The Huddle Blog

Sharing thoughts on cognitive-based therapy and how online group therapy can help us get better, together.

An overview of Experiential Avoidance

By maggie

We use the term experiential avoidance rather than simply avoidance to remind ourselves of how we avoid both ourselves and the world around us. Situational avoidance is usually easy to identify. Also, many anxiety sufferers don’t avoid situations. Still, anxiety is always maintained by avoidance. We all avoid thoughts, feelings, sensations, memories, and urges with varying degrees of intensity and rigidity. This month we’ll discuss the subtleties of experiential avoidances and help you try out more flexible responses. Any good discussion of avoidance should start with action. Tell me what you want to move towards and I can help you stop moving away. Every week in Community Time and in Group, you make commitments to behaviors that enhance your functioning and/or improve your relationship with your anxiety. By making public commitments to behavior, you are taking the philosophical stance that you can change. You believe that attempting to change in an intentional way is a worthy goal. The commitments that you make are process commitments, not outcome commitments. You commit to studying, not acing a test. You commit to showing up to work, not performing perfectly at work. You commit to initiating a conversation, not having the best conversation of your life. …

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Pervasive negative beliefs – who made you feel worthless and why do you believe them?

By maggie

Pervasive Negative Beliefs Pervasive negative beliefs are deeply held core ideas that influence thinking patterns, interpretations of events, and behavioral responses. When activated, these ideas trigger unhelpful response mechanisms and mood or anxiety symptoms. One type of pervasive beliefs that occur in anxiety and depressive disorders is negative core beliefs. Think about these beliefs like goggles. They are filters through which you interpret reality. Negative core beliefs typically fall into three broad categories: Helplessness (“There’s nothing I can do to make this better.”) Hopelessness (“This is never going to get better.”) Worthlessness (“I am unworthy of love or acceptance. I am bad.”) Content typically includes: Beliefs about self (“I am unloveable and unworthy.”) Beliefs about others (“People are uncaring and judgmental.”) Beliefs about the world (“The world is a dangerous place.”) Beliefs about the future (“Things will not get better.”) Negative Core Beliefs are to Depression like Second Fear is to Anxiety Disorders.  Second fear turns an anxiety state into an anxiety disorders because the fear of the fear creates resistance that creates more fear (and more resistance and more fear). Negative Core Beliefs turn a feeling into a depressive state because the interpretation of that feeling is that it means you …

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Inflated responsibility – I think, therefore… nothing. Thinking it doesn’t make it true.

By maggie

An excessive or inflated sense of responsibility occurs when you interpret your thoughts in terms of whether they can cause distress or harm to yourself or others. That is, having the thought in and of itself gives you a sense of guilt or responsibility. Examples include: I have the thought that I could have cancer or an STI. Does that mean I do?!? And, I feel anxious and uncertain. What does that mean?!? I had the thought that I don’t love my partner. Does that mean I don’t?!? And, I feel anxious and uncertain. What does that mean?!? I had the thought that I might have hurt, murdered, assaulted, offended someone in the past. Does that mean I did?!? And, I feel anxious and uncertain. What does that mean?!? I had the thought that I could have done more to help someone. Does that mean I should have?!? Am I bad because I didn’t act on that thought?!? And, I feel anxious and uncertain. What does that mean?!? I had the thought that I could work harder at something that I value. Does that mean I must?!? And, I feel anxious and uncertain. What does that mean?!? I had the thought …

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Fear of negative evaluation and relearning how to play

By maggie

As we discussed last week, imposter syndrome occurs when there is a discrepancy between your performance and your beliefs about your performance. I differentiate between two types of imposter syndrome: anxiety-driven imposter syndrome and developmental imposter syndrome. Anxiety-driven imposter syndrome occurs when you have the skills to perform at the level that is expected of you, but you feel anxious about your skills anyway. Developmental imposter syndrome occurs when you have the potential to perform at the level that is expected of you, and you feel anxious about the process of reaching that potential. Developmental imposter syndrome Developmental imposter syndrome shows up in any area of life where there is an opportunity for learning. It is the opposite of playing. In the process of learning, there is a discrepancy between what you know and do and what you have the potential to know and do. If you experienced a relatively safe childhood educational environment, this truth was so fundamental to your growth process that you didn’t notice. Each day that you showed up to second grade, for example, you assumed that you would engage in some activity that you may or may have ever heard of before. If your teachers and …

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Fear of positive evaluation and the imposter syndrome

By maggie

Imposter syndrome occurs when there is a discrepancy between your performance and your beliefs about your performance. I differentiate between two types of imposter syndrome: anxiety-driven imposter syndrome and developmental imposter syndrome. Anxiety-driven imposter syndrome occurs when you have the skills to perform at the level that is expected of you, but you feel anxious about your skills anyway. Developmental imposter syndrome occurs when you have the potential to perform at the level that is expected of you, and you feel anxious about the process of reaching that potential. Both fear of positive evaluation and fear of negative evaluation can show up in both types of imposter syndromes. We’ll talk about anxiety-driven imposter syndrome and fear of positive evaluation this week and developmental imposter syndrome and fear of negative evaluation next week. Assuming you have the appropriate skills, fear of positive evaluation can be maintained by the pressure to maintain high performance, by the belief that confidence is synonymous with arrogance and dissonance between your belief about your worthiness and the evidence of positive evaluation. Let’s get curious about these patterns! Pressure to maintain high performance As we’ve discussed, consistent high performance (in any area of life) is a paradox. If you fear …

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Emotional perfectionism and the paradox of checking on your recovery

By maggie

Anxiety and OCD treatment is a paradox. You must become more anxious before you can become less anxious and you must become more anxious in the right way. The answer to anxiety is curiosity and compassion. Mental illness is the only type of illness where you go to the doctor to get relief from a symptom and your doctor prescribes you more of that symptom. It doesn’t make sense. It’s reasonable for you to be confused and frustrated about your treatment plan and your treatment progress. Let’s talk more about this paradox. You typically see a medical professional for structural disorders caused by pathology or injury. You need penicillin for an infection and a cast when you break your arm. Your eye doctor will prescribe you glasses as your eye sight declines; your dentist will give you a root canal for a decaying tooth. You are vulnerable to the effectiveness of your doctor, because something is wrong and someone else needs to fix it. Mental health treatment involves some important differences. The first difference is that the experience of anxiety is not a structural problem caused by pathology. You don’t have an infection that we can treat with medication. In fact, medication that completely sedates …

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Clinical perfectionism: a problem of strategy, not outcome

By maggie

Clinical perfectionism is a problem of strategy, not outcome. Perfectionists have high standards and expectations for themselves and others. This value can be a strength, as long as perfectionistic strategies aren’t compulsively used to control thoughts and feelings. Adaptive perfectionism is a healthy, ego-syntonic way of approaching tasks that leads to a good outcome. Clinical perfectionism occurs when anxiety and OCD hijack your values and bully you into approaching goals in a way that undermines your performance. Some of the characteristics of clinical perfectionism include: Rigidly following rules (“I should or must do things this way.”) Every task is equally important. Mistakes are catastrophic. Repetition until it feels/looks/sounds “right.” Missing deadlines due to procrastination. To shift clinical perfectionism into adaptive perfectionism: Prioritize based on values. Experiment and take risks. Notice when your efforts result in diminishing returns. Fight procrastination. Identify conscientious people as models. Self-talk that reduces Clinical Perfectionism includes: “It’s okay for me to have high ideals. In any given moment, it’s also okay to be uncertain or make a mistake.” “Any progress is better than no progress.” “I’m willing to take a risk or make a mistake in this instance, in light of my values.” Behavior that reduces Clinical Perfectionism includes: …

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Intolerance of uncertainty and exposure to uncertainty as an opportunity

By maggie

I described the nature of intolerance of uncertainty in my last post. Let’s talk more about shifting your interpretation of uncertainty to opportunity, rather than fear. When you’re feeling very anxious, it’s normal to attend to your anxious sensations, uncomfortable feelings, and catastrophic thoughts over everything else. You are not being selfish or going crazy. The nature of the anxious response is such that your mind fixes your attention on potential threat in order to help you survive. Some part of you knows that you aren’t running from a tiger and it would be okay to stop scanning the environment for danger. Another part of you does not know whether or not you are in danger. That part of you is uncertain. It’s okay. You’re not doing it on purpose, it isn’t your fault that it’s happening, and you aren’t doomed to feel this way forever. You just need to be more strategic. Let’s first honor evolution. Way to go fellow homo sapien! We made it! Your response to fear was adaptive the first time it happened. If you are in danger and you avoid, you survive. If you are not in danger and you avoid, you will develop an intolerance of …

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The role of intolerance of uncertainty in all anxiety disorders

By maggie

Intolerance of uncertainty is the tendency to react negatively on an emotional, cognitive, and behavioral level to uncertain situations and events. There are two beliefs that maintain Intolerance of Uncertainty 1) Uncertainty has negative behavioral implications for me and means something bad. 2) Uncertainty is unfair and spoils everything. I shouldn’t feel uncertain. There are two types of Intolerance of Uncertainty 1) Fearful anticipation of uncertainty often leads to avoidance. 2) Inhibitory anxiety in the face of uncertainty often leads to difficulty thinking, talking, making decisions, and taking action. Self-talk that reduces Intolerance of Uncertainty includes: “It’s okay to feel uncertain. Feeling uncertainty doesn’t mean I’ve done something wrong.” “Anticipatory anxiety is a feeling, not a fact or prediction. That is, it predicts my past, not my future.” “Uncertainty signals opportunity. I don’t know if something will go poorly, but I also don’t know what could go well.” “It’s okay for me to take the next small step in the presence of uncertainty.” Behavior that reduces Intolerance of Uncertainty includes: Commit to valued behavior to reduce indecisiveness. Practice guessing at the smallest next step. Live in your decision, including taking responsibility for the consequences of those decisions. Bring up an attitude of curiosity …

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Anxiety sensitivity as fear of all strong affects

By maggie

Anxiety sensitivity as fear of all strong affects In my last post, I explained that anxiety sensitivity is the fear of arousal-related sensations, arising from beliefs that the sensations will have adverse consequences such as death, insanity, or social rejection. Fear of fear is common when you are in a neurologically vulnerable state, including being hungry, tired, angry, lonely, and stressed. We discussed how to make a plan to prevent and manage your sensitized states. Let’s focus on other thoughts, feelings, memories, and situations that contribute to sensitization. We can try to predict and prevent sensitization, but triggers happen. The paradox of introspection is that when you are very triggered and sensitized, all the thinking you engage in to try to “figure out” why you’re upset will likely make you more upset. It isn’t your fault. Your amygdala is doing its job searching through your memories and fears in an attempt to figure out why it’s happening, how to get out, and how to prevent it again in the future. Most people get caught in this attempt to figure it out and their rumination and worry make them feel worse. Even if you gain insight every once in a while, the …

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