The Huddle Blog

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

Post-event processing

By maggie

Post-event processing is a term from social anxiety research. It is used to describe the combination of worry, rumination, and self-criticism an individual with social anxiety experiences after a social event. In, we seem to be using it to refer to the after-effects of every anxious situation. Consider it our growing shared language.  The repetitive negative thinking patterns that occur during post-event processing include concepts that we’ve discussed over the last several weeks, specifically worry, rumination, mental compulsions, and self-criticism. The concept of post-event processing is useful because of its ability to increase your motivation to get distance from unhelpful thoughts and feelings.  As a reminder, the first step to the therapeutic attitude of acceptance is expecting and labeling an experience as an anxiety or OCD experience. In doing so, you’re saying: This is a false alarm, not a real problem for me. I accept that this is a part of my experience right now. I’m not going to pretend like this doesn’t happen to me. I have compassion for myself for having this experience. Given that I have this experience, I should respond to it as effectively as I can.  When you are able to pull up this attitude, you will also be able to head …

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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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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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Distinguish between anxiety and danger

By maggie

Before we discuss the difference between danger and anxiety, several people wondered about whether or not their self-talk was compulsive or Wise Mind. I want to say more about that: The voice of Wise Mind is always orienting you towards a therapeutic attitude of acceptance of what you’re currently experiencing.  Sometimes Wise Mind is educational. He knows what’s happening. He might say, “You feel dizzy because your breathing changed rapidly. You aren’t in danger.” Sometimes Wise Mind is observational. She’s watching. She might say, “Notice that we’re having thoughts. We often have these types of thoughts when we do what we’re currently doing.”Sometimes Wise Mind is encouraging. He believes in you. He might say, “Uncertainty! Great! This is an opportunity for us!” If your Wise Mind is an internalized compassionate parent, she’s the type of parent that is always helping move towards what you value.  If the voice that is responding to your Worried Voice is arguing with the content of your worried voice, it is False Comfort, rather than Wise Mind.  Here’s another example:  Worried Voice: “Am I a good person?” False Comfort: “Yes, of course, you’re a good person.”Wise Mind: “You’re having a thought that feels like a problem because you …

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Prepare for the anxious moment

By maggie

Let’s discuss how to prepare for the anxious moment. We’ve already covered the therapeutic attitude of willing acceptance and differentiating between anxiety and danger. Let’s quickly review. Remember that for all techniques, we’re always trying to orient towards the therapeutic attitude of willing acceptance. When we think about how to get to the therapeutic attitude of willing acceptance, we want to be thinking of our Wise Mind.  So your Wise Mind is your internal compassionate parent, both participating in and observing you throughout your whole life. Wise Mind has more experience in the part of you that is reactively or fearfully responding to whatever is happening in this moment. Wise Mind has been with you observing you your whole life. She knows the moments you’ve shown up with courage. And also when you’ve lived less than your best life. Compassionate parents have time and space for all of it and want to be there with you. We all have an observational self. Some of us didn’t know it was there and don’t pay attention to it. You can strengthen your access to your wise mind by bringing attention to her. If it doesn’t seem like your Wise Mind knows what to …

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Celebrate uncertainty

By maggie

Here are a few questions to consider about this topic: In what areas of your life are you most sensitive to uncertainty? Does the feeling of uncertainty make it difficult for you to identify how you can take responsibility? That is, does uncertainty make you feel like you don’t have the ability to respond when you do?  Does the feeling of uncertainty trick you into taking responsibility under conditions when you don’t have the ability to respond?  What would help you differentiate these two reactions to uncertainty more effectively?  The three concepts for today are: Uncertainty is an opportunity to take responsibility  Negative reinforcement maintains anxiety  Intentional and incidental practice should be frequent willing and flexible. First when we think about embracing uncertainty with responsibility, let’s differentiate between inflated responsibility and real responsibility. We’ve talked frequently about inflated responsibility and what we mean by that is when you take responsibility for something you don’t have responsibility for.  So, you don’t have responsibility for the thoughts, feelings, and sensations that show up. Other uncertainties that you don’t have control over include Other people’s thoughts and feelings.  Some of the things that happen to you.  And, for instance, in the case of …

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Avoid avoidances

By maggie

The road to recovery is paved with details! We need to identify and observe the details of your anxious moment to know what to challenge, what to expose you to, and how to do the opposite. Anxiety disorders are created, maintained, and intensified by avoidance, and overcome with approach and exposure. Let’s start with understanding the difference between an anxiety state and an anxiety disorder. Anxiety disorders are maintained by different avoidances An anxiety state is a normal, natural, healthy and adaptive reaction to a threat or perceived threat. In the presence of a perceived threat, we get anxious sensations — the fight or flight response — as well as catastrophic thinking. Your fight or flight response might include an increase in heart rate, sweating, blood rushing out from your stomach to your arms and legs, an increase in blood pressure, pupil dilation, and muscle tension. In the presence of muscle tension, people often take deeper breaths. As you breathe out, you experience a change in CO2. This is not dangerous to you, but can make you feel dizzy and tingly. In addition to the fight-or-flight response, people often experience catastrophic thinking or worry thoughts. The various anxiety disorders are …

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Float through experiences mindfully

By maggie

Dr. Claire Weekes was an Australian physician and an anxiety treatment pioneer who started writing about acceptance-based methods for relating effectively to anxiety in the 1960’s. She used the concept of floating through anxiety, as opposed to swimming through it, to emphasis the need to let go of control, rather than focusing on coping with it. The concepts “don’t just do something, sit there!” and “let time pass” come from Claire Weekes. Here are the three main concepts: Paradoxical effort is a trap. Metaphors facilitate your internalization and ownership of your growth. Compassion reduces secondary processes that undermine your growth. First, before we talk about paradoxical effort as a trap, let me tell you a joke. Paradoxical effort is a trap. What do overcoming anxiety, falling asleep, sneezing, feeling happy, and having an orgasm have in common? Wait for it… They all require surrender! You have to surrender to the process to allow it to either pass or to happen. The opposite of this is called paradoxical effort, where the more effort you put towards a certain outcome, the further you get from it. Paradoxical effort undermines people and keep them in their stuck places, unable to move through uncomfortable …

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Perfectionism is the wrong strategy for excellence

By maggie

Perfectionism is a cognitive pattern, with behavioral implications, that maintains many different responses leading to anxiety. You can think about perfectionism as a problem of strategy, not outcome. Many perfectionists struggle to challenge their perfectionism because they’re afraid that it will lead to dropping their standards. They will no longer be striving for excellence. The most important concept here is: We are challenging the strategies you use to strive for excellence. We are not challenging the idea that you should strive for excellence. When your strategies for trying to arrive at excellence are undermining your goals, then we consider that perfectionism. The goal is to be on the lookout for anxiety driven behavior that undermines your overall goals, it is not to make your work mediocre. We’re still striving for productive work. We’re still striving for excellence. We’re just trying to use strategies that actually allow us to get there in the long term. When I’m thinking about clinical perfectionism, I’m going to start with the underlying fears that drive the compulsive behaviors. There are four main fears that I see most frequently as the drivers of perfectionism.  The four main fears are: Fear of evaluation Inflated responsibility Intolerance of uncertainty …

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Inflated responsibility is excessive

By maggie

There are two types of inflated responsibility.  The first is thought-action fusion.  The second is taking responsibility over something you can’t control.  Thought-action fusion occurs when having a thought feels like an action. Thoughts and actions feel fused together. This is common in Harm OCD. You might have the thought, “What if I hurt someone?” which gives you the feeling of guilt and makes it feel like you actually did it. Having the feeling of guilt doesn’t mean you’ve done something wrong. Here are some examples of thoughts that could give you the feeling of guilt and make you feel like you’ve done something wrong. “What if I hit someone with my car?” “What if I left my stove on?” “What if I said something inappropriate that offended someone?” “What if I forgot to say something kind?” “What if I wanted to harm that person?”  “What if I wanted to harm myself?”  “What if I wanted to do that sexually inappropriate act, like molesting a child, that I don’t really want to do?”  “What if I could have helped and I didn’t?” “How do I know that my motives, intentions, and actions are good, kind, and pure?”  These are all …

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