the question, “Does anxiety make you need to pee or poop? Yes, you read that right! Today, we are talking ALL about how anxiety can cause frequent urination and the fear of peeing your pants. Have you found yourself getting anxious you might need to pee or poop in public which, in turn, makes you need to pee or poop in public? Bathroom emergencies are way more common than you think. I even share a story of how I, myself, had to handle the urgency to 🏃🏼‍♀️🏃🏿‍♂️ to the restroom. In This Episode: Why do we need to pee and poop when we are anxious? What causes the psychological need to urinate or defecate when anxious? How to stop anxiety Urination How to manage a fear of peeing your pants or pooping your pants How to use mindfulness and self-compassion when experiencing nervous pee syndrome Links To Things I Talk About: Overcoming Anxiety and Panic https://www.cbtschool.com/overcominganxiety ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com. CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors. Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 280. Welcome back, everybody. I am so thrilled to have you here with me again today. Today’s format is going to be a little different. I have fused the “I did the hard thing” with the question that we’re going to address today. Usually, I sit down to the microphone and I look at my screen and I think about what I want to talk about, and I just start talking about it. To be honest, that is how this show goes. It has always been how this show has gone. But a follower on Instagram reached out to me this week and posed a really great question. So, with her permission, I will anonymously invite you to listen to the question, and then we’re going to talk about some solutions. The reason I wanted to go word for word is I think you’re probably going to get what she’s saying, because I’ve been in this position. I know most of my clients have been in this position. It’s not the funniest thing to talk about. I mean, I love talking about it, but it’s not the funniest thing for you to talk about, or often people have a lot of shame and embarrassment around this topic. So, I wanted to just, let’s just talk about it. Now, the reason I say I love to talk about it is, you know probably from previous episodes, I commonly ask my clients pretty personal questions. And often questions are like, are you prioritizing time to pee and poop? Are you holding your pee and poop? My job is to ask the questions that people are often too afraid to bring up. I often ask some personal questions about sexual arousal and things like that, again, because I have been trained to understand there’s a lot of stigma and shame, and embarrassment around these topics. And so I try to de-stigmatize them and take the shame out of them by just addressing them because they’re normal human struggles that we have. As you may imagine, today, we’re talking about anxiety and pee and poop, and how anxiety can often make us feel like we urgently need to pee or/and poop. That’s the topic of today. I’m going to read you this. It’s a two-part question. I’m going to address them separately, but all from the same situation. It said: “Kim, I hope you are well. I was reading your post yesterday about the hardest part of facing your fear.” To give you some backstory, I did a post on what the hardest things about facing fears are. I posed this question to Instagram and everyone wrote in. And using the results of what everyone wrote in, I created a post. And number seven was physical symptoms, especially bowel issues, and it really resonated with me. Why do we need to pee and poop when we are anxious? “You have said before that when you get feelings of discomfort, to just sit with it and do nothing.” That’s a common theme I talk about, is if you have discomfort, do nothing at all. You just sit with it. “But when it comes to bowel issues or needing to urinate due to anxiety, I get confused at what to do. Should I be sitting with it or going to the loo because that’s what my body needs? There are sort of two parts to my anxiety. With this, I’ll give you an example.” She said, “This weekend, I’m going to a christening and I get anxious for these types of events, like christenings, weddings, theater, anywhere where there is lots of people and they sit together in a certain way. I feel anxious about needing to go to the bathroom. It’s almost like I’m anxious of the symptom of anxiety.” Yes. Now this is exactly what it is like for so many people, and it’s a really great question. Here is my response. Naturally, it’s a normal part of the human instinct to need to pee and poop when you’re anxious. Hundreds of thousands of years ago, when we were faced with danger or some kind of threat, in order to get away from that threat, usually you needed to be able to run many, many, many miles in a very short period of time. Now, we have cars and planes to get away from danger, or we have technology to help us to get away from danger. But back we needed to run that long-distance and exert a lot of energy. And so naturally, our bodies get rid of weight and waste so that you can be prepared to run a long distance away from the threat. Often the easiest way to get rid of that waste and weight is to defecate (to go poop) and to urinate, which is to go pee, or in some cases, throw up. Some people when they’re anxious, because their brain has detected danger, whether there’s danger or not, you may do one of those three things. That’s a very, very normal approach to the fight, flight, and freeze. So, in this case, let’s say your brain has set off a false alarm and is saying there’s going to be lots of people there, and what if you need to pee and poop? So now you’re afraid of the symptom of anxiety like they’ve asked. What do you do? So here is my answer to that. When we have any symptoms of anxiety – increase in heart rate, sweating, lots of racing, thoughts, it could be tummy ache, it could be the need to urinate – yeah, we do want to practice the art of sitting with it, meaning tolerating it without reacting to it in an aversive way, meaning trying to resist it, make it go away, how can we remove this discomfort from our life? When we do that, we get into a cycle where you’re constantly trying to get rid of discomfort and that keeps you stuck. In this situation, yeah. If you have a slight urge to urinate or to go to the bathroom, if you’re able to, do try to tolerate that discomfort. However, if there’s a strong urge to go to the bathroom, there is absolutely nothing wrong with going to the bathroom. What I would say to you is it depends. The answer is it depends, and it’s a very personal one. I will tell you a story personally. I know it was probably TMI, but I remember when I was becoming an American citizen, I was overwhelmingly anxious about this situation. I was afraid of everything. I was afraid of the test. I was really emotional about becoming an American. I felt like I was denouncing my country. I was so anxious about the security process. I was so afraid that I was going to mess up and get into some legal trouble, even though I’d done everything by the book. It was really, really overwhelming. The minute I got in line, which were these thousands of people in line, I needed to go to the bathroom, like right now, it had to happen. So, in that instance, yes, I’m going to ask somebody where the bathroom is and I’m going to go to the bathroom. So, I did okay. TMI, but we’re talking about it. Everybody pees and poops, so I’m not embarrassed. Now, as soon as I got back in line, I lost my spot. I was at the back of the line again. My husband was with me. “Uh-oh, I need to go to the bathroom again.” I already know, I’ve probably dropped a lot of that weight. My brain thinks that there’s a major danger when there’s not. So, my job then is I could have easily gotten out of line again to try and get rid of that discomfort and that fear and that uncomfortableness in my stomach. But because I knew I’d already gone, my job was, I really need to get into this security building as a government building. I can’t keep getting out of line. My work then was to practice seeing if I could just hold that feeling. Now I’m not here at all saying or suggesting that you should hold for long periods of time or even to be where you’re tolerating an experience of pain. Again, it depends. The answer is, it depends. If you’ve already gone, can you hold on? If let’s say you’re holding on and you’re like, “Oh no, it’s definitely coming, I need to go,” by all means, go. That’s not a compulsion. It’s just you listening to your body. It’s you giving yourself permission to just go with the flow and again, it’s a wonderful exposure of giving your body’s permission to run the show. How to stop Anxiety Urination? I think the answer is, listen to your body, see what you can do. Again, we always want to be experimenting with tolerating discomfort for long periods or as long as you can. Bit for no reason should you hold for long periods of time and put yourself in additional pain. Now that being said, if you’re going to the bathroom, just to remove your anxiety about going to the bathroom, or you’re going to the bathroom to remove your anxiety of whether or not you will pee or poop your pants, that’s a different story. If you’re going to the bathroom to relieve anxiety, not physical, like actual urgency to go to the bathroom, well then yes, you’re giving into fear. We don’t want to let fear win, particularly when your brain is telling us there’s danger when there’s not. A perfect example, I’m becoming a citizen. I have to take a test. There’s no real danger. The worst thing that could happen is I fail the test or I don’t bring a paper or something. In this case for the ceremony, the worst thing that could happen is you would need to go to the bathroom, right? Or even if you maybe-- again, the worst thing that could happen is you would have to go. But if fear is saying, “Oh no, no, there is really bad possible, maybe possible maybes,” because fear does that, it always gives you the possible maybes – then no, we would not go to the bathroom just to relieve anxiety. If a lot of people, specifically those with panic disorder, they are very, very afraid of the sensations of anxiety. So, your job is actually, if that’s the case, to practice leaning in and having those sensations, tolerating those sensations. Or if you’re going to do exposure and response prevention, even better, you would purposely try to create the scenario so that you could simulate the anxiety and practice tolerating it that way. So, my answer, I know, isn’t direct. It is, it depends. But when it does come to fear, it’s always going to be the same – do not let fear make your choices. Do no. The next part of the question, I think, is another part of this, which I think is really important. So, they said, the second part is, “If I do need it and I have to leave the room during the ceremony, I wonder what people will think of me. I feel like I’m being a disruption. Also, if I have to move past anyone, I sit down, I feel like a nuisance. And then too, so often at the end of the seat--” so they sit at the end of the seat, excuse me, just in case. “Some of my compulsions, safety behaviors around this are needing to know where the nearest toilet is, going multiple times beforehand. Or I may do a certain number of pelvic floor squeezes whilst in the toilet.” They said, “Sorry if this is a long message, I just wanted to explain fully. I think the main thing I’m asking you is, should I be sitting with the feeling or not? If you do not see this up, the rest is just saying about the message.” There we go. I think there’s so much great opportunity here for exposure and really willingness to be uncomfortable. The first thing is, everyone pees and poops. There is no shame in needing to go to the bathroom. I have a lot of clients who, when they’re anxious, they got to go. They got to go. It’s not anxiety. They’ve got to go to the bathroom or there’s going to be an accident. Not the fear. It’s like, “No, it’s actually coming.” If that’s the case, your job is to give yourself permission to be a human with anxiety and to be gentle and compassionate toward yourself that yes, sometimes people need to leave ceremonies. If someone behind you is judging you for needing to leave, that is a full reflection on them. It means nothing about you. Human beings are allowed to come and go as they please. If they need to pee and poop, that is their right. What I would encourage you to do is, this is like a social anxiety sort of talk, and we’ve got some podcasts on social anxiety, but your job is to give other people permission to judge us and do nothing about it. Do nothing. Do nothing about their judgment, because their judgment is a full reflection of them and their beliefs, not of us. The next part is they’ve gone over a ton of safety behaviors – checking the toilet, going multiple times. I would strongly-- if it were my client and you guys do what’s right for you always, take what you need, leave the rest. But if it were my client or if it were myself, I would strongly suggest other than otherwise not doing these behaviors. We don’t want to be doing behaviors. This goes for every topic. We don’t want to be doing behaviors just in case, that just in case behaviors keep us stuck in a cycle of anxiety, that just in case behaviors validate your fear as if your fear is true and important and a fact. We don’t want to do that. We can’t do that because when we do that, we keep the fear cycling. So, I would actually encourage you to not check for bathrooms, not go to the bathroom before, unless of course you genuinely need to, not just because of fear. If for some reason you have the need, practice saying “I can have it.” If the feeling is the pressure is down in that bowel and that pelvic area, that won’t kill you either. I always think of when I’m on an airplane to Australia, you know what happens? You get on the plane, you put your bags away. You’re getting ready. And then they say, preparing for takeoff, the seatbelt light comes on, and then immediately you need to go pee. And you can’t get up. They won’t you, so you hold it. People hold it all the time. Again, we don’t want you to push you through pain, but you can hold it. Be really honest with yourself. Nothing terrible is going to happen. If it’s really urgent, of course, I mean, even on a plane, if you’re really going to pee or poop your pants, they’re going to let you stand up. They’re not going to make you sit in the chair. Try not to be doing these behaviors. Practice tolerating the discomfort of other people possibly judging you. One thing to keep in mind here too is when-- let’s say you go back to my story, I had to leave the line. I could have done a lot of mind reading, which is a cognitive distortion, which is going, “Oh, they think this and he thinks that, and she thinks that about me.” That’s all mind reading. You don’t actually know what they’re thinking. They might be thinking, what a beautiful dress you’re wearing, or they might be thinking, man, I can’t wait for this ceremony to be over. You have no idea, they might be thinking about something so different. So, it’s important that we also practice not mind reading what people think about us. There you have it. These urgencies to go are normal. Everyone pees and poops. That’s just the facts. It doesn’t matter whether you do it once a day or 20 times a day, depending on if you’re anxious. Give yourself to not be perfect. A lot of times, we also talk about when people are doing exposures or they’re having a panic attack, they’re like, “Ah, it’s not just the panic attack. I don’t want people to see me having a panic attack,” or “It’s not just the anxiety. I don’t want to have to cry in public.” The work here is you’re a human being. If you’re a human being, you won’t be perfect. If you’re holding yourself to a standard where you, number one, aren’t allowed to cry, you’re not allowed to pee, you’re not allowed to poop, you’re not allowed to disrupt other people, Well, that’s a lot of expectations you’re putting on yourself. That’s a lot of pressure that you just created in your head. No one else is expecting perfection from you. So, maybe adjust the expectations there as well. Now the last thing I will address, which isn’t specifically to the pee and the poop, is some people get a lot of gas when they’re anxious. They have a strong urgency to pass gas. This is very common for people who have irritable bowel syndrome, same with getting diarrhea or needing to pee or poo. This is very common. If you have IBS, please do speak with a doctor. Let them know that you’re struggling with this. There’s nothing to be ashamed of. They can, of course, diagnose you, make sure they maybe get you some help in those areas. Again, if you need to pass gas, no different. Humans pass gas. It’s not something to be completely ashamed of. Is it embarrassing? Yes, it is. But you do what you have to do. You just have to get through. I’ve heard so many people tell me stories of their most anxious moment being made more difficult because they had no choice, but to pass gas during that. And if that’s the case for you as well, again, I think any human who ridicules someone for needing to pass gas, which is such a human thing, I think we pass gas 17 times on average a day. Everyone, not select people, everyone, anyone who passed judgment on you for that is probably may want to step up their ability to be compassionate and empathic. Again, it’s not about you, it’s about them. So, be super, super gentle with yourself. I think I hit my limit of how many times I said pee and poop, and now we’ve added in pass gas and we’ve even used the “diarrhea” word, which I think is epic. I think I’ve checked all the boxes for today’s episode. So, I hope that it was helpful for you. I genuinely hope that it just dropped some of the anxiety and judgment you have about yourself in regards to the urgency to need to go and pee and poop. If I were to summarize it, I would say it’s very common to need to urinate, go to the bathroom or even pass gas. Lots of people have even diarrhea, very, very strong diarrhea. If that is the case for you, do what you need to do as best as you can. It’s okay if you need to go to the restroom. No problem. If you’re only going to reduce your anxiety about needing to go, I encourage you to try and challenge that some. Again, we do not want to give all of our power to fear. We actually want to ignore fear and give it none of our attention. If you can do that, you’re doing amazing hard work. I love you all so much. Thank you for holding space for me as we talk about all things, bowel-related and urination-related. Even though it’s uncomfortable, it is so important for us to be having these conversations. I hope again, it was helpful for you, and thank you for holding space for me as we talk about these things together. All right. I love you all. I hope you’re having an amazing, amazing week. I hope you’re being kind to yourself and really opening your heart to your own suffering instead of shutting it down because you’re suffering matters. It deserves to be held tenderly. It is a beautiful day to do hard things. I cannot finish an episode without saying it. I encourage you, if you’ve gotten this far in the episode, to practice the hard things as much as you can every single day. Have a wonderful day, everyone.

In todays podcast episode, together we do a self-compassion check in.  First, we address what is self-compassion and then, we check in on our needs.  Mindful Self-Compassion involves first, being aware of what we need and what needs tending to.  In this episode, we also walk through a self-compassion meditation together. In This Episode: What is Self-Compassion? What do I need? How can I give myself self-compassion right now? Self-compassion meditation. Links To Things I Talk About: https://read.amazon.com/kp/embed?asin=B08WGW9XCZ&preview=newtab&linkCode=kpe&ref_=cm_sw_r_kb_dp_XSDYJ2MCRJBYEFCPS5NF&tag=cbtschool-20 ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com. CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors. Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 279. Welcome back, everybody. Today on Your Anxiety Toolkit podcast, we are talking about self-compassion. We’re doing a self-compassion check-in. It’s been a little while since we’ve checked in on how are you doing with your self-compassion practice. Now, today, we have added a little meditation for you just to supercharge your self-compassion practice. That is my agenda for today. We haven’t done a ton of check-ins lately because life just seems to get away from us. For those of you who do not know, in 2020, I wrote a book called The Self-Compassion Workbook For OCD. It was the joy of life and the biggest challenge of my life business-wise. It was such a huge agenda to have on my plate just as 2020 and COVID breakthrough, but I’m so grateful it’s out. When it was released, I had a lot of stuff out about self-compassion. And then I haven’t checked in with you guys on how you’re doing. So that’s what today is about. Now, before we get into the episode, let’s do the “I did a hard thing” for the week. We always check-in and someone submits the thing that they’ve done that is hard, because what we like to say is “It’s a beautiful day to do hard things.” And today’s is from Anonymous. They said: “I’ve recently been diagnosed with OCD and struggled my whole life with anxiety. Unfortunately, until now I was never properly diagnosed until I was 45. I have started working with a new therapist and we are focusing on ERP. At first, I couldn’t even tell her about my fears and intrusive thoughts. I have harm OCD among other various categories. Now, we are doing imaginals around some of the things I never thought I could even address, and I’m so proud of myself.” I’m proud of you too. “It is changing my life. I cannot tell you how important it is to get a proper diagnosis and never give up. You will get better. You just have to get the right help and be willing to do the hard things.” Anonymous, you are giving me the chills. Now, for those of you who don’t have access – anonymous has access to a therapist – if you don’t have access to a therapist, we do have an online course called ERP School. An ERP School is an online course that will teach you how to practice ERP at home, in your pajamas, all the skills that you need to get you started. Now, it does require you to be self-motivated. But if you are self-motivated and you are ready to learn, head on over to CBTSchool.com and you can get all the information there. All right, let’s go over to the show. It’s self-compassion check-in time. WHAT IS SELF-COMPASSION? What is Self-Compassion? It means how have you been treating yourself? Remember, self-compassion is ultimately treating yourself with the same that you would treat somebody else. So, if somebody else came to you and said, “I’m struggling with A, B, and C,” what would you say to them? How would you treat them? How would you respond to them? How would your body language change? Would your voice lower? Would your voice soften? Would you give them a hug if that was appropriate? Would you soften your eyes and let them know that everything was going to be okay, and that you had their back unconditionally? That is how you would treat yourself. So my question is, how are you doing with this? I want you to check in regularly, way more regularly than we are here today. But I want you to check in with yourself preferably every day or multiple times a day and ask yourself, how am I doing? And then we’re going to move into, and I know a lot of you remember this from previous episodes, but I want you to ask yourself the golden self-compassion question, which is, what do I need right now? What do I need? Let’s do this together. I want you to find a comfortable place. If you’re driving, please do not close your eyes. You may listen along. If you’re not driving, you may close your eyes. You may rest your shoulders. You may bring a gentle smile to your face. And I want you just to slowly bring your attention to your breath. And when I say breath, I don’t mean the physical rise and fall of your chest. I want you to bring your attention to the air that is going in and out of your body. You breathe in... The air goes into your lungs, replenishes, restores you. And then you breathe out air. And I want you to become familiar with this air as it enters your body and exits your body, replenishing you, supporting you, feeding you. And as you bring your attention to this air, I want you to gently slowly drop down into where you are and ask yourself, what is it that I need right now? If you notice being bombarded by many, many thoughts, that’s okay. Just tend to one at a time. Each one of them, each one of those thoughts gets a moment. And you are going to use your wise mind to decide which ones you’re going to tend to. As you ask yourself “What do I need right now,” you may notice your mind sharing with you, “I need rest. I need a moment. I need to laugh. I need food. I need to pee. I need water. I need to be kind to myself.” And take one at a time and take stock in acknowledging nonjudgmentally that that’s what you need. Nonjudgmentally, which means we’re not going to judge that we need it. We’re not going to treat ourselves poorly because we need it. We’re just going to acknowledge that’s what we need. Now, if you notice that your mind is coming up with other things like criticisms, a list of things to do, it might be telling you, you should be doing something different and more productive, they’re the thoughts that we maybe don’t tend to because you’re tending to those all day. Now is the time to check in for what you need. Say, “I’ll be right with you later, thoughts. Right now, it’s time to nourish me, to fill my cup so I can go and do those things later.” We breathe in air... And we breathe out air. Now we bring our attention to those needs and ask ourselves, is there anything we can tend to right now? Maybe the softening of your shoulders. Maybe to let go of the to-do list. Maybe to celebrate the wins that you’ve had today or yesterday or whenever. What do I need? Sometimes it’s to cry. Sometimes it’s to feel our feelings. Sometimes it’s to validate our own feelings and that’s our job. That’s our job. What a wonderful opportunity and a wonderful job we have, which is to be our first line of support and care, that we deserve that. Maybe you’re surprised by what’s showing up in what you need. Maybe you’re surprised that you need something and it’s something that you don’t usually need. That’s okay, too. Just be curious and open to that voice inside you. Now, if you’re struggling to identify what you need, I want you to just gently remind yourself that the wish to be compassionate towards yourself is self-compassion enough. If it doesn’t land and you don’t have this powerful experience or gentle experience, and for you, it’s actually quite gritty and edgy, that’s okay. Just the intention of being here and asking is so wonderful. I often think of my husband. If I went to him and he was struggling, and I said, “Is there anything I can do to support you?” he may not be ready to ask for my help. But just me offering it, the intention of being there to support means so much. And we can be that for ourselves. So again, take a deep breath in... And breathe out. And just give it one last time. Is there anything you can offer me in how I could support me? Which is you. Or is there anything you need? You might even offer it to your body parts if there’s particular areas struggling. Mind, what do you need? Tummy, what do you need? Foot, what do you need? Neck, what do you need? Now, as you’ve done this, I hope that you have been kind and non-judgmental, and non-critical. But if you are, I still want you to see this as a win. The check-ins can be so rich even when they’re bumpy. We’re going to slowly open our eyes... We’re going to bring our awareness to what’s around us and come grounded into the present again. And I hope that it’s the check-in you needed. I hope that you got to explore your needs, which are important, and then nothing to be embarrassed or ashamed of. It’s okay to have needs. In fact, it’s normal and natural and healthy to have needs. We all have them. Have a wonderful day, everybody. I hope you are doing well. Before we finish up, we are going to do the review of the week. This one is from Jessrabon621, and it says: “Amazing podcast! I absolutely love everything about this podcast! I could listen to Kimberley talk all day and her advice is absolutely amazing. I highly recommend this podcast for anyone struggling with anxiety or any mental health professional that wants to learn more.” Thank you so much, Jessrabon621. I love, love, love, love your reviews. Please do leave a review. I am trying to get to a thousand reviews and I will be giving away a free pair of Beats headphones to one lucky winner who leaves a review. Have a wonderful day, everybody. And I will see you all next week.

In this week’s episode of Your Anxiety Toolkit Podcast, I share what I learned from my 3-day silent meditation retreat. This 3-day silent meditation retreat was rough, I won’t lie.  I had to ride many highs and lows, so I wanted to share them with you. Links To Things I Talk About: Tara Brach Silent Meditation Retreat home schedule https://www.tarabrach.com/create-home-retreat/ Mindfulness Book https://www.amazon.com/ ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com. CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors. Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 178. Welcome back, everybody. I am so thrilled to be here with you today. I recently got back from a three-day silent retreat. I was by myself for the entire three days. It was a three-day silent retreat. I have done silent retreats in the past at Buddhist monasteries and Buddhist retreat centers. This is the first time I’ve done it on my own, and I followed the Tara Brach self-retreat website. I will leave the notes in the show notes so that you can check that out. It was amazing. I can’t lie. I had so many mind-blowing moments and I want to share with you each and every single one. I’m going to give you the cliff notes version. Otherwise, I would have you here for days on end. But I am so excited to share that with you. Before we do that, of course, you know we always do the “I did a hard thing.” This is a segment where someone can write in, submit the hard thing they’ve done. This one is by Mgwolfie1992, and they’ve said: “I have OCD and ASD. Certain shirts do not feel right. Before starting ERP, when I put on a shirt that’s uncomfortable, I immediately take it off, which was making me late for work. After starting ERP, I have slowly worked my way up to wearing and keeping that uncomfortable shirt on for 12 minutes.” Mgwolfie1992, this is just you doing the work. I’m so, so impressed. This is exactly what it’s like for everybody listening or watching today, is it is about just small baby increments and getting yourself higher and higher and a little more difficult, a little more difficult. I’m so impressed with the work that you’re doing. This is just so incredibly powerful and rewarding, and I hope that you keep going. Let’s talk about what I learned from my three-day silent retreat. Just to give you a setup, I rented through Airbnb a small little cabin in the depths of Topanga, which is very close to where I live in Los Angeles. I was following the Tara Brach home retreat that she created at the beginning of COVID. Now, when COVID hit, I so desperately wanted to do this, but I was in the middle of writing The Self-Compassion Workbook For OCD, and so I did not have time or the bandwidth to really go and really be with myself. I just had so much going on. As you probably remember, the world just felt so scary and no one knew what was happening. So I definitely wasn’t ready to do something at that time. After several years or even months at this point where I feel like I’ve really, really prioritized my mental health and my medical health, I was finally in a place where I just felt like I needed some time to really go and let go of some things. I could be doing this at home. I could do this every day and I have since I returned, but I really felt that I needed these three days to do a deep dive into really some things that I had been working through having a medical illness, a chronic illness. I have postural orthostatic tachycardia syndrome, really coming down out of the pandemic and so forth. So, I really felt like I just needed this time to really not have the kids around and just drop down in and do that really hard work. I took with me a journal. I took with me a book called Mindfulness by Joseph Goldstein. I strongly recommend that you try it. It is very heavy on Buddhist philosophy, but it is such an important book about mindfulness. And so to start off, the thing that I learned the most was I needed so desperately to go back to basics. Everything felt so complex – everything I was teaching, everything I was doing in therapy, the practices of my own. It just felt like there were so many spinning parts. When I got there, I just dropped down to like, “Kimberley, let’s go back to the basics.” So I wanted to share with you what those basics were. Number one, I went right back to the core of mindfulness, which was mostly me. The main agenda was to observe what showed up instead of being in reaction to it. Here, when life is so busy and chaotic and so many things happening at once, it’s really hard to be an observer. I think I have lost my ability to do that. And so once I got there, I promised myself and my friends that I would not be contacting them, that I would have just one part of the day where I would text people back. I would check my phone, make sure everybody was okay and my clients were okay and my staff were okay. I would respond back, but very limited. And that throughout the day, if I felt the need to pick up my phone, or I felt the need to call, or I felt the need that I needed to talk to someone, that I had to stay in that feeling. And that’s why I really chose the silent retreat. I wanted to create an environment where I couldn’t rely on anybody except myself, and that no matter what I felt I had to hang on and I had to ride it out and I wanted to really drop down a little deeper and really explore what was going on for me. Now, the thing that was most profound is the first day was excruciating. I mean, painful. I had every emotion under the sun. At one point at the evening, when I told my husband I would call after me waiting through these emotions all day, I did text and he asked how I was doing, and I said, “This is so hard. I don’t even want to be here.” I didn’t ask for his advice, but he did say via text, “Just keep going.” So, I did. Of course, I did. But what was so fascinating to me, and one thing I really learned about myself, and I’m wondering if you do the same thing, is I had gone into this silent retreat not exhausted. Usually, by the time I take a break, I am so wiped out that I’m completely like starfish on the bed, completely out of it. This was really interesting because, for the first time, I wasn’t exhausted, and on the first day, I kept having the thought, “You don’t deserve this.” I kept thinking, this is ridiculous. People are at war. There is floods in my home country. So many people have it worse than me. “You don’t deserve this, Kimberley. This is unnecessary. This is actually very silly of you to have asked to do this three-day silent retreat.” I was so shocked at those thoughts. Now, here is where the observing skill was so helpful for me. Instead of having that thought and then going, “Yeah, you’re right,” and then beating myself up or maybe even going home or feeling guilty or punishing myself, I just observed it and went, “Huh, that’s interesting. I’m having thoughts that this is selfish,” or “I’m having thoughts that this was silly.” Instead of fusing with those thoughts, I just observed them. And I also observed the feeling and going, “Uh-huh, I feel guilty,” or “I feel selfish.” But instead of saying, “I am guilty and I am selfish,” I didn’t over-identify with those emotions, which is another mindfulness skill that I wanted to go back to the basics, is how much we over-identify with the thoughts we have. If something is uncomfortable, we go, “Oh, that means it must have to go away, and this is wrong. I’m wrong and I shouldn’t be feeling this way.” Instead, I just sat in it and I had this-- I want you to just imagine me. If you’re listening to the podcast, you won’t be able to see me. But if you’re watching me on video right now, I just had my head and kept nodding and smiling, like I was almost dancing with my head and just going, “Uh-hmm, yes, brain, I hear you. Yes, mind, I can hear what you’re saying, but I’m not going to connect with that. I’m going to allow it. I’m not going to push it away, but I’m just going to observe it.” Oh my gosh, I had so many breakthroughs, one after or the other, of just catching these rules and beliefs I have and how invasive they are and how reactive I am to them. Even though I’ve practiced this for years, I just knew I needed this time to let go of all of this. Now the second thing I learned besides really dropping down into the basics and observing everything and not identifying was, in the Mindfulness book that I was reading, and I had it as my agenda to read it, is I had to practice going back to accepting impermanence. Now impermanence is a Buddhist concept that they talk about a lot. Basically, what it means is that this is temporary. As I sat and I meditated so much on this three-day retreat, not so much the second day, but the first and the third day were really good meditation days. I sat on my meditation seat and all I would do is just try to stay in the moment and notice the impermanence. So, as a satisfying feeling showed up, I would just notice that this is temporary, that it will go, and I’m not going to cling to it. As an uncomfortable thought showed up, I said to myself, “This is temporary. I’m not going to cling to it. I’m not going to push it away.” Everything that showed up, I just kept going, “This is temporary. This is temporary.” Some people would probably argue that that’s a problem. Like, why would you push away good thoughts? But I had to keep reminding myself that my attachment to good is what creates a lot of my suffering. A lot about impermanence is also looking at the fact that everything is temporary. In this beautiful rental that I had was these beautiful windows. I would sit right at the edge of the window and I would overlook this beautiful creek, all these trees, and leaves. A part of the meditation that I had practiced and I have practiced for many years is to meditate on impermanence, which is to sit and look. This time my eyes were open, and everything I see, I contemplated how temporary it is. If it was a leaf that is just newly budded, I would imagine it fully coming into bloom, falling off the tree, and then completely breaking down into the ground where it was mud muddy and sludgy and yucky. And then looking at, let’s say the wood and going, “Yes, that too will break down over time.” Looking at my hand and my face and my body and imagining me too once was very youthful and now looking slightly older and acknowledging that that too is impermanence and that I too will die. From that meditation, I cried. I sobbed actually, and I let go of a lot of beliefs and values I was hanging onto that really aren’t my values in terms of me having to stay young, that me having to stay liked by people, that I had to hold onto this idea. Instead, I was actually moving towards saying, “It’s okay. You can like me or hate me, because you liking me may actually be temporary. You may only need me for a period in your life. And then you may not need me.” And then again, observing what showed up for me and letting go of that too. It was just this massive cycle and it kept going and going. I would keep hitting these same things that I needed to let go of and learn and practice like observing and recognizing that things are temporary and that it doesn’t mean anything about me. I know this may actually be a lot, but I can’t tell you how powerful it was. It was such a beautiful experience of letting go, of catching where I’m attached to things, and then letting go of that as well. I’m not saying that because I let them go they don’t bother me anymore. I am now in a cycle and it got me going and now allowing that letting go to be more automatic. Whereas before, I used to joke with my husband and my best friend. When they’d make a suggestion to me, like maybe they would offer me some advice, I would respond a little defensively. And that’s one of the reasons I really wanted this three-day retreat, is I could feel the tension in me on how inflexible I was and how I was being stubborn and holding tight on things. I knew that’s not what my core nature is. I’m going to keep this short and I’ll give you one more thing that I learned. And this thing has probably been the most beautiful lesson I’ve ever learned. It’s been so synchronistic because so many things have really reinforced things since I’ve returned. This is the idea of independence versus interdependence. I think since I recovered from my eating disorder, I have made it my goal to be independent. I don’t want to rely on people. I don’t want to ask them for help. I want to be a strong woman. I want to be a powerful human. I want to be peaceful in myself. I want to be self-sustaining, if that makes sense. This has been such amazing growth for me. I have learned so much and really learned my own strength because I made a deal with myself that I would always be my first person. Through that, I have learned to trust myself, to rely on myself, that I’m stronger than I thought. It’s a big reason why I say it’s a beautiful day to do hard things, is because I’ve practiced that my whole life. But I was reading something from one of these, in the Tara Brach retreat, she has a lot of retreat talks and I was listening to some of these Dharma talks. One of them was that we’re interdependent. Even though we’re independent, we also need other people. And that actually through being interdependent is where we build community. It made me realize that I think I’ve swung too far in the independence. If there was a pendulum swinging, I’d swung too far in the independence and I needed to recognize how much I need other people. I need my friends, I need my husband more, I need my children more in different areas, that I need to ask for help more. It doesn’t mean I have to pay people. It doesn’t mean they owe me. It doesn’t mean I now fully swung the other direction into always being dependent. It’s that I’ve acknowledged that change happens more on the local level. Since I created this podcast and I have an Instagram profile, I think my mind had very much gone to a large scale. Like, I have to make a huge difference, that I could make a huge difference. Something came through me, a sense of knowing in terms of, yes, I can make a large difference, but I can’t forget the local difference that I can make, the connection with my neighbors, the connection with my school. Particularly since COVID, we’ve become so technological. How can I actually connect with people more on a one-to-one basis instead of a one-to-thousand? For some reason, that really spoke to me and I’ve never been more empowered and excited to serve you all because I think I needed to come out of the big crowd, thousands of people and really just start to go back to thinking one-to-one and thinking about the person instead of the crowd. I think that that will help me a lot in terms of being more connected, feeling more connected, feeling not lonely in things. They have that whole thing about you can be surrounded by people, but still feel lonely. I think that’s probably why I felt lonely in the past. They’re the main things I learn. There are so many more, but really, I just want to emphasize, if you can create a one day or even a half-day silent retreat where you sit and really be with your emotions and commit to seeing what comes up, you will be shocked at the explosion of experiences that you have inside you. It doesn’t have to be three days. You don’t have to rent someplace. You could do it in your own home, even in one room if you need it, and really drop down. When those really painful emotions come up, really sit with them and be with them and practice letting them wax and wane as much as you can. That’s what I learned. I hope that that has been inspiring to you in some way or another. For me, I’m more committed to my meditation practice than I’ve ever been. I’m more committed to my mindfulness than I’ve ever been, and I’m more connected to my business than I’ve ever been, which is really, really beautiful. All right, thank you so much. I am so grateful for you being here with me today. I just love this work I’m doing with you and I hope that it is beneficial to you. Before we finish up, let’s do the review of the week. This is from kdeemo and they said: “This podcast is a gift. I just found this podcast and I’m binging on the episodes. I learn something through each episode, and I love her practical advice and tools. I feel like part of a community-what a gift!” Thank you, kdeemo. Please, please do go and leave a review. I know you are very busy. I very much respect your time, but the best gift you can give me is just a view and honest review. It helps me to reach more people and that makes me feel so fulfilled and happy. Have a wonderful day, everybody.

Common treatment of derealization and depersonalization Kimberley Quinlan SUMMARY: Derealization & depersonalization are common experiences of anxiety. In this episode, we take a look at the definition of derealization and depersonalization. We also explore the common symptoms of derealization and depersonalization and the treatment of derealization and depersonalization. I also explore mindfulness and CBT skills to help you manage your discomfort and anxiety. In This Episode: The definition of derealization The definition of depersonalization Explore the symptoms of derealization Explore the symptoms of depersonalization Comparing derealization vs depersonalization Common treatment of derealization and depersonalization Links To Things I Talk About: ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com. CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors. Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 227. Welcome back, everybody. I am so grateful to have this time with you. As you know, I promised this year would be the year I doubled down and get really into the nitty-gritty of some of the topics that people don’t talk enough about regarding anxiety. Today is so in line with that value Today, we are talking about what is derealization and depersonalization. These are two what I would consider symptoms of anxiety. I see it all the time in my practice. I see it reported and commented all the time on Instagram. If you follow me on Instagram, we put out tons of free information there as well. This is such an important topic. And for some reason, we aren’t talking about these two topics enough. My goal today is actually to give you a 101 on derealization and a 101 on depersonalization. We can touch upon derealization disorder and depersonalization disorder as well, but at the end, I want to give you as many tools as I can to point you in the right direction. Before we do that, let’s do the “I did a hard thing,” because we love that, right? The “I did a hard thing” is a segment where people submit the hard things they’re doing. The main reason I do this is because, number one, you’re my family. We’re all in this together. But number two, often people, many years ago when I started the podcast, people were like, when I started saying it’s a beautiful day to do hard things, which I say all the time, a lot of people were saying, “But how hard does it have to be? And how do I handle the hard things? Can you give me an example?” And so, these have been just such a wonderful way to share how other people are doing hard things. This one was submitted anonymously, and they said: “I’ve struggled with suicidal ideation for a very long time. And after years of therapy, self-discovery, and lots of hard work, I’m finally accepting that I am better off in the world than out of it.” Now I just have to take a deep breath and nearly cry because this is seriously the hard work. Sometimes when we’re talking about “I did a hard thing,” we’re talking about facing one small thing or one large thing, but I really want to honor Anonymous here and all of you who are doing this really long-term work and deep, deep work around really acknowledging how important you are and how much the world needs you in it and on it. So anonymous, I love you. You are amazing. I have such respect for the work that you’ve done and are doing, and thank you. Again. I think we don’t talk about suicidal ideation enough either. In fact, I should really do an episode on that as well. I respect you and I’m so grateful you submitted this week. Okay, here we go. I have some notes, which I rarely use notes for episodes, but I didn’t want to miss anything. I’ve got so much I want to share. I will do my best to break this down into, like I said, a 101, small bite-size helpful tools. You will hear me, as I talk, taking little deep breaths and that’s because I have to practice slowing down. Just a little off-topic, when I’m doing podcasts, I get so geeked out that my brain races, and I’m all over the place and I’m talking fast and I have to slow down, “Kimberley, pump the breaks, lady.” Let’s together take a breath... and let’s just be together. First let’s talk about derealization. The definition of derealization is that derealization is a mental state or a psychological experience, it could also be a physiological experience, where things feel unreal. Not like, “Oh, that’s totally unreal, man. Amazing.” I’m talking where they don’t feel real. When you have derealization, you might feel detached from your surroundings. You don’t feel connected to what’s going on around you, and people and objects may also seem unreal. Often people, when they have derealization or derealization disorder, feel like they’re going crazy. Actually, they feel like they’re going crazy. Not just the term that people use on the street. They actually feel like they’re losing touch with reality. When we talk about derealization disorder, we’ll talk about that here in a little bit, but we could use them interchangeably. Lots of people have derealization without having the disorder, but to have derealization disorder, you have to experience derealization. So I’m including them both there. Now the prevalence of derealization, I wanted to just give you this information because I felt it was very validating. I myself struggle with derealization and depersonalization. It was really validating for me to hear that more than half, more than 50% of people may have this disconnection from reality at least once in their lifetime. 2% of people experience it enough for it to become some kind of disorder, just like derealization disorder or even a dissociative disorder like amnesia. If you’re concerned, you can go speak with your doctor or your therapist, or a licensed therapist for an assessment if you’re concerned about it. A lot of people who I have seen have already been to the doctor, gotten cleared. Schizophrenic is often a very big concern. People often feel that they’ve been misdiagnosed. Now derealization is similar, but distinctly different from depersonalization, which we would talk about here soon. Some symptoms of derealization include feelings of being unfamiliar with your surroundings. You feel like you’ve never been there before, or you may feel like you’re living in a movie or a dream. You may feel emotionally disconnected from your loved ones or colleagues or friends. You just feel very numb. Like I said, you’re just very out of order. Things feel very strange. Your surroundings and the environment also may appear distorted, blurry, colorless, two-dimensional, or artificial. I remember the first time I ever had derealization. I was sitting across from a client and I was an intern. I was very anxious. I’ve talked about this on the podcast before. I was sitting across from them and all of a sudden, their body looked like a caricature of themselves. The caricature is where their body is really small and their head is huge. I was looking at my client, trying to be a therapist, and I’m thinking what happened. All of a sudden, their neck was very, very small and short and their head looked gigantic. It looked like a drawing, not three-dimensional, but two-dimensional. And that was so concerning to me. I freaked out. I got through the session. Thankfully, again, I had tools to use. But it was really scary. It actually brought on some panic later in that evening because it didn’t go away for a little bit of time. Now, depersonalization, the definition of depersonalization involves feeling a detachment, not from your environment like in derealization, but from your own body and your thoughts and your feelings. Think of it like it’s like you’re watching yourself from an outsider. I always say it’s like you’re flying on the wall, looking at yourself, or it’s like looking at a movie of yourself. Now, symptoms of depersonalization include feelings that you’re an outsider observer, like I just said. You’re disconnected to your body again. Others report that it feels like they’re a robot and that they don’t have control of their movements. Again, you feel like you’re watching yourself and you don’t have control of what’s going to happen next. Another symptom of depersonalization may include the sense that your body and legs and arm appear distorted. They may feel enlarged or shrunken. Some people report that their head is wrapped in cotton. That’s a different symptom. Another example I always use with my patients is often when I have depersonalization, which isn’t very often anymore, is I’d look at my hand and I couldn’t tell if it was my hand or not. I didn’t feel like it was my hand. Again, really scary, can feel really concerning in the moment. Now you may also experience some numbness, whether that’s emotional or physical. Some people say all of these symptoms are similar for derealization as well. You may feel like your memories lack emotion. Again, you’re disconnected from your own experience. So, that can be an additional symptom of depersonalization. Now for both, I’m going to talk about them together now. For both, the duration of these symptoms may last just a few minutes, they can last a few hours. Some people, particularly if you have derealization disorder or depersonalization disorder, it can be days, weeks, and months. In that severity, I would encourage you to go and speak with a mental health provider who is trained and can assess you properly. Now, to be diagnosed with derealization or to be diagnosed with depersonalization, there is no lab test. There’s no scan you can have. It requires a trained professional to review your symptoms and give you the diagnosis. You could probably, by listening to this, define for yourself whether you have the criteria to meet this classification. But if you’re wanting to be sure, I strongly encourage you to seek professional help to get that diagnosis. Now, the prevalence of the struggles almost always start in late childhood or early adulthood. The statistics, this is why I have my notes today, the average age starts around 16. 95% of cases are diagnosed before the age of 25. Not always, but that has been the common statistics that they’re showing. I think that’s really helpful to know. Now, that being said, what do you do from here? The treatment of depersonalization and derealization is often CBT (Cognitive Behavioral Therapy). Basically, what we do, and this is a lot of the work that you probably already have skills if you’ve listened to a lot of the podcast episodes – a lot of it is around practicing your mindfulness tool. The first thing I want to let you know is it doesn’t mean you’re going crazy. I totally get that. It feels like you are, but it doesn’t. The good news is, when you can’t stop appraising it as “I am going crazy,” you’ll actually start to notice it’s just a really strange feeling, but it doesn’t mean anything is wrong. I once had a teen client who told me, he said he was laughing and we were giggling together. He said, “The crazy thing is some of my friends pay a lot of money to feel this way by using drugs,” and he says, “I have it for free. I have this strange feeling, this out-of-body experience. And I don’t even have to be under the control of a drug or a substance.” He said, “When I looked at it from that perspective, I stopped appraising it as if it’s dangerous.” And that was a game-changer for him to stop appraising it as if it is a dangerous problem. For me now, when I have derealization, it usually occurs when I’m driving. I used to panic that that meant I was going to crash. But then when I just said, “Okay, I’m just having a feeling and I’m going to let it be there.” I’m not going to do anything about it. I’m not going to judge it negatively. I’m going to allow it to rise and fall on its own. And I’m going to put all of my attention on just staying present. Now your brain is going to say, “Yeah, but present is bad. Present is terrible. Bad things are going to happen. What if you’re going crazy?” And your job is actually to practice just letting those be thoughts, because that’s what they are. They’re thoughts. Just because you have them doesn’t mean they’re facts. Lots of people have derealization. The clients I’ve had who’ve had severe derealization and derealization and depersonalization disorder, they now say, “Yeah, it happens. No big deal. They just go about my day.” Now in the early stages of treatment, you’re going to hate this idea, but it works, is we actually used to purposely induce this sensation so that they could practice tolerating the discomfort without responding in unhealthy ways or in compulsive ways. We would sit them down and spin them around in a chair. We would have them stare at the wall. We would have them look at really psychedelic YouTube videos where the colors and the patterns are all wavy like seventies, like psychedelic. And we would practice inducing the feeling. From there, they would practice willingly allowing the discomfort and going about their day, being gentle with themselves, engaging in the things they value. Of course, they might feel great, and that’s okay. You can slow down a little and do what you need to do. But ultimately, when you have depersonalization and derealization, the goal is simply to do nothing at all. Crazy. When I tell my patients that, they’re like, “Oh my goodness, you’re either crazy or you’re brilliant.” By the end, usually, they say that this treatment, not me, but the treatment is brilliant, because it teaches them not to be afraid of it and not to try and live their life avoiding it. I’ve had patients report that they’ve avoided things at great length just to avoid the experience of depersonalization and derealization. And when they avoid it, it just keeps them stuck and keeps them scared and keeps it happening more. The other thing I will add is, do not check to see if you’re derealized or depersonalized, because just the act of checking for it, like a mental check, can actually bring on the symptoms. Now, that’s easier said than done. Am I right? Yes, it’s very hard. I know it’s easy to say, “Just stop doing that.” But if you’re engaging in a lot of checking behavior, sometimes it’s helpful to catch when you are and bring yourself back to the present, do whatever disengagement skills you can use to get you back into the present moment. Again, we don’t want to push the discomfort away, but we also don’t want to give too much hyper attention to these sensations and symptoms. If you’re struggling with these symptoms, go and see a mental health professional. You can quiz them, ask them if they have skills in this. Look on their website, see if they’ve got any information about it that will help you to get the help that you need. This is great. Like I said, this is what I call derealization and depersonalization 101. But there are many, many other tools that you can use to help manage this. One day I will do my best to create an online course about this that goes into detail so you have that, but for right now, I hope that this is helpful. Now, before we finish up, I’m going to do the review of the week. We have an amazing review here from Jessrabon621 and they said: “Amazing podcast. I absolutely love everything about this podcast. I could listen to Kimberley talk all day and her advice is absolutely amazing. I highly recommend this podcast to anyone struggling with anxiety or any other mental health professional that wants to learn more.” Thank you, Jessrabon621. I am so grateful that I’ve helped and I’m so happy that you’ve left a review. Thank you. I love your reviews. They help me so much. 2022 is the year that I want to get a thousand reviews. If you can help, I would be so grateful. Go in wherever you’re listening, click on the reviews, leave a review. You don’t have to write something. You can just rate it. Leave an honest review. I am so, so grateful. We will be giving a pair of Beats headphones to one lucky winner by the time we hit 1,000 reviews. So I am so grateful. Have a wonderful day, and I’ll see you next week.

SUMMARY: Overcoming Health Anxiety is possible! Today, we interview Ken Goodman and his client Maria on overcoming hpyochondria using Cognitive Behavioral Therapy. In this episode of Your Anxiety Toolkit Podcast, you will learn key concepts of health anxiety and how to overcome their health anxiety. In This Episode: What it is like to have health anxiety The key concepts of treating Hypochondria Tips for managing fears of death and cancer. A step-by-step approach to overcoming health anxiety. Links To Things I Talk About: https://www.kengoodmantherapy.com/ Quiet Mind Solutions ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com. CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors. Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 226. Welcome back, everybody. If you have health anxiety, hypochondria, health anxiety disorder, or you know of somebody who has health anxiety, you are going to love this episode. I mean, love, love, love this episode. Today, we have Ken Goodman, who’s on the show. He’s a clinician who’s here with his patient and they’re sharing a success story, a recovery story of health anxiety, and it is so good. I am so honored to have both of them on. It was so fun to actually interview other people and the way they’re doing it, and look at the steps that were taken in order to overcome health anxiety. And this is the overcoming health anxiety story of all stories. It is so, so good. I’m not going to waste your time going and telling you how good it is. I’m just going to let you listen to it because I know you’re here to get the good stuff. Before we do that, I wanted to do the “I did a hard thing” and this one is from Dave. It says: “I’ve been trying to get back into meditating regularly. I was sitting at a desk this morning, reviewing my work emails. And I told myself, before I get even further in my day, I need to meditate. I did a guided meditation, even though I felt a strong pull inside to go back to work. I kept getting caught up in my thoughts, but I just kept telling myself it doesn’t need to be a perfect meditation. I said the goal today is just to be able to sit without being busy for three minutes. Nothing more. It was hard, but I did it.” Dave, thank you so much for the submission of the “I did a hard thing” segment, because I think that meditation is so important. In fact, I keep promising myself I’m going to implement it more into this podcast. And Dave has really looked at some of the struggles people have with meditation. And look at him, go, it’s so amazing. Totally did it. So amazing. Dave, thank you so, so, so much. I love it. If you want to submit, you may submit your “I did a hard thing” by going to KimberleyQuinlan-lmft.com. If you go to the podcast page, there is a submission page right on the website. And from there, let’s just go straight to the show. I hope you enjoy it. Kimberley: Welcome. I am so excited for this episode. Welcome, Ken and welcome, Maria. Ken: Thank you for having me. Maria: Hi, Kimberley. Kimberley: So, as you guys, we’ve already chatted, but I really want to hear. This is really quite unique and we get to see the perspective of a client and the therapist. If I could do one of these every single week, I would. I think it’s so cool. So, thank you so much for coming on and sharing. We’re going to talk about health anxiety. And so, Maria, we’re going to go back and forth here, but do you want to share a little bit about your experience with health anxiety? Maria: Yes. I think I’ve had health anxiety probably for like 15, 20 years and not known about it. Looking back now, everything comes clear when you see the multiple pictures that you’ve taken of certain lumps and whatever five years ago. I’m like, “Oh my gosh, I have so many pictures that I’ve taken and so many different things.” But yeah, I’ve been struggling for a while I think, and had multiple doctor’s appointments. Until I realized that I had health anxiety, it was an everyday struggle, I think. Ken: Well, you came to me and you were mostly worried at the time about ticks and Lyme disease and skin cancer, but you told me that for the previous 15 years or so, you were worried about other things. What are those things? Maria: Well, I was mostly completely obsessed with moles on my skin and them being cancerous. And I was scared of ticks. I would not be able to walk through any grass or go hiking. I was scared that I would have to check my whole body to make sure that there were no ticks on me. I was completely scared of Lyme disease, and it just completely consumed my life really. And they were the main things. But looking back before that, I think that I always had a doctor’s appointment on the go. I would book one, and as soon as they said, “You can book online,” That was it for me. I would have one booked, and then I’d go, “Oh, what if there’s something else next week? You know what, I’m just going to book one for next week, just in case something comes up.” I am a terrible person when it comes to that because I’m taking up multiple doctor’s appointments. And I knew that. But it was trying to reassure myself, trying to control the situation, trying to control next week already before it even happened. So, yeah. MARIA’S SYMPTOMS OF HEALTH ANXIETY Kimberley: Right. What did it look like for you? What did a day look like for you pre-treatment and pre-recovery? Maria: Some days it could be fine. I remember days where nothing was bothering me. It was such a nice feeling. And then I was scared because I never knew what was going to trigger me and it could be anything at any time. And I think that was the not knowing. And then as soon as I would latch onto something, I would come to the phone, I’d start Googling over and over again, hours of Googling and then checking. And then it was just ongoing. And then my whole day, I was in my head my whole day, just what if, what if, asking questions, going back to Google, trying to find that reassurance that of course never happened. Ken: Yeah. You tell me that you would take pictures of your moles and then compare them with the cancerous moles online and do those things. Maria: Yeah. And I would book-- and interestingly enough, looking back now, I went through a phase of always having a doctor’s appointment. And then I also went through a phase of completely avoiding the doctor as well, not wanting to go because I didn’t want them to say something that I knew was going to trigger a whole host of anxiety. So, I’ve gone through multiple doctors. And then once you start the doctor’s appointments, then you’re on a roller coaster. Because you walk away from that appointment, never feeling, or for me, never feeling reassured. Or feeling reassured for maybe a few minutes, and then you leave, and then the anxiety kicks in. “Oh, I never asked them this,” or “Oh my gosh, well, what did that mean?” And then the what-ifs start again and you’re back to square one. So then, you go, “Oh, no, I didn’t try just what they said. I’m going to book another appointment and this doctor is going to be the doctor that reassures me.” MANAGING DOCTOR VISITS WITH HYPOCHONDRIA Kimberley: Right. Or sometimes a lot of clients will say to me like, “The doctor made a face. What did that face mean? They made a look and it was just for a second, but were they questioning their own diagnosis and so forth?” And I think that is really common as well. Ken: Well, the doctor will say anything and it could be something very simple like, “Okay, you’re all good. I’ll see you in six months.” And the person will leave thinking, “Why would he want me to come back in six months if nothing was wrong?” Maria: Well, that’s interesting that you would say that because I think probably at my lowest point, I was keeping notes about my thought process and what I was feeling when I was actually going to the doctors or waiting for the results. And actually, I thought it might-- if I have a few minutes to read what I actually was going through in real-time, I know it’s probably very relatable. Kimberley: I would love that. Maria: I had gone to basically a doctor’s appointment, an annual one where I knew I was going to have to have blood tests. And they’re the worst for me because the anticipation of getting the results is just almost worse than getting the results, even though-- Ken: Did you write this before we met? Maria: No. While I was seeing you, Ken. Ken: In the beginning? Maria: Yeah. When you’d asked me to write down everything and write down what I was feeling, what I was thinking, and then read it back to myself. And this is what I had written down, actually, when I was going through the doctor’s appointment and waiting or had just gotten the results. Kimberley: If you would share, that’d be so grateful. Maria: So, my blood results came back today. I felt very nervous about opening them. The doctor wrote a note at the top. “Your blood results are mostly normal. Your cholesterol is slightly high, but no need for medication. Carry on with exercise and healthy eating.” “Mostly,” what does that mean? “Mostly”? I need to look at all the numbers and make sure that everything is in the normal range. “Okay, they’re all in the normal range except for my cholesterol. But why does she write mostly? Is there something else that she’s not telling me? I need reassurance. I’m driving down to the doctor’s right now. I can’t wait the whole weekend.” I go into the doctor’s office and ask them, “Is there a doctor who’s able to explain to me my results?” The receptionist said, “No, you have to make another appointment.” I explained to her, “You don’t understand. I just need somebody to tell me that everything is normal.” Finally, this nice lady saw the anxiety on my face. She calls the doctor over to look at the labs. The receptionist shows the doctor the one lab panel, and he says, “Everything is completely normal. Nothing was flagged. Everything is completely fine.” I thank him so much for looking and walk away. As soon as I get outside, I realize I didn’t ask him to look at all the lab panels. What if she meant mostly normal on the other lab panels that I didn’t show him? When I get home, I look over each one multiple times and make sure that each one is in the exact number range. After looking over them four or five times and seeing that each one is in the number range except for my cholesterol, I still feel like I need to have her explain to me why she wrote the word “mostly.” The crazy thing is I’m not concerned about the high cholesterol. I can control that. I don’t know what she meant by the word “mostly.” I’m going to send her a message. And I’m going to ask her to clarify. I have to believe that she would tell me if something was wrong. I wish there was an off button in my head to stop me worrying about this. Ken: I remember this now. I remember. And this was in the middle. Maria was really avoiding going to the doctor and she had overdue with some physical exams. And so, we really worked hard for her to stop avoiding that. She got to the point where she felt good enough about going to the doctor. And she really, I think I remember her not having any anticipatory anxiety, handling the doctor very well, host the doctor very well, until she got the email and focused on the word “mostly.” And that sent her spiraling out of control. But the interesting thing about that whole experience was that we processed it afterwards, and that whole experience motivated her to try even harder. And then she took even bigger strides forward. And within a couple of months, she was really doing so much better. And I think it’s been over a year now since that and continues to do really well. Kimberley: Yeah. Thank you so much for sharing that. I actually was tearing up. Tears were starting to come because I was thinking, I totally get that experience. I’m so grateful you shared it because I think so many people do, right? Maria: Yeah. And there’s always and/or. You go into the doctor’s appointment, they tell you everything. And because your adrenaline is absolutely pumping, you forget everything. And then you come out and you go, “Oh my gosh, I can’t remember anything.” Then the anxiety kicks in and tells you what the anxiety is like, “Oh no, that must have been bad. That must have been--” yeah. Ken: And that boost in adrenaline that just takes over is so powerful. You can forget any common sense or any therapeutic strategies or tools that you might have learned because now you just get preoccupied with one word, the uncertainty of that word. Maria: Yeah. I would have to have a family member come in, my husband to come in and sit in the-- it got to that point where he would have to come in and sit in the appointment, so then after the appointment, I could have him retell me what was said, because I knew as soon as the adrenaline kicked in, I would not be able to remember anything. ROADBLOCKS TO HEALTH ANXIETY TREATMENT Kimberley: Right. Ken, this brings me straight to the next question, which would be like, what roadblocks do you commonly see patients hit specifically if they have health anxiety during recovery or treatment? Ken: Well, unlike other fears and phobias, the triggers for health anxiety are very unpredictable. So, if you have a fear of elevators, flying or public speaking, you know when your flight is going to be, you know when you have to speak or you know when you have to drive if you have a fear of driving. For health anxiety, you never know when you’re going to be triggered. And those triggers can be internal, like a physical sensation, because the body is very noisy. And everyone experiences physical sensations periodically and you never know when that’s going to happen. And then you never know external triggers. You never know when the doctor is going to say something that might trigger you, or you see a social media post about a GoFundMe account about someone that you know who knows someone who’s been diagnosed with ALS. So, you never know when these things are going to happen. And so, you might be doing well for a couple of weeks or even a month, and suddenly there’s a trigger and you’re right back to where you started from. And so, in that way, it feels very frustrating because you can do well and then you can start becoming extremely anxious again. Another roadblock I think might be if you need medicine, there’s a fear of trying medicine because of potential for side effects and becomes overblown and what are the long-term side effects, and even if I take it, I’m going to become very anxious. And so, people then are not taking the very thing, the medicine that could actually help them reduce their anxiety. So, that’s another roadblock. Kimberley: Yeah. I love those. And I think that they’re by far the most hurdles. And Maria, you could maybe even chime in, what did you feel your biggest roadblock to recovery was? Maria: Being okay with the unknown. Trying to be in control all the time is exhausting and trying to constantly have that reassurance and coming to terms with, “It’s okay if I can’t control everything. It’s okay if I don’t get the 100% reassurance that I need. It’s good enough,” that was hard for me. And also, not picking up the phone and Googling was the biggest. I think once I stopped that and I was okay with not looking constantly, that was a huge step forward. Ken: You really learn to live with uncertainty. And I think you start to understand that if you had to demand 100% certainty, you had to keep your anxiety disorder. In order to be 100% certain, that meant keep staying anxious. Kimberley: Yeah. Being stuck in that cycle forever. Ken: You didn’t want that anymore. You wanted to focus on living your life rather than being preoccupied with preventing death. SKILLS AND TOOLS TO OVERCOME HEALTH ANXIETY Kimberley: Right. So, Maria, I mean, that’s probably, from my experience as a clinician, one of the most important skills, the ability to tolerate and be uncertain. Were there other specific tools that you felt were really important for your recovery at the beginning and middle and end, and as you continue to live your life? Maria: Yes. I think the biggest one was me separating my anxiety from myself, if that makes sense. Seeing it as a separate-- I don’t even know, like a separate entity, not feeling like it was me. I had to look at it as something that was trying to control me, but I was fine. I needed to fight the anxiety. And separating it was hard in the beginning. But then I think once I really can help me to understand how to do that, at that point, I think I started to move forward a bit more. Kimberley: So, you externalized it. For me, I give it a name like Linda. “Hi, Linda,” or whatever name you want to give your anxiety. A lot of kids do that as well like Mr. Candyman or whatever. Maria: Yeah. It sat on my shoulder and try to get in my head. In the beginning, I would be brushing off my shoulder constantly. Literally, I must have looked crazy because I was brushing this anxiety off my shoulder every 10 minutes with another what-if. What if this? What if that? And I think I had to retrain my brain. I had to just start not believing and being distracted constantly by the “What if you do this” or “What if that?” and I’d say, “No, no.” Ken: Yeah. I’d treat a lot of health anxiety. I have a lot of health anxiety groups. And I do notice that the patients that can externalize their anxiety and personify it do way better than the people who have trouble with it. And so, whether it’s a child or a teenager or an adult, I am having them externalize their anxiety. And I go into that, not only in my groups, but in the audio program I created called the Anxiety Solution Series. It is all about how to do that. And it makes things so much easier. If now you’re not fighting with yourself, there’s no internal struggle anymore because now you’re just competing against an opponent who’s outside of you. It makes things easier. Kimberley: Right. Yeah. And sometimes when that voice is there and you believe it to be you, it can make you feel a little crazy. But when you can externalize it, it separates you from that feeling of going crazy as well. Maria: I felt so much better as soon as I did that because I felt, “Okay, I think I can fight this. This isn’t me. I’m not going crazy. This is something that I--” and I started to not believe. And it was long, but it was retraining my brain. And I would question the what-ifs and it didn’t make sense to me anymore. Or I would write it down and then I would read it back to me, myself, and I’d be like, “That’s ridiculous, what I just thought.” And the other tool which was hugely helpful was breathing, learning how to breathe properly and calm myself down. I mean-- Ken: Yeah. There’s lots of different types of breathing out there. And so, I teach a specific type of breathing, which is, I call it Three by Three Relaxation Breathing, which is also in the Anxiety Solution Series. And it really goes over into detail, a very simple way to breathe that you can do it anywhere. You can do it in a waiting room full of people, because it’s very subtle. It’s not something where you’re taking a big breath and people are looking at you. It’s very, very subtle. You can do it anywhere. MEDITATION FOR HEALTH ANXIETY Kimberley: Ken, just so that I understand, and also Maria, how does that help someone? For someone who has struggled with breathing or is afraid of meditation hor health anxiety and they’ve had a bad experience, how does the breathing specifically help, even, like you were saying, in a doctor’s appointment office? Maria: I’ve done it actually in multiple doctor’s appointments where I’ve had that feeling of, “I’ve got to get out of here now.” It’s that feeling of, “Uh, no. Right now, I need to leave.” Before, before I started, I would leave. And now I realized, no, I’m not. I’m going to sit and I’m going to breathe. And no one notices. No one can see it. You can breathe and it really does calm me down, especially in the past, I’ve had panic attacks and feeling like I can’t breathe myself. When you start to realized that you can control it and it does relax you, it really helps me a lot. I do it all the time. Kimberley: It’s like a distress tolerance tool then, would you say? Maria: It’s something that I can carry around with me all the time, because everyone needs to breathe. Kimberley: Yeah. I always say that your breath is free. It’s a free tool. You could take it anywhere. It’s perfect. Maria: Yeah. So, it’s something that I can do for myself. I can rely on my breathing. And now knowing after Ken teaching me really how to do it properly, it’s just invaluable. It really is, and empowering in a way. Now, when I feel like I can’t be somewhere, and in fact just not so long ago, I was in a doctor’s appointment, not for myself, but I sat there and it was really high up and there was lots of windows around. Of course, I don’t like being [00:22:34 inaudible]. And I felt I have to get out. “Nope, I’m not going to do it. I’m not going to do it.” I sat there, I did my breathing. I actually put my earphones in and started listening to Ken’s anxiety solutions and listened and took my mind off of it, and I was fine. I didn’t leave. And actually, I walked away feeling empowered afterwards. So, it’s huge. It’s really helpful. Ken: Yeah. You just said a couple of very important things. You made a decision not to flee, so you decided right there, “I’m not going anywhere. So, I’m going to stay here. I’m going to tolerate that discomfort, but I’m going to focus on something else. I’m going to focus on my breathing. I’m going to listen to the Anxiety Solution Series.” And then by doing that, I’m assuming your anxiety either was contained, it stayed the same, or maybe it was reduced. Yeah? Maria: Yeah, it was reduced. It stayed the same. And then it started to reduce. And naturally, by the end, I was like, “I’m fine. Nothing is going to happen.” So, it was great. And the other-- I want to say actually one more thing that really, really helped me. And it was actually a turning point, was that I was in another appointment. The doctor came in and told me I was fine. And it was actually like an appointment where they had called me back medically. So, it was a different scenario. It wasn’t me creating something in my head. But anyway, there was a lot of anticipation beforehand and he came in and he said, “You are fine. Go live your life.” And I walked away and I went home. And within maybe about 40 minutes, I said, “Maybe he was lying to me. Maybe he was just trying to make me feel good because he saw how anxious I was.” And at that point I realized, this is never going to stop, never. Unless I fight back, I will never-- I felt robbed of the relief that I should have felt. When he told me that, I wasn’t getting that relief and I was never going to have that relief unless I used-- and at that point, I actually got angry. And I remember telling Ken, I was like, “I’m so angry because I felt robbed of the relief.” And at that point, I think I then kicked up my practicing of everything tenfold. And that was a turning point for me. Ken: Yeah. That anger really helped you. And anxiety is a very, very powerful emotion, but if you can access or manufacture a different emotion, a competing emotion, and anger is just one of them, you can often mitigate the anxiety. You can push through it. And for you, it was an invaluable resource, because it was natural. You actually felt angry. For other people, they have to manufacture it and get really tough with their anxiety. But for you, you at that moment naturally felt it. And you’re right. You said it is never going to stop. And physical sensations, the body is noisy. People will have the rest of their life. You’re going to have a noisy body. So, that will never stop. It’s your reaction and your response to those physical sensations that is key. And you learn how to respond in a much more healthy way to whenever you got any sort of trigger external or internal. TREATMENT FOR HEALTH ANXIETY/HYPOCHONDRIA Kimberley: It’s really accepting that you don’t have control over anxiety. So, taking control where you have it, which is over your reactions. And I agree, I’ve had many clients who needed to hit rock bottom for a certain amount of time and see it play out and see that the compulsions didn’t work to be like, “All right, I have to do something different. This is never going to end.” And I think that that insight too can be a real motivator for treatment of like, “I can’t get the relief. It doesn’t end up lasting and I deserve that like everybody else.” So, Ken, how do you see as a clinician the differences in recovery and health anxiety treatment for different people? Do you feel like it’s the same for everybody, or do you see that there are some differences depending on the person? Ken: Well, when I treat people with health anxiety, although the content of their specific fears might be different – some might worry more about their heart, some might worry more about shaking that they experience and worry about ALS – the treatment is basically the same, which is why I can treat them in classes or groups because it’s basically the same. There are some variations. Some people are more worried about things, where other people feel more physical sensations. And I may have to tailor that a bit. So, some people have to-- their problems are more the physical sensations that they feel and they can’t tolerate those physical sensations. And other people it’s more mental. They’re just constantly worried about things. But in general, they can be treated very similarly. It’s learning how to tolerate both the uncertainty and the discomfort and the stress that they feel. Kimberley: Right. And I’ll add, I think the only thing that I notice as a difference is some people have a lot of insight about their disorder and some don’t. Some are really able to identify like, “Ah, this is totally Linda, my anxiety,” or whatever you want to name your anxiety. “This is my anxiety doing this.” Whereas some people I’ve experienced as a clinician, every single time it is cancer in their mind and they have a really hard time believing anything else. Like you said, they feel it to be true. Do you agree with that? Ken: Completely. Yeah. Some people will come to me and they know it’s probably anxiety, but they’re not sure. And some people, they are thoroughly convinced that they have that disease or that disorder. And even after months and months and months of-- and oftentimes the content changes. So, I have patients who, when I first start seeing them, they might be afraid of cancer. And then two months later, it’s their heart. And then a couple of months later after that, it’s something else. There’s always something that can come up and they’re always believing it’s something medical. And of course, they go back to, “Well, what if this time it is? What if this time it is cancer?” And that’s where they get caught in the trap. So, for them, it’s answering that question. For Maria, it’s the word “mostly” that she became fixated on to get lured in and take the bait. It’s like, what happens to a fish that takes the bait? Now they’re struggling. So, now once you take the bait, you’re struggling. Kimberley: Right. And I would say, I mean, I’ll personally explain. A lot of my listeners know this, but I’ll share it with you guys. I have a lesion on the back of my brain that I know is there. And I have an MRI every six months. And I have a lot of clients who have a medical illness and they have health anxiety, and it’s really managing, following the doctor’s protocol, but not doing anything above and beyond that because it’s so easy to be like, “Well, maybe I’ll just schedule it a little earlier because it is there and I really should be keeping an eye on it.” And that has been an interesting process for me with the medical illness to tweak the treatment there as well. Ken: Yes, absolutely. I have a patient right now and she has a legitimate heart issue that is not dangerous. They’ve had many, many tests, but all of a sudden, her heart will just start racing really fast, just out of the blue. And it happens randomly and seems like stress exacerbates the frequency of it. But it’s not just irritating for her, it was scary because every time she would experience it, she thought, “Maybe this is it. I’m having a heart attack.” But she really had to learn to tolerate that discomfort, that it was going to happen sometimes and that was okay. It happens and you just have to learn to live with it. Kimberley: Right. So, Maria, this is the question I’m most excited about asking you. Tell me now what a doctor’s appointment looks like for you. Maria: It looks a lot better. You can actually pick up the phone and book an appointment now without avoiding it. I practice everything that I’ve learned. I’m not going to lie. The anticipation, maybe a couple of days before, is still there. However, it’s really not as bad as it was before. I mean, before, I would be a complete mess before I even walked into the doctor’s office. Now, I can walk in and I’m doing my breathing and I’m not asking multiple questions. I’m now okay with trusting what the doctor has to say. Whereas before, if I didn’t like what he had to say or he didn’t say exactly the way I wanted to hear it, I’d go to another doctor. But now, I’m okay with it. And it’s still something I don’t necessarily want to do. But leaps and bounds better. Leaps and bounds really. I can go in by myself, have a doctor’s appointment, ask the regular questions and say, “Give me the answers,” and leave and be okay with it. GETTING TEST RESULTS WITH HEALTH ANXIETY Kimberley: How do you tolerate the times between the test and the test results? How do you work through that? Because sometimes it can take a week. You know what I mean? Sometimes it’s a long time. Maria: Yeah. I mean, I haven’t-- so, obviously, it’s yearly. So, I’m at that point next year where I will have to go and have all my tests again and get the results and anticipate. But I think for me, the biggest thing is distraction and trying not to focus too much beforehand and staying calm and relaxed. And that’s really it. I mean, there’s always going to be anxiety there for me, I think, going to the doctors. It’s not ever going to go away. I’m okay with that. But it’s learning how to keep it at a point where I can understand what they’re telling me and not make it into something completely different. Ken: I think you said the keywords – where you’re putting your focus. So, before, your focus was on answering those what-if questions and the catastrophic possible results. And now I think your focus is on just living your life, just going about living your life and not worrying or thinking about what the catastrophic possibilities could be. Is that accurate? Would you say it’s accurate? Maria: Yeah. Because if you start going down that road of what-if, you’re already entering that zone, which it is just, you’re never going to get the answer that you want. And it’s hard because sometimes I would sit and say to myself, “I’m going to logically think this out.” And I would pretend. I mean, I even mentioned to Ken, “No, no, I’m logically thinking this out. This is what anyone would do. I’m sat there and I’m working out in my head.” And he said, “You’ve already engaged. You’ve already engaged with the anxiety.” “Have I?” And he said, “Yeah. By working it out in your head, you’re engaging with the anxiety.” And that was a breakthrough as well because I thought to myself after, “I am.” I’m already wrapped up in my head logically thinking that I’m not engaging, but I’m completely engaging. So, that was an interesting turning point as well, I think. Kimberley: Amazing. You’ve come a long, long, long way. I’m so happy to hear that. Ken, before we wrap up, is there anything that you feel people need to know or some major points that you want to give or one key thing that they should know if they have health anxiety? Ken: Oh my gosh, there are so many. There is a tendency for people with all types of anxiety to really focus their attention on the catastrophic possibilities instead of the odds of those catastrophic possibilities happening. The odds are incredibly low. And so, if you’re focusing on the fact that it’s probably not likely that this is going to happen, then you’ll probably go through your life and be okay if you can focus your attention on living your life. But if you focus on those catastrophic possibilities that are possible, they are, then you’re going to go through life feeling very, very anxious. And if you focus on trying to prevent death, prevent suffering, then you’re not really living your life. Kimberley: That’s it right there. That’s the phrase of the episode, I think, because I think that’s the most important key part. I cannot thank you both enough for coming on. Ken: This is fun. This is great. Maria: It was fun. Kimberley: Maria, your story is so inspiring and you’re so eloquent in how you shared it. I teared up twice during this episode just because I know that feeling and I just love that you’ve done that work. So, thank you so much for sharing. Ken: Yeah. She’s really proof that someone who’s suffered for 15, 20, some odd years with anxiety can get better. They just have to be really determined and really apply the strategies and be consistent. She did a great job. Kimberley: Yeah. Massive respect for you, Maria. Maria: Oh, thank you. Kimberley: Amazing. Ken, before we finish up, do you have any-- you want to share with us where people can hear from you or get access to your good stuff? Ken: Yeah. So, quietmindsolutions.com, I have a whole bunch of information on health anxiety. I have two webinars in health anxiety on that website, as well as other webinars in other specialties I have. Also, I have the Anxiety Solution Series, which is a 12-hour audio program, which focuses on all types of anxiety, including health anxiety, as well as others. And you can listen to a few chapters for free just to see if you would like it, if you could relate to it. And there’s other programs, other articles, and videos that I produced. I have a coloring self-help book, which is basically a self-help for people with anxiety, but every chapter has a coloring illustration where you color. And the coloring illustration actually-- what’s the word I’m looking for? It’s basically a representation of what you learn in that chapter. It strengthens what you learn in that chapter. Kimberley: Cool. Ken: Yeah. And then a book called The Emetophobia Manual, which is a book for people who have fear of vomiting. Kimberley: Amazing. And we’ll have all those links in the show notes for people as well. So, go to the show notes if you’re interested in getting those links. Ken: Ken Goodman Therapy is the other website. It has similar information. Maria: I wanted to mention as well that I actually watched one of Ken’s webinars quite by accident in the beginning before I realized I had health anxiety. And after watching it, I thought, “Oh my gosh, I’ve got that.” And so, it was hugely, hugely helpful because I think that having this for so many years and not realizing, there’s a lot of people that still don’t realize that they suffer from health anxiety. For me, as soon as I could label it as something, it was a relief because now I could find the tools and the help to work on it and get that relief. Kimberley: Amazing. Okay. Well, my heart is so full. Thank you both for coming on and sharing your overcoming health anxiety story. It’s really a pleasure to hear this story. So inspiring. So, thank you. Ken: Yeah. Thank you for doing this, Kimberley. Maria: Thank you. Ken: And thanks, Maria. ----- Thank you so much for listening. Before we finish up, we’re going to do the review of the week. This is from kdeemo, and they said: “This podcast is a gift. I just found this podcast and I’m binging on the episodes. I learn something through each episode, and love her practical advice and tools. I feel like part of a community-what a gift!” Oh, I’m so, so grateful to have you kdeemo in our community. This is a beautiful, beautiful space. My hope is that it’s different to every other podcast you listen to in that we give you a little bit of tools, a little bit of tips, but a huge degree of love and support and compassion and encouragement. So, thank you so much for your review. I love getting your reviews. It helps me to really double down in my mission here to give as many practical free tools as I can. It is true, it is a gift to be able to do that. So, if you could please leave a review, I would be so, so grateful. You can click wherever you’re listening and leave a review there. Have a wonderful day.

SUMMARY:  Many people ask me, “Why do I have anxiety?” and the truth is, there is no clear-cut answer. However, in this week's episode, I give you nine possible causes of anxiety and what you can do to manage anxiety in your daily life. Some causes are in your control, and some are not.  Either way, it is important that you are super gentle with yourself as you explore some of the reasons for anxiety in your life.  In This Episode: NINE possible causes of anxiety for you in your life What you can do to manage your anxiety How to overcome anxiety by changing small behaviors Reasons you experience anxiety may include Genetics Caffeine Distorted Thoughts Behaviors Trauma Environment Stress Management Lack of Tools Isolation (lack of community) Links To Things I Talk About: Time Management for Optimum Mental Health https://www.cbtschool.com/timemanagement ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 225. Welcome back, everybody. Today, we are talking about the causes of anxiety, why you are anxious and what you can do about it. This is a topic I feel like keeps coming up with my clients like, “But why? Why is this happening?” And I totally get it. Now, a lot of the times, I encourage my patients the end goal, jump straight to the end goal is we don’t want to spend too much time trying to solve why we’re anxious. That in and of itself can become a compulsive problematic behavior. But I wanted to just address it because I don’t think I have addressed it yet in the podcast. I thought now is a good time to really just look at some of the reasons we humans are anxious. I’m an anxious person, my guess that the fact that you’re listening to Your Anxiety Toolkit means you or someone you love is an anxious person. So, let’s talk about why we’re anxious. What are the causes of anxiety and what are some of the reasons we are anxious. Now before we do that, we want to, of course, do our “I did our hard thing” segment, and this one is for Bradley. Bradley wrote: “I was at a family event and had to see a family member I haven’t seen in four years. I said a firm, no contact boundary with her since she was so toxic. And as much as I tried, I knew I could not control whether she came or not. Seeing her was very hard, but I gave myself loads of self-compassion and allowed that moment to be very difficult.” Oh, Bradley, this is so good. “I was pleasant to her, but I did not engage beyond what was necessary. I took multiple moments throughout the event to check in with myself and see what my body needed.” This is so good and this is such great modeling of how we can regulate and monitor ourselves, giving ourselves kindness as we do hard things. I love this. Thank you so much for sharing it. This is really super inspiring. I think we all need to practice this one a little better, myself included. I hope that that brings you some inspiration before we move on into the episode. Thank you again, Bradley, for submitting that. I love hearing the “I did a hard thing.” Let’s talk about why you and I, and we might be anxious. 1. Genetics Reason number one is genetics. I think that if I’m with a client and they ask me, this is usually the spiel I would give them, which is, genetically, a lot of us are set up to have anxiety. What that means is somewhere in our lineage, our parent, our grandparent, someone had anxiety and it is quite a genetic trait to have. As we go through these, I’m really wanting you, just as a side note, to think about these things, but we don’t want to use these as an opportunity to blame other people. We don’t want to blame, of course, our parents or our grandparents. It wasn’t their fault. Obviously, they probably had it passed down from somebody else as well. But as we move through some of these, I also don’t want you to displace blame onto yourself, and we can talk about that as we go. But genetics is a reason that some of us are anxious. I’ll give you a little bit of a piece of my personal experience here, is I often-- I mean, I know every anxiety tool in the book and there’s been many times where I’ve visited doctors or psychiatrists and they ask me about anxiety and I’ll say, “Yes, I have anxiety.” They’ll say, “Well have you had therapy? Have you tried medicine?” “Yeah, I’ve tried all of those things and I’m highly functioning and I have a wonderful life.” But I also have to accept that some degrees of anxiety are just genetic. I’m not going to get rid of them all. In fact, I don’t want to get rid of all anxiety. I want to use this as an opportunity to remind you that this is not meaning that it’s a list of things you now have to go and fix. Not at all. This is about just being aware of what’s going on. Hopefully, at the end, we’ll talk more about this, is you can then acknowledge what might be bringing the anxiety on, but then go straight to your toolkit. The tools are the most important part here –acceptance, not judgment, willingness, compassion, being mindful. Go straight back to your tools once you’ve listened to this podcast because that’s going to be the most important piece. 2. Caffeine The second reason you might have anxiety is because of caffeine. A lot of people report that if they have too much caffeine, they get jittery and it sets off a nervous response in the body where the brain then sends out a whole bunch of anxiety hormones and chemicals in the body. Caffeine mimics anxiety, which then means that now you have more anxiety, because when you have anxiety and you experience something like it, usually, if you go, “Oh my gosh, yeah, something must be wrong,” your body proceeds to send out more and more and more and more anxiety. Caffeine can be one, but I will also tag on additional one here, which is alcohol. A lot of my patients have reported that if they’re drinking too much alcohol, they do feel that same jitteriness the next day, which then causes their brain to think something is wrong. Therefore, again, send out more anxiety, chemicals and hormones, something to think about. 3. Distorted Thoughts Now, the third is really important. I’ve done podcast episodes on this before, and it’s distorted thoughts, catching your distorted thoughts. If you are at the supermarket and the man or woman next to you drops the cereal box all over the floor or they drop a can or a glass bottle, and it shatters everywhere, you are naturally going to have anxiety. Normal. Anyone would have anxiety. It’s a big shock to the system. But if you then have distorted thoughts about that, like that means it’s bad luck, I did something wrong, I’ve humiliated myself, they’re going to be judging me – there are so many different distorted thoughts. I’m just using this as an example. Or another example would be you are interacting with someone at the bank and you have then following the distorted thought of like, “They are judging me. They think I’m stupid. I I didn’t handle that well.” Maybe you have the thought bad things are going to happen and you’re catastrophizing. Those thoughts will create anxiety. Now again, if you go back and listen to those episodes back a few weeks ago, you will remember me saying, we cannot control our intrusive thoughts. I want to make that really clear. There are a lot of thoughts you are having right now that you have no control over. What I’m talking about at distorted thoughts are the thoughts on how you appraise a situation. Let’s say you have a thought, let’s say you have harm obsessions, and you have a thought like, “What if I wanted to hurt somebody or so forth?” That you can’t control. But if then you appraise it going, “I’m a terrible person for having that thought,” that’s the distorted thought that you can actually work on. Those distorted thoughts can cause anxiety as well. 4. Behaviors Sometimes our behaviors can create anxiety. Avoidance is one of them. You would think that avoiding your fear makes anxiety go away. Makes sense, right? But actually, it’s not true. The more you avoid things, the more you actually increase your anxiety about that thing. If you’ve avoided something for a very long time, let’s say you avoided flying. Now, even the thought of flying is going to give you anxiety. So, behaviors can cause anxiety as well. Now, this also includes compulsive behaviors. It includes reassurance-seeking behaviors. It includes rumination in your mind, mental compulsions. Behaviors can increase the degree in how your brain responds. People pleasing, this is a big one for me. If I’m people pleasing, trying to make everybody happy, no one upset, you would think, oh, that’s a good thing. You’re being a kind human being. Well, yeah, except it then creates a lot of anxiety at the idea that someone doesn’t like something you did or that they’re upset with you about something that you did. Now, you haven’t built up a tolerance to just the fact that we can’t please everybody. These are ideas on how behaviors can actually cause anxiety. 5. Trauma In the mental health field today, everybody is saying everything is trauma. It’s like, “You’ve traumatized me. I was traumatized by this.” It’s important that we-- and this is for another conversation, but I’m going to slide it in here. When we talk about trauma, where I’m actually talking about life-threatening trauma. Not to say that we call it little “t” trauma. There’s big “T” trauma, which are life-threatening events, war, assault, witnessing a death, and so forth. There’s some examples. It doesn’t include all of them, but that’s what we call capital “T” trauma. There are little “t” traumas. We all have little “T” traumas and they can cause anxiety. I’ll give you an example. When I was a kid, we went through, in 1992 I think it was, this devastating drought. I grew up on a farm. We really needed water and the whole environment was just desperate for water and we didn’t have enough water. We had to pay to have a truck bring water just so that we could have baths. It was really scary as a very young child to be afraid of not having enough water to drink. It was scary. We could call that a little “t” trauma. Still to this day, when my kids, my son just spends forever in the shower, I start to notice I get anxious when he’s in there for a long time because my brain is telling me we’re going to run out of water. That’s an example of why you may notice some anxiety show up. Now I can correct that and remind myself that I live in times where there’s no drought or that we have excess water and so forth. And that’s where I check those cognitive thoughts and errors of my thinking. But the trauma itself can cause the anxiety. Again, I want us to be really careful around the word “trauma” because I don’t want us to be using “trauma” about all the things, because that actually isn’t good for our brains either to keep telling ourselves we were traumatized. That actually can create anxiety in and of itself. 6. Environment You all have experienced this. Even though I don’t know you and your beautiful face, this you would have experienced in the last few years – the environment of COVID creates anxiety. Seeing people with the mask at the beginning of COVID, I’m guessing you would’ve had a bout of anxiety. Being around loud noises can create anxiety. Being in countries or regions where there are discord, conflict, war, they can create anxiety. Being in an abusive household, the environment of abusive household can create, of course, anxiety. Having someone around you who yells a lot and screams and throws things can create anxiety. There we’re going into the line again of trauma, but we want to consider environment. 7. Stress Management A big one for right now as well. If you have an incredible amount of stress on your plate, you will naturally have anxiety. If this is you, I’m going to encourage you to consider taking some of the stress off your plate, if possible. I know it’s hard. Some of you have double jobs and family and chronic illnesses and medical, mental illnesses. It’s hard. But anywhere you can, ask yourself, is there a way I can make this easier or simpler so that I can reduce my stress? 8. Lack of Tools Now this is a big one for me because I get really grumpy and cross. That’s an Australian term for everyone who is an Australian. When you say you’re cross, it means you’re angry or very grumpy about something. I get really cross when people who claim to be anxiety specialists give these strategies that actually make anxiety worse. Sometimes people do have generalized anxiety, but the tools they’ve been given can actually make it worse. Telling people just to use oils – oils are fine. I have nothing wrong with oils. I actually, PS, love oil. But if that’s your only skill and only tool that you have and your only agenda for recovery, that’s not going to help. It’s actually going to create more anxiety because you’re going to keep getting frustrated on why it’s not working. If your only tool is to, again, another gripe I have that makes me very cross – ah, so funny that I get so upset about it – is people who talk about thought-stopping, like just think about a big red stop sign. That is not a helpful tool. Sometimes it works for some people. But if you have a repetitive intrusive thought, that is not going to work. It’s actually going to make your anxiety worse. Lack of tools is an important one. I’m even going to say be critical, even of me when I’m giving tools. Really stop and ask yourself, does this work for me? Because I don’t know each and every one of you and all the intricacies of what’s going on for you psychologically. Always stop and ask yourself, is this helpful? I like to give you as many science-based tools as I can. I try not to just decide of a strategy that I use and just use it. But I want you to be really critical of everybody. Be very wise in your selection of who you choose to get advice from. That’s just a little piece to think about. Like I said, I always say this, take what you need and leave the rest if it’s not helpful. 9. Isolation The last one is important. It’s not last for any specific reason, but it’s isolation. If you are in isolation for too long, meaning that you’re alone, you don’t have community, you don’t have connection, your brain will naturally get anxious. Sometimes people love isolation. I myself love isolation and quiet and to be by myself. Oh, it’s so good. I just love it. I just can sit and be still. It’s good for some people, but too much isolation, prolonged periods of isolation often can cause anxiety, because we are community humans. Humans are built on community and tribe and needing each other. That goes back thousands, millions of years. For those who are struggling, they’re like, “Everything’s fine. I don’t know why, I’m in my safe house.” It’s like, “Well, when’s the last time you saw somebody?” “Oh, it was months ago.” “Okay, well, that makes sense. You haven’t had any of that.” There is some science to showing that your parasympathetic nervous system slows down when you’re in connection and even physical touch with somebody. That’s just something to think about as well. There you have it. Those are the nine reasons, 10 if we include alcohol. They’re the reasons that you might feel anxiety in your life or in your lifetime. I hope that this brings you some insight and you had a few aha moments about maybe why your anxiety is showing up again. I promised I would say at the end, this is not to say that now you have to go and fix all of those nine things. Actually, quite the opposite. We don’t fix anxiety. In fact, the more ideal option would be to practice befriending and allowing and not judging anxiety. But if this is helpful for you to maybe make some tweaks in your life, change your distorted thoughts, reduce your caffeine, manage your stress, change your environment, get some connection, get some helpful tools, that would make me so, so happy. Before we finish up, we are going to do the review of the week. This one is from Tennessee Lana. She said: “Game changer. I found this podcast four years ago and it has been monumental in my anxiety and OCD recovery. Many podcasts led to new content that I could follow and learn. I could write about this and never stop but instead I’ll leave a few adjectives that I think adequately describe this podcast. Kind, insightful, intelligent, easy, interesting, practical, helpful, uplifting, and LOVING.” Oh my goodness, Tennessee Lana, do you know the word I love the most? Practical. If I can be practical in helping you, I feel like I am winning in my career. All of those adjectives make me so overjoyed, but I love these. Actually, Tennessee Lana, I’m going to steal them from you. Copy and paste them. Maybe put them on my desktop just to remind me of the goals of the podcast. Love it. I hope you found this helpful. Have a wonderful day. Please go to leave a review if you can. Those reviews allow me to reach more people from people who trust the show, which is key. If someone can see that other people are enjoying it, that means they can trust us quickly, which is the goal. And then from there, I hope that this episode was helpful and gave you some insights. All right. I will see you next week. Have a wonderful day.

SUMMARY:  In today's podcast episode, we have Dean Stott from DLC Anxiety talking about his experience with Panic Disorder and Overcoming Panic Disorder.  In his upcoming book, Greater Than Panic, Dean talks about what it was like for him to experience agoraphobia, panic disorder, and other struggles after the death of his father.  Dean spread an inspiring story about overcoming panic and how he is Greater than Panic. In This Episode: What it was like for Dean Stott to have Panic Disorder How he overcame panic disorder using CBT and Mindfulness How Dean created DLC Anxiety, an online platform that helps millions with panic, anxiety and other mental illnesses. Tools that he found helpful to manage his Panic Disorder while also grieving the loss of his father. Links To Things I Talk About: DEANS BOOK GREATER THAN PANIC  Amazon link Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 224.    Welcome back, everybody. We have an amazing guest, a very, very sweet friend of mine. I am so excited to have on with us Dean Stott from DLC Anxiety. He is a true legend. Dean is on the episode today to tell his story about going from having a fairly severe panic disorder to then creating a mental health platform with over 1 million followers. He’s now all about creating mental health awareness sharing with people. He’s such a cool human being. And I’m so honored to have him on today.    We talk about his recovery, which you will get a lot of hope from because, like everyone who comes on the podcast, he really did the work, which is so cool. But then we also talk about the role that social media can play in mental health recovery, things to look out for, how to handle trolls, the benefits of being online, especially social media. If you have a mental illness, we go through it all. And it’s such a great episode. So, I’m so excited to have Dean on today.    Before we get into the episode, I want to give you the “I did a hard thing” for the week. This is from Nicole, from the Netherlands, and she said:   “I did a hard thing and I get very anxious when I have to call my doctor. My heart rate goes up and I get all trembly. So, I tend to avoid calling the doctor. But because I had been feeling dizzy, I had to get my blood checked. Afterwards I would have to call the doctors for the results, except I didn’t. I told myself if there was anything serious, surely they would call me. I kept this up for almost two weeks and then I suddenly thought I really should call for the result. So I pushed in the numbers to the doctor’s office, feeling all kinds of nervous. I was very tempted to just hang up. While I was waiting, I thought, why did I do this? What if I get bad news? But then I had another thought, if it’s bad news, all the more reason to hear it. So I hung on and I faced my fears. Turns out I have a vitamin D deficiency. It’s not very worrisome, but important to fix. I’m so glad I phoned the doctor, even though I REALLY DIDN’T WANT TO. Nicole from the Netherlands.” Nichole, I love this story. And the thing I love the most, and for those of you who want to submit for this, please do go. I’ll leave a link in the show notes. But Nicole, I love that you detailed what got you to do it, how you did it, what thoughts you had to shift up to get yourself to do the hard thing. You walked us through step by step and it makes my heart want to explode with joy. Thank you so much for sharing it. Amazing, amazing, amazing, amazing, amazing work. I am so, so impressed. So, thank you, Nicole. I love it.  Let’s get over to the show where we can hear all about Dean’s recovery. ----- Kimberley: Welcome, Dean. I am so happy to have more-- actually, as much as I’m happy to have you on the podcast, I’m just happy to have chats with you. Welcome. Dean: Thank you so much. Thank you for inviting me, Kim. Kimberley: Yeah. So, I feel like I know you and your story pretty well. But I would love for you to share your story with my listeners because I think you have some really great stuff to share. So, can you share whatever you’re comfortable about your recovery? Dean: Yeah, sure. So, basically, once upon a time, I was going through a panic disorder. So, dealing with four panic attacks, maybe four or five panic attacks every single day, where I get the worst period. And yeah, I went through a panic disorder, did my own research, a lot of science research, CBT research, mindfulness meditation, and curated my own plan out of recovery with the guidance of a really good support network, friends, and mentors, who’d been through an anxiety disorder and come out the other side and fully recovered from the panic disorder. I then wanted to take that feeling of the support that I was given from my older mentor, the friend that had been through it. I wanted to share that with as many people as I possibly could. So, I came up with DLC Anxiety. So, at first, I remember sitting down and I was like, “How can I get this message out to as many people as possible?” And I was thinking of local support community groups, like the Alcoholic Anonymous groups where people go and it’s a supportive network between each other. But then I was just so eager to try and get it even more on a global stage. And I saw what Instagram does and I just thought it would fit nicely in there, because I did see that there wasn’t many mental health communities when I first started. So, I thought there was definitely a nice place for it to fit there. So, yeah, I started to tell my story on Instagram. People started to relate, and it was a snowball effect from there. And now we’re over a million followers in the community, which is fantastic. Kimberley: So cool. So, I think that the whole concept here is really to look at what-- let me backtrack a little bit. So, in your recovery, did you do it all on your own? Did you have a therapist? What was that process like for you? Dean: Yeah. So, my father passed away. Like any people, any male in that situation, I bottled up the feelings that I was going through and tried to carry on with going to work and trying to get back into my daily routine. Almost putting it to the back of my mind because I wasn’t-- well, I didn’t have the techniques to cope with that and I’d never cope with loss before. So, it was from that bottling up of the grief that the panic attacks started and occurred.  So, when I first started having panic attacks, the first thing I did was go to the doctors who then referred me onto a grief counselor, but just specifically to address the grief side of things and not the anxiety, not the panic attacks. Regarding the anxiety and panic attacks, that was me curating, delving into a lot of psychoeducation, which I found very useful, learning about the system and the symptoms of anxiety. Now I’d done Psychology at university and done CBT before. So, it is like not I’d never--I knew the basic concepts of anxiety, but learning more about it and learning about the scary symptoms where you think-- firstly, when you have a panic attack, you really think that you’re going to die. It’s a really, really scary thing to go through. And yeah, to start learning about that was super important for my recovery.   Kimberley: Right. And so, let’s talk about community, why do you feel the community aspect was so important for you? Tell me about the idea of creating a mental health community for someone, let’s say, who’s suffering with panic disorder or grief or OCD or anxiety. What’s your thoughts on that?   Dean: Yeah. So, when I was going through panic disorder, I felt isolated, I felt alone, and really, I didn’t really want to bring it up to people around me because I just didn’t think they’d be able to relate to me. I thought these symptoms was just something that I was going through and something that I’d have to stick with for the rest of my life. I thought that was me, that I was going to be Dean who has these panic attacks. And I was going to have to navigate my way through my daily routine. And I think when I opened up to my mentor, a close friend of mine, who was working with me at the time – when I opened up and he shared his experience, it was the biggest weight off my shoulders, knowing that someone else had been through not the exact same story, but it experienced all these scary symptoms that felt isolated, felt alone, but more importantly overcome an anxiety disorder. And I think it was that inspiration and motivation that really helped me in my recovery.  So, yeah, having an important-- so, DLC is Dean’s Like-Minded Community. So, it’s a community full of like-minded people on anxiety recovery journeys. Some people are at the end, like myself, I don’t deal with panic attacks anymore, but some people are at the start, some people are in the middle. And they can all relate to each other no matter where they are on that journey. And then what’s beautiful about the community is where you see them sharing tips and experiences that work for them. And I know you speak about it highly as well, having an anxiety toolkit, because some tools might work for one person, but then might not work for another. But I think it’s very important to get as much information out there about all the different range of tools, so then each person can individualize their own recovery. Kimberley: Yeah. So important more now than ever, I think, given that the degree of mental illness is so high given COVID and isolation and everything. Okay. So, you have this platform. I love it. Very much, I loved being a part of your community. Why do you think that that is the most important piece, the community aspect? Can you share a little bit about what you see and hear from your community and why that’s so important? Dean: Yeah. So, again, so many DMs from people saying that they just feel connected. They feel hope, they feel inspiration, they feel motivation. Not only for me, who’s at the head or the founder of the community, but of all these people that are going through it, jumping over a million people worldwide. We know mental health. It doesn’t have a face, it doesn’t have a color, doesn’t have a social structure, it doesn’t matter what you’re working as it can affect anyone. And I think that’s why it’s really important and became an integral part of the community, was the interview series that I started doing with firstly mental health professionals from around the world. So, CBT professionals like yourself, Kim. Then we’ve had psychiatrists, psychologists, doctors. And having just as much information about anxiety and anxiety recovery, I think has been a super important part.   So, again, it’s not only having this community, it’s having the psychoeducation and real good-- I’m in a real good place now where I can guest on who I’ve joined a world-renowned within the space of anxiety. And also, we’ve had so many celebrities, musicians, actors, actresses come on and tell their own mental health stories where they struggled or where they’ve been vulnerable. And that’s really related to the community as well. Because obviously, people work at celebrities, people work at musicians and they might not know that just too, they’re going through a mental health disorder. So, yeah, having people like that come on and tell their own stories has been super, super beneficial for everyone as well.  Kimberley: Yeah. See, the cool thing is that the science, this is why I’m really fascinated in, is the science of self-compassion says that there are three components of self-compassion. One being mindfulness, the second being common humanity in that reminding yourself that you’re not alone in your struggles is the second most important part of self-compassion. The third being self-kindness. Now the reason I love this is I know for myself in the areas that I struggle, if I look at an account and I can see that a million people follow a mental health account, it gives me a sense of common humanity that there are a million people struggling with something. If you see an OCD account and it’s got 60,000 followers, you’re like, oh my God, that’s a lot of people. I must not be alone in my struggle or an eating disorder account. Or I love some of the autism accounts. I think it shows that it gives you permission to see that you’re not alone. And I love that. It’s such a beautiful piece of the work. Dean: Yeah. And especially where you just mentioned self-kindness as well. I think that’s an important subject just to speak about, is that when you’re going through an anxiety disorder, you have this inner critic that’s telling you that you’re never going to come out of it, that you’re not good enough, that maybe this is happening to you for a reason. When you come across these communities of people who are on their own journey of recovery might be a little a few more steps ahead than you, and you see that they have a positive outlook, some of them, on recovery and they are making steps. I think knowing to change that in a narrative and have that self-love and compassion is super important when it comes to anxiety disorders. Kimberley: Yeah. And that’s the benefit of social media right there. I think social media gets a really bad rep, but we have to weigh the pros and cons because there are lots of pros, right? Dean: Yeah, no, 100%. What I’d say is this is how I define it, is that if we just take Instagram and our mental health community so all the mental health accounts that are doing great, I see just like a safe haven corner of Instagram where people can go to and feel supported and connected and learn more about mental health in general. An app, like you say, can have a negative effect on people. And I think people speak about the algorithm and obviously, it’s all guessing what the algorithm’s going to do next, but I think we can actually use the algorithm in our favor.  And if you just bear with me on this, if you think about all the accounts that you’re following, so if you’re following all positive mental health accounts or self-compassion or self-care, self-love, then the algorithms are going to spew that out to you in your own feed. So, what are you doing? You’re starting to change that in a narrative like in your digital world, because you open up your app and you start to see all this self-love and positivity. So, you can definitely use the algorithm. So, I think it’s super important in taking a look at who you’re following and seeing, does that benefit your mental health? And if it doesn’t, then I don’t think you should be following them.   Kimberley: Yeah, I agree. Actually, I just was saying yesterday that I was just scrolling my-- I’m rarely on social media just to scroll. I’m usually there to do the work I do. My son was sick. I was sitting there wasting time. But the cool thing is the suggested was all cool stuff. It was really cool. I was like, “Oh, I love all these new ideas and these new looks.” And I was really appreciating what was being suggested to me, even though I know there’s some controversy around that. It was very cool. Dean: And you can imagine if somebody’s just starting or at the beginning of anxiety disorder and they’ve got this negative outlook and they’re isolated and they haven’t connected, then the algorithm may be spewing them not the right information. So, I think it’s important to really highlight the best we can our corner of Instagram, this mental health community that’s doing so great. And it’s a new wave of mental health support really and much needed, like you say, with COVID and everything that everyone’s still going through. I think over the next five, 10 years, it’s going to be more needed than ever. Kimberley: Right. Absolutely. I can’t agree more. I don’t even think we have the stats yet on what mental illness is like from COVID, mostly the isolation of COVID. So, I 100% agree. So, let’s step outside of the online world and let’s talk generally, how did you find this community? Not the online community, but as you were going through recovery, did you tell them about your struggles? Did they come to you? How would you suggest people tell somebody about their struggles? Do you have any thoughts on that?    Dean: Yeah. So, my body and my mind and everything was telling me not to open up about anxiety and not to speak to anyone and to keep it as an inner struggle, because everything with anxiety, we know it’s all internal, it’s all inwards. We’re ruminating on our thoughts, feelings, and sensations. So, it doesn’t make sense to then speak to other people. It’s not natural to do that. So, I had to go against that and I just started to open up and not feel ashamed to tell people what I was going through. I think I got to a point where it felt like I was struggling too much for me to be going through it, so I felt like I had to. So, my advice to people would be, speak to the people around you, have a support network. You may come across people who dismiss your anxiety [00:15:20 inaudible]. And it’s super important to know that just because they dismiss it doesn’t mean anything. It’s just, they may be their views. They might not have the education on mental health. So, yeah, if you get dismissed, that shouldn’t stop you from opening up, because I know that people often, especially in my community, say, “Well, I feel like I can’t tell people because if I tell my parents, for example, they just tell me to continue to get on with it that I don’t have these issues.”  So, I think that when that happens and you have parents and it’s important to put mental health boundaries in place, obviously, especially if we’re living with our parents, we can’t just move out or whatever or if we’re young. So, we have to put these boundaries in place and have a support network around us. So, if you are younger, it could be someone in your education system, it could be a support worker, or it could be the online communities like we mentioned.   Kimberley: Yeah. That’s interesting because what’s been on my mind lately, particularly in the online space, is what to do when you have been dismissed. Now that happens from parents and loved ones. But I think it does happen on social media as well, right? You will have-- the message I’ve been trying to give is, if it’s helpful, take it. And if it’s not helpful, leave it. Because a lot of people will come to my platform and say, “I’m freaking out because I just read this, which goes against what you’re saying. And I don’t know who to believe.” And they’re doing the best they can with what they’ve got. So, I think that it’s important for people, even on the online, to also dismiss bad advice online, right? Dean: Yeah, definitely. So many people get dismissed online, don’t they? But I think you gave some great advice, Kim. And that was, anybody can write anything on social media doesn’t mean that it’s true, does it? So, we need to take in what someone’s saying to us, but if it doesn’t fit our way of thinking or it doesn’t benefit us, then it’s okay to reject it. Just like if we think of anxiety and thoughts and you get these irrational thoughts. We get this irrational thought and we don’t believe it. What do we do? We don’t accept it. We can reject and replace it. And that’s what we should do with the information around us. So, if we see a negative comment towards us, it’s so easy, isn’t it? It is so natural for us to react in a negative way because that’s the way we’re built. You know what I mean? It’s our protective system there to try and protect us. But yeah, if it’s not benefiting you, then it’s okay to step away and move away from it. Kimberley: Okay. So, let’s talk about the dreaded trolls because that’s the perfect segue. So, what I would love for you and I to talk about, and if it’s okay, be as open as you can, but let’s talk about the mental impact of having a troll, because I think you could have a bully at school and you could have a bully for a boss or you could have a bully online. And I think it’s similar in how we can internalize it. So, I have had a troll for over a year now who’s pretty aggressive. And most of my people know aggressive and awful. And in the beginning, I took it completely personally, right? Completely personally. I thought everyone was just going to hate me. And it was the most-- you know the whole thing about you have to break something to put it back together the right way? Dean: Uh-hmm. Kimberley: That’s how it felt for me, because obviously, I had built my platform and what I do, my businesses on this idea that if I just do good and I’m kind all the time, no one will ever hate me. It’s impossible to hate me if I’m kind. I think it was this belief system that I had. And that got shattered into millions of pieces because there were people who really didn’t like me. And so, I think that I’m glad it broke and it got shattered because I got to put it back properly of I had to restructure that belief. But that was really, really hard. And having someone online say things, such horrible things, I really, really had a difficult time of not taking it personally. So, can you share what your experience of online trolls and that kind of thing has been? Dean: Yeah, sure. So, with the DLC Anxiety community, especially when the first lockdown happened and we had the celebrities and musicians, they all started to gain control back of their own social media accounts. So, we saw a lot of celebrities sharing mental health stuff, which is amazing because it’s shining a big light on everything to do with mental health. So, I saw an exponential growth within that period of the community. And yeah, I remembered it was on either speaking on interviews with people or just on lives. Again, your mind zones in. Doesn’t matter how many positive messages you see on your Instagram lives, for example. It’s only natural if you see one negative comment for your mind to then just zone in on that. And I remember the first time that happened to me. I was really taken back because I was putting 23, out of 24 hours into being in this community and helping the best I can, sharing a very vulnerable story to do with my father passing and then an anxiety disorder. And I thought I was being vulnerable and open and honest, and like you say, just trying to give as much love and support for people as I could. And then to see that someone else, some people were being negative towards this, it was dismay. I couldn’t believe it. It didn’t feel real. It was like, “Why are they saying negative things towards me?”  So, it was definitely a learning curve. I always remember the first time that happened. Over time, it has got better. Like you say, you managed to structure and rearrange things and you managed to not take these things personally and look from the outside, that the people that are spreading hate or being negative, they may be hurting themselves.  My take on it now, Kim, is that even if these people are spreading hate and being horrible on my community, especially towards me, is that hopefully, they may get some good out of one of the other interviews with someone else, because I know that these people, they’re in need of mental health support themselves. And for whatever reason, they haven’t been able to get it. And I always think that if they’re giving me hate, I can now take it. And hopefully, they might see something that benefits them. But it has been very hard to change my perspective on that. It was not an easy road. Kimberley: Yeah. That’s hard for me. I think on my end, I just had to keep reminding myself that, well, all the words are about me, it’s really not about me. It’s a lot about them and their struggle. The way I work through it-- and maybe you could tell me what you think as you see the troll, like how do you think about it. For me, when I see really awful, hurtful, hard comments, I first remind myself, this person had to suffer a great, great deal to be spreading this much hate. To understand that they had to-- no one who’s had a really easy life is jumping onto the internet and spending hours spreading hate on people. It’s usually that they’ve been through an immense. And that was really helpful for me, compassion-wise, of just to be like, “I actually have compassion for you. You’ve obviously been through the wringer.” And then the second piece for me, and this was the hard part and I’m curious, I really want to know your thought, was to start to trust that people will trust me, that people will see the real me, not me that that person is saying I am by me being consistent and showing up as me. And that was a hard piece because, at the beginning, I was like, “But what if they don’t trust me?” The consistency has been really helpful for me. But I think the truth is, that has also been really helpful for me to translate it into the real world.    Dean: I was just going to say, yeah, because if your inner critic, like you say, is wanting for everyone to relate to everything that you’re putting out there, all the amazing stuff that you’re putting out there, the last thing you want is somebody trying to discredit that because, you know what I mean? All we’re trying to do is help the people around us. So, yeah, it’s that inner critic and working on our inner ourselves.  When I see a troll online now, I just tend to leave them be. I think just leave them to do what they want. I think we know that our communities know what we’re about. They know how much we give to our communities, they know how much support and wealth that we give everyone on a continuous day. And like you said, you can’t stop these people, but also, just because they’re writing something, it doesn’t mean that it’s true, which I thought was beautiful for you to say.  Kimberley: Yeah. It’s tough. I mean, I think that that is a huge part of our mental wellness, is how we relate to people, right? And we’re in relationships. So, even if we’ve got a panic disorder, I was thinking about this the other day, is we’ve had a really, really rough house here in the Quinlan house this week. It’s been pretty chaotic, lots of sickness, lots of scary COVID scares, and so forth. And there was a time where I would’ve lashed out because of my own anxiety. I would’ve been really snarky to my husband because he goes to work and he doesn’t have to handle it. And I would often displace my anxiety and anger, just snotty. And that happens a lot. I hear a lot of people talking about just in daily life like, “I’m really struggling because my partner and I aren’t getting along because everyone’s anxious and so forth.” So, I think it is helpful to be in relationship with people who do have their own struggles. Like I said, it happens online, but it’s also happening at home.  Dean: Yeah. It can just happen on a day-to-day basis. A lot of people say that they can’t deal with people when they’re being negative towards them in real life. But it’s about taking a step back and knowing that the person who’s spreading that negativity towards you, that maybe they’re having a really rough time at home with their partner, that maybe they’ve got troubles with their job, money. It could be anything. Maybe they were traveling to work and they got caught up. And we’re all a product of our emotions at that time. And emotions, as we know, they come and go and it doesn’t curate who we are as a person.    So, if someone’s being angry towards you and negative towards you, it’s about taking a step back and knowing that it’s more on them again and it’s more on what their experience and the feelings and emotions and putting the correct boundaries in place. But it is really hard to do. I’m not saying that it’s easy to do. It is super, super hard, especially when someone’s coming at you with negativity. Your first line of defense is, you know what I mean, to attack normally, isn’t it? Or to take a massive step back. So, yeah, it takes a lot of practice, but it can be done. Kimberley: So, talk to me about, you’re probably the one person who would know the answer to this, can you share with us about managing mental illness with social media? How might someone have a healthy relationship with social media and the use of social media? Dean: Yeah. I have to put boundaries in myself because I say everything that I do is on Instagram, 99% of it. And if I’m not working on Instagram, I’m working on my website, which again is online. So, yeah, putting boundaries in place is super important, having rest away from social media, what we mentioned earlier about following accounts that really benefit you and have a positive impact on you and just getting rid of the negative accounts that are not making you feel good. You don’t want to go onto social media and not feel good because we all know we spend way too much time on social media. And if we’re spending that time looking at negativity, then that’s what it’s going to do. It’s going to put our mood in that sense. And we could really spiral into a state of being in a negative state just by what we consume. It’s like when people speak about the news and say, “Oh, well, I can’t watch that because it affects my mental health.” Social media is exactly the same, but probably more so, because we’re spending more time on it and it’s literally part of who we are now. Kimberley: Right. What would you say to someone who uses social media to cope with their anxiety, meaning to distract against it or to get them through their panic? Do you have any thoughts on managing it for anxiety? Dean: Yeah. It’s a very good question. So, I always go back to thinking, at the start of my panic disorder, if there were communities like ours out there, would it have been beneficial for me? And the number one answer is yes, 100%. It would’ve been an eye-opener. I would’ve felt I wasn’t alone. I would’ve felt motivated and encouraged that I can continue. But if you’re using anxiety communities as a way to not do the hard work, then I think it can be detrimental. I think anxiety recovery is about doing the hard work.  Now, a lot of people, and I’ve just done a post on this, unfortunately can’t have the access towards therapy, which we know has a massive benefit on mental health. We speak about anxiety, the latest sciences, the medication and a combination with CBT therapy has the best results. Now, that doesn’t mean for everyone, but some people may do better with medication, some people may do better with therapy. So, I think that having a community to help you and understand the psychoeducation behind it is great. But if you’re using it as a distraction to try and distract you from feeling anxious and dealing with the anxiety head-on, that’s when it can become detrimental.  I often say that there’s so much information-- and you can obviously maybe shine away on this, Kim, but what would you say to people who say that they can’t access therapy? Maybe it’s a money thing. Maybe it could be anything, couldn’t it? Do you believe that these people can still recover? Because there seems to be a narrative online that therapy is the only way forward. I think that’s an unhealthy way of looking at it because we know that anxiety recovery, there’s so many different routes out of it, and it all leads to the same angle, doesn’t it? Which is anxiety recovery. So, what would you say to the people that can’t access therapy? Would you be still giving them hope? Kimberley: Well, to be honest with you, 1000% I would give hope. I myself have had therapy for some things, but I really didn’t feel like therapy for other issues were helpful. And I felt it was better for me to actually work through a workbook, listen to a ton of podcasts. I’m a real mix. I’ve been blessed and privileged to have some amazing therapy, but some of my mental illness, I really needed to do on my own. But I did them through, like I said, a workbook, a support group, some were online courses. I mean, that’s why I created ERP School, was because people didn’t have-- that we’re turning them away to nothing. But what was really interesting about ERP School and CBT School is just recently, out of the blue, a bunch of people have reached out to me and said, “I wanted just to let you know that that got me right back on my feet.” It’s so wonderful to hear those stories, because otherwise, you’d don’t know them and you didn’t realize what an impact. So, no, I absolutely believe, I’m a real big believer in workbooks. I struggled with workaholism and that workbook for workaholism was huge for me and perfectionism. These are two really, really important things that I use that did not require therapy at all. Dean: Yeah. So, like you, Kim, I like to be guided by the science. So, I know obviously how important therapy and how life-changing it can be for some people with anxiety. But also, I think there’s still a lot of stigma around medication when it comes to anxiety, especially online. And yeah, I think we need to do a little bit more work on that because I think anxiety medication is being dismissed more so. Maybe that’s another conversation that we can have in the future. But I didn’t go through therapy with my own anxiety disorder, with the panic attacks. Mine was going online. I think you have to go to a trusted site. So, over here, you have the National Health Service, which has a ton of resources, all scientific, proven, all credible from the correct sources. And I think if you’re researching and looking at all the correct things, I think that can be really powerful for you. So, if you can’t access therapy, of course, there’s still hope. Of course, you can still recover. And that my message to everyone is I did it. So, if I can, I’m just a regular guy, you can do it too.  Kimberley: I love that. Just because I know, and thinking of the person listening here, like how did you do it? I know we haven’t got a ton of time, but could you just say, how did you muster up the courage on your own to face your fears?   Dean: That’s a great question. And I do have my book coming out, which is-- Kimberley: All right. Dean: Yeah. So, the book is called Greater Than Panic. It’s the number one question that I’ve been asked since day one of starting out the anxiety community, and that was, what is your story and how did you get from four panic attacks a day to be in the head of DLC Anxiety and be in the face of the interviews and not having panic attacks? Obviously, I’m still having anxiety. That’s a message that I think isn’t hammered home enough, whereas the goal of anxiety recovery is not never to feel anxious again. I think people often are misguided and have misinformation, especially at the start of an anxiety disorder, thinking that the goal is to never feel anxious again. The goal is to change your behavior to when you’re feeling anxious and make sure that it doesn’t have a detrimental impact on your day-to-day. I go right back to the basics. I go back to speaking about my father’s death, which was obviously a really terrible time, and it brought out a lot of emotions but also, I think it was important for me to go back and just explore it again. And I speak about my relationship with the doctor. It’s again another message that I like to hit home, is that if you’re dealing with any physical symptoms to do with emotional symptoms, to do with anxiety, your first port of call has to be the doctor, because we know that anxiety disorders can mimic other things. And so, it’s super important for a medical professional, a GP, a doctor, to run diagnostic tests to make sure that everything else is okay. And then when they tell you that it is okay, you can sit down with the doctor and you can start to plan your journey of recovery, which may be therapy, maybe self-help, maybe meditation, mindfulness, exercise, medication, so many different routes.  But yeah, my number one message is, if you’re dealing with physical symptoms and you haven’t had them checked out, you have to go to the doctor. So, I speak about my relationship with the doctor. I speak about curating my own anxiety toolkits. So, what worked for me and the research and the science behind each thing that I was trying and how it had a benefit impact for me. And I speak about exposure therapy and how that was really beneficial for me, but doing it not guided by your therapist.  Now, if you look at the science, you would say that the best effects of exposure therapy is guided with a therapist, but I didn’t personally have a therapist in my journey. But if you can have a therapist, I definitely recommend that that’s the best route to go down. But I speak about how exposure therapy worked for me and I speak about the hiccups on that road to recovery and what recovery looked like, what it meant to me. And then I speak about the anxiety community and how I wanted to spread the message and get that message across to as many people as I possibly can. And yeah, it takes me to the present day.    Kimberley: I can’t wait. That’s so exciting. So, tell me about the name of the book.   Dean: Greater Than Panic. So, that’s the message that you are greater than panic. Just because you have feelings of panic, if you’re up in panic attacks or panic disorders, it doesn’t mean that you’re broken, it doesn’t mean that you can’t be fixed. There’s nothing to fix because you’re not broken. So, you are greater than panic at all life, things, all the dreams, aspirations, careers, travel, love, money, whatever it is that you want, you can get. Doesn’t matter that you’re going through panic or have panic attacks. O if you’ve been through panic disorder, the other message is that you’re greater than panic. Kimberley: Amazing. Okay. So, I’m going to leave you. I feel like that’s the perfect way for us to end out. Is there anything else you want to share with us, any links, or how people can hear about you? Dean: Just DLC Anxiety over on Instagram and the website, www.dlcanxiety.com. I’d just like to thank you, Kim, for obviously inviting me on here. And I’d like to thank you for everything that you’re doing in the mental health space. CBT is super important to me. It’s an integral part to my recovery. And yeah, I’m just super grateful for our connection on Instagram and just everything that you’re doing. Kimberley: Thank you. I feel so blessed that we randomly got to meet. You know what, it’s such a blessing. So, thank you. I’m so grateful. Dean: Thank you. ----- Thank you so much for listening. I’m sure you got so much from that. Before we finish up, let’s do the review of the week. This is from Disc Golf Nate. They gave five stars and they said: “As Kimberly would say, this is not necessarily a substitute for in-person therapy. But it is still a very powerful tool. I’ve used this podcast in conjunction with my therapist and some books, but this podcast brings me the most peace.” Thank you so much, Disc Golf Nate. I am so honored for that amazing review. And yes, this should not substitute therapy, but my hope is it gives you some tools, some skills, some hope, some support, some joy, and compassion into your recovery. So, I’m so honored to have this time with you. I will see you all next week.  

SUMMARY: We all know that self-compassion is am important tool for anxiety recovery.  In this weeks episode of Your Anxiety Toolkit podcast, I address a common concern; “What if I dont deserve self-compassion?”  This is such a common reason people do not provide themselves with compassion.  In this episode, review the reasons YOU DO DESERVE SELF-COMPASSION and some key concepts and self-compassion mediations to help you practice self-compassion. In This Episode, we cover: Self-Compassion Definition Reasons people feel they do not deserve self-compassion Ways to manage feeling unworthy of self-compassion How to practice Mindful Self-Compassion Links To Things I Talk About: Self-compassion Mediation: Here is a link to several self-compassion meditations from previous episodes. https://kimberleyquinlan-lmft.com/episode-2-lovingkindness-meditation/ https://kimberleyquinlan-lmft.com/ep-134-giving-and-receiving-meditation/ https://kimberleyquinlan-lmft.com/ep-110-this-compassion-practice-tonglen-meditation-for-anxiety-will-change-your-life/ Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 223. Welcome back, everybody. It is a joy to be with you again. Thank you so much for being here with me. Thank you so much for putting aside your valuable time to spend it with me. I feel so honored. Today, we are talking about a question. And in effort for us to respond to this question, we’re actually going to ask ourselves some questions and I’m going to have some questions for you, and you’re going to think about them, hopefully, and then make some changes if you think that is what you need. The big question of the week is: What if I do not deserve self-compassion? Now, one of the most common questions I get is this question, particularly when I’m with patients and we’re discussing the idea of practicing self-compassion or kindness towards themselves. Often, that is a question they ask, what if I don’t deserve it, or they may even make a statement like, “I don’t deserve self-compassion.” Now, this is particularly true for those who are very self-critical and blame themselves for certain things that have happened either to them or that they have done. Like I’m saying, it’s like things that were accidental, things that they didn’t have control over, or maybe some things and mistakes that they did make. This is a really important question for us to explore. I’m going to hopefully get to explore it with you. Before we do that, I would like to do the “I did a hard thing” for the week. This one is from Sophia. Thank you, Sophia, for writing in and telling us your hard thing. Sophia said: “I suffered from OCD starting when I was 19. My hard thing I did was I reported my stepfather in for sexual abuse that occurred when I was nine when I found out I wasn’t the last victim. It took me 28 years to get to this place. And let me tell you, OCD really played into my intrusive thoughts. It made the process so much harder. But I did it and I feel like I’m out of the web of manipulation from my stepdad. This podcast helps so much and the book for self-compassion and fear workbook my OCD therapist recommended to me. I saw your podcast listed in the first few pages. Thank you for being a part of my support system without even knowing.” Wow, that was an amazing “I did a hard thing.” Thank you so much, Sophia, for sharing that amazing hard thing. You are showing up and facing fear and pulling your shoulders back and living your life according to your values. That is impressive. I’m so honored to have you share that with us and really do wish you the best. You are doing amazing things. Okay. So, let’s move into the bulk of the podcast in terms of let’s talk about what if I don’t deserve self-compassion. This is so important. I’m going to first pose to you the first question I have for you, which is, who actually deserves self-compassion? If someone says to me, “Well, I don’t deserve it.” I’ll say, “Well, who does? What do you have to do to be warranted of compassion? Who does deserve it?” I really pose this question. I really hope you answer it. I would like actually you to sit down and ask yourself, “Well, then who does?” And you will begin to see very quickly, I’m guessing, the rules in which you have for yourself that keep you stuck. Oh, the people who don’t have these thoughts, the people who don’t make mistakes, the people who are perfect, the people who look like they’re happy and are doing well. Or often people will say, “Everybody else is off the hook. It’s just, I’m not off the hook. Everyone else can be imperfect, mistake makers, but not me.” You’ll quickly learn the rules of your life. I want to ask you, do you want to live by those rules anymore? Because this is not playing games. This is your life. Do you want to keep holding yourself to those rules that you just listed off? How does it benefit you to continue to hold yourself to that high, high standard? Often, we say, “I shouldn’t have these feelings. I don’t deserve it because I’m weak. I don’t deserve self-compassion because I’m not valuable. I don’t deserve self-compassion because of the content of my thoughts. The content of my thoughts is too heinous.” Okay. So, there you might want to look at, again, what are the rules and do you want to live by those rules? Because the truth is, you can’t control your thoughts and you can’t control your feelings and you can’t control life a lot of the time, almost all of the time. And so, again, do you want to live by those rules? Next question: Are you beating yourself up for something that’s not your fault? Meaning can you control your thoughts? Because my thoughts aren’t my fault. I know my feelings aren’t my fault. I know how I interpret things aren’t my fault. That’s usually coming from years and years of being trained to think that way. I know my beliefs aren’t even my fault. I actually think we’re just creatures of habit and we were raised to believe certain things and we are going to make mistakes. I’m going to say this again: What would you have to do to warrant deserving self-compassion? Often when we actually explore this, I really, really hope you start and actually write your answers down to these questions because when we stop and we look at like, okay, so if you don’t deserve self-compassion, we really know the benefit of you practicing self-compassion so much so that I am in the process of creating a course that will teach you. I’ve already written a book for people with OCD, but I’m creating a minicourse on how to practice self-compassion. It’s that important. I want everybody to have access to it, not just those who have OCD. That is a big part of my mission, is to get everybody to be practicing self-compassion. Let’s say we really understand the benefits of it. We know it’s important. We know it can increase motivation, make you more successful, decrease procrastination, make you feel like a better sense of self. It can help you achieve your goals. So many benefits. It actually reduces inflammation. It gives you better wellness and health. It increases life satisfaction. So many benefits. Let’s say we want you to do it because it’s healthy, just like you would exercise because it’s healthy, or you would go get it to the dentist because it’s healthy. What would you have to do then to be warranted and deserving? And often then, again, you’re going to be very clear in terms of this list of things. I’m going to ask you, are the list of things even realistic? Really, if you said, “Okay, I’d need to no longer have these thoughts and I would have to have changed the past and done something different. I’d have to regulate my emotions all the time. Never snap at my children and never say something silly at a party.” Is that even possible for any human? Really for any human, is that realistic? Do you actually think you can actually achieve that really honestly? This is a question. This is not rhetorical. This is an actual question. The chances are, when you really answer it, the truth is, you’re not giving yourself self-compassion because you don’t feel like you deserve it. But the truth is, you will never be able to meet these rules that you’ve created for yourself. I don’t want to say that as if I’m blaming you. We’ve all done this. But I want you to be really honest with yourself in regards to, you’re never going to get to the place where you practice self-compassion if you keep those high level of rules, those perfectionistic rules. And then you miss out on this wonderful opportunity for your mental health and for your physical health, and for your wellbeing. Here is another question: What would you have to feel in order to offer yourself self-compassion? Meaning how would you need to feel about yourself? What emotion would you need to feel in order to feel like you deserve it? What would you have to experience about yourself? Not the rules, but like would you have to. Some people say, “I don’t feel like I deserve it.” It’s a feeling. The reason I ask this question is because often people will say, “It’s just a feeling I get. Sometimes I feel like I do and sometimes I feel like I don’t, usually depending on whether I’ve checked off all of these boxes.” But it’s still a feeling that you’re going off because it’s different. It’s not like you get your notepad out and you check the boxes. It’s a feeling. I might pose to them, could you actually offer yourself self-compassion without the feeling and just do it anyway? It’s a very, very radical thought. What a radical idea that you might offer it to yourself even though you don’t feel like you deserve it. Could you offer it because of what you’ve been through or because of the checkboxes that you haven’t checked? Meaning I believe, and I’ve said this on the podcast before, and I’m going to say it very, very clearly here for you, I believe the more that you suffer, the more you are deserving of self-compassion. It’s not the more mistakes you’ve made and the more you’ve suffered, the less you deserve it. It’s actually the more you deserve it. “Oh, I’ve made a lot of mistakes today.” Oh, you’re even more deserving of self-compassion. We want to offer more to you. Oh, you are having a really hard day with some really hard emotions and some strong emotions. Oh, even more of a reason to offer compassion. Now, usually when we talk about this, clients will say, “No, that’s just letting yourself off. That’s just getting out of jail free card.” I’m going to offer to you, like let’s trick this belief and check made it a little bit if we were talking chess, is self-compassion is not a get-out-of-jail-free card. It doesn’t mean you stop holding yourself accountable. It’s actually what helps you towards change. You are saying, “I don’t deserve self-compassion. I need to suffer and be criticized and punished because of something that happened.” Does that actually move you towards perfection? No, it doesn’t. It doesn’t create any change. In fact, it keeps you now doing behaviors, like I said, self-criticism, self-punishment, which keeps you stuck in a cycle of feeling bad and negative thoughts and feeling depressed and feeling hate towards yourself. Very little good comes from that. That is not getting you out of any problem. It doesn’t lead you towards being the best version of yourself. In fact, it leads you towards more and more suffering. Mindful Self-Compassion Offering mindful self-compassion doesn’t absolve you from what happened in the past. Ideally one day you will forgive yourself, but that’s a different topic. Forgiveness is not self-compassion. You can do both. You could forgive yourself as a form of self-compassion and you could be self-compassionate, which could lead you towards forgiveness. But here, what I don’t want you to think of is that people who are self-compassionate are just like, “Oh no big deal. I just totally did a terrible thing, and it’s not a big deal. I don’t have to beat myself up because that would be unkind.” No, that’s not what we’re talking about. And no one does that. If that’s the case, you’re not practicing self-compassion at all. Self-compassion is just simply offering kindness towards suffering. That’s it. It’s not ranking you higher or lower and the good or bad person. It doesn’t mean that you don’t matter. It doesn’t mean that your pain doesn’t matter. It doesn’t mean that you can’t hold yourself accountable and take responsibility. It just means the absence of beating yourself up and meeting your pain with kindness and compassion instead of criticism and punishment. The thing you’ve got to run mind yourself, and this is a huge thing I’m doing this year, is really trying to identify what’s working and what’s not. I do a lot of therapy. I think a lot. It’s one of my best skills and one of my biggest flaws, is I think a lot, I feel a lot. And it’s not a bad thing, but I’m really trying to be more efficient and effective. Meaning, okay, what’s the right amount of being responsible and taking responsibility? Because you could do a little bit, which is really responsible and very helpful. But then if you do too much of that, that doesn’t make you a super responsible person. It means now you’re moving into self-punishment. So, too much of one thing can be good and too much of one thing can also be bad. It gets you into trouble. So, how can you be effective with the behaviors that you engage in, is the amount of criticism or self-punishment or deprivation of compassion, which is what we’re doing here and talking about, does that bring you benefits to your life? It’s an important concept for you to think about. Whether you think you deserve it or not, or whether you feel you deserve it or not, is it effective? We’ll come right back to one of the first concepts, which is, just because you think it, still doesn’t make it true. So, just because you think you don’t deserve it doesn’t mean you don’t deserve it. It just means you’re having thoughts that you don’t deserve it and thoughts aren’t always right. We recently did a whole episode on guilt, quite a few months ago, but the whole concept was just because you feel guilty doesn’t mean you’ve done something wrong. Our brains make mistakes all the time. So, just because you think you don’t deserve it doesn’t mean you don’t deserve it. We think messed up, scary, wrong things all the time, and the truth is, anxiety lies. Depression lies. OCD lies. Panic lies. Chances are, a lot of these beliefs you have around self-compassion are also just lies. We want to move you towards recognizing that everyone deserves compassion. So, that’s the final where we land here, which is everyone deserves it. Everyone. Really to be honest, even when I say the more you suffer, the more you deserve it, that’s actually not completely correct too, because that would still be buying into this idea that certain people deserve it more than others. Everyone deserves it equally every day, 24 hours. It’s just a done deal. You don’t have to give yourself self-compassion. But what are the negative impacts of your life, if you don’t, and what are the positive impacts in your life if you do? Think about how much good you can do in the world if you did. That’s the point I want to make. Keep an eye out. We have a whole course on self-compassion coming. It will be for everyone. It will be $27. I’m in the process of making it. It will probably be available when this comes out, but just in case it’s not, keep an eye out in future podcasts. I will have a link on CBT School. You can go there and check it out. I cannot wait to share that with you. It’ll be a lot of these concepts, but actually more applicable skills for you to practice. Head on over to CBTSchool/self-compassion. I’m sure it’ll be there by the time we get to this episode and I am so excited to share it with you. Before we finish up, let’s do the review of the week. This one is from Kanji96 and it says: “This podcast is very helpful for me, especially when I’m going through hard times. Right now happens to be one of those hard times and here I am back listening to Kimberley. Thank you.” Thank you so much, Kanji. Your reviews mean the world to me. Please, please, please go and leave a review. I mean it. If you get any benefit from the podcast, this is one way that if you feel at all so inspired to leave a review, it really helps me. It helps me to reach more people. It helps people to feel like they can trust the information here. I would love your honest review. So, go over to podcast app or wherever you listen and leave a review there. I am so grateful. Have a wonderful day, everybody, and I will see you next week.

SUMMARY: This week’s episode is incredibly inspiring, with Lora Dudek talking all about getting real about OCD recovery.  Lora shares her experience of having harm obsessions and harm OCD and how she managed being a mom during ERP. Lora also shared some wonderful ERP activities she did to help her keep track of her exposures. In This Episode: What OCD Recovery looks like for Lora Her experience with Harm OCD What kind of Exposure and Response Prevention (ERP) Lora used for harm OCD How she used ERP and recovery to decide what her values were (starting a career in ERP) Links To Things I Talk About: ​​Lora Dudek OCD Contact info: https://www.psychologytoday.com/us/therapists/lora-dudek-lockport-il/935049 https://www.graceandgratitudecounseling.com/ourtherapists ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 222.  Welcome back, everybody. I am so happy to be with you today. Oh my goodness, I’m going to tell you a story, totally off-topic. But today’s episode is number 222, and coincidentally, it’s coming out just by coincidence the week of February 22, 2022. The reason that that is special for me isn’t because I have any kind of affiliation with numbers, it’s that I have this amazing memory of when I was very young. It was the 9th of the 9th, 1999. My mom, who is the most amazing human being in the whole world, had a 9/9/99 party, and everyone had to bring nine of something, nine flowers, nine chocolates. You could bring whatever you wanted. Nine of... We had nine of everything – nine shrimp on the plate, nine prawns. In Australia, we call them prawns. It was such an amazing memory.  I told my children that we were going to do something similar because I just feel like that was such a beautiful memory. And so, I feel like I’m beginning that whole celebration with you because coincidentally, it’s episode 222 on the week of 2/22/2022. Oh my goodness. I’m sorry. I know that has nothing to do with the episode, but it is a story that is so near and dear to my heart and I just wanted to share it. It isn’t actually an off-talk topic because I really do want to bring some more joy to this episode and I really do want to slow down and enjoy with you all. It is a huge part of my goal for this year. So, thank you for sitting in that joyful story with me. If you would like, I hope you do something with twos, if you can, on that day, something fun. Buy yourself 22 flowers, say 22 nice things to yourself, whatever it may be, because these are very much once in a lifetime experiences and memories.  Today, we have Lora Dudek with us on the podcast. Now, to say that I am a Lora Dudek fan is an understatement. I love this human being. She is such a shining light, especially for people who have OCD and want to feel like there is hope. She has such a beautiful story, such a hard, but beautiful story, and a real authentic, genuine story to share. I am honored to have her on the show like I am to have so many people come on who have a recovery story to tell. I particularly love when I can be a part of it and I was a part of their story, or CBT School was a part of their story or ERP School was a part of their story. And so, it is just such an honor to have Lora on here. She’s talking about what recovery looks like for her. The reason I love this idea is, recovery is different for everybody. I really wanted you to get an experience of what it looks like for someone who has really done the work. Like I said, so many of our podcast guests have done the work and Lora is no exception. So, I’m going to head over and let you guys listen to that.  Before we do that, I first want to do the “I did a hard thing.” This week’s “I did a hard thing” is from Fabian, and they said: “Hi, Kimberley. First of all, thanks for creating the room to write about my anxiety. I am recovering from OCD, and today I was at the dentist for a tooth filling. I don’t like it because my mouth is blocked and I’m scared of getting enough air. And moreover, I do not like to get injections.” Oh my goodness, Fabian, I feel you on this one. “I was able to face both and stay very present with the body sensations like cold hands, many, many thoughts, high heartbeats. It was a hard thing to finish the week and I’m happy that I did it. I will have to face it again in February 🙂. All the best to you and your team.” Amazing, Fabian. I feel you on so many levels. The dentist is so hard for me. No matter how many tools I use, it’s always going to be hard, but you did the hard thing. And that is what I love. So, thank you so much for contributing your “I did a hard thing.” I am honored and major props to you.  Okay. Let’s get over to the show. Kimberley: Welcome, everybody. I am so excited about this episode today. We have Lora Dudek. She is now a Licensed Professional Counselor, but when I first met her, she was going through her own journey, and I wanted her to share her journey with you today. Welcome, Lora. Lora: Thank you so much. I’m so excited to be here.  Kimberley: Oh my gosh. Okay. So, we’ve already pretty much cried before we even got on today together, which is beautiful. And so, I can’t wait to get into this whole conversation together. You and I met online many years ago, and now you’re a therapist, which just blows my mind, helping people. Can’t believe that. So, that’s amazing. Do you want to share with us your full-circle story? Lora: Yeah, absolutely. So, one of the things that we were just talking about was that I started listening to Kimberley’s podcast back in 2017, somewhere around then, when I had been newly diagnosed with OCD. This is a total full-circle moment for me because she was such a-- I just called her a ‘lighthouse’ back in the day.  My own story really started when I was just a kid. I mean, I was a little girl and was having intrusive thoughts. My intrusive thoughts have always been harm-related. As a kid, I didn’t obviously really didn’t know what that meant. I had a big obsession with death. I was very, very scared to die and other people around me dying or me somehow hurting them. But when I was little, it always just manifested as telling someone I was scared that they were going to die, and then them reassuring me that they weren’t going to die, which is such an interesting thing to look back on. No one ever knew that. But that’s where the reassurance started.  I was looking back. I can see these areas of my life that were impacted from the get-go really. And then when I had my daughter in 2014, the anxiety just became absolutely overwhelming. From the moment that I knew that I was pregnant, there were just basically constant thoughts about something bad happening. I felt the entire time that I was pregnant like, I don’t know how to describe it really. Maybe nine months of almost getting ready to attend a funeral truly is how I felt, because it just seemed so heavy, already knowing I was going to be really responsible for this life.  While I was pregnant, I even got one of those sonogram machines or the fetal heartbeat machines. I would be sitting at the office and have an intrusive thought that something had happened to her, and I would rush home and I’d make sure that her heart was still beating. My doctor knew me very well because I was basically calling every other week with something that might be wrong, that never was. And then once she was born, it really manifested as just constantly checking on her. These intrusive thoughts that something really bad was going to happen to her, that I wasn’t going to be able to take care of her, and constantly asking my husband at the time that I’m an okay mom. I can do this. I’m able to do this.  Those went on really. These thoughts and that heightened anxiety went on for-- she was 16 months old at her first Christmas or her second Christmas, sorry. We traveled with family to go see family, and I was putting her down for her nap and ended up laying down beside her. She fell asleep and I fell asleep next to her. It was in a bed. When I woke up, my first thought was, oh my God, is she breathing? I thought I had smothered her. And so, I put my hand on her chest and I could feel that she was breathing and I went to get up and walk away. I had the thought, what if she’s not? I was like, “Okay, let me check one more time.” That is where I say the walls came down, because from that moment on, it was like, there wasn’t any-- the checking just got out of control and it flipped. It got into this area where I was scared that something bad was going to happen to her, but now, I was going to do something bad to her. It just changed flavors really quickly.  We got home from that trip and I told my husband. He had to go on a business trip for two days. I basically didn’t sleep for two days. “I thought I’m going to hurt her. Something awful is going to happen to her. I can’t take care of her.” Just going out of my mind. I used to get up and check on her, probably 10 times a night, to make sure she was still breathing. At this point, I became so scared of myself that I would block my bedroom door at night with my dresser to make sure that I wasn’t going to get up and do something to her. I was like, “Whoa, something’s really wrong here.” So, I looked up an Anxiety Specialist and went and saw her. It took me about a couple of months seeing her and building rapport with her to actually let her in on some of the thoughts that I was having. I remember very vividly. It was an early morning appointment. It was a 7:00 AM appointment. The night before I barely slept, because I really did think like, this is it. I’m going to get hauled away tomorrow. I’m going to tell her these thoughts I’m having, and this is going to be the end of me. And so, that morning, I kissed my daughter, I kissed my husband. I walked out the door and got in my car and I was like, “All right, that’s the last time I see him for a while.”  But I got into my therapist’s office and I broke down. I’m like, “I have these thoughts that I’m going to hurt my daughter. It’s the worst thing in the world.” She was like, “Do you want to?” I was like, “Oh my God, how could you even ask me that? She’s the most important thing in my life.” She asked me a couple of other questions. But then she said, “Do you know anything about OCD?” Through my tears, I was like, “Yeah, I do. I know OCD. I’m not clean. In fact, I’m really messy. I don’t even know why you’re asking that.” I was frustrated.  And then she told me about intrusive thoughts and compulsions, and it was the biggest light bulb moment of my life. Everything just started making sense really from some of my earliest thoughts. I do have to say it was a bit of a relief at the beginning. So, that’s the story. That’s how I got diagnosed, and it started a whole new part of my journey. Kimberley: Yeah. So you had relief.  Lora: Yeah.  Kimberley: And then what was your emotion? Lora: Yeah, I mean, the relief was like, I’m not crazy, that it was so like something has got to be really wrong with me. And then it was just like, whoa, I checked the box for everything she just talked about with this disorder. And then the emotion, after a little bit, the emotion became like, this is going to take a lot of work. This is going to be a level of acceptance that was like, I started getting acclimated to what exposure therapy was. She didn’t practice exposure therapy, but she was amazing in the sense that she was like, “I have the person for you.” She knew enough, which is so important-- Kimberley: Yeah. Thanks for that. Lora: Yes. To send me to an OCD Specialist. That therapist was amazing. She laid out for me how this was going to work, what we are going to do. It was a relief at first. And then there was a lot of grief. There was a lot of heartache, realizing how much this disorder had taken from my life. Ignorance can be bliss sometimes. I think that I dismantled that notion through doing ERP and exposures, and it became a very interesting part of the journey. Kimberley: I know, I was thinking about you. You were saying you got in your car, you said goodbye. And then you had to walk back to your car and drive back to your house, right? How is that? Lora: It’s like, I mean, I have some health anxiety too, so I always liken it too. I walk into a doctor’s office thinking this is going to be cancer. And then I walk back like, “Okay, now I just go back to life.”  Kimberley: Right. I can just have this image of you, walking back to your car, going, “I guess I’m going home now.” Lora: Yes. And I got back. My husband was like, “Hey, you doing okay?” I was like, “I got to tell you what just happened. This is what they said. Did you know that obsessive-compulsive disorder is like this?” And he is like, “No, but I mean, makes a lot of sense.” Kimberley: Yeah. How crazy. It’s so amazing that you had that opportunity. Again, we know that that’s not a lot of people’s stories, so I’m so happy that you had that experience. Lora: The thing, Kimberley, is that I do want to point out that I had been seeing someone for anxiety almost my entire adult, different therapists. This is the first time. Like, I said, I would have these harm thoughts, but I was just like, push them away, get rid of them. This was the first time I’d ever come head to head with being actually like, “I’m responsible for a little life. This is all on me.” It felt like I wasn’t going to be able to live the life I truly wanted to live. Other times, it was just like, okay, I can walk away from it. I can find some way to not be around it. Now I’m talking about my daughter who means more to me than anything in the world. Something has got to give. Kimberley: Yeah. That’s really helpful to know that you have been in therapy.  Lora: Yeah. Kimberley: When I had previously done a presentation with you through the International OCD Foundation, and you shared about your exposure board, this whole idea blew my mind. The reason I really want the listeners to understand, when I teach ERP, I’m literally just teaching my way of doing it and I love hearing other people’s way of doing it. It’s the same, but it’s different. And so, I’d love for you to share about that as an idea for people.  Lora: Yeah. Well, what started as one of the biggest, I felt like, almost hindrances of my pregnancy was that at the time I was pregnant, there were seven other women at my work that were also pregnant. I remember seeing them all being so happy. And then they had their babies and they were so happy, and they were-- obviously, it wasn’t like, we’re not going to blow this up like some kind of blissful totally time. They were new moms too, but they were going out and doing stuff. And that’s all I wanted. That’s what I wanted so badly, was to have those experiences with my daughter.  So, my therapist and I started with imaginals and started with some really small things. I mean, I laugh about it now, small. Back then, it was like, no way. I did one where I was going crazy, where this wasn’t really OCD, the timeless tale of it’s not OCD. Such a classic. So, we started with imaginals and then even imaginals into sleepwalking at night, hurting my daughter, things like that. So, we worked our way up then to one day I was sitting in her office and she said, “What do you want to do?” I was like, “I just want to do normal stuff. I want to go to the zoo.” And she’s like, “All right, we’re going to the zoo.” And I was like, “What?” Kimberley: You’re like, “Take it back.” Lora: “I don’t say zoo.” Kimberley: “I meant Zoom.” Lora: “I want to have a video conference in the safety of my own home.” So, we started putting together this hierarchy based off things that I wanted to do with my daughter. And then she said, “I think a really good idea would be to take some pictures while you’re doing these and we’ll see what happens.” And I was like, “I’m absolutely not doing that.” There’s no way I’m taking pictures, because as I’m sitting there and having this conversation with this OCD on my shoulder, telling me, “You’re going to bring pictures back in here of you dumping your daughter into a tiger cage. Great. Let’s do that.” But we talked about it and I was like, “Okay, I’m going to do it.” So, that was the first real exposure I did when I went out on my own. We start actually-- I should back up, we did start with driving, because I had this thing with my daughter not actually being in the car. I had left her somewhere. So, we drive and I wouldn’t look in the rear view. That was a whole exposure. When we got past that, then we went to the zoo. We went to the mall to have lunch. We went to the swimming pool, which was just like the death pool as far as I was concerned. Let’s see, I have the whole exposure board still on the side of my wall. I mean, we went and got pedicures and manicures. We did things that I wanted to do with my daughter. We got flu shots. That I wanted to do with my daughter that OCD told me was absolutely not possible, without having someone to tell me the whole time what I was doing.  My reassurance came in the form of calling my husband, texting my sister pictures because then everything’s okay. They can see what I’m doing. And so, doing these exposures without engaging in calling anybody the entire time, without texting anybody the entire time. Just me and OCD and my daughter and here with the three Amigos. Here we go. Kimberley: Mom and daughter and the third wheel, right? Lora: Yeah. So, that’s how they looked. It was like, I really, really hit it hard over a summer, the summer of 2018. I called it my summer of ERP. Once I got going, I just wanted to keep going. It was terrible at the beginning, terrible because I would complete an exposure and I’d get home and then the rumination would want to start. It was difficult not to engage in that. It was difficult to just watch it. But through the exposures, I said at one point that the butterflies were my yellow brick road. Whenever I’d think about something and I got that feeling like, oh, it was OCD being like, “Really, are we?” And then I was like, “Ah, okay, here we go. Follow, follow, follow, follow.” Kimberley: Isn’t it that in and of itself is beautiful? I always say with my staff, is you follow the smell. Meaning wherever it’s smelly and you don’t want to go, you go there. And that’s what you were doing, is just wherever you felt butterflies, if I’m right, you would go and do that thing.  Lora: Yeah, absolutely. Because it became that-- my therapist phrased it in a way where she was like, “We’re going to play scientist.” That’s what she’d tell me. “We’re going to go try this out. Let’s just bring back what we find.” It was such a compassionate way to do that. It wasn’t like, “Here’s your exposure, do it. Go. Boom,” which sometimes I think can be a little helpful. But for me, it worked to be like, “Let’s go see about this.” Kimberley: Yeah. “Let’s be curious.” I love it. Now I’ve seen this exposure board and it is so beautiful. You would have no idea you’re doing exposures. You look delighted most of the time. I wonder if you could even send me a photo and maybe we could show that in the show note, that would be wonderful. Lora: I would love to.  Kimberley: Yeah. I’d love to be able for people to click and actually see what it looks like. Maybe we could even say-- I try to give homework during the podcast. We could even say, “If you have anxiety, you could create your own.” Lora: Yes. That would be awesome, because I’m telling you, whoever’s listening to this right now, you’re going to see that I look back on this board and it’s us smiling. There is one picture where my daughter is screaming, but that was the flu shot picture, and we did a hard thing. It was a beautiful day to do a hard thing, and I put it on that board, man. Kimberley: Good for you. She deserved to cry. I think that you’re making a good point here, and I’ve had this conversation with some of my clients, is exposure is even if you don’t smile for the photos, still put it up because you did it, right? Lora: Right. You did it. And that’s a thing. Along the way, those victories, I really don’t believe that there’s such thing as small victories. I know we say it a lot. A victory is a victory is a victory. Take it, hold onto it, and know that’s the fuel that you’re putting in this device right now that is getting you through this. Kimberley: Yeah. I love it. Are there any other exposures that you did that you want to share that people may find different or creative? I love the creative ones. Lora: Well, I just think that the exposures started to become organic. When I was first diagnosed with OCD, I did not know OCD’s voice at all. I was like, “No, no, no, that’s the voice that’s kept me safe my whole life.” And so, along the way, the more I started to do some of the work, I started to realize that that what-if voice, that’s when I’m like, “Ah, if I’m going along and doing something, what-if pops up.” That’s my voice of OCD. I’ve learned that. And so, for me, a lot of my exposures, even to this day, have to do with when the what-if pops up. How can I look the what-if in the eye? I left out obviously in a place where my daughter couldn’t get them, but I’ve left out kitchen utensils before. Just last night, I mean, I mentioned how I’m doing some OCD work again right now because it continues. The what-if popped up and my daughter hadn’t drained the bathtub. I was going to drain it right away. Now it’s not even like what-if. It’s OCD being like, “Whew, way to think of that one.” That was it really. And then I stopped myself from draining the bathtub and it’s like, “No, no, no.” And so then, I left the bathroom and I’m like, “We’re just going to leave that tonight.”  Kimberley: That’s so cool.  Lora: Really anywhere that I can poke the bear, I guess me and my daughter doing things out in public, then that just confronting that fear of me that I’m going to lose control, not be able to help her if she needs it. All those things, wherever the what-if pops up, that’s where I knew my work was. And it still is to this day. Kimberley: Yeah. I love that you share that too. So, it sounds like some people, when we’re hearing this amazing story, they think it’s just, you’re done. Your exposure is done. Is that the case for you? Lora: Yeah. I was one of those people, I’m going to get through this summer of ERP, which is why I still call it summer of ERP. It was the one summer. I had these high hopes that then once I get into grad school and once I really start working with people with OCD and helping people that the OCD just fizzles. I have recently just come into this space of understanding and ultimately, some acceptance of like, this is kind of a way that I live right now. I don’t know what five or 10 years down the road looks like. And I’m really, as far as OCD is concerned, not too focused on it. I’m focused right now on, how’s it showing up and are the things that I’m doing helpful? Are they getting me to where I want to be or am I staying in the same spot? That’s my litmus test, is am I living the life according to my values that I want to live? So, recovery for me right now looks like I do exposures still, and I have even after the 20 months of COVID. I thought, man, I bet it could be really helpful to speak with an OCD Specialist again to get a little bit of guidance, get some creativity because that can help sometimes. So, I’m doing that right now even, and it’s been amazing. I think it’s just a process of building the muscle, of keeping the muscle and I think I’m gaining more acceptance by the year.  Kimberley: Yeah. I mean, that’s a piece of it. You had said before, as we talked like mindfulness and self-compassion and act was such an important piece of your work and acceptance is such a core part of all of that, because there is so much grief. We don’t talk about it enough, right? Lora: Yeah. There is though. Kimberley: What was it like for you-- let me rephrase that. Was mindfulness and self-compassion a part of this process for you?  Lora: Yeah, absolutely. So, my amazing therapist knew about Mindfulness-Based Stress Reduction and she had mentioned it to me. There was a program that was going on. I lived in Dallas at the time, at the Dallas Yoga Center. It was an eight-week MBSR program and I signed up for it. We did a body scan, a 40-minute body scan, the first class, and everybody woke up and they were like, “That was so relaxing. That was so awesome.” I raised my hand, I literally raised my hand and I was like, “I don’t think I did that right. I just had a 40-minute panic attack.” It was awful.  But I should say too, that shortly after I got diagnosed with OCD, I realized I had become incredibly dependent on alcohol, especially being a new mom. So, I had completely quit drinking. I was like, “All right, if I’m going to do this, I’m going to do this. Let’s go.” I quit drinking. I didn’t want to have that crutch. I was in the MBSR program. I talked to the teacher. She convinced me to come back the next week. And then the next week, we did another meditation. Towards the end of it, she read a Mary Oliver poem that ends with “Tell me what you plan to do with your one wild and precious life.” It felt like a dam burst open in me at that moment. I was like, it is so precious and it is so amazing, and like, “Lora, you can do this. Let’s give this everything we’ve got, the exposures.” Learning to sit with myself through mindfulness was huge because OCD and anxiety do not like that. We need to be moving.  So, mindfulness was so huge for me to be able to just breathe and be in a moment and watch my thoughts instead of engage with them. Mindfulness then I say was the gateway to self-compassion because I’m not sure-- maybe I would’ve gotten there, but it wouldn’t be as soon to be able to be with myself and to hold myself and that loving-kindness. When you don’t even want to sit with yourself, it’s really hard to be able to look at yourself and be like, “I’m here.” You want to be like, “Let’s go.” So, yeah, self-compassion then was huge, because that voice of OCD is so nasty. I worked on a self-compassion journal for about six months straight, every day, really journaling. Kimberley: What would you write? What would that look like?  Lora: Yeah. So, I read and worked through with my therapist the Kristin Neff’s first book. And so, each day I would pick something that had happened, that was a little difficult and I would break it down into the three components of self-compassion. I would be mindful about what happened. Didn’t need any of my judgment in there. Let’s just lay it out there, what happened. Then the common humanity of it. Who else do you think in the world might have experienced this, or that feeling of not being alone. Man, probably a lot of people ran into something like this today. And then self-kindness. A lot of times, my self-kindness sounded like, “I’m really proud of you. That was really hard.” I don’t know how many entries I had over those months of being in a grocery store. Like a toddler going nuts in a grocery store and then just the flare-up of like, “Ah!” At the end of the day, that’s what I choose.  I remember a couple of months, maybe three or four months in, where I was sitting down to write and I couldn’t think of something really hard that had happened that day. And I was like, “What?” It was such a weird feeling. After months and months and months of really intense therapy and some difficult things I was working with, I was like, “Today, I’m just going to be compassionate then about how much work I’ve been doing.” Kimberley: Wow. I love that you’re sharing that because I’ve found even since-- I mean, I wrote a book on self-compassion, but since I wrote the book, I’m even pushing my clients to do it even more. The journaling and the writing to themselves seem to be the most powerful part of the work, the writing to themselves. Lora: Yes. And I think that the writing to myself and the speaking to myself was the most powerful part of it. In the beginning, it was absolutely the hardest, especially with the voice of OCD. When I would look in the mirror and I would say, “You’re doing the best you can, Lora. You’re really doing this,” OCD would be right there to be like, “Are you?” It’s so egotistical. It just wants all the attention. “Maybe you’re not.” I sat down with my therapist a couple months into really keeping that journaling and I was just exhausted, just so tired from some of the work. I don’t know if you can see it. Can you see on my back wall “As long as it takes”? Kimberley: Yeah. Lora: I sat down and I just started crying one day and telling her this has just been so hard that sometimes I feel like I haven’t made any progress. I feel like I take two steps forward and five steps back, and was just really down about stuff. She sat there, just really holding some amazing space for me, but I said, “How long is this going to take?” She just looked at me and she just put her head to the side. Really, she’s such a sweet person, and she said, “As long as it takes.” She said it just like that, “As long as it takes.” And I was like, “Okay. As long as it takes. Throw out the timeline then. Let’s just keep going.” Kimberley: Yeah. I love that I got goosebumps hearing you say it. All the hairs in my arms are standing up. And I love that you have it on the wall, because I read it as we were starting. I was like, “You know what? We’re good.” It shakes off all the rules and stories we tell ourselves. Lora: Yes. My mom actually, she made that for me, for my graduation from grad school. She made that and framed it for me.  Kimberley: I love it. Yeah. You are so inspiring really. Lora: Thank you so much. Kimberley: Yeah. Number one, I’m so grateful that you’re here and you’re sharing this, and number two, I’m so excited that you’re going to change lives for people, being a therapist and so forth. I’m just so grateful that I got to see some of it. Lora: Yes. Because before we even started recording, we were talking about how on the Mondays-- what were they? Magic Mondays? Kimberley: Magic Mondays. Lora: Magic Monday. I’d be like, “All right, it’s magic Monday.” I’d log on and I’d ask questions and I was really inquisitive and you were so sweet. You answered all the questions and you were just so-- it was like this feeling of it’s going to be alright. It is. I think when we can cultivate that and know the sky sometimes can feel like it’s falling, we do really have the power to look around and say like, “Here I am.” Here I am, put our hand on our heart and say, “This is what I can do in this moment. I can at least show up for me at the very least.” And that’s not the least thing at all. Kimberley: No, no. Like I said, you’re so inspiring. I’ve written so many notes, which is so fun. I don’t usually get that many notes down. So, I’m just so grateful for you for coming on and sharing your story. I loved presenting with you. That’s where I felt like I got to know you, so I’m so grateful. Where can people find you? Lora: I am on Instagram and the account that I share a lot of my OCD journey with and things that I have learned along the way is Judgment-Free Anxiety, but it’s judgment_free_anxiety. Kimberley: I love that. What’s for you in the future? Tell us about what’s popping out for you. Lora: Oh man. Well, right now, I hope to be employed somewhat soon. It’s a new life now after grad school and after becoming licensed, and just hopefully a lot more adventures with my daughter, going to do that. And man, that’s it. I did actually recently become certified to teach mindfulness, so I’m also looking at doing something with that as well, but I’m not sure exactly what. Kimberley: Yeah. Such good skills to have in your toolbelt. Lora: Yes, absolutely. Kimberley: Well, thank you so much. You filled my heart up today. Thank you.  Lora: Thank you so much, Kim. Thank you. ----- Thank you so much for coming and listening to our podcast. Before we finish up, let’s do the review of the week. This is from nmduncan827, and they said: “Compassion, comfort, and wisdom. I’ve been following Kimberley Quinlan for years now and I can’t say enough wonderful things about her and her work. As someone who has had OCD their entire life, I feel like finally at the age of 33 I’m beginning to find helpful resources to really push me along in my road to recovery. Between Kim’s Instagram page and her podcast and her new book— there’s little nuggets of compassion, comfort, and wisdom. I found this no matter where I am on my journey. I couldn’t recommend this more for my fellow OCD and anxiety-disorder community! So grateful for Kim.” Thank you, nmduncan827. Thank you so, so, so much. I am so honored. And of course, you can find me at Your Anxiety Toolkit on Instagram. You can get my book anywhere where you buy books, specifically on Amazon and barnesandnoble.com called The Self-Compassion Workbook for OCD. And of course, the podcast is here. Any time you like, go back, listen to old episodes. Sometimes they’re the best ones. I will see you guys next week.

SUMMARY: Today, we are going to talk with you about the 7 common struggle you have with time management.  Do you find yourself constantly looking at the clock? Or, wishing time would go faster?  Do you feel like your to-do list is so long that you will never get them done? Or, do you feel like you never have time to prioritize yourself?  In today's, podcast, we talk all about your relationship with time and why it is a HUGE part of managing anxiety, depression, and stress. In This Episode, we address the 7 common struggles you have with time management. “I don't have enough time” “I have so much to do” “I have so much I want to do” “I struggle to start and stop activities” “I don't a good understanding of how long things take” “I don't like structure” “I hate being told what to do with my time” Links To Things I Talk About: ONLINE COURSE Time Management for Optimum Mental Health https://www.cbtschool.com/timemanagement Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 221. Welcome back, everybody. I am so thrilled to have you here with me today for Episode 221. Oh my, how is that possible? We are getting so much feedback, such amazing feedback from last week’s episode. I wanted to additionally offer you one more bonus piece of content from our new course, which is called Time Management for Optimum Mental Health. You can check it out at CBTSchool.com/TimeManagement. It is a course. We have it for $27. It’s a mini-course, so it shouldn’t take up a ton of your time, and it’s me showing you exactly how I manage time. Now, the reason I created that course was because so many people were reporting to me – clients, followers, listeners – that COVID has destroyed the rhythm and the routines that they had, and that they really want to find a way to implement during their day time to do their therapy homework, do get exercise, maybe have more pleasure in your life, maybe reduce overwhelm, a lot of overwhelm because the to-do list is always so long. Am I right? The to-do lists are always so long. There seems to be a never-ending list of things to do. So, I added all that in, showed you exactly how I did that. Again, you can go and check that, or you can click the link below in the show notes. But as a bonus to that course, I did a Q and A where people submitted their questions. I have addressed that in that bonus, and I’m today giving it to you free in today’s podcast episode. If you want to get a feel for what we’re covering, you will have some reference to the course throughout, but you don’t need to purchase the course to get benefit out of this episode today. However, together they would be really beneficial, I’m sure. Today, we’re going to cover a couple of main topics. Here I’m going to give you some overview. Some of the questions people or the concerns or roadblocks they had around time management were things like, “I don’t have enough time. I have so much to do on my to-do list.” Another question we will cover in today’s episode is, “I have so much I want to do. I just can’t, again, find time.” Someone brought up-- multiple people, forgive me, brought up that they struggle to start and stop activities. They struggle to get the motivation to get going. And then once they’re going, they have a hard time transitioning into other activities. We address that as well. Someone posted in that they struggle with having a good understanding of how long things take. This is one of the reasons I have myself had to use a lot of time management, is I was underestimating how long things were taking and I was leading to a lot of anxiety and overwhelm. We also address people who don’t like a lot of structure in their life and we also address people who don’t like scheduling and don’t like time management because they don’t like being told what to do with their time. We’re going to address all of that today, but we also go much deeper into that in the time management course. You can run over there if you want to take a look at that. Before we get into the show, let’s do today’s review of the week. This one is from Sheffie, and they said: “Wonderful resource! You can’t help but love Kimberley.” Oh, that’s so kind. Thank you, Sheffie. “She has such warmth and sincerity, is positive and funny, and spreads so much good into the world. On top of all that, she’s a gifted clinician who does a great job sharing her knowledge with others. And she does all this with a lovely Australian accent.” Oh my goodness, this is so kind. “All of her content is fantastic, but I especially love the podcast because each episode is packed with so many nuggets of wisdom that are applicable to so many situations. They’re thought provoking and I find myself pondering them for a long while after. They’re also a good length - great content without going on for hours, very digestible.” Thank you so much, Sheffie. That is so kind. Actually, one thing, as I’m really listening and reading that off, sometimes I know I’ve mentioned this before, but creating a podcast can feel really lonely because I’m talking into a microphone. Sometimes I don’t know if things land for everybody. I’m talking about what resonates for me and what I know has resonated from my clients, but it’s never really sure, like how is anyone feeling about this? So, just getting your reviews actually is very heartwarming to me. So, thank you. It actually helps me to feel like I’m on the right track and I’m helping and I’m bringing value to your life. Thank you so much, Sheffie. Please do go and leave a review. It does help me so much in my heart, but so helps me just to get more followers and listeners. All right, let’s get over to it. Let’s talk today about your relationship with time. Let’s address some of these common roadblocks to time management, and I hope you find it incredibly helpful. Have a wonderful day, everybody. Welcome, everybody. I am so excited to be here with you to talk about your relationship with time. Now, this is an interesting topic, I think, and one that very much relates to our mental health. I personally find a lot of my thoughts are around time and about my belief that I don’t have enough of it. This has probably been a very big part of my own experience of suffering because I keep telling myself, “I don’t have enough of it.” I really want to see whether this is true for you. Now, I did a poll on Instagram and asked my friends there to give me their biggest struggles with time management. As you may know, I have a full course on time management specifically related to managing mental health, how you can make time for your recovery, how you can make time for things that really benefit your mental health. A lot of the times we end up getting our to-do list done instead of scheduling in pleasure and downtime and rest, and we don’t rest and have pleasure until we’ve got our list of to-dos done. But the problem is, the to-do list is always longer than the day. Am I right? We cut all of these submissions of things that people struggle with, a lot of the topics we discuss directly in the course, but a lot of them I wanted to discuss today specifically related to these struggles and the relationship people have with time. The first one here is, “I don’t have enough time.” Now I have two answers to this concern. number one, chances are, you are right. You don’t have enough time to do the things that you are pressuring yourself to do. Now, I understand that many of you have jobs and you’re going to school and you have children or you have loved ones and you have your own chronic illnesses or mental illness. So I agree. The list of things to do is very, very long. But I’ve wanted to first just ask you, is all the things on your to-do list being demanded of you, or are you demanding them of you? It could be one or the other. I just wanted to ask you, because I know for me, there are lots of things that I get demanded to do. I have to work. I have to make money. I have to be a mom. These are things that I really value and I want to take care of. But in addition to that, there’s a lot of things on my to-do list that I actually don’t have to do. I place those stresses on myself right. Now we’re not here to blame. I never want this to be about blaming ourselves, but it’s helpful to inquire. What things on your list do you have that actually create more stress? Is it helpful to add those things on your list? Is there a way you could maybe give yourself a break from the long things of all the things you have to do? Assess for yourself what’s important. Is it important to me to get this done? But here is the thing. As we talk about in time management, the online course, is I have so many things that I value. I have so many things I want to do. I have so many ways I want to show up for people and friends and family. At the end of the day, it’s unrealistic. Even though I want to do it, I don’t have the time. To reflect, I don’t have the time. Yeah, that’s true. Sometimes the most compassionate thing I can do is to acknowledge that and be more realistic with the projects I put on my to-do list. Often I’ll speak with clients about, are you taking too many courses? And they’ll say, “No, I have to. Everybody is taking this many.” And I’ll go, “But is it working for you?” If you’re really honest with yourself, does taking that many courses benefit you and give you time to recover from your mental illness? Does saying yes to volunteer, while volunteering is an incredibly valuable and helpful thing, are you in a place in your life right now or a season in your life where you can do that in a healthy way that still prioritizes your mental health? Just questions to think about. You may have some strong reactions to these, and I would inquire if you do. I’m not suggesting anything here, except I want you to inquire what is best for you. Now on the flip side of this, I can also say, even on the days when I’ve managed my time and my to-do list, I still just have the thought. “I don’t have enough time. I don’t have enough time. I don’t have enough time.” And that’s my relationship with time. It’s not great. My personal relationship with time, I have a long way to go. My relationship with time, as if it’s a thing, is when I look at it, I say to it, “There’s not enough of you.” But I only have 24 hours. You only have 24 hours and we have to negotiate with what we want to cram into that 24 hours. It can be whatever you like really. You can sleep for as long as you think you need to sleep. You can work, you can go to school, you can take up whatever hobbies. Your job is to decide what’s best for you based on your values and your family and your needs. The next one is, “I have so much to do.” Again, we have a relationship with time. When it’s not about time, it’s about our to-do list. I really want this time management course that I’ve created. You can go to https://www.cbtschool.com/timemanagement. If you haven’t already, if you’re listening to the course right now, I want you to really, really think about the to-do list and reassess the to-do list. If it doesn’t need to be done, I would encourage you to consider taking it off. Now, I understand, a lot of things on the list have to be done and I want them to be done, which is why you should, if you need, take a look at the procrastination episode and module, and you can maybe look at that as well. But like I said always, a lot of the thoughts we have about time are either facts or the mindsets that we have. So, we may need to think about how much pressure we’re putting on ourselves. Another very small shift to that thought is, “There’s so much I want to do.” Now, here is another, this is very important. I personally, as a human being, there is so much I want to do. I have such passion to do this project and write that book and to create that podcast. I have all these things and hobbies I want to do. It’s a wonderful thing. Some of you may not have that experience right now and that’s okay. Sometimes depression and anxiety can take the passion out of things. But a lot of you, I hear because you want to get things done and you can’t find a way to put it into your schedule. I really want to encourage you to start to do these things you want to do, but you have to be realistic about time. A part of the reason I made this course and not other courses is that this course could be a very quick make. Meaning it didn’t take me six months to make some of my courses. The Time Management course is-- what is it? Almost 100 minutes or 120 minutes. It’s easier for me to do this than to create a six-month-long course. I did it in small 20-minute increments. I want to encourage you that if your relationship with time is saying, “I have so much I want to do, I don’t have enough time,” find in your schedule 10 minutes to start, because 10 minutes today and 10 minutes next week and 10 minutes the week after that, before you know it, you will start to have some momentum, even if it’s 10 minutes a week. A lot of times we don’t do things because we tell ourselves that there’s not enough time and there’s too much to do. Instead of just giving yourself permission to just do little baby steps, create what you can in small amounts of time. Somebody had written, “I struggle to start and stop activities.” This is very, very important. A lot of people struggle with time because getting going needs a lot of created momentum. The thing to remember is that motivation, and I will create a full mini-course on this very soon as well, is motivation is not something you just get. It’s not inherent. You don’t wake up with it. Motivation is something that you have to really create of your own. You have to cultivate motivation. You have to harvest motivation. It’s something that you generate on your own. So to start an activity, usually, you will need to look at first what’s getting in the way. We talked about procrastination in last week’s episode and in other modules of this course. That’s a big one. Starting usually means you have to generate motivation based on willingness to be uncomfortable, cleaning up any negative thoughts you have or critical thoughts you have about doing the activity. Setting time and reminders to remind you, because sometimes really honestly, you’re busy. You’re a busy person or you’re an overwhelmed person. So, you will need timers and reminders and calendars, but it’s really generating that activity. One of the best things to do is to keep in mind or to draw on a piece of paper or write it down, how you will feel when it’s done, what it will look like when it’s done, like a vision board almost, but it’s okay. Put some time into it, like what emotions will I feel when I’ve completed this email? Or what will be the result if I create this course 20 minutes at a time? Little baby steps. When it comes to stopping, it’s probably going to be much of the same tools. Schedule your time to do things, set an alarm or a reminder if you’re someone who gets stuck in it. So set a time or a reminder, put up sticky notes, and then also be willing to be uncomfortable. When I let my kids have tech time, we schedule tech time every day. When I say, “Turn it off,” they don’t like it. They’re in this mode of playing their game. They’re watching the thing they want to watch. Moving out of that can feel very jarring and uncomfortable. And so, we have planned ahead for that. We know that when tech time is over, my husband and I, we may want to implement some family time or snack time, something that can help move us onto the next activity. Something motivating and pleasurable is often very helpful when moving from some kind of either uncomfortable experience to a different experience or you’re in a pleasurable experience. You’ve got to move into something uncomfortable. There are some tips that may help that you may want to experiment with. The next one is, “I don’t have a good understanding of how long things take.” Now, this is huge. Again, if you’re listening to this on the podcast, this is another reason where I stress the importance of you. If you want to take the course, I stress how helpful it can be. I write down how long things take often. Probably once a month, I do an inventory of my day. How long does it take to get my emails done? How long does it take to get the kids to school? How long? While this may seem like a lot of work, it pays off because I will then realize I only scheduled 30 minutes for emails, but to be honest, emails are taking me 45 minutes. Helpful data. Important data to help me then renegotiate my schedule so that it is kind, or to really work at not spending as much time on emails, or to be less perfectionistic about emails, or to delegate emails or whatever project it is that you’re doing to somebody else. It may be that there are multiple solutions to this problem of not understanding how long things take. But I think the first thing is, you’ve got to have data. You can’t assume a solution if you don’t know what the problem is. Please, I encourage you. It doesn’t take long. Just have a little notepad, scratchpad, how long things take, particularly the things you’re having trouble in the day. It doesn’t have to be the whole day. The next one is, this was very cool, “I don’t like structure.” Now, if this is you, I am so with you. I was and have been in my life someone who doesn’t like structure. It stresses me out, makes me anxious. The pressure is overwhelming. I don’t like structure. However, as someone who was forced to practice these skills, because life was so chaotic and unmanageable, I have found now I have a much better life with structure. I have found I’m more creative and spontaneous now that I have structure in my life because I know the things I need to get done are done. So then I feel free to go and do spontaneous things, take a drive, go on a vacation, and so forth, because I know. Or in this case, during COVID, because everything is so uncertain, I know how long things take, the structure of days. If there were, let’s say someone in my family gets COVID – my children, myself, my husband – I know how to renegotiate the day really quickly because I have a really good understanding of the structure. It helps me to recalibrate if there is a major change in the day, because I’m used to that structure. I know how long things take. I know the practice of things. It’s been overwhelmingly beneficial in my life. If you don’t like too much structure, it doesn’t matter. You can actually just block schedule. I like to really be specific, but I know a lot of my colleagues and clients that I’ve taught this to, they just like blocks, like bigger blocks, like four-hour blocks. From 10:00 to 2:00 is work, from 2:00 to 5:00 is this. And those blocks can actually just create a little bit of structure for them. And then they can slice in new projects if they have them. Homework for therapy, if they need it. A lot of my patients, I see they’re professional successful people who are now I’m giving them additional 45 to 90 minutes of homework a day, and they say, “How am I ever going to fit this in? I’m already overwhelmed.” We go through this process and we look at where they could slide in, 10 minutes here and 15 minutes here. Can you do some of your homework on your way to work and so forth? That can be really beneficial. That way, even though they don’t like structure, they’ve found a way to prioritize what they need to get done so that they can get the benefits that they wanted. Last one, this is a big one, “I hate being told what to do with my time.” This is actually, I think, sponsored by my husband, but this was actually given to me from many social media people who have submitted their questions about time management. But I agree. I think my husband would very much agree with this – I hate being told what to do with my time. There is, when it comes to time management, a-- I wouldn’t say it’s a humbling, but it’s a letting go, a letting go of control, because when you don’t want to be told what to do with your time, it feels like you’re being controlled. Again, I don’t think you have to do any of this if you don’t want to. I wouldn’t encourage you to make any of these changes if you really, really disagree with them. However, I would encourage you to consider at least giving it 30 days, because what you will find is, when you schedule things, it might feel like you’re being told to do something with your time. You’re doing it. I don’t want you to have anybody else telling you what to do, but if you’re putting down on your schedule what you want to do, I want you to remind yourself why. Why are you doing this? Often it’s because the chaotic and unplanned day only creates more suffering. Chances are, you already have a lot of suffering. I’m guessing because you know about me, you have some kind of anxiety or depression or medical or mental struggle. So, even though this scheduling and this time management practices can feel like you’re using your freedom, I personally think it’s gaining freedom. It’s taking back control over the chaos in your mind – the running list, the mental rumination, the anxiety of all the things, and having it to be where it’s all there and it’s done. Now, it doesn’t have to be for you. I want you to find specifically, and you will see, remember we talk about in the course, we have a whole module on considering your specific set of circumstances. I want you to consider what’s good for you and make plans and adjustments, but keep my voice in your mind. Sometimes the more you plan it, the more freedom and free space you have in your mind to do the things you want, because you’re not constantly carrying around the to-do list. It’s there anyway, you might as well handle it efficiently. So, that’s my real encouragement. Again, I’m really for it. You may not be for it. I’m not going to harass you and make you agree with my view on it. But I know the science here and I have seen it benefit so many people, and I really hope that you can give it a go and let your guard down and let go of your need to have that control and honor what’s important to you and follow through with what’s important to you so that you get the things that you want and you get the mastery of the things in your life that are important to you. I hope that’s helpful. I’m so grateful to have you here with me today to talk about your relationship with time. There may be many other things I haven’t addressed. If I haven’t addressed your specific struggle with relationship with time, I encourage you to journal down and explore how you might manage that because we do only have 24 hours and I want you to really find some peace in some of those parts of your day instead of carrying around the to-do list. Have a wonderful day and I will talk to you very, very soon.

SUMMARY: In this episode, we review how important it is to address procrastination, as it impacts so many people in so many ways.   We also will review how procrastination is the same thing as avoidance and how people can work towards implementing time management skills to help them build a routine that helps them get the things they want to get done. In This Episode: We outline procrastination definition and procrastination pros and cons. How procrastination is simply an avoidance safety behavior. How to manage procrastination in , Anxiety, OCD and OCD recovery Our new course called Time Management for Optimum Mental Health Links To Things I Talk About: ONLINE COURSE Time Management for Optimum Mental Health https://www.cbtschool.com/timemanagement Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 220. Welcome back, everybody. How are you? Really, really, how are you? How is your heart? How is your mind? What’s showing up for you? How are you? I really want you to check in, in case you haven’t checked in for a while. How are you doing? It’s important. Let’s make sure we check in. Today, we’re talking about procrastination. It’s one of the most common questions I get when I’m doing live calls on Instagram and Facebook, like how do I manage procrastination? A lot of you are also managing perfectionism and it’s getting in the way of you doing the things you want to do or doing the things you have to do. Because I get asked this so much, I actually wanted to show people how I do it. So what I did is I created a whole mini-course, it’s called Time Management For Optimum Mental Health. You can get it if you go to CBTSchool.com/TimeManagement, or you can click the link in the show notes below. It’s a full course of showing you how I manage time and why I manage my time to help manage my mental health and my medical health. A lot of you know I have struggled with a chronic illness. Time management has been huge in me staying functioning and managing mental overwhelm and a lot of procrastination. In the course, it’s only $27, it’s a mini-course and it shows you exactly-- I have recorded the screen as I’m showing you exactly how I do it. If you’re interested, go over and check it out. I’d love to have you take the course and put it into practice. Now, one of the things about this episode is this is actually me giving you a sneak peek into the course because it’s one of the bonuses of the course to talk about procrastination. So I wanted to share it with you here on the podcast as well. You will hear me refer to the other parts of the course as you listen. That doesn’t matter. You’ll still get everything you need to know about procrastination and how to manage it today. But yes, if you’ve already taken the course, you probably have already listened to this bonus. But for today, let’s talk about procrastination. Before we head over into the episode, I wanted to do the review of the week. This is a review from Sadbing, and they’ve said: “Desperately needed. I am an LICSW that has searched high & low for a podcast that delivers quality content. I felt relieved to finally find one! This podcast provides an honest depiction of how anxiety shows up in people’s lives & gives you effective feedback on how to live with it. Thank you!” Thank you, Sadbing. Thank you so much for that amazing review. I do ask that anyone who’s listening, please, the one thing you can do, this is what I offer freely to you all. If you get a second, just click below, in whatever app you’re listening to, and leave a review. It helps me so much reach all the people. The more reviews we have, the more people will trust the podcast and continue listening to this free resource. So, yay. All right. Let’s get over to this episode about managing procrastination. I hope you find it helpful. If you want to learn more about time management, head on over to CBTSchool.com/TimeManagement, and you can get a mini-course for 27 bucks. It’s amazing value for a short period of time and a short amount of money. So, yeah. All right. So happy to have you here with me today. Thank you for giving your time to me and trusting me with your precious time. I will see you after the show. Welcome. You wouldn’t have a time management course without really addressing procrastination. Procrastination is, number one, the biggest question I get, which is another reason why I wanted to make this course, is because it’s so common. It’s such an easy trap to fall into. It’s such a human trap to fall into to procrastinate. But I wanted to take a deep dive into procrastination today and talk about some skills that you can practice to manage procrastination. Let me really just dive into, first, what is procrastination? Now simply put, procrastination is an avoidant safety behavior. What does that mean? When human beings assume or see or assign things as a threat, our mind does that. So our mind will assign something as threatening, whether it be, “I have to write this email.” It could be as simple as writing an email. It could be, “I have to present something. I have to get a project done. I have to go and exercise.” Our brain will present that as some kind of danger or challenge or threat. Now you might be thinking to yourself, there’s nothing dangerous about exercise or writing an email, but there may be for you because doing that means you have to have some uncomfortable feelings. Maybe shame, maybe anxiety, maybe irritability. Anger might show up. Guilt might show up. Because those emotions are uncomfortable and maybe if we haven’t developed skills on mastering those emotions, events like writing an email or exercising or doing a project may be experienced as dangerous or a threat. When our brain interprets things as a threat, naturally, it is going to set off the alarm and try to either get you to run away from it, to fight it, or to freeze. That’s how fight, flight, and freeze response. And the most common as humans is avoidance. We avoid the thing that will create discomfort for us, and simply put, that is what procrastination is. Now, why do we call it a safety behavior? We could call it a compulsion. But we call it a safety behavior because not everybody does it compulsively, but they may do it to create a false sense of security, a false sense of safety. As human beings, we want safety. It feels good to feel safe. It feels good to feel like, “Oh, I don’t have to face that hard thing.” So, yes, we consider it a safety behavior. Now, does that mean that you’re bad and lazy or not good? Absolutely not. Everybody engages in safety behaviors. It’s a human part of life. But what we want to look at here is, is it creating trends in your life? Is it creating impact or consequences to your life that create more discomfort and more distress later? Most of the time people say, “Yeah, I avoid,” and it’s getting to be a problem. If that’s for you and that’s happening to you, you’re definitely not alone. Now, how do we manage procrastination? The first thing is identify what it is you are avoiding specifically. Don’t just say, “I’m avoiding the email.” Don’t just say, “I’m avoiding exercise,” or “I procrastinate.” Don’t say those things. I mean, you can, but ideally, you will stop and go, “Okay, what is it about the email that I don’t want to tolerate? Ah, writing an email brings up social anxiety for me,” or “Ah, writing the email reminds me that I’m really behind on that project. Writing that email brings up shame because last time I spoke to them, I said something silly or something like that,” or “I don’t want to exercise because, ah, every time I exercise, it creates discomfort in my chest and it makes me feel like I’m panicking.” So you’ll identify the specific thing that is causing you to avoid specific. You might even get a specific like I did. It’s the physical sensations I don’t want to feel. Or it’s the thought that this was my fault that I don’t want to think. You may get to the bottom of that. Now, of course, if you guys know anything about me, I’m always going to say, it’s a beautiful day to do hard things. The only way we can overcome these strong emotions, particularly fear and guilt and shame, is to stare them in the face. Our job, and this is what I’m going to encourage you to think about, is to really look at, yes, avoiding. What is the pros of avoiding this? And then on the right-hand side, you could write this on a piece of paper, what are the cons? What are the consequences of me continuing to avoid this thing? Now often when you write that down, that in and of itself is a motivator because you’re going, “Oh my goodness, writing the email is uncomfortable for the duration that I write the email, not writing it is uncomfortable, even when I’m not working on it, because I’m constantly nagged by the fact that I have to write it, or it’s constantly sitting on my list or I constantly see it in the schedule.” A lot of you in, and we’re in the Time Management course – a lot of you have avoided managing time because putting this in the calendar makes you face the fact that you’ve got something scary to do. Now, you will see me, I’m holding my hand on my chest right now and I’m sending you much compassion because these are really difficult things. These may seem easy for other people, but they’re hard for you and me. And so we must be compassionate with the fact that they’re hard. Here is what I’m going to say: Being compassionate can actually take some of that pain away. It won’t take it all. You still have to do it. You have to ride the wave of discomfort. It will rise in full as you go. But you can also be gentle with yourself and reduce your suffering instead of criticizing yourself or how hard it is for you. Don’t compare how it is for you compared to your friend or your seatmate or your neighbor. This is what you do. You practice compassion before you do the activity first. I’m sorry. You commit to doing the activity. You put it in your schedule. You write down when you’re going to do it and how long you think it’s going to take. And then you practice compassion. “Wow, I’m going to be really gentle with myself as I ride out the emotions and the experience of doing that thing.” You may want to get a partner, an accountability partner, who can help remind you and support you as you do the thing. A lot of my patients have an accountability partner. They’re like, “It’s three o’clock.” They’re texting, “It’s three o’clock. I know you’re about to do a scary thing. Good job. Keep going. Don’t stop. Don’t back out. I’ll be right here. You text me as soon as you’re done.” See if you can do that. If you don’t have someone to do that, be that for yourself. So it’s in your calendar. You’re going, you’re gentle. You’re going to do the thing. What I personally like to do is keep a notepad down next to me as I’m writing an email or recording a podcast or doing something that creates anxiety for me. I jot down the thoughts and feelings I’m having. Not a lot, bullet points. Like, “Oh, I’m having the thought that this is not helpful. I’m having the thought that this is not good enough. I’m having the thought that this should be better. I’m having the thought that I made a mistake. I’m having the thought that this should be going fast or better.” Like I said, and you may start to notice – and this is true, I’ve seen a lot of patients say – as you write it down, it’s the same five thoughts over and over and over. When you’re not aware of that, it feels like 55 thoughts or 55,000 thoughts. But once you have it on paper, you will see, often our brain is just repeating the same thing. When you can see that, you can go, “Oh, brain, I’m sorry that you’re sending those messages. Thank you for showing up. Thank you for trying to alert me to the possible dangers, but I have avoided this for so long, and it avoiding it and it procrastinating only delays and continues my suffering.” And you feel your emotions. You ride them out. You tender with yourself as you do the thing. And that’s how you get through it. Once you’re done, you must celebrate and say kind things and congratulate yourself. Don’t forget that stage because that’s so, so important. But the main point to remember here is that avoidance keeps you stuck. Avoiding the thing you’re afraid of is actually what then creates some depressive thinking, some hopeless thinking, or helpless thinking. “I’ll never be able to... I won’t be able to... I can’t...” We really want to be careful of that type of thinking, because that is the thinking where depression lives. Again, the more you face the things that are uncomfortable, you will build a sense of mastery of that. It won’t go well the first time, I promise you. Most of life is trial and error. I have found the only way to move forward is to practice failing. Here is what I’m going to ask of you. As you practice this activity or practice of not procrastinating, of facing the thing you’re afraid of, of doing the thing you’ve been avoiding, I want you to practice or remind yourself that you are really not growing if you’re not failing. I’m going to say that again. You’re really not growing if you’re not failing, because if you’re only doing things that go well, chances are, you’re avoiding a lot of things. If you’re only doing things that are going well, the chances are, you’re not building mastery with the hard things in life, and life is 50/50. We know this, that life comes with 50% good and 50% hard. We have to practice failing so we can learn how to be better. This whole course is about that. You’re going to practice not procrastinating. You may or may not succeed. That’s not really the important part. The important part is that you look at the data, the data being, how did it go, like that reassess stage, which we have as one of the steps in the course. Look at the data, what worked, what didn’t and what do I need to change? This is not a perfect practice. It’s going to be changing as you change. And so having the ability to adapt and having the humility to say, “All right, it’s not working. What do I need to do?” This has been probably my biggest struggle in my entire life, is I avoid looking at the data of what’s not going well. If someone tells me what’s not going well, I get offended instead of going, “Okay, this is not personal. It’s just data. How can I use this data to help me not make the same mistake over and over again?”  Often what I’m doing, I’m churning out a lot of content and I’m not looking at the data when the data could help me to say, what is the most effective? What is the most helpful to other people? How can this be as jam-packed helpful as possible? I have to look at the data, and in order to do that, I have to be willing to fail. It’s okay to fail. This is a practice. It’s not perfection. But when it comes to procrastination, you have to be willing to be uncomfortable. You have to be willing to do hard things. This is why we keep saying, it’s a beautiful day to do hard things. Now, of course, go back, follow the steps of the whole course. You’ve gotta get it in the schedule before you can really do that. But then I want you to even get very microscopic and look at when you’re scheduling. Let’s say there’s something you’re avoiding and procrastinating on. Schedule small activities so that you don’t procrastinate. One of the best lessons I’ve learned when it came to me, recovering from my medical struggles, is I have to get a lot of exercise. Not running exercise, a lot of personal training, physical therapy type of exercises, and I hate them. They’re the most boring, annoying, monotonous things on the planet. However, I have found that if I schedule, “Kimberley, at this time, you’re going to put your shoes on. Kimberley, at this time, you’re going to fill up your drink bottle,” I am more likely to do it. I get very microscopic in my planning. Now, again, you won’t want to do this with all the things in your life. Pick one thing if that’s what you want to work on, and work at creating a system that gets you to do the thing that you continue to procrastinate on. I would not probably do my physical therapy and my training, these annoying, repetitive activities, if I hadn’t created a system that makes it doable. I have a Bluetooth speaker, I put very loud music on. It’s usually reggae or something very hippy, so I feel like at least I’m chilling out as I do it. I marry the thing that’s uncomfortable with something that’s tolerable. Now, you won’t always be able to do this, and that is fine. Sometimes you just got to ride the wave and face your fear. That’s okay. But that is an idea if it’s for things like daily activities and routines in your life. If it’s facing fears and exposure work, well, no, we don’t want to marry it with these things because that can work as a neutralizing compulsion. If you’re someone who is in treatment for an anxiety disorder and you’ve been given an exposure, well, no, you’re just going to have to practice riding the wave of discomfort, but do not forget that self-compassion piece. It is crucial. Do not forget using your mindfulness skills where you allow your discomfort. You’re non-judgmental about your discomfort. You’re willing to allow it to be there. These are all crucial practices. I would even consider writing down all the things where you struggle with procrastination and work through them, practice them, just like you would be lifting a weight, just like you would practice if you were learning French or piano. Pick up the basic things and practice the basics first and go through all of them. Try to get yourself through as many as you can so that you build a sense of mastery like, “I can do that. Even if I don’t want to, I can. I could if I had to,” which I think is a really great way of thinking about things that are uncomfortable in your life. “I don’t want to do them, but I could if I had to.” It’s better than “I can’t” and “I don’t want to.” All right. That is procrastination. I hope that has been helpful. I really want to stress to you that procrastination is a thing that everybody does. Again, it’s not personal, but I really, really encourage you to master doing the things that you avoid. Avoidance keeps anxiety strong. Avoidance keeps you in the cycle of anxiety, and we want to break that cycle. I hope that is helpful. I am really excited to see you go out and do those things. If you want to, you can share them with me on social media or things that you’re doing. It’s a beautiful day to do hard things. I love when people tag me with that. Have a wonderful day, everybody, and I will see you in the next module.

SUMMARY: Today we have Amanda White, an amazing therapist who treats anxiety, eating disorders and substance use. Amanda is coming onto the podcast today to talk about her book, Not Drinking Tonight and how we can all have a healthy relationship with alcohol. Amanda White talks about ways you can address your relationship with alcohol, in addition to drugs, social media and other vices. Amanda White also shares her own experience with alcohol use and abuse and her lived-experience with sobriety. In This Episode: Do you have a healthy relationship with alcohol Why we use alcohol and substances to manage anxiety and other strong emotions How to build a healthy relationship with alcohol. How to manage substance abuse, anxiety and substance use in recovery. Tools and tips to manage alcohol use and abuse Links To Things I Talk About: Easiest place to get Amanda’s book with all links amandaewhite.com/book Instagram @therapyforwomen My therapy practice therapyforwomencenter.com ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com. CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors. Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). Episode Transcription This is Your Anxiety Toolkit - Episode 219. Welcome back, everybody. I am thrilled to have you here with me today. You may notice that the podcast looks a little different. That is on purpose. We have decided to update the cover of the podcast. It now has my face on it. There were a lot of people who had reached out and said that the old podcast cover art looked like a gardening podcast. And I thought it was probably time I updated it. So, that was something that I had created years and years and years ago. And I’m so thrilled to have now a very beautiful new cover art. Okay. This episode is so, so important. I cannot stress to you how overjoyed I was to have the amazing Amanda White on the podcast. She’s a psychotherapist. She’s on Instagram, under the handle Therapy For Women. She’s so empowering. And she talks a lot about your relationship with substance use, particularly alcohol. But in this episode, we talk about many substances. And this is a conversation I feel we need to have more of because there are a lot of people who are trying to manage their anxiety and they end up using alcohol to cope. Now, this is a complete shame-free episode. In fact, one of the things I love about Amanda is she really does not subscribe to having to do a 100% sobriety method. She really talks about how you can create a relationship with alcohol based on whatever you think is right. And she has a new book out, which I am so excited that she’s going to share with you all about. Before we get into the episode, I’d first like to do the review of the week. Here we go. We have this one from Epic 5000 Cloud 9, and they said: “This podcast has absolutely changed my life and made my recovery journey feel possible. After completing ERP, I felt lost and confused as to why I did not feel ‘better’. Kimberley has given me so many tools to build my self-compassion, grow my mindfulness skills, manage OCD, and do all the hard things.” So amazing. I’m so grateful to have you in our community. Epic 5000 Cloud 9. So happy to have you be a part of our little wonderful group of badass human beings. I love it. Let’s go right over to the show and so you can learn all about Amanda and this beautiful, beautiful conversation. Have a wonderful day, everybody. Kimberley: Okay. Well, thank you, Amanda, for being here. I’m actually so grateful for you because you’ve actually brought to my attention a topic I’ve never talked about. And so, I’m so happy to have you here. Welcome. Amanda: Thank you so much for having me, Kimberley. I’m excited to chat with you. Kimberley: Okay. So, tell me a little bit about you first. Like, who are you? What do you do? What’s your mission? Amanda: Yeah. So, my name is Amanda White. I am a licensed therapist. You might know me on Instagram from Therapy For Women as my handle. I’m also sober and I’m really on a mission to destigmatize sobriety and destigmatize the idea that you can question your relationship with alcohol. And it’s really why my Instagram page and everything I do isn’t sober only focused because I want it to be something where people who maybe aren’t necessarily sober or haven’t thought about it can, in a safe unstigmatized, unpressured way, also explore their relationship with alcohol. And that is what led me to write a book. And my book is called Not Drink Tonight. Kimberley: So good. So, I already have so many questions. Why wouldn’t one question their relationship with alcohol? Because what I will bring here is a little culture. I’m Australian. Amanda: Yeah. I was going to say. Kimberley: I live in America. The culture around drinking is much different. I have some great friends in England, the culture there is much different. So, do you want to share a little bit about why one wouldn’t maybe question their relationship with drinking? Amanda: Absolutely. I think I can only speak for America specifically, but I know enough people in England and Australia, too, that there is a culture of drinking is good, drinking is normal. We watch our parents or adults drink when we’re young. We think that’s what makes us an adult. If you look at the media, you look at movies, TV shows, it’s what everyone does when they’re stressed. Women pour themselves a glass of wine. Men pour themselves a bourbon. So, I think that we’re just raised in the society that doesn’t ever question their drinking, because alcohol use is so black and white, where you either are normal and you should drink alcohol and it’s what’s expected, or you’re an alcoholic and you should never drink alcohol. And there isn’t a lot of space in between. So, if someone questions their alcohol use, people assume that they’re an alcoholic. Kimberley: And so, now let me ask, why would we question our relationship? What was that process like for you? Why would we want to do that? Some people haven’t, I think, even considered it. So, can you share a little bit about why we might want to? Amanda: Absolutely. I think it isn’t talked about enough of how much alcohol really negatively impacts your mental health. For a while, I know doctors used to talk about there are some heart-healthy benefits of alcohol, which new studies say is not true. There really aren’t any benefits to drinking alcohol in terms of our health. But really, I think especially anxiety and alcohol are so intertwined and people don’t talk about it and don’t think about it. And what I want people to know is when you drink alcohol, it’s a depressant and your brain produces chemicals because your brain always wants to be in homeostasis. So, your brain produces anxiety chemicals, like cortisol and stuff like that, to try to rebalance into homeostasis. And after alcohol leaves your body, those anxiety hormones are still in there and it creates the phenomenon where you end up being more anxious after you drink. There’s other mental health effects too. But I feel like, especially on this podcast, it’s so important that people realize how intertwined alcohol and anxiety is. Kimberley: Right. You know what’s interesting is I do a pretty good amount of assessment with my patients. But really often, I will have seen them for many months before-- and even though I thought I’ve assessed them for substance use and not even abuse, they will then say and realize like, “I think I’m actually using alcohol more than I thought to manage my anxiety.” And I’m always really shocked because I’m like, “I swore I assessed you for this.” But I think it takes some people time during recovery to start to say like, “Wow, I think there is an unhealthy relationship going here.” Is that the case from what you see or is that more my population? Amanda: No. Absolutely. Because I think it’s easy to lie to yourself. Maybe not even lie, just like not look at it because again, it’s so normalized because we have an idea in our head of what someone with a problem with alcohol looks like. We don’t consider ourselves to have that problem. But just because we aren’t drinking every day or we’re not blacking out or something like that doesn’t mean that we might not be using it to numb, to cope with anxiety, to deal with stress. Kimberley: Right. You know what’s funny is I-- this could be my personal or maybe it is a cultural thing because I always want to catch whether it’s an Australian thing or a Kimberley thing, is I remember-- I think hearing, but maybe I misinterpreted as a young child that you’re only an alcoholic if you get aggressive when you drink, and that if you’re a happy drunk, you’re not a drunk. You know what I mean? And that it’s not a bad thing. If it makes you happy and it takes the stress away, that’s actually a good coping. So, I remember learning as a teen of like, oh, you get to question what is an alcoholic and what’s substance abuse and what’s not. So, how would you define substance use versus substance abuse? Or do you even use that language? Amanda: I mean, yes and no. I use it in terms of it exists, and it is part of the DSM. So, it is in terms of, I do diagnose when needed and things like that. A lot of times though, I think the current narrative and I think people spend so much time trying to figure out if it’s use or misuse, that they miss out on the most important question, which to me is, is alcohol making my life better. Kimberley: Yeah. Amanda: And if it’s not, if it’s right-- I have exercises in my book and I talk a lot about like, what are the costs of your drinking, and what are the payoffs? And if it’s costing you a lot or it’s costing you more than it’s bringing to your life, I think that is where you should question it. And I think your life can change. You can go through different things in your life and maybe that’s when you can ebb and flow with your questioning of it, especially people get so obsessed with the idea of whether they’re an alcoholic or not. And the term ‘alcoholic’ is completely outdated. It’s not even a diagnosis anymore. It’s now a spectrum. So, to me, that word is just so outdated and unhelpful to think about really. Kimberley: Right. And even the word ‘abuse’ has a stigma to it too, doesn’t it? Amanda: Right. In the DSM, it’s alcohol use disorder and it’s mild, moderate and severe. But it’s wild thinking back. I mean, I was in grad school. Oh my gosh, I’m going to date. I don’t even know how long ago, 10 years ago. Kimberley: Don’t tell them. Amanda: A certain amount of time ago, I just remember being in ‘addictions class’ as it was called and we were talking about what is the difference between use and abuse and what makes someone an alcoholic. And I think people also get very attached to being dependent. It means it’s abuse. And it takes a lot to become dependent on alcohol physically. So, we’re just missing out on so many people. I say often, we can question so many things in our life. I’m sure you do too with your clients. I question how their sleep habits interact with their mental health. We talk about how getting outside impacts their mental health, all these different factors. But for some reason with alcohol, which is a drug, we don’t question it or we are not allowed to. Kimberley: Right. Yes. I will address this for the listeners, is I think with my clients, one of the most profound road, like if we come to the edge of the road and we have to decide which direction, the thing that really gets in the way is if I put a name to it, then I have to stop. And that can be, a lot of times, they won’t even want to bring it up – be in fear of saying, well, like you were saying before, is that meaning now-- as soon as I admit to having a problem, does that mean I’m in AA? Is it black and white? I think that there’s so much fear around what it means once we really define whether it’s helpful or problematic. That can be a scary step. What are your thoughts? Amanda: Yeah, I completely agree. And that’s why I really believe in looking at it as a spectrum, especially I think about disordered eating, right? It’s like, we know that based on studies, if someone engages in disordered eating, they’re more likely to develop an eating disorder. So, in my book, I coined this term ‘disorder drinking’ and how I really think we need that term where people can-- it makes the barrier to question your relationship with alcohol much lower, where I find in my practice because I work with a lot of people with eating disorders. People are very open about saying, “Yeah, I’m maybe engaging in some unhealthy, disordered eating. I don’t know.” But there’s a whole step there before maybe you recognize that you have an eating disorder, where I really think that that is what we need with alcohol. We need to be able to talk about how, like, yeah, most of us in college engage in disordered drinking. It’s not super healthy, the way that we drink. Or we may go through a period of time in our life because we’re super stressed or something’s going on, where we engage in that. And that doesn’t mean that you have, for sure, a substance use disorder or you’re addicted or you have to never drink again. But I think it’s important to recognize when we start to fall into that so we can change that pattern. Kimberley: Right. Particularly with COVID. I mean, alcohol consumption is, I think, doubled or something like that in some country. And I think too, I mean, when we’re struggling with COVID that we have less access to good tools and less access to social. So, people are relying on substances and so forth. Yeah. So, what is this solution? There you go. Tell me all your answers. What is their options? How might somebody move into this conversation with themselves or with their partner or with their therapist? What are the steps from here, do you think? Amanda: Yeah. So, I think that the first step is to try to take a break. I think 30 days is a good starting point. A lot of times, if people just start off by cutting back, they don’t really get any of the positive feel-good benefits of taking a break, which is why I recommend starting with taking a break first. Obviously, I believe in harm reduction. And if you are in a place where you can’t take a break, moderation is definitely a good tool and better than nothing. Kimberley: Can you tell what harm reduction, for those who don’t know what that means? Amanda: Yeah. So, harm reduction is the idea that rather than focusing on completely eliminating a behavior or especially completely eliminating a substance is we think about cutting back on that. And I think about specifically, if someone is in an abusive situation, if someone has a lot of trauma going on and alcohol is the one thing that’s keeping them afloat, that to me is like, of course, I’m not going to say you must quit cold turkey or something like that. And even if you’re talking about, alcohol is very dangerous to physically detox from if you are drinking every day, which a lot of people don’t know. In those cases, yeah, it’s really important to get support and detox in a safe environment. Kimberley: Right. Okay. So, sorry I cut you off. Take a break-- Amanda: No, it’s okay. Yeah. So, that’s what harm reduction is. But yeah, in general, I recommend starting with taking a 30-day break, seeing how that goes, see how your health improves, see how your anxiety might be reduced and improved. And really to me, the goal is to learn how to live your life without being dependent on alcohol. Because if we can’t process our emotions, set boundaries, socialize, go on dates, whatever, without the help of alcohol, we never really have freedom of choice over drinking or not drinking because we need it on some level. So, my whole goal is for people to learn how to do some of those skills so that they don’t have to rely on alcohol, and then they can use alcohol in a healthier way for celebrating or in a way that positively impacts their life and they don’t use it as a crutch. Kimberley: So, that’s so helpful. I’m pretty well-versed in this, but I wouldn’t say I’m a specialist. So, I’m really curious. So, if somebody is using alcohol or any other substance to manage their anxiety, would you teach them skills before they take the break so that they have the skills for the break or would you just start to take the break and then pick up what gets lost there? What might be some steps and what skills may you teach them? Amanda: I think it’s a bit of both. I think if you only teach skills before, someone might never take the break, which is fine. But I think if you are only teaching the skills, a lot of times, the skills, I think that’s really good to start before you take the breaks. You can learn how to start dealing with your emotions maybe without drinking, for example. But some of the other stuff like going to a party, without drinking is something where if you don’t actually take that step, it’s probably unlikely that you’re ever going to do it until you’ve pushed yourself to take that break. But in general, yeah. I mean, I think one of the most important ones is learning how to cope with your emotions. People use alcohol all the time, especially alcohol becomes a way to deal with loneliness, to deal with stress, to deal with sadness. And I think-- Kimberley: Social anxiety is a big one. Amanda: Social anxiety. Absolutely. And I think a lot of us literally don’t know how to process an emotion, say no, set that boundary, take care of themselves on a basic level without drinking. So, those are some of the skills I think are really important to learn. Kimberley: I mean, yeah. And for a lot of the folks that I see because their anxiety is so high, would you say they’re using it to top off that anxiety to try and reduce it? In the case where if you’re not drinking, you’re having high states of anxiety. Is there any shifts that you would have them go through besides general anxiety management? Amanda: I think the example I’m thinking of is maybe social anxiety. If there’s a specific instance, right? I know you talk about this a lot on Instagram, like exposures can really, really help with reducing anxiety. And I think there are steps that you can take that are small if you have a lot of social anxiety about going to a party and not drinking, for example, and you’re relying on alcohol to deal with going to a party. I mean, some of the things off the top of my head I can think about are like driving to the place where the party is before it happens, talking to someone who is going to be at the party – taking these small steps to desensitize yourself to it so you can build up your tolerance before you go. Or maybe you go, if this is the first year and you only stay for a short period of time, rather than going from nothing to expecting yourself to go and have fun and stay at the whole party the whole time. Kimberley: Right. What was your experience, if you don’t mind sharing? What were those 30 days like, or can you share it, put us in your shoes for a little bit? Amanda: Yeah, absolutely. So, I struggled a lot with an eating disorder and I kept relapsing in my eating disorder when I would drink. And I had said to my therapist at the time, “I think that I might have a problem with alcohol. I don’t know.” And she recommended me do those 30 days. And it was really hard for me. I didn’t actually make it to the first 30 days when I originally tried because I was so afraid of the pushback of friends, of people asking me why, of not being able to be fun. A huge part of my identity at that time was all wrapped up in what people thought of me and going out and being the fun, crazy one. Kimberley: Yeah. And it’s interesting how the different experience, because I too had an eating disorder. But my eating disorder wouldn’t let me drink. Amanda: Yeah. Kimberley: That would be letting go of control, and what if I binge, and what if I ingest too many calories? So, it’s funny how different disorders play out in different ways. It was actually an exposure for me to drink. What we quote, I think I’d heard so many times “empty calories” or something. So, that was a different exposure for me of that. But I can totally see how other people, of course again, it does-- I mean, I think that this is interesting in your book, you talk about the pros and the cons. It does make it easier to be in public. It does “work” in some settings until it doesn’t. Amanda: Exactly. And I think that’s so important to normalize and it’s part of why I wrote my book because there aren’t many books that are, you’ll get this as a therapist. I can think of many different situations where, like you said, I wouldn’t tell a client, “You should absolutely stop drinking,” because everything is unique. So, I really wanted to write a book that took into account different things and really led the reader through their own journey where they get to discover it for themselves because while there’s amazing books out that I love, there aren’t a ton that talk about this gray area, drinking, this middle lane, this truth that a lot of times you can feel lonely when you don’t drink because you’re left out of certain things. And that can cause more anxiety. So, we have to navigate all of that. Kimberley: Yeah. It’s interesting too, and I don’t know if I’m getting this research correct. And maybe I’m not, but I’ll just talk from an experiential point. It’s similar with cigarettes, I think. There is something calming about holding the wine glass. Even if it’s got lemonade in it, for me, there’s something celebratory about that. And so, the reason I bring that up is, is that a part of the options for people? Is to explore the areas? It’s funny, I remember my husband many years ago that we talk about cigarettes, because he works in the film industry, and he would say, “The people who smoke cigarettes are the ones who actually get a break because they have to leave set and they get to go outside and sit on something and breathe and have a moment to themselves. If you don’t smoke, you’re lazy if you take a break.” And so, is that a part of it for you in terms of identifying the benefits and bringing that into your life? Like, I still now drink sparkling cider or something, an alcoholic in old champagne glass. My kids are always joking about it. Is that a part of the process? Amanda: Absolutely. And that’s something that I completely agree with you. I think sometimes we don’t even want an alcoholic beverage. We want a moment. We want a break. We want a feeling different or celebratory, which is why we take out the wine glass that isn’t a regular glass, something like that. And that is why I really believe, I mean, it depends on the person. And sometimes if someone has more severe drinking a non-alcoholic beverage initially could be something that’s triggering for them. But I am a big believer too. And yeah, put it in a fancy glass. If you enjoy a mocktail, drink something different than water, you can explore different options. And I think some people are really surprised at how much it’s not actually about the drink sometimes, it’s the ritual of making a drink or the ritual of using that special glass, or the ritual of drinking something that isn’t water. Kimberley: Right. Yes. Or even just the ritual of the day ending. I always remember, my parents would be five o’clock, right? And at five o’clock they would have the-- this is a big family tradition, is at five o’clock, you’d bring out the cheese and the crackers and the grapes and the wine. And it was the end of the day. And so, I could imagine, if someone said, “We’re going to take that away,” you’d be like, “No, that’s how I know the day is over. That’s how I move from one thing to the other.” And sometimes we do think black and white. It means you have to take the whole cheese platter away as well, right? Amanda: Absolutely. We can get almost in our heads of maybe we think we’re more dependent on that cheese platter or the wine or whatever, without realizing that what we really like about it is the ritual. Kimberley: Yeah. So, you can share it or not, how does your life look now? And for your clients, give me maybe some context of what do people arrive at once they’ve been through this process and how might it be different for different people. Amanda: Totally. So, I’m completely sober. I don’t drink alcohol. I’ve been sober for seven years. And in terms of how the process looks for me, I drink mocktails. I drink out of wine glasses sometimes. I love going to a bar and seeing sometimes if there’s an alcohol-free option on a menu, I think that’s really fun. And for me initially, when I was thinking about this and working on it, like I said, it was very tied to my eating disorder. But the biggest thing for me is I used to think, well, I can’t totally stop drinking because that’s black and white, and that’s not freedom. Freedom is being able to decide. And I think what is different and unique compared to an eating disorder, for example, is that alcohol is addictive, right? Unlike food, it is an addictive substance that we can live without. And for me, I used to, or for me, I don’t have to think about it if I don’t drink. When I was trying to moderate, it was a lot of decision fatigue. It’s like, “What am I going to drink? How much am I going to drink? When will I stop? Am I going to drink too much?” It was all of these decisions. And freedom for me now actually is just not drinking and not thinking about if I’m going to drink or not. So what my life looks like now is I’m sober, I’ve been sober for seven years. I enjoy going out to restaurants and getting alcohol-free drinks and things like that. And I used to be really worried that that was too reductive, that I was too black and white if I just said I wanted to be sober. But the truth is unlike food, alcohol is an addictive substance. When you have one alcoholic beverage, it does create a thirst for itself for most of us. So, for me, the freedom is actually not worrying about whether I’m going to drink or not. It’s so exhausting for some people, myself included, to be constantly thinking about how much you’re going to drink, if you’re going to drink, when you’re going to drink, what you’re going to drink. And now, the real freedom for me is I don’t drink. I don’t think about it. And that’s the freedom because-- sorry, I just got caught up in what I was saying. Kimberley: No, I think that that is so beautiful. As you were saying it, I was thinking about me in a Fitbit. I will never be able to wear a Fitbit. Because as soon as I know, I could wear it for day-ish. And day two, I’m all obsessive and compulsive. I just know that about myself. And some people can wear it and be fine, and I can never wear a Fitbit. I just can’t. My brain goes very, like you said, on how many? More or less, what’s happening? And so, I love that you’re saying that, is really knowing your limits and whether it’s-- the Fitbit, it’s not actually the problem, but the Fitbit is what starts a lot of problematic behaviors that I know is just not helpful for me. Amanda: Yes. And I think it’s important to recognize there are factors that make us more likely to be able to moderate successfully or not, right? The amount of alcohol you’ve drank throughout your life, your past drinking habits, whether you have a history of addiction in your family or substance use, whether you have trauma, whether you have anxiety, all of these things might make it more difficult for you to moderate compared to someone else. Kimberley: Right. I don’t know if this is helpful for our listeners, but I went sober. My husband and I did for the first year of COVID. What was interesting is then I got put on a medicine where I wasn’t allowed to drink and I felt offended by this medicine because I was like, “But you’re taking my choices away.” And so, I had to go back. Even though I’d made the choice already, I’d had to go back and really address this conversation of like, “Okay, why does that feel threatening to you” and to look at it because a part of me wanted to be like, “No, I’m going to start drinking now just because they told me I’m not allowed.” So, it’s so funny how our brain gets caught up on things around drinking and the rules and so forth. So, I didn’t think of it that way until you’d mentioned it. Amanda: Yeah, absolutely. And I think that that can be why people rebel against “I’m not an alcoholic” mindset instead of it being a choice, instead of it being “My life is better without drinking.” I often say, my drinking was like Russian roulette. A lot of times it was fine when I drank, but the times where it wasn’t fine, I was not willing to put up with it anymore. And I don’t know whether I could drink successfully or not, but it’s not a risk that I’m willing to take. And it’s not worth it compared to all the benefits that I have from sobriety. And because of that, it really feels like an empowering choice. Kimberley: Yeah. My last question to you before we hear more about you is, what would you say to the people who are listening, who aren’t ready to have the conversation with themselves about whether it’s helpful or not? I think I learn in a master’s grade the stages of change. You’re in a pre-contemplation stage where you’re like, “I’m not even ready to contemplate this yet.” Do you have any thoughts for people who are so scared to even look at this? Amanda: Yeah. For people who maybe are in that pre-contemplation, not sure if they want to do the deeper work to question their relationship with alcohol, what I would recommend to them is start by just trying to reduce some of their alcohol intake. They don’t have to stop drinking. They don’t have to even think about whether it’s serving them or not, but there are so many amazing alcohol-free beverages that exist now. I mean there’s alcohol-free beers and wines and all kinds of things. And you could just try swapping one of your alcoholic beverages with that when you go out or at home and just see how that makes you feel. Kimberley: Yeah. It’s a great response in terms of like, it is. It could be. Would you say that’s more of the harm reduction model? Amanda: Yeah, absolutely. Or someone who’s not ready or really interested in the big conversation. That’s one of the reasons I really support and like the alcohol-free beverages and stuff like that because it gives people, I think, an easier way to step into it. And sometimes even realizing too, like alcohol-free beverages can taste really good compared to the beverage that has alcohol in it. So, you’re not drinking this for the taste. Kimberley: Exactly. Sometimes when I have drunk alcohol, I’m like, why am I even drinking this? It’s not delicious. Amanda: It’s true. Kimberley: It’s not delicious. I love that you say that about-- I think one of the wins of the world is they are creating more, even just the bottles and the look of them are much nicer than the general or dual looking kind of bottles, which I think is really cool. I love this conversation, and thank you so much for bringing it to me because I do really believe, particularly in the anxiety field, we are not talking about it enough. So, I’m so grateful for you. Amanda: Absolutely. I’m so glad that I got to chat about it because, yeah, the anxiety connection is huge. Kimberley: Yeah. Tell me about your book and all about you. Where can people find you? Amanda: Yeah. So, my book comes out on January 4th. It’s called Not Drinking Tonight. And 2022, because this is out. Kimberley: Yeah. Amanda: Sorry if I messed up. Kimberley: No, no it’s good. So, for people who are listening on replay, it will be out as of 2022. Amanda: Yeah. It’s called Not Drinking Tonight: A Guide to Creating a Sober Life You Love. It is broken up into three different sections so that you can learn in the first section why you drink, and I go into evolutionary psychology and trauma and shame. In the second part, it’s about reparenting yourself or the tools that you need to stay stopped. So, I talk about boundaries and self-care and all of the things, emotional health, how we take care of our emotions. And then in the last section, I talk about moderation, relapsing, the overlap of alcohol use and other substances or ways we numb. So, really though my book is structured around alcohol. I talk a lot about eating disorders, perfectionism, workaholism, other drugs, because I think a lot of it is the same in that sense. Kimberley: 100%. Amanda: So yeah. And you can find me on Instagram at Therapy For Women, or my website is amandaewhite.com. Kimberley: Amazing. Thank you so much. It’s so great to actually have a conversation with you face to face. Well, as face to face as we can be. So, thank you so much. Amanda: Thank you. This was so great. ----- Okay. And before we get going, I’m sure you got so much out of that episode. Before we get going onto your week, I wanted to share the “I did a hard thing.” This one is for on Paula, and she said: “I started ERP School earlier this year. While looking into my OC cycle, I was surprised to find out that I had some overt compulsions. I thought they were mostly mental. And that’s when I figured out I had a BFRB. My loved ones had commented on my hair pulling in the past, but I didn’t realize how compulsive it could be. I watched Kimberley’s webinar on BFRBs, and I got inspiration to be creative. I tried to use hand lotion, so it would make my hands sticky and demotivate hair pulling. I also got a fidget toy to keep my hands occupied whenever I felt like pulling. But what worked best was you using a transparent elastic band to tie up the two strands I used to pull. It’s perfect because it creates a physical barrier to pulling, but also a sensory reminder. If my fingers feel the band, I can say to myself, “Oh, the band, that feels different.” And because I’m trying to make a change, way to go me. Thank you, Kimberley, for all the amazing work you do.” So guys, this is amazing. If you didn’t know, if you go to CBT School, we have a free training for people with BFRBs. If you have OCD, we have a free training for people with OCD. So, head on over to CBT School, and you can get all of the cool resources there. Have a wonderful day, everybody. And thank you so much for the “I did a hard thing.” That was so cool. I was not expecting that, Paula. Congratulations! You are doing definite hard things. Have a wonderful day, everybody.

In today’s episode, Kimberley Quinlan talks about the importance of identifying catastrophic thinking. The reason this is so important is that this type of cognitive distortion or cognitive error can increase one’s experience of anxiety and panic, making it harder to manage it at the moment. Kimberley talks about the importance of mindfulness and self-compassion when responding to catastrophization also.  In This Episode: What is Catastrophization? Why is it important that we catch how we catastrophize? How to manage Catastrophization? How correcting our thoughts can help, sometimes..but not always. Links To Things I Talk About: ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 218. Welcome back, everybody. How are you doing? How are you really? Just wanted to check in with you first, see how you’re doing. We’re friends, so it’s my job to check in on you and see how you are. Thank you for being here with me again. I do know how important your time is, and I am so grateful that you spend it with me. Thank you. That is such a joy and it’s such a wonderful experience to know that I am spending time with you each week. This week, we are talking about the danger of catastrophization. Now, I’ll talk with you a little bit more about what that means here in a second, but basically what I want to do in this episode is really to take off from the very first episode of this year, which was the things I’d learned in 2021. One of the points that I made there was to really take responsibility for your thought errors, right? And I wanted to pick one of the thought errors that I see the most in my clients. In fact, in the last couple of weeks, it’s been an ongoing piece of the work we do. It’s not all of the work, but it’s a piece of the work, is for me just to be, I’m still doing teletherapy. So, we’re sitting across from the screen and just reflecting and modeling back to them some of the ways in which they speak to themselves and really looking at how helpful that is and how that impacts them. So, before we get into that episode, I want to offer to you guys to submit your “I did a hard thing.” Today, as I went to prepare for this episode, I checked the link and we’d actually used up all of the ones that were submitted probably in August of 2021. And so I’m going to encourage you guys to submit your “I did a hard thing” so I can feature you on the podcast. When we first submitted, we had like 70 submissions, and I’ve used all of them up. And I would love to get new ones to share with you and have you be featured on the show. So, if you want to go over, you can click on the show notes for the link, or if you want, you can go to kimberleyquinlan-lmft.com. So, that’s Kimberley Quinlan - L for License, M for Marriage, F for Family, T for Therapy.com. Click on the podcast link, which is where we hold all of our podcasts, and you could submit your “I did a hard thing.” And I’d love to have you on the show. It actually is probably my favorite part. I could easily just have a whole show called “I did a hard thing” and it could be just that. All right. So, let’s get into the episode. Today, I want to talk with you about the danger of catastrophization, and let me share with you how this shows up. So, I want to be clear that you cannot control your thoughts, your intrusive thoughts that repetitively show up, and you can’t show your fear up. You cannot change your feelings. So, you can’t tell yourself not to be sad if you’re sad and you can’t tell yourself not to be anxious if you’re anxious and you can’t not panic if you’re panicking. But you can change how you react and how you behave. That is a common CBT rule. Now often, when you have an intrusive thought, a lot of my patients or clients will report having anxiety or having a thought or having a feeling or having an urge or having an image that shows up in your head – because that’s what I do, right? People come to me with a problem. The problem is usually a thought, feeling, sensation, urge, or image. That’s what I do. And what I try to do is change the way they respond. That is my job, right? Now, what often happens is, there is a thought or a feeling or a sensation or urge, impulse, whatever it may be that shows up, and they often will respond to that by framing it in a way that is catastrophic. I’ll give you some examples. So, when they have the presence of anxiety in their body, they may frame it as: “I’m freaking out.” That’s a catastrophic thought. When they had a lot of anxiety or maybe they had a panic attack, they frame it or they assess it by saying, “Kimberley, I almost died. I had the biggest panic attack of my life. I almost died.” Or “It nearly killed me. The anxiety nearly killed me,” or “The pain nearly killed me.” They may have tried to do an exposure or they may have tried to reach a goal that they had set, and they’ll say, “I failed miserably. It was a total disaster.” They are trying to recover from a mental illness or a medical illness, and they’ll say, “I’ll never amount to anything. I’ll never get better.” Or they’re suffering. We have different seasons in our lives. We have seasons where things go really, really well and we’re like winning at life. And then we have seasons where things are hard and we just have hurdle after hurdle, after hurdle, and they’ll say, “There’s no point, my life is not worth living,” or “I’m never going to be able to solve this.” Now, first of all, if you’ve thought any of these things, I am sending you so much love. Your thinking is not your fault. I’m not here to place blame on you like, “Oh, you’re bad at this,” because our brains naturally catastrophize, because our brain wants to make sense of things and put them in little categories because that is the easiest, quickest way to understand our world. So naturally, we do this to make sense of the world. If I said to my daughter, “How are you doing with math?” She’d go, “Oh, it totally sucks,” because it’s easier to say, “It totally sucks,” than to say, “There are some things that I’m doing well with and some things that I am not. I am struggling with this thing, but I’m finding this part really enjoyable.” That takes a lot of energy to say that, and it takes a lot of energy to hold opposing truths. We’ve talked about this in the past. It’s not the fastest, efficient way to live when you’re living in those types of ways. So, what we often will do, particularly if we are having a lot of strong emotions, is we catastrophize. Now often a client will say some of these or many others. There’s many ways we can catastrophize, which is to make a catastrophe out of something. When they say it, I don’t say, “That’s wrong. You’re bad for thinking that.” I’ll just say, “I’m wondering what percent of that is correct. Like I almost died. Okay, I’m interested to know a little bit about that. Did you almost die?” And they’ll be like, “No.” I’m like, “Okay.” And I’m not there to, “I really want to model to you.” I’m never across the screen or across the office with my patient, trying to tell them how wrong they are. Never. That’s never my goal. But I want them to start to acknowledge that the way in which they think and they frame an experience can create more problems. Now if they said to me, “Kimberley, I want to think this way. I like it. It makes me happy. It brings me joy. I’m fulfilled this way,” I have nothing to fix. But often, once we reflect, and I often will then ask my patients, “So when you say ‘I totally freaked out.’ You had anxiety and you said, ‘I totally freaked out,’ how does that feel?” And often they’ll say, “Not good.” They’ll say, “It actually makes me feel more anxious.” Or if they had an intrusive thought, let’s say they had OCD and they had an intrusive thought and we can’t control intrusive thoughts, and then their response was, “I’m a horrible human being who doesn’t deserve to be a mom for having that thought,” I’ll say, “How does it feel to respond to your intrusive thought that way? How does that have you act?” And they’re like, “Well, it makes me feel terrible and not worthy. And then I don’t want to do anything, or then I just want to hide, or then I have so many emotions. I start freaking out even more. And now it’s a big snowball effect.” So then we start to gently and curiosity-- sorry guys. Then we begin to gently and curiously take a look at what are the facts or what actually lands to be true and helpful. I want to be clear. We do not replace catastrophization with positive thinking. I would never encourage a client to replace “I am freaking out” with “I am feeling wonderful” because that’s not true. They’re actually experiencing discomfort. They are experiencing panic. They had an intrusive thought. They’re having an urge to pick or pull. They’re having an urge to binge. They’re having depression. They’re having self-harm thoughts. So I’m not here to, again, change those particularly. But I really encourage them to look at how you frame that experience, how you respond to that experience. What would bring you closer to the goal that you have for yourself? Because usually, when people come to me, they’ll say, “I want to feel less anxious,” or “I want to do less compulsions,” or “I want to pick my skin less,” or “I want to binge less,” or “I want to love my life. I want to feel some self-esteem and worth. I want to take my depression away.” So, we want to really look at catastrophization and look at the danger of continuing to use that pattern. Now, let me get you in on a little trick here. I titled this podcast “The Danger of Catastrophization” because the title in and of itself is a catastrophization. Did you pick that up? That’s a lot of what happens in social media, is they use catastrophic words to peak your interest. It sells a lot of things. In fact, some businesses sell on the principle of catastrophization. They tell you what catastrophe will happen if you don’t buy their product. They might say, “You’ll have wrinkles. Terrible, old wrinkles if you don’t buy our product.” And that may feel like a catastrophe because they’re trying to sell you their product. They may say, “If you don’t buy this special extra filter for your car, it could explode on the highway.” That’s a catastrophe. “Okay, I’ll buy it.” So, even my naming of it, I want you to be aware of how it piques your interest, the catastrophes, and how it draws you in because nobody wants a catastrophe. But for some reason, we think in this way. So I made a little trick there. I tricked you into listening. I try not to use it as a tool, but I thought today it would be really relevant to bring it up and see whether you caught that catastrophization that I did to get you onto this episode. I’m a naughty girl, I know. There it is. I want you to catch how you frame things and how you tell stories about things that you’ve been through or about the future and catch the catastrophization that you do. If you have a supportive partner or friend or somebody in your life, a loved one, and you trust them, you may even ask them to just give you a little wink every time they catch you using a catastrophization. Sometimes you don’t catch it until someone brings it to your attention. Because again, our brain works on habit. Our brain works on what it knows, and it doesn’t really like to change because that means you have to use more energy. But I promise you. I promise, promise, promise you, this is the energy you want to use. This little extra piece of energy is totally worth it, because think about it. If I said to you, “I had a panic attack, it was really uncomfortable. I rode it out. There were some moments where I felt really confident and some moments where I was struggling, but it did go away eventually,” ask yourself how that feels. And then I’m going to tell you a different version: “I was totally freaking out. I totally thought I was going to die. It was so bad. I really think it was the most painful thing I’ve ever been through in my whole entire life.” How does that feel? It feels terrible. A lot of panic comes from people catastrophizing, using language that feels really dangerous. The danger of catastrophization – remember, it feels dangerous when we use catastrophization. So, just be aware of it. Catch it if you can. Okay? All right. Before we finish up, I want to do the review of the week. This is by Dr. Peggy DeLong and she said, “Wonderful practices!” She gave it a five-star review and said, “I appreciate that you highlight these skills as practices. Coping with anxiety is not a one-and-done deal. Practicing these skills, even on good days, especially on good days, helps to promote long-term well-being. Thanks for providing this service!” Thank you so much, Dr. Peggy DeLong. I am so grateful for your reviews. Please, go and leave a review if you have some time. I would be so grateful. It really helps me reach people who, let’s say, look at the podcast and think to themselves, would this be helpful to me? And if there’s lots of reviews, it helps build trust for them that they would then click, and then hopefully I can help them. Okay? All right. Sending you all my love. One quick thing to remember is if you go over to cbtschool.com, we actually have a full training on this, on correcting the way that you think. Again, the goal is not to change your intrusive thoughts, but the goal is to work on how you reframe things. So you can go there for that training. All right. All my love to you guys. Have a wonderful day. It is a beautiful day to do hard things.

SUMMARY:  Today we have Windsor Flynn talking about how she realized the benefits of meditation for anxiety and OCD in her recovery. Winsdor brought her lived experience and training to the conversation and addressed how meditation has helped her in many ways, not just with her OCD and mental health. In This Episode: The benefits of meditation for general anxiety The benefits of meditation for OCD The roadblocks to practicing meditation How Mindfulness and mediation help with daily stress (especially through COVID-19) Links To Things I Talk About: Instagram: @windsormeditates Instagram: @Windsor.Flynn Website: www.windsorflynn.com (Windsor is certified to teach the 1 Giant Mind 3 Day Learn Meditation course). ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 217. You guys, 217. That’s a lot of episodes. I’m very excited about that. Today, we have with us the amazing Windsor Flynn. I cannot tell you how incredibly by inspired I am with Windsor. She is very cool and has so much wisdom and so much kindness to share. Today, we have her on to talk about having anxiety and learning the importance of meditation. Now, Windsor speaks specifically about having OCD and how much it has helped her to take up a meditation practice. She goes over the couple of main key points, which is number one, anyone can meditate. And that meditation can be user-friendly for people, even with OCD. And she said, “Especially for people with OCD.” And she actually gives us the amazing gift of a guided meditation at the end, that just helps you bring your attention to the present and learn to drop down into your compassion and your body. And then the third point she makes is that meditation can be integrated into your life, even if you feel like you don’t have time, or even if it’s really uncomfortable. And she shares some amazing experiences and examples of where she really struggled and how she got through those difficulties. So, I’m going to quickly first do the “I did a hard thing” and then I’m going to let you guys get right into the amazing conversation with Windsor Flynn. So, today’s “I did a hard thing” is from Anonymous, and they said: “I wear a dress that has been sitting in my closet for months. I was always scared to show my skin since breaking out in hives over my social anxiety. I felt proud for the first time in a long time.” This is so cool. You guys, I love this so much. They’re really talking about showing up imperfect and all, or letting people judge them and going and doing what you want to do anyway. And that is what this podcast is about. It’s about living the life that you want, not the life that anxiety wants you to have. And often, anxiety will keep your life very small if you only listen to it and only follow its rules. And so, anonymous is doing this work, walking the walk, not just talking the talk. So, yes, I’m so, so in love with this. Now you guys, you can go over to my private practice website, which is where the podcast lives. It’s Kimberley Quinlan - L for License, M for Marriage, F for Family, and T for Therapist – I had to think there – .com. So, KimberleyQuinlan-lmft.com. And then you can click on the podcast and right there is a link for you to submit your “I did a hard thing” and you can be featured on the show. So, go do that, but not right away. First, I want you to listen to this amazing, amazing episode. Kimberley: Welcome. I am so excited for this episode. I have a reason for being so excited, which I’ll share with you in a second, but first, I want to introduce to you Windsor Flynn. She is incredible. I have watched you grow over the last what? A year or two years since I’ve known you. It is so wonderful to have you on, so thank you for coming. Windsor: Yeah. Thank you for inviting me. This is so cool because I’ve spent a lot of time listening to your podcast and, I don’t know, just hoping to be on Monday, but I didn’t know for what. So, this is really cool for me. Kimberley: Yeah, this is so cool. So, you’re coming on to talk about meditation. And the reason that this is so exciting for me is that is actually what this podcast was originally for – was to bring mindfulness and meditation practice to people who have anxiety. And I did a lot of meditations at the beginning and then I lost my way. So, I feel like you coming here is full circle. We’re going back to the roots of the show to talk about mindfulness and meditation. Do you want to share a little bit about your story with mental health and why you landed on this as being your passion project? Windsor: Yeah, sure. So, I started-- I guess my mental health story goes way back, but I’ll just start at the beginning when I first came to my OCD diagnosis. I had been experiencing anxiety. Looking back, I will say it was pretty debilitating, but I was sort of just powering through it. I was a new mom. I didn’t have a lot of mom friends, the first in my group to have kids. My parents are across the ocean in Hawaii. I’m in California, in San Francisco with my boyfriend who is shocked at being a dad. So, I’m very anxious, but I’m doing all the things. And I had started experiencing intrusive thoughts, which I didn’t know were intrusive thoughts. I was just really worried that I was going to become a headline for like moms that murder. I hate moms that kill because I had heard of this story. I’m sure so many people who grew up at the same time as me were really familiar with the Andrea Yates story. I don’t need to go full into detail, but she had some mental health issues and she ended up killing her kids. It’s a very, very sad story, but I had attached to that because I was just so, so scared that that would happen to me. And I don’t know why I was nervous that this would happen to me. But ever since I was little, I just always thought that anything drastic, it would happen to me. I would be there for the end of the world. I would be there to witness a mass murder, or I would be a victim of a serial killer. All these things, I just thought it had to be me. I don’t know why. So, of course when I have a baby, I’m thinking, “Oh no, this horrible thing, it’s bound to happen to me. I need to pay attention.” So, that’s when the hypervigilance started, all of these things that I now have language for, but I wasn’t quite sure how to explain, and I also didn’t want to explain it to anyone because it sounds unhinged. So, I was doing this alone. I was trying to keep myself very busy. I was doing all the classic compulsory activities that happen when you’re trying to avoid intrusive thoughts and avoid this massive discomfort in fear. And eventually, we moved out of the city. So, not only was I mothering by myself-- not really by myself. I had a partner, but he was working a lot just with his schedule. So, he was sleeping most of the day and gone all night. So then we moved across the bay to Alameda and then I just didn’t even have friends anymore. So, I was all alone. So, I was thinking, “Wow, if there’s ever going to be a time that I’m going to just completely go off, it’ll be now.” And then it just snowballed. It spiraled into this thing where I couldn’t not be scared and I didn’t know what was going to happen. I was convinced that I was going to kill my son for no other reason. Then I just had a feeling that something bad was going to happen. So, I looked up postpartum mood disorders because somehow, I knew those existed. And I was hoping that this had something to do with it. I still had hope that there was an explanation. And I found something that said Postpartum OCD, and anxiety. And of course, I hit every single track mark. It wasn’t mild symptoms. I was just, yup. Check, check, check, check, check. And so, I felt a little okay. Not really, right? And I finally saw someone who ended up being-- she said she was a postpartum specialist, which was great. I signed up with her. We talked. She told me I had OCD. It was cool. But she didn’t give me any tools. She was doing the root cause stuff, which is probably really helpful in other circumstances, not necessarily for OCD. But she reassured me enough that I was cool with my OCD. I was like, “Well, I’m not going to kill anyone. That’s fine. I can go home. I can continue being a mom as long as you’re telling me I’m not a murderer.” Just like, “No, you’re not a murderer.” I was like, “Great, well, we’re done here, I guess.” And I got pregnant again. And of course, I was so scared. I was like, “That’s going to happen again. I’m going to have postpartum OCD.” So, I couldn’t pause my whole pregnancy, but it was in the name of preparedness. So, I didn’t know that I was making my symptoms worse and worse and worse until I had the baby. This time I’m not scared I’m going to kill anyone. I’m just scared that now I think she’s the devil, which I did not know how to recognize it. So, finally, I’m experiencing a whole different subset of OCD symptoms. I didn’t know, but I just thought, well, it was OCD the first time. I’m just going to check. And luckily, I landed on my therapist. I still see-- even though this was four years ago, I still see her every two weeks. I love her. She’s the best. She’s given me all the tools I needed to manage my mental health, got me to a place where not only was I totally understanding the disorder, but I felt really comfortable sharing and sharing in a way that I thought would be helpful to other people. So, that’s when I started advocating for maternal mental health and OCD, and that’s how we know each other, through the internet, social media space. And I guess that was a mouthful, but that was how I landed onto the advocacy part. And eventually, I switched to meditation because I felt like this was a tangible way that I could offer a service that I know to be helpful for the management of mental health. And I know how much resistance there is towards starting this meditation practice because I too went through a number of years where I absolutely said no to this idea of meditation. But once I started, I realized, wow, I don’t know why I didn’t do this sooner. There’s really something to it. And it’s very teachable. And I know from firsthand experience how beneficial it is. Kimberley: I love that. I actually don’t think I’ve heard your entire story. So, thank you for sharing that with me and everybody. I didn’t realize there were two waves of OCD for you and two different subtypes, which I think is common, for a lot of people. Windsor: Yeah. Kimberley: I love that. So, I think what you’re saying, and can you correct me if I’m wrong? So, the first wave was reassurance, what you used to get you through. And then the second you used ERP? Windsor: Yes. Kimberley: Okay, great. And then from there, the third layer of recovery or however you want to say it, was it meditation, or were there other things you did to get to the meditation place? Windsor: Well, I was doing ERP and that really helped with my OCD management. I was able to recognize whenever I had a new obsession, and I feel like I could recognize anyone’s new obsession. At this point, I was like, ‘Oh, that’s this, that’s this. It’s tied into this.” So, I had a really great understanding, and that was cool. But I still have two kids, we’re still in a pandemic, I still have communication issues with my partner – all these normal things that ERP doesn’t necessarily help with. So, it was really just about finding that balance between working on myself and stress management and really getting to be that calm, chill person that I’ve always wanted to be. Even when I was doing the best with my OCD, I was still not so relaxed because I had a lot of attachments to how I wanted people to perceive me, how my children were behaving, not necessarily in a controlling way, but just really feeling a lot of responsibility over everything. And so, the meditation was just this next step that I was hoping would get me there, because I was feeling a lot of stress, not even related to my OCD, just in general. And I wanted to be able to find something that would help me get through that stress so that I could start really figuring out what it is I wanted to do, just even for fun again, instead of just only feeling this overwhelmed. Kimberley: Yeah. No, I really resonate with that. All I can say for me is, while I had a different story, I had an eating disorder, I was trying to do meditation during that, but the thoughts and everything was just too big for it. And it was hard for me to access actual meditation without it just being an opportunity to ruminate, sitting there, just cycling. So, the main thing I really want to ask you, if you’re willing to share, is let’s say specifically someone with OCD, what were some of the struggles that you had with meditation? Because I know so many people with OCD are really resistant to it because the thoughts get louder when you sit still and so forth. So, what were some of the things that you had to work through to be able to sit on a cushion? Windsor: Yeah. That’s such a great question because I feel like, had I not figured out that I had OCD and then done all this work with ERP to really learn how to acclimate myself to the presence of intrusive thoughts, I don’t know that I would’ve been successful in meditation. Actually, I know that I wasn’t because I had tried it before, and it was too hard. So, I really-- even with ERP, once I started the meditation journey, the first few weeks were pretty challenging for me because as someone with OCD, every time I close my eyes and I’m not occupied, or my brain is not occupied, it’s like prime time. This is OCD’s favorite. It’s like the time to shine. It’s like, “Okay, here I am. What can we throw out to you today?” And so, knowing that this was a possibility, even when I signed up to learn meditation, I was like, “Okay, I’m going to do this. I’m going to try, I’m going to give college a try.” Then my OCD was like, “No.” You close your eyes, something could happen, like you could have a breakdown or you could make all these realizations that you are a psycho killer. And then you’ll just definitely kill everyone. Thank God you tried meditation. Now your true self can come out. And I was like, “Okay, I’m going to just do it anyways. I’m just going to meditate because I have to see, not even in a compulsory way, I have to see if this is true. But I can’t-- knowing now what OCD does, I couldn’t-- it was almost I took it as a personal challenge. Kimberley: Like an exposure, right? It was like an exposure, like, “Okay, fine. I’m going to-- let’s see.” Windsor: I signed up to learn meditation as a true exposure because now I had this fear that if I come to all these realizations, it won’t be cool. It will be devastating for everyone around me. So, I was like, “Well, I’m going to try. I’m going to try to meditate.” And do you know what? I cried and panicked the first time. I had to turn off my camera because I did not want the teacher to see. Kimberley: So you did it live. Windsor: I did it live. It was so hard. It was like a total exposure because this was in front of-- I think there were 25 people in the course and everyone was closing their eyes, I’m assuming. But 20 minutes is a long time to meditate. So, I know people were going to be opening their eyes. So, I was live having this fear that I was going to turn into a psycho killer on the camera. So, I was crying because it was hard. But you know what? I’m so glad I did because also ERP showed me that crying is fine. We can cry when we do hard things. I was doing the hard thing and I was proud of myself. I even shared afterwards. We were like, “Who wants to share?” And I was like, “Me.” I cried and I had a panic attack. Kimberley: See. That is so badass in my mind. That is so cool that you did that. You rode that wave. Windsor: Yeah. And it was great because if I didn’t do that or purposely put myself into the situation to cry and do this hard thing, I wouldn’t have been able to get to the good part of meditation, which I love. I like to talk about the good part of meditation. But having OCD makes starting the hardest part. Kimberley: Yeah. What is the good part of meditation for you? Because I think that no one wants to do hard things unless they know there’s some kind of reward at the end. Everyone’s going to be different, but for you, what is the why? Why would you do such a thing? Windsor: Well, because I learned this thing, right? That was so valuable. Someone told me, we don’t gauge the benefits of meditation for how we feel when our eyes are closed. We’re more interested in what happens while our eyes are open. How is it impacting? And I noticed almost right away that when tensions were high, when I usually would be the first to participate-- because I’m really affected by the way other people’s moods are. I feel responsible or I have to change it. I became dysregulated really easily. I noticed almost right away that when other people were feeling their feelings around me, I was able to observe them instead of participate in that, which was really cool. And it was just so much nicer to be able to be supportive instead of become one of those people who also needed support in that moment. And I also noticed right away that I had a higher tolerance for loud noises and just disruptions, because I’m pretty sensitive to lots of different noises at once. It gets me pretty anxious and agitated. So, having kids at home all day isn’t ideal for that. And so, the meditation really helped me a lot with that. I was able to recover more quickly from periods of dysregulation. Maybe I would become dysregulated, but I could calm down quicker. And so, I really loved that. And I noticed that as before where I would be like, I need wine at 4:30 or whatever time it was. Once I started meditating for a few weeks, then wine just became something that tasted good that I liked in the afternoons. I didn’t need it. Sometimes I would be like, “Wow, we’re having dinner. Oh my God, kids, I didn’t even have wine.” And they were like, “Wow, you’re right.” And so, I would pour myself a glass just because I like it. Kimberley: Right. Not because you needed it to get through the afternoon. Windsor: Yeah. And so, I really liked all those changes. And it just is really restful, which I wasn’t expecting. The practice itself, the one that I practice, it’s twice a day. And I find that doing those two meditations really gives me more energy because I’m not a coffee person. So, yeah, I just feel like what started as a thing that I wanted to feel more rested and less stress, it has actually become a tool that I can use to help maintain a busier lifestyle, which as much as I don’t love for everyone, I can’t avoid it. Anyway. Kimberley: That is so cool. I mean, how amazing that this practice came to you. So, you are talking about this specific meditation practice that you use and the benefits. Do you want to share a little about what specifically you use? I’m sure some people here have heard from me of self-compassion meditations and mindfulness meditations, but do you want to share specifically what practices you are interested in practicing? Windsor: Yeah. So, the practice that I find the most success and enjoyment out of is a silent meditation, which actually was the most intimidating for me, but I love it. It’s the one giant mind being technique. It’s called a being technique because, I guess the focus of the meditation is to connect with your being, which I guess if you say it without sounding too woo-hoo or anything like that, we’re just connecting to your true self apart from all the thoughts and the ideas and all the conditioning we have. Just getting back to you, which is something that I really wanted, especially after having two kids and being confused in the state of life that’s not really developed yet. So, I love that part. And since I didn’t have to focus on anything like someone else’s voice, or trying to follow a guided meditation, sometimes I feel that takes more energy because I still have to pay attention to something. A silent meditation allowed me to really find that rest and allowed my brain to just slow down. Kimberley: Yeah. I too. I mean, I love guided meditations for people who are starting off and need some instructions. But I find the silent meditation once I got the hang of it, I could practice it in a minute between clients. I could just sit for-- I could quickly go into that and then come out. Or if I’m presenting and I’m listening to someone, I could just drop down into that. So, I really love the idea of this as well because it’s something you can practice in small pieces.  Not so formally, but drop into just connecting down out of your head into your body kind of thing. Okay, so the biggest question I’m guessing people have is, are you “successful” with your meditations daily? What does it look like day-to-day? Are there ups and downs? How is it for you? Windsor: Yeah. This is something that comes up a lot when people ask, because we know that, yes, all meditation is helpful. But we also know that to get the most benefit out of meditation, it’s best to have a regular practice. And this could mean meditating once a day, or with this particular technique, meditating twice a day. And it sounds a lot. And I would love to say I meditate twice a day every day, no matter what. But I have OCD, so I allow myself to be a little bit more flexible. I don’t really love rigidity when it comes to things like that because I have a tendency to really grab onto them. So, I do allow myself to skip it sometimes, either for reasons like I forget, or the day just gets ahead of me. As important as meditation is, there’s a lot of things that trumpet, like do my kids need something? Do I have to pick someone up? Is everyone being fed? There’s all these things that are also really important. So, I do try to meditate twice a day. Most days I do. Sometimes I don’t. But that’s okay because I did what I had to do to keep everything going. Kimberley: What about during your meditation? Windsor: What, excuse me? Kimberley: What about during your meditation? Is that an up and a down process? Do you have “good days” and “bad days” with it or is it pretty consistent for you now? Windsor: Well, I don’t like to talk about the meditations as being good or bad. Some are really gratifying and some are less gratifying, because even the less gratifying meditations are really good for you. You’re still going to benefit from them, even though it wasn’t necessarily easy or didn’t feel good. But that’s just like a lot of things. Meditation can be categorized as something like that, like maybe brushing your teeth or exercising. Maybe you don’t love it all the time, but you do it because it’s good for your body and it helps you reach certain goals. And sometimes it’s really hard for me to get to a good juicy place, and that’s okay. I’ve just started to not expect a certain experience when I go into the meditation. And that makes everything a lot easier because then I’m not letting myself down or I’m not feeling disappointed or I’m not crushing a goal. I don’t go into the meditation feeling like I’m going to feel so relaxed and cool. I just say, “Oh, I’m going to close my eyes and we’ll just see what happens during this session.” Kimberley: And that’s why I love what you’re saying because it’s so in line with recovery, like dropping the expectations, dropping just the good feelings, dropping goals, having these big goals all the time. I think that’s-- sometimes I have found, what happens in your meditation is like a metaphor for life, right? Like, okay, today is a busy brain day. There’s going to be days like that. And I think that it’s a great way to just practice the tools in a small setting that you would be practicing in the day anyway. Windsor: Exactly. That’s why I love it for people with OCD too because let’s say you commit to doing it 20 minutes a day or 20 minutes twice a day. During that 20 minutes, you know that any thoughts can come up, any feelings can come up, and you’re just going to let them be there. And this is excellent practice for when you’re going about your daily life and you have no control ever over what comes into your mind or what happens. But since you’ve been practicing this in your meditations, those responses to accept and let go become more automatic. So, not only are you having great meditation experiences or anything, but in your life, you can use those same tools. It’s not just adding another thing. It all works together. The meditation is so helpful in every aspect. Kimberley: Right. It’s like we go to the gym to strengthen our muscles and we meditate to strengthen our brain muscles, right? Windsor: Yeah. Kimberley: Yeah. I love that. So, one thing I didn’t ask you ahead of time, but I’m wondering, would you be interested in leading us through a couple of minute meditation to get us experiencing that? Windsor: Yeah. And you know what? I was thinking of like, maybe I should think of something to say in case she asks it, but I don’t think she will. So, yeah, we can just do a short-- what I do sometimes when I don’t do the whole 20 minutes is I just do a short mini one, like a minute or two. Kimberley: Would you lead us? Windsor: Yeah. Okay. So, for everyone listening and for Kimberley, I just want to show you a little bit about what it looks like to connect to your being and to practice a silent meditation, just for a short little grounding experience in the middle of a busy day or before a meeting, anytime you need to. So, what I like to do before I meditate is to just get into a comfortable spot. You don’t necessarily have to be on a fancy cushion. You just have to have your lower back supported. And go ahead and close your eyes. And what I like to do before I start any meditation is take a few deep belly breaths. So, we’ll just breathe into our noses right now. Feel your belly. Feel your chest... And release through the mouth. One more deep breath into the nose... into your belly... and release. And one more deep breath into the nose. Feel your belly... and release. So, now you just want to let your breath settle into its own natural rhythm. This isn’t a breathing meditation. We’re not going to focus on our breath. And you can scan your body for any tension that you might be holding. A commonplace is in your neck and your shoulders. Make sure you drop your shoulders, can wiggle your jaw a little bit, and just let all of that tension go. So, when we’re meditating, we don’t want to put a focus on any thoughts that might come into our mind. But when they do come in, we just want to acknowledge them and recognize that this is a normal part of meditation. We never want to resist any thoughts or feelings that we might have. These are all important. And just continue following your natural breath. And has any thoughts come into your mind, just remember that we don’t have to engage with them. It’s okay to just witness them and let them pass through you. Maybe you might notice a sound outside or a body sensation. That’s okay. Just be a witness to that too. Now you can take another deep breath into the nose... Into your belly... and breathe out. And you can start to bring your awareness back to your body and see how it feels to be where you are. You can start to bring your awareness back into the space. And slowly, when you’re ready, you can open your eyes. Kimberley: Oh, what a treat. Windsor: And that’s a little meditation, but I was really feeling it for a second. Kimberley: Yeah. I just kept smiling because it was such a treat. What a treat that I get to have my own little meditation instructor in the middle of a podcast. It’s my favorite. What a gift. Thank you so much. Windsor: You’re welcome. Kimberley: Yeah. Thank you. I think I love-- I just want to highlight a couple of things you said, which is, for those who have anxiety, meditation is not the absence of thoughts and feelings, right? You highlighted that and that was so helpful, just to acknowledge that thoughts and feelings will happen, sensations will happen, but we just become an observer to them, which I think again, not only helps us with meditation, but it helps us with response prevention, during our exposures. It helps us during panic. Such a great tool. So, I’m so grateful for you sharing that. Windsor: Cool. Well, thanks for letting me. I love to talk about it when I have the chance. Kimberley: Yeah. Okay. So, I want to ask one final question, which is, what do you really want people to know? If there’s something we’ve missed today or if you want to drive home the main point, what is your main message that you’re wanting people to take away from today’s podcast? Windsor: I guess what I really want people to know about meditation is that you don’t have to be a certain type of person to do this. You don’t need to be a specific personality type or have certain interests to make meditation work for you. You can just be yourself and come as you are and treat this practice as a gift that you’re giving yourself, that you deserve to take part in because it offers such deep rest and relaxation. That meditation can be a part of a modern, busy lifestyle. You don’t have to be common Zen all the time to do it. I think that meditation is for everybody. Kimberley: I love that. I always remember, I think I could be killing this here, but the Dalai Lama says, and this always gets me laughing because he always says, if you don’t have time for meditation, you are the one who needs to meditate the most. Windsor: Yeah. I love that one. Kimberley: I killed the way that he said it, but for me, so often I’m like, “Oh, I don’t have time. Oh, I didn’t get time today.” And he really keeps nagging me in my mind in terms of knowing the more busy you are, the more you may want to prioritize this. Of course, like you said, that happens and priorities happen. But for me, that was the main message I had to keep reminding myself when it came to meditation. So, I loved that. Windsor: Yeah. Kimberley: Well, thank you so much. This is just delightful. Really it is. It has brought such joy to me today because like I said, it feels full circle to be coming back and talking more about meditation and doing more of that here. Where can people get a hold of you and hear about your work? Windsor: So, I have my Instagram, @windsor.flynn, and that’s my OCD one. I talk a little bit about meditation on there, but I know that not everyone is necessarily ready for that. So, I do have my other Instagram, @windsormeditates. And that’s when I focus a little bit more on the meditation. And if you’re interested in taking any of my group courses or private meditation sessions, you can just go to my website, windsorflynn.com. All very easy, just search my name on the internet, and then you’ll find some links for those. Kimberley: And we’ll have all the links in the show notes as well. So, if people are listening on, they should be able to connect to that. So, amazing. I’m so-- pardon? Windsor: I was just going to say thank you so much for having me. I’m a big fan of yours and I love the work that you’re doing and I feel so honored that I get to be on your podcast. Kimberley: No, I feel likewise. I love what you’re doing. There’s so many things I wish I could focus on. And I love when somebody like you will come along and they focus on that one thing. It just makes me really happy because I just love when people are finding little areas, particularly in the OCD and mental health space where it’s like, we need these sources. So, I’m so happy that you’re doing that work. Thank you. Windsor: Cool. Thank you so much. Kimberley: My pleasure. And like I said, go follow Windsor. She’s amazing, and I’m just honored to have you here. Windsor: Thank you. ----- Okay. So, before we finish up, thank you so much for being here and staying till the end. Before we finish, I want to share a review of the week. This one is from Cynthia Saffel and she said: “I’m so excited to share these podcasts with my clients.” She gave it a five-star review and said, “I first was introduced to Kimberley’s clear and compassionate teaching style when I took the ERP school course for therapists.” For those of you who don’t know, we have a CEU approved course called ERP School, where you can learn how to treat OCD using ERP. And she went on to say, “In the past 3 weeks since taking the course I recommended both the course and podcasts to my clients.” Thank you so much, Cynthia, for your review. And for everyone who leaves a review, it is the best gift you can give me in return for these free resources. So, if you have the time, please do go over and leave a review and have a wonderful day. It is a beautiful day to do hard things. Have a wonderful day, everybody.

SUMMARY:  Today, I wanted to dedicate an entire episode to the five things that I learned in 2021. I have found 2021 to be one of the harder years, but probably the most transformational for me, and that is one of the things I’ll talk about here very, very soon. The 5 Things I learned this Year: Recovery goes smoother when you slow down and act intentionally Life is not supposed to be easy It is my responsibility to manage my mind Catch your thought errors I am not for everyone Links To Things I Talk About: Changed our name on Instagram Lots of exciting information on cbtschool.com ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 216. Hello, my friends. Happy 2022! Oh my goodness, it is crazy to say that. I’m excited for 2022, to be honest. I’ve had enough with 2021, I’m not going to lie. And I’m guessing that you are in the same boat. I’m grateful for 2021. Absolutely, I’m not going to lie, but I’m really happy to be here in 2022. Today, I wanted to dedicate an entire episode to the things that I learned in 2021. I have found 2021 to be one of the harder years, but probably the most transformational for me, and that is one of the things I’ll talk about here very, very soon. Before we do that, you may notice that the show looks a little different. We have new podcast cover art. If you follow me on Instagram, there’s a ton of different visual and aesthetic changes there as well, as well as that we have changed the name to Your Anxiety Toolkit instead of being Kimberley Quinlan. I will explain a little bit about why I’ve made these changes here in a very little moment. Before we get into the good stuff of the show, the bulk of the show, I want to give you the very best stuff, which is the “I did a hard thing” segment. So here we go. For those of you who are new, every week, people submit their “I did a hard thing” and we talk about it, and we share it and we celebrate the big and the small and the medium wins. This one is from Kboil, and it says: “I went to work for the first time in five weeks after a horrendous meltdown where I wanted to take my own life. I am still struggling daily with my anxiety and panic attacks, but I am doing it. XO.” This is the work, you guys, that may be triggering for some people. But the truth is we have to talk about how impactful our mental illnesses can be and how important mental health is, because if we don’t take out care of our mental health, it can get to the place where people are feeling suicidal. Let me also reframe that. Sometimes we get to those really difficult places and dark places. Not because you’re not taking care of yourself, but for multiple reasons, daily stresses, genetics, medical struggles, grief, trauma, high levels of anxiety. Kboil is really bringing the most important piece of mental health discussions, which is, when we’re really, really struggling, number one, it’s important to celebrate your wins, and number two, nothing is off-limits. We must be willing to talk about these really difficult topics. Thank you, Kboil. I am just so honored that you shared this and so excited that you’re taking baby steps, and I really wish you well. I know it says you’re still struggling, so I’m sending you every single ounce of my compassion and love to you. Ugh, it’s so good. My heart just swells for you all when you write in those “I did a hard thing’s.” Okay. Let’s go over to the five things I learned in 2021. The first one is probably the most important, and it does explain why I’ve made certain changes in the way that I run my business, the way that I show up on social media and here on the podcast, and why I really want to make some changes in 2022. Be very intentional. First of all, this is proof that people can change their mind. It’s okay to change your mind. Actually, that’s probably the sixth thing I learned. Number one is, it’s okay to change your mind. But really the number one was, it’s important to act intentional. I did a whole episode on whacking things together, how it’s okay to whack things together. I did that because I found myself becoming very perfectionistic. I am still a massive fan of the whack-it-together model, which is ultimately to practice not being perfect and just getting things done. But what I think I did is I went a little too far in the whack-it-together model and I wasn’t being as intentional. I was doing too much and not doing a great job of the things I was doing. I mean, it was still great and I was still helping people and I was still showing up and I’m so proud of what I did in 2021. But what I really learned is sometimes when you get into moving too fast and pushing too fast and too hard that you lose the intentionality. And when you lose the intentionality, you often lose the real lesson and the growth. If you’re in recovery for anxiety or an OCD-related disorder or an eating disorder, or a body- focused repetitive behavior, if you’re rushing through and pushing through and wrestling with things instead of slowing down and being really intentional in your practices, chances are, you’re going to miss a lot of opportunity for real growth and real recovery. So slow down and be very intentional. Some question you may ask is: What is it that I’m trying to achieve here? For me, often I’m like, because I’m trying to reach a certain goal or so forth, it’s like, well, is this rushing? Is this behavior actually moving the needle forward? If it comes to recovery, particularly if you’re having anxiety, I’m going to encourage you to ask: What am I trying to achieve here? Am I trying to get away from anxiety? Or am I trying to be with my anxiety? Because if you’re intentional and you’re trying to be with your anxiety, your recovery will benefit. Now, how does this apply to me and you guys and us together is, I really don’t want to be as much on social media anymore. One of the things I really learned this year is that it’s not good for my mental health when I push it like I was, and I found that I was showing up on social media. Even here on the podcast, I’m not afraid to admit, I would sometimes sit down and just throw myself into it instead of actually stopping and doing what I originally did, which is I used to, and I used to do this all the time, but I think I fell out of the practice, which was to stop, and before I did anything, get really clear on like, who am I speaking to? What do they need to hear? How can I show up and serve them in a way that also serves me? Am I just showing up here to say that I showed up and recorded an episode so I can say that I did a weekly episode? That’s not how I want to be anymore. I really want to move towards being intentional and engaging in behaviors that actually push the needle forward and that are healthy for me. I’ve moved Instagram from Kimberley Quinlan to Your Anxiety Toolkit because for some reason, every time I got onto Instagram, I felt like it was about me, even though I know it’s not. And I don’t want it to be about me. I want it to be about mental health and anxiety and tools to help you. So, that’s how it’s going to shift. We’ve got a ton of amazing guests happening, which I’ve already pre-recorded. And then after that, I think I may even take a little break from having guests and just practice sitting down with you and really talking about the important stuff I want you to know. Like this stuff that sits on my heart, that I really want you guys to know. So, that’s number one, is become a little more intentional if you can. Don’t become perfectionistic, but move towards being intentional. Life is not supposed to be easy. This is a huge one that I learned early in 2021. I was learning from a public speaker, and she constantly says, “Life is 50/50.” And that used to bug me so bad. It used to really make me angry because I’d be like, “No, life is not 50/50. It’s like 80/20. It’s like 80% good and 20% bad.” Until I was like, “Wait, if I’m really honest with myself, it is 50/50.” I think a lot of the suffering that I was experiencing, and I’m guessing a lot of the suffering that you were experiencing is trying to get it to be 80/20 or 90/10, because life is not supposed to be easy. Life happens. Life is hard. Bad things happen to good people, and that was a big lesson to me. A friend of mine was going through a really hard time. I kept thinking, this is crazy. Why is this bad stuff happening to good people? Until I was like, that’s an era in my thinking. When did I learn that bad things shouldn’t happen to good people? Because bad things do happen to good people, and it’s not their fault. Sometimes when we can give ourselves permission to drop the expectation of the 80/20 or the 100% or the 90/10 and just let everything be 50/50, it’s so much easier. Even as I parent my children, I think I was parenting them with this expectation that I’m supposed to be really, really good at it. But when I accepted that things will be 50/50, they’re not going to like when I ask them to pick up their room. They’re not going to like when I serve them vegetables that they don’t like to eat, and I can’t be disappointed when they’re disappointed about the vegetables I’ve served them because life is 50/50. One of the best lessons I can give them is for them not to expect too much either. I’m not saying drop your standards and accept terribleness at all. What I’m saying is, do the best you can. Go for your dreams. Love your life. But still come back to the fact that you still have to brush your teeth and we break things and we spill things and we have to pay taxes and we are exhausted at the end of the day after having a great day at work. You might have some negative parts of it too. There’s pros and cons to everything. So, that was really powerful for me, is life is not supposed to be easy. I’ve talked about this before. I think it was in the summer of 2019, where I would catch myself throwing mental tantrums in my head like, “It’s not fair. It shouldn’t be this hard.” And I’m like, “That is exactly the problem. Those mental tantrums that I have in my brain.” The other one, let me add, is I actually had a whole therapy session about this, which was about this entitlement that I caught in myself of like, “This isn’t fair. Things should be easier. Things should be going easier or they shouldn’t be so hard.” And this real entitlement that came with that, and even though we use the word “entitlement,” I’m not using that as a criticism towards myself. It’s just naming it what it was. I felt this entitlement inside me of like, “No, things should be good. I should succeed at everything I try.” And that’s totally not true. It is my responsibility to manage my mind. This one really hit me in September. I actually think I read something online that really hit me with this. I’m writing this down as I talk to you just so I make sure I get it in for you in the show notes. Often, I talk to my patients and clients that you can’t control your thoughts and you can’t control your feelings, but you can control your reaction to those thoughts and feelings. And when you do that, you may find that your thoughts and feelings start to change. It’s a very basic concept of cognitive-behavioral therapy. Cognitive-behavioral therapy is a helpful modality of therapy for many, many, many different mental illnesses. But when I talk about managing my mind is being, again, very intentional about the way I respond to problems and stresses in my mind. I’m not saying that you can control your intrusive thoughts, but I’m going to say it is my job to manage when anxiety shows up. It is my job to manage when thoughts and strong emotions hit me and make me want to lash out or project. A lot of my patients have reported this. They’ll come to session and they’ll say, “You will not believe my husband. He just won’t do A, B, and C, and he knows it makes me crazy. He knows it makes me anxious. So why is he doing it? If he loved me, he wouldn’t do this.” And I have to keep gently reminding them, “It’s your responsibility to manage your emotions. It’s not their job.” We talked about this in one of the last episodes of the year in 2021, which is setting boundaries, you are responsible. You’re in your lane to manage your mind and your emotions. It’s not anybody else’s. I think what was really hard about this is when I heard this, I used to take offense and I’d be like, “Oh my God, that’s just so mean. What about the people who are really, really, really suffering?” or “Wow, that’s so abrupt and dismissive.” Until I really sat with it. I actually journaled a lot on this of like, what shows up for me when someone talks about the word “responsibility”? I wrote about this a lot in the self-compassion workbook for OCD – compassionate responsibility. And I think the word “responsibility” really triggers us into thinking that if we’re taking responsibility for ourselves, we don’t deserve other people’s support. And that’s not true. But when I really sat on “It’s my job to manage my mind,” everything changed. I think that’s why I came to the place where I was like, “Okay, I’m going to be way more intentional because it is my job. It’s my job to really slowly and in baby steps, work at changing how I react and having really hard conversations with myself on like, ‘Wow, you fully reacted in a little bit of a crazy way there.’” What was going on for you? What do you need to change? How do you need to show up for yourself different? How can you be intentional around this? Because it’s your job. I’m saying that to myself, “Kimberley, it’s your job. It’s your responsibility.” It’s the most compassionate act you can do, is to practice managing your mind. Catch your thought errors. Again, these all tie beautifully in together because once I took responsibility for really managing my mind and really owning what was showing up for me, it was then my job to catch the thought errors. Again, I want to be really clear here. I’m not saying that you can control your intrusive thoughts. Absolutely not. But what I’m speaking about more, and I’m actually going to do a whole episode on this in just a couple of weeks, is catching thoughts like, “I’m going to screw this up. That was the worst. I am a failure. I am freaking out.” These are all often not accurate statements, So I’m talking about the way in which we frame and perceive things, not your intrusive thoughts. I want to be really, really certain. We’re not in the business of correcting intrusive thoughts of anxiety. When it comes to depressive thoughts or very negative thoughts or catastrophic thoughts, or very black and white thoughts, we can be very intentional and be like, “Wait a second, I catch myself on this all the time. I’ll be like, my husband often comes home in the end of the day and says, ‘How was your day?’ And I’ll often make these sweeping statements like, ‘Oh, it was a really hard day.’ Even if that’s true, how does it benefit me? Was it 100% true? Because what’s probably 100% true is, oh, there are a couple of really, really difficult times that took me some time to come down from. But there were also some really beautiful moments.” That’s the truth. It takes more effort to say that and you have to be more intentional to say that. But if we say, “It was a really hard day,” our brain is going to pick up on that and it’s going to start to feel overwhelmed and heavy. I am not for everybody (and that’s okay). I’m going to leave you with this one because this one was the best. That is the lesson I took away – I’m not for everybody. I guess what we could say in parentheses is, “and that’s okay.” I actually was on a podcast this week with Bryan Piatt, an amazing OCD advocate. He had asked me this question and I was reflecting on it the other day, which is, I think that in my many years of being on the planet earth and being in my human body, I thought that if I was just kind, there’s really no reason anyone could not like me. If I was just kind to everybody and I did my best and I kept out of drama, everybody should like me. There can’t be much to hate. I think I banked on this as a way of avoiding conflict and as a way of getting people to approve of me. I learned last year that even when I’m kind, even when I show up in the best version of myself and I do nothing, but show up with loving kindness in my heart, I’m still not going to be for everybody. Do you want to know how crazy that made me when I realized that? In 2021, a lot of you may know, but I was very seriously online bullied and shamed and trolled. There is this one particular person who really trolls a lot of mental health accounts, and I seem to be one that they loved to really bully and shame. I kept crying and going home to my husband and saying, “But why am I so kind?” I had to realize it’s that same kind of concept of like, good things should happen to good people and bad things should happen to bad people, until I was like, “Oh, that’s not true.” Life is 50/50, and you’re never going to be for everybody. So, I’m going to offer to you the same thing. I’m not for everyone. You’re not for everyone. Try to get a good 10 people in your life on your side and the other billion gazillion people, you don’t need to please them. Just be a little intentional there. And I’m too, I’m doubling down now in really just being intentional on who matters and whose opinion does matter and everyone else can take me or leave me. I hope that those five things were helpful to you. Maybe they sparked some curiosity for you and you may or may not agree with some of those. The good thing to remember here is, these are the things I learned, but they might not be exactly what you needed to hear today. And that’s totally okay. Sometimes we need to hear things at a certain time. At other times, they’re not for you at that particular time in your life. And that is okay. So, there are the things I learned this year, in 2021. I’m so excited about this year because I have those amazing lessons that I learned. I’m going to be much more intentional about the podcast and I’m going to try to use the podcast to be a little more personal, where people in my podcast are more my insider group compared to social media because again, I want to be really intentional and healthy around social media. Before we finish, I want to do the review of the week. Please, please, please, please. If you can do me one gift, it would be to leave a review for the podcast. This one is from Kanji96 and they said: “Thank you, Kimberley. This podcast is very helpful for me, especially when I’m going through hard times. Right now happens to be one of those hard times. Here I am back listening to Kimberley. Thank you.” I’m so grateful, Kanji, for that you support me. Thank you so, so much. I’m going to leave you all with a quote that Kanji almost used and that I always use, which is, it is a beautiful day to do hard things. Let’s do 2022 together. I’m so incredibly thrilled to be walking on this path with you. I know that your time is valuable. I appreciate you coming and spending your time with me, and I’ll see you next week.

In This Episode: How to identify what your role is in a relationship How to manage a mental illness and set boundaries How boundaries are needed when you are in recovery How to set boundaries with a loved one during the holiday season. Links To Things I Talk About: ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor: This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety... If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 215. Welcome back, everybody. It is the final episode of Your Anxiety Toolkit for the year 2021. I will not be putting out a podcast next week because it falls right on the holidays, and I really wanted to make sure I give you all time to be with your family instead of listening to my voice. If you are in the holiday season and you want to listen to my voice, there are so many, in fact, there are 214 episodes. You can go back and listen to. I just want to be with my family, and I want you to be with the people you love. Speaking of people you love, today we’re talking about setting boundaries with loved ones or managing our relationship during the holidays. However, I did a whole episode about this last week. You can go back. It’s episode 214, where we talk about holiday anxiety. We did discuss some of this there as well. So, you can go back and listen there. But for right now, I want us to talk about managing relationships, specifically during the holidays, but this episode can be applied to any old day of the week. Now, before we get started, we always do the “I did a hard thing.” This one is from Rachel. We do an “I did a hard thing” to motivate you, to remind you that there are more people out there going through what you’re going through. You’re not alone. Rachel shared with us today: “I have somatic OCD.” For those of you who don’t know what that means, it means that you have OCD about specific sensations that show up in your body. You sometimes feel like you can’t stop noticing them or you’re afraid you will never stop noticing them. Sometimes you’re afraid that the feeling will never go away and it can feel really disorienting. So, Rachel says: “I have somatic OCD, and I always need to distract myself not to notice them. I’ve been able to drive without the radio or calling anyone and it feels so good.” Rachel, this is so good. You’re doing what we talk about in ERP School. ERP School is our online course that teaches how to expose ourselves to fears, specifically obsessions for people with OCD, health anxiety, and these types of OCD, like somatic OCD, on how to practice facing our fear. In this case, it was her driving, that without using safety behavior or compulsions. So, in this case, the compulsion would be to have the radio on or calling someone to distract her on her somatic obsession or her sensation. So, Rachel, amazing job, you’re doing the work. You’re doing the exposure and the response prevention. One thing I want to mention to everybody, if you have OCD or an anxiety disorder, is we must do both. We must face our fears and not do the safety behaviors to reduce or remove that discomfort that we feel when we face our fear. So, you’ve explained this perfectly. Congratulations. I am so proud of you. Love getting the “I did a hard thing’s” from you guys. And so, just so thrilled to get that message from you. All right, let’s go over to the episode. It’s the holidays. You’re anticipating the gifts and the food and the time and the travel and all the things, but what’s worse than that is anticipation of the interactions that you’re going to have with certain family members. Now, if you’re listening to this and it’s not the holidays, it’s the same. You’re anticipating going to work, but you’re dreading the interactions. You’re dreading how messy things get. You’re going to school, and you’re dreading how messy things get with the people you have in your life – your students, your classmates, your teacher, your friends, whoever it may be. I want you to think about your responsibilities. And I talk a lot with my patients and clients about responsibility because it’s a really important part of recovery. When we think about the holidays, we think about a certain event that’s coming up. I’ll often explain to my patients that really all you need to do is you need to focus on your lane. So, I’ve talked about this before on the podcast, but I want you to imagine you’re driving on the highway, you’re in your car, and the only thing you’re responsible for is to not run into other people in their lane and to stay in your lane and to go at a pace that’s right for you and a speed that’s right for you and in a car that’s right for you. Now, that metaphor is exactly how you’re going to get through the holidays or get through this event that you’ve got coming up. Your job is to take responsibility for you and your lane. Now, sometimes people in the lane next to us come on over into our lane and they want to tell us how to act, and they want to tell us what to do, and they want to impose on you their beliefs. Now, our job is to remind them and set boundaries that that’s not your lane, that’s their lane. And their job is to stay in their lane. And our job is to stay in our lane. Now, in addition, we have to be careful that we are not popping on over into their lane and telling them how they should be, and telling them how they should act, and trying to take responsibility for their feelings, and trying to prevent them from judging you because that’s their lane. We talked about this in the last episode. Go back and listen to that. But that’s not your job either. It’s not your job to get their approval because that’s their responsibility. How they feel is their responsibility. We can’t control that. And so, first, before we even talk about setting boundaries, we have to be really clear on what’s in your lane. So, an example for me is, as I go into the holidays, I am going to be really aware of what is my responsibility, how do I want to show up? And then it’s my responsibility to show up in my lane doing so. But it’s also important to catch when I’m-- often we do this. It’s like, “Well, I’m going to do X, Y, and Z because I really want A, B and C to like me.” But that’s your lane. It’s not your responsibility. It’s not your job to get them to approve of you because we don’t have any control of that. And as we talked about last week, their judgment of us is their responsibility. It’s a reflection of them. It’s not a reflection of us. So, we have to be really careful of really getting clear on how we want to show up and only trying to control us, because we can’t control our family members. They’re going to do what they do. They’re going to act out. They’re going to be up in your lane. From there, we can set a boundary to protect ourselves from them coming into your lane. So, when we set boundaries, we usually set boundaries when somebody is imposing their stuff onto us. Imagine if someone came into your house and walked in with their shoes on and put dirt all over the carpet, you might say, “Excuse me, please would you take your shoes off?” There’s like a boundary violation. If they come into my house and they start smoking cigarettes, no disrespect or judgment on people who do smoke cigarettes, but I’m going to say, “I’m really sorry, we actually don’t smoke in this house. Can you please put your cigarette out and go out to the back?” And so, that would be me setting a boundary. Now, a lot of you brought in and you asked questions about this. Last week we addressed a lot of the questions. So, an example, somebody said, “How can I communicate with my family about my OCD and keep my boundaries?” So, what you might do is first ask yourself. If I was going to communicate about my OCD or my anxiety or my depression or my eating disorder or whatever you may have, panic, is ask yourself, are you communicating with it so that they change the way they act because that’s their lane? The only reason we would need to communicate about our stuff is so that we can set a boundary. Let’s say a really big one that I have had to practice is when family members comment about weight. I had a couple of family members in my childhood who every Christmas would, “Have Merry Christmas, Kimberley, your weight is blank. You’re up a bit. You’re down a bit. You’re bigger, you’re smaller, whatever.” And it was so incredibly painful and so incredibly unhealthy for me. And so, the boundary here would be to say, “I would really prefer that you don’t comment on my way. And if you do, I’m going to remove myself from this interaction.” So, that’s a boundary and it’s respectful and it’s compassionate, and I’m not doing it to harm them or discipline them or pay them back. I’m doing it because it’s a boundary violation, and it’s in my lane. When I’m in my lane, I want to have a really positive idea about my food and my body. If a family member is telling you how you should act, you might say to them, “Thank you so much for your thoughts. I am going to choose to do it this way. And I would really appreciate if you didn’t comment.  if you’re unable to hold that boundary, I’m going to have to leave,” or you can say whatever you want. You can just set the limit. Sometimes you don’t even need to tell them your boundary. You might just keep it to yourself. Like, “Oh, if they’re going--” if a family member says, “I’m so OCD about stuffing,” or whatever they say, “I’m so OCD about my cooking,” you might just not even need to express the boundary with them. You might gently just get yourself up and walk away. That’s a boundary. Sometimes we don’t have to verbally express boundaries because we can just remove ourselves from the situation and stay in our lane. Somebody said, “How to say no to things?” So, you’ve decided you don’t want to do something. We talked about this last week in Episode 214. You’ve decided you don’t want to do something. And so, you say to them, “I’m going to bring baked goods. I’m not going to bake them myself. I will buy them at the bakery. No, I’m not going to hand bake them.” Or you might say, “No, I’m not going to go to that Christmas party,” or “No, I am not going to buy gifts this year.” Okay? Now, that’s you holding your own boundary. Then your job, and again, this is why I shared about the lanes, is your job is to let them have their feelings about it. They’re allowed to have their feelings. They’re even allowed to act out. If they act out and they say something unkind, you may set a boundary with them. But we can’t hold everybody to our standards. Some people are going to act out. They may not have the skills you have. They may be triggered. They may have expectations of you. And that’s okay. They’re allowed to have expectations, but it doesn’t mean you have to do it. You may choose to follow their expectations. We talked about that again last week. But that’s your decision. You have to be responsible for you and saying yes to what matters to you and saying no to what doesn’t matter to you. Any time you notice resent, show up, that’s usually because you violated your own boundary. You did something you didn’t want to do and you should have said no to. It’s okay. I’m going to keep saying this to you guys. It’s okay to disappoint people. We will disappoint them. It’s either they get disappointed, or you do the thing they want you to do, and then you’re disappointed. And you have to choose. It’s your responsibility to choose. And we do this responsibility work compassionately. I speak a lot in my book, The Self-Compassion Workbook for OCD, about compassionate responsibility. That’s saying: “I am responsible for me,” but not in a disciplinarian, like you’re responsible for yourself, you’re alone, you’re on your own kind of way. It’s a compassionate act of, “Yes, I get to take responsibility for myself. I get to take care of myself. I get to say no, I get to say yes. I get to make those choices and I’ll do them kindly.” Somebody asked a question about managing irritability. This is a great one, because our family members and our friends and our loved ones and the people at our Christmas party or our Hanukkah party, our Kwanzaa, they may irritate us. Yeah, it’s okay to feel irritated by our family members. My husband and I always-- we learned this maybe five years ago. We get caught up in it. I’ll be like, “Why are you acting that way?” And he’ll say gently to me, “Kimberley, I’m allowed to feel this way.” And I’m like, “Oh crap, you’re right. I keep forgetting that you’re allowed to feel what you want to feel.” Or he’ll be upset and he’ll be like, “What’s wrong? Why are you being this way?” And I’ll be like, “I’m allowed to feel this way.” And he’s like, “Oh crap, you’re right.” You’re allowed to be irritable. You’re not allowed to be unkind. I mean, you are, but you have responsibility, There’s consequences. But ideally, let yourself be irritable. Be compassionate with your irritability. Like say, “Yeah, it makes complete sense that I’m irritable. This is hard. It makes complete sense that I’m annoyed. They’ve said something that annoyed me.” Again, they’re allowed to say annoying things. We get to remove ourselves if it doesn’t feel right or we get to express ourselves.” That really hurt my feelings. That made me upset.” This is why you’re allowed to share. Let’s see. Someone said dealing with a toxic parent. Well, it depends. My answer to that is it depends on whether you’re a minor or an adult. If you’re a minor, it’s hard to remove yourself from a toxic parent. They are your guardian. You’re legally under their care. But you can remove yourself from them physically in terms of going to another room. You can try and share with them. “That was really painful for me to hear that. If you do that again, I’m going to leave the room.” Or you get to make your own boundaries. They may be physical boundaries where you leave. They may be emotional boundaries where you don’t go to them and you don’t share with them if they can’t hold space for you compassionately and respectfully. If you’re an adult, you can choose to set as many boundaries as hard or as strong, as light as you need. Some people set boundaries with their family members. Like, “You can’t come here without announcing yourself. You must let us know first. You can’t say those things about me or I’m going to leave.” Or you may, again, you don’t even have to say them out loud. If they’re really toxic, you may say to them, “I’m not going to see you anymore if you keep acting like this towards me and my family. I can no longer put myself through that.” You get permission. We don’t get to choose our family, but you don’t have to see them either if they’re really unhealthy for you. You may want to get some therapy around it and have the help of a clinician to help you navigate what’s a right boundary for you. Everybody’s different. Someone said, “I get really bad depression during the holidays and people have expectations for me to be happy.” Well, that’s their lane. You don’t have to act or be any way. Be kind, be compassionate, but do the best you can. It’s your lane. You got to just do the best you can with what you have. So, again, I think that’s a really big part of this, is really take care of you because that’s your job. One thing actually, before we finish up, let me mention, it’s no one else’s job to make us feel better either. I know a lot of this today is going to feel like a lot of hard truths, but I promise you, there is so much liberation that comes from this. It’s a hard pill to swallow, but it’s still a really, really good pill. It’s a good pill. It’s a helpful pill. And so, it’s not other people’s job to make us joyful on Christmas either. That’s our job. I’ll tell you a story, when I was really a young adult, I think it was quite shocking to me that when you’re a kid, everyone throws you a big party. And when you’re an adult, it’s not as big of a deal. And I used to get really offended that people didn’t throw me a massive party until I was like, “Wait, it’s really not their job.” And so, I started doing it for myself, and I have no shame about it. If I know I want to feel special on my birthday, I always organize something really special for myself. For the last three years, except for the year of COVID, I always rent-- you guys, probably know this. I rent an RV and I invite my three best girlfriends and I have a party for myself, and I’m not ashamed about it. I’m happy to celebrate myself. A If you are feeling like other people’s job is to bring you joy on Christmas, I would say, no, bring yourself joy. Buy yourself a gift. Make your special meal you want to have. Treat yourself and shower yourself with the joy that you want to feel. That’s a huge liberation, a huge freedom. Such a gift. Okay. So, that’s it. That’s how you set boundaries. You get to set them. It’s your lane. You get to decide. But other people are allowed to have their feelings about it. And that’s okay. That doesn’t mean you’re bad. They can even tell you you’re bad, and that doesn’t mean you’re bad. They can say, “I don’t like you,” and you don’t think you’re doing the right thing and they get to have their opinion, it doesn’t make it a fact. This is hard work. I am not going to lie, I am still working on this. I’m still learning from this. I still have to practice it every single day. So, be gentle and remind yourself, this is a journey. This is not a destination that you’re like, “Yay, I’m great with boundaries.” It will be something you’ll have to keep practicing. But the holidays are the perfect time to practice them. It’s so important. My loves, you probably have lots of questions about this. Do go over to social media. I’ll leave links in the bio. If you want to send me questions, I do a live Q and A every second and fourth Monday of the month at 12 o’clock Pacific Standard Time. So, I’m happy to answer your questions there. Have a beautiful day. Happy 2021. I will be seeing you in 2022, holy macaroni, but I can’t wait. I’m actually really pumped about Your Anxiety Toolkit next year. I’m going to put a ton more effort into it. That’s where I want my attention to be next year. So, sending you love. Have a wonderful day, and I’ll talk to you soon. Oh no, wait. Before we finish up, what was I thinking? It is time for the review of the week. This is from IsaacRThorne, and they said: “Love this show and I look forward to it every Friday.” Sorry, Isaac, I nearly missed you here. “No matter what you struggle with, there’s more than one episode where your mouth will drop open, your eyes will grow wide, and you’ll shout: “That’s totally me!” Isaac, this is the best review ever. It just brings me so much joy. “Your mouth will drop open, your eyes will grow wide, and you’ll shout, “That’s totally me!” So, I hope this episode was that for you. Thank you so much for your wonderful review. Please, if you don’t want to give me any gift of the world, it would be to leave me a review on the iTunes app. Thank you so much for your reviews. They bring me joy, but they also help us reach more people. So, thank you, thank you, thank you so much. We are going to give a free pair of Beats headphones to one lucky reviewer when we hit a thousand reviews. We’re on our way. Please go and leave a review. It would be the best, best, best gift you could give me. Have a wonderful day, everybody. And now I officially say, have a wonderful day and I will see you in the New Year.