The Huddle Blog

Sharing thoughts on a cognitive-based understanding of anxiety and how online group support can help us get better, together.

Know your OCD

By maggie

This week, several members asked for strategies that help them decide whether or not they were experiencing OCD. Put another way, the topic is: “When I know it’s OCD, I know what to do. What do I do when I don’t know whether I’m bothered by a real problem or it’s OCD?”Let’s come back to this topic this week in Community Time. Here are some ideas to get us started: Is it a real problem? If the thought that you are bothered by hadn’t arrived in your mind, would you still have an issue? You won’t always know that you are experiencing OCD when you decide to act as though you are. The nature of OCD is that you feel uncertain about something that is not a threat. When you decide to treat your thought as though it is OCD, you are saying, “The uncertainty I feel about this does not mean that there is something wrong. I’m going to act as though there is nothing wrong even though it feels like there is something wrong.” Try using urgency as a cue for OCD. Real problems are still real problems regardless of when you think about them. If you have a medical illness, …

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The Anxiety Effort Paradox

By maggie

You arrive at this community with the intent of reducing or eliminating anxiety. You have heard that there are tools, techniques, and coping skills that will either help you manage your anxiety or cure it completely. Other people around you seem to be less anxious and seem to use methods like meditation, yoga, nutrition, sleep, and exercise to stay calm and healthy. For some reason, the more you try these methods, the more anxious you feel. Or, you’re having trouble consistency engaging in these behaviors, even though you commit with your whole heart and you completely believe they would be helpful for you. Welcome to the anxiety effort paradox! First off, remember that anxiety disorders in general are a paradox. Don’t think of a white bear. Don’t think of a white elephant. Don’t think of a gorilla. Don’t think about all of them dancing together. When you tell yourself not to think about something, you will think about it more. If you desperately fear specific sensations or feelings, they are more likely to occur in your experience. An example is feeling lonely, then thinking that you shouldn’t feel lonely, and then feeling lonelier. This is a loneliness loop. A loop …

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Shame

By maggie

Shame is a painful emotion caused by consciousness of guilt, shortcoming, or impropriety. Although very painful, the capacity for shame is healthy and part of being human. The function of shame is to prevent us from damaging our relationships and motivate us to repair them if we’ve damaged them.  As Brene Brown explains, guilt says “I’ve done something wrong.” Shame says “I am something wrong.”  OCD is marked by hypersensitivity to uncertainty, disgust, and guilt. Those that experience the mechanisms that maintain OCD (that is, anxiety sensitivity + intolerance of uncertainty + inflated responsibility + experiential avoidance) not only have sensitivity to the feeling of guilt, but also feel guilt excessively.  Experiencing an unwanted intrusive thought doesn’t mean that you’ve done something wrong. You didn’t choose to experience the thought. If you didn’t choose it, then you are not responsible for it. A crucial belief that maintains OCD is thinking that you should have control over your thoughts and feeling guilty when you don’t control your thoughts. Rather than trying harder to force yourself to control your thoughts, you need to change your belief that you can control your thoughts in the first place. As long as you believe you can control your …

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Predicting anxious patterns

By maggie

As you set yourself up to relate effectively to anxiety, you want to predict the phases of your anxious pattern, so that you know what strategies you will need. The phases tend to be different depending on whether the trigger was external or internal.  Anticipatory anxiety, situational anxiety, and post-event processing In the case of an external or situational trigger, there are 3 phases to the anxious moment. Many people experience anticipatory anxiety, situational anxiety, and post-event processing. We’ve discussed each of these phases in great detail and you can read more about them by clicking on the above links. Here’s your self-talk for an external trigger:  Anticipatory anxiety self-talk: “Anticipatory is a feeling, not a fact, prediction, message, or threat. It doesn’t mean I’m doing something wrong or that something is going to go wrong. If it must mean something, it is just indicating to me that I have had anxiety in situations like this in the past. If I can stay with this anticipatory anxiety, and not do anything to make it worse, I am on my way to having less anticipatory anxiety in situations like this in the future.” Situational anxiety self-talk: “During this situation, I want to …

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Avoidance v. workable behaviors and preferences

By maggie

Avoidance happens. Avoidance creates every type of suffering. You suffer. Suffering is pain plus resistance. Resistance and avoidance are functionally synonymous.  Sometimes acting in accordance with your values and experiential avoidance will be the same behaviors. The difference between your values-driven action and avoidance is your attitude. Workable behavior is a dynamic adaptation based on your context, rather than rigid, rule-based behavior. Anxious sufferers want to know what they need to do in order to cure or overcome their anxiety. The reason that a manual, self-help book, and app can’t offer you a comprehensive plan is not because there isn’t an effective strategy. A one-size-fits-all strategy doesn’t work because your anxiety uniquely shifts based on the function of your behavior in a dynamic way. The meaning your mind gives to your behavior and its consequences is more predictive of an increase or decrease in anxiety over time than the behavior itself. As an example, acting polite, bubbly, grateful, and thoughtful can be values-driven. It can be a challenging exposure and a confidence boost to act in these ways with friends or family no matter how anxious or depressed you feel. And, if you act this way frequently, rigidly, across many areas of your life and in all of your relationships, this value-driven behavior will …

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Fixed Attentional Focus

By maggie

Another response mechanism that creates, maintains and intensifies psychological suffering is fixed attentional focus.  The attentional bias in worry and OCD tends to be threat-related stimuli. Social anxiety is maintained by a self-focused attentional bias. Depression is maintained by a ruminative attentional bias.   When you are worrying or stuck in obsessive content, your mind is hyper-vigilantly scanning for potential threats. As you scan for uncertainties and potential catastrophic possibilities, your mind will generate more possibilities and you will feel more uncertain and anxious. The sensations that come with anxiety create thought-action fusion, making the possibilities your mind generates seem more and more likely. Worrying and mental compulsions create more possibilities and the possibilities feel more and more likely, creating more and more anxiety and possibilities.  When you are experiencing social anxiety, your mind will become self-focused. Rather than focusing on your task (such as speaking in a meeting or joining a conversation), your attentional focus shifts to what you are thinking and feeling. Many people get tangled in their self-focused attention and fight with themselves about whether or not they can complete the task while thinking and feeling whatever they are thinking and feeling.  When you are experiencing depression, your mind …

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Rumination

By maggie

Rumination as a repetitive negative thinking state is triggered by pervasive negative beliefs. It is a sticky thinking pattern that shows up habitually when triggered by certain environmental or internal states. Type 4 – Rumination Ego-orientation: Ego-syntonic, meaning that ruminative thoughts seem believable to the thinker. Time orientation: Past Content: Churning through memories to figure out why you feel helpless, hopeless, worthless, sad, guilty, lonely, or angry. Beliefs that maintain it: “If I feel hopeless, helpless, or worthless, that means that I am.” “Feelings mean something. I wouldn’t be feeling this if it wasn’t true.” The function that maintains it:  Helpless, hopeless, and worthless feelings arrive and the thinker buys into and expands on the thoughts that come with it. Pervasive negative beliefs and rumination High anxiety isn’t the consequence of lots and lots of anxiety, but rather an anxiety state plus a secondary interpretation of the state as a threat itself (also called second fear). Similarly, depression isn’t lots and lots of sadness, but rather an uncomfortable feeling (like sadness, guilt, loneliness, anger) plus an interpretation of that feeling that you are hopeless, helpless, or worthless because of it. As an example, everyone feels lonely sometimes. Loneliness can be a clean …

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Mental compulsions

By maggie

The nature of obsessive thoughts is that they are unwanted and intrusive. They arrive with a spike of anxiety or uncertainty and the urge to do something that makes them stop. Behavior that you feel compelled to perform, against your conscious wishes, with the sole intention of ending a thought, feeling or sensation is a compulsion. Let’s discuss the nature of compulsions in greater detail so that we have shared language to understand mental compulsions. Here is a list of common physical compulsions:  Excessive hand washing or bathing Checking locks or appliances Checking that you haven’t made a mistake Checking that you did not or will not harm yourself or others Checking your body for sensations or your mind for thoughts and feelings Rereading or rewriting Repeating routine activities like moving a chair up and down Counting Excessive list making Needing to tell, ask, or confess what you are thinking Needing to touch or tap Needing to arrange or order objects Hand washing and all other behaviors listed above becomes excessive and problematic when the function of the behavior transitions from problem-solving to anxiety reduction. When your hands are visibly dirty or your body is sweaty or smelly, washing is …

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Worry as a process

By maggie

Your process for any task is your series of steps to achieve your end. Your process for brushing your teeth or cleaning your kitchen may seem to you like “that’s just how you do it,” but if you surveyed the next 10 people you encounter it is very likely that their process for those tasks are not as similar as you were expecting. For worriers, the mental process of worrying might otherwise be described as thinking. Where does your worry end and your thinking start? To sort this one out, first off, bring attention to and get control over any functional worry that you experience. Read more about worry that functions as an emotional suppressant here. We’ll also discuss mental compulsions, rumination, and post-event processing over the next several weeks. These are triggered thinking patterns. There are external circumstances or internal thoughts, feelings, and sensations that make these responses more likely in your thinking. To overcome mental compulsions, rumination, and post-event processing, observe what triggers it, what keeps you fused to the content when it arrives, and what you feel. We can work together to challenge the beliefs that keep you fused to the content and to stay present to the …

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Functional Worry

By maggie

I’ve decided to organize the categories of repetitive negative thinking into types so that I can also organize interventions that will be most helpful for each type. You won’t find this in any textbook, scholarly articles, or elsewhere on the internet. I’m using these types for us to have shared language without unhelpful interpretations that come with the current label of each type of thinking pattern. (For instance, “I have anxiety, not OCD,” which may or may not be true in any given person.) Refer back to my previous post for a review of the dimensions. Type 1 – Functional worry Ego-orientation: Ego-syntonic, meaning that worries seem reasonable to worrier. Time orientation: Past and future Content: Can be anything Beliefs that maintain it: “I don’t feel as upset by everything when I worry.” “I worry because I care.” “Worrying helps me problem solve.” The function that maintains it:  Suppresses all feelings (examples: uncertainty, not-just-right  feeling, guilt, disgust, embarrassment) Worry as a function is a cognitive form of experiential avoidance, similar to thought control or thought suppression. In thought control and thought suppression, individuals make active attempts to stop thinking about the stimulating topic and distract themselves. When worrying as a cognitive avoidance, …

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