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.

Tricked into listening to dread

By maggie

Let’s discuss what individuals with anxiety disorders often do instead of self-monitoring, identifying, labeling and allowing dread: Listening to dread by avoiding Because individuals with anxiety disorders characteristically avoid what they are thinking and feeling, they don’t recognize their dread as part of the pattern of anxiety. Rather it feels like information, as though whatever its saying is truth. Feeling dread, you may think, “I’m so nervous right now. What if my anxiety just gets worse and worse? What if something bad is going to happen? Maybe I shouldn’t do it. Maybe I should do it some other time when I don’t feel like this. Maybe I don’t actually want to do this because I feel so bad when I think about it.” Dread, when interpreted as information, triggers indecision and doubts; avoiding based on doubting thoughts causes more anxiety and more dread. Listening to dread and becoming depressed Dread can feel more like depression, and can hit you like a sudden lack of energy and motivation. If there are many thoughts, feelings, sensations, and situations that trigger your anxiety, you may feel a consistent and pervasive sense of dread that doesn’t feel like a passing feeling. Similarly, if you always …

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The relationship between dread and confidence

By maggie

Responding effectively to anxiety is a challenging skill that develops experientially with time and practice. Think of a challenging skill you’ve acquired in your life: riding a bike, learning to read, speaking a foreign language or learning a programming language, or playing a sport. You didn’t have trust in your ability to execute those skills — that is, you didn’t have confidence — until you had many experiences of practicing and succeeding. If the skill was important to you, you likely had feelings of anticipatory anxiety prior to experiences that would test your ability because you didn’t know what would happen. That’s perfect! That’s exactly how anticipatory anxiety works! It’s not alerting you that you can’t do something. It’s alerting you that you don’t know yet how you’ll do. For this reason, decreases in your anticipatory anxiety will be the last part of overcoming your anxiety disorder. For many people, the anticipatory anxiety is the worst part. They want it to go away now! Anticipatory anxiety is a clever trickster that causes people to avoid, become demoralized, self-criticize, and waver in their decision-making. Do not be fooled! Your mind is actually working adaptively. Like learning anything else, your body won’t …

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The difference between productive and unproductive worry

By maggie

It is rare that the anxious person will go to a doctor and say, “My problem is that I’m afraid of my thoughts.” You are more likely to complain, “I’m always thinking… I can’t stop thinking… I can’t turn my mind off… I can’t relax… I can’t sleep… I can’t concentrate because of my worries.” This is called fear of thoughts, because of the process that got you to the point where you feel as though you can’t stop thinking.  The more you resist what shows up in your mind, the more likely it will occur in your mind. Make sure you don’t think of a white bear right now. Are you able to do it? It is very likely that the image of a white bear popped in your mind, because of the way your mind works. When you tell your brain not to do something, it has to scan to see if the thing it should be avoiding is there. Thus, you’ll think of what you’re trying not to think of. Worriers have of paradoxical relationship with their worries because a part of them wants to stop worrying, but another part of them thinks that worrying shows them …

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Belief problem v. Workable Attitude

By maggie

As I described in the section on theories of responding to psychological suffering, I belong to the school of thought that believes that it is your response to yourself and your environment that determines your sense of wellbeing. It is not your circumstances themselves, but rather your interpretation of them and your beliefs about them that determines how you think, feel, and act. I call those thoughts that drive ineffective behavior “belief problems.” Various psychologists throughout the years have used different terms for the same problem. They are called cognitive distortions, negative schemas, problematic scripts, and over-used defense mechanisms in other schools of thought. I use the term belief problem because I want it to cue you to remember that your thought, feeling, sensation, or situation are not your problem. They may cause you pain but they don’t cause your suffering. If you recognize that it is human nature to experience pain and you let the moments of pain occur without resistance, your suffering will decrease over time. I also like the term belief problem because it speaks to the foundational parts of who you are. Typically when people talk about their beliefs, they are referring to a particular set …

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Example of self-monitoring for Obsessive Compulsive Disorder

By maggie

1) What was the trigger? Was it internal or external? My mom told me about her friend that was diagnosed with cancer 2) What sensations do you feel? heart beating faster, tightness in chest, short of breath, light-headedness 3) What thoughts are you having? what if I have cancer?   4) What is your reaction to the sensations and the thoughts? what if I can’t stop thinking about this? what if my anxiety doesn’t go away?   5) What types of avoidance do you want to engage in? I knew it was OCD, but I wanted to check my symptoms on WebMD. I wanted to ask my mom about it. Then I wanted to distract myself. 6) Did you engage in avoidance/neutralization/compulsions? Yes 7) If yes, what did you do? If no, why didn’t you? Immediately after my mom told me about her friend, I told my mom I was anxious and asked her if I could possibly have cancer. She said no, but then I felt a weird sensation in my arm and looked it up online. Later in the night, I kept thinking about it and watched some movies to distract myself.

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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Example of self-monitoring for Social Anxiety Disorder

By maggie

1) What was the trigger? Was it internal or external? Being at a social event, having critical thoughts about my competence 2) What sensations do you feel? Stomach in a knot, muscle tension, light-headed, pain in chest  3) What thoughts are you having? “What if other people notice how anxious I am and judge me? What if my mind goes blank when I’m trying to talk to someone? What if I don’t know what to say?”  4) What is your reaction to the sensations and the thoughts? I remembered that I talked about this happening in therapy, but in the moment I just felt so embarrassed that I couldn’t bear it. The sensations felt out of control and I believed my thoughts.  5) What types of avoidance do you want to engage in? Reassuring myself, getting reassurance from my friend who was there, comparing myself to other people there, leaving the party 6) Did you engage in avoidance/neutralization/compulsions? Yes 7) If yes, what did you do? If no, why didn’t you? I did all of them and it just kept getting worse. The more reassurance I tried to get from myself and my friend, the more anxious I felt. Comparing myself to others made me feel awful too.

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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Example of self-monitoring for Panic Disorder

By maggie

1) What was the trigger? Was it internal or external or both? Driving on the highway  2) What sensations do you feel? I’m having the sensations of heart racing, sweating, stomach in a knot, shoulders tight, arms and legs tingling, head hurts a little, dry mouth 3) What thoughts are you having? I’m having the thought, what if I panic while driving?  4) What is your reaction to the sensations and the thoughts? Initially I didn’t like that I was having these sensations and thoughts, but then I remembered that I should practice wanting them, and I told myself, ‘Good job!’ for triggering them. 5) What types of avoidance do you want to engage in? I wanted to avoid driving. 6) Did you engage in avoidance/neutralization/compulsions? No 7) If yes, what did you do? If no, why didn’t you? I didn’t avoid driving because I remembered that I was uncomfortable, but not in danger, and that if I keep driving when I have these sensations and thoughts, they will eventually go away. Once I was a few blocks away, my sensations did in fact subside.

Using self-monitoring to start facing your anxiety

By maggie

Self – Monitoring is helpful for two reasons: #1 –  One of anxiety’s best tricks is hiding itself from you. You’ve gotten into the habit of avoiding so quickly that you don’t actually observe what’s happening. You are having a thought, the thought is arriving in your body with sensations, and your mind is interpreting the thought as important. Since the thought feels important, you are responding to it as if it is important. Whether you distract yourself, analyze them, get reassurance from others about them, or do anything else to try and make them go away, the point is that you are responding to your thoughts as if they are facts, and threatening facts at that.  Self-monitoring is the opposite of avoidance. The act of slowing yourself down, identifying, and labeling the thought as a thought shifts you from content to process and you are on your way toward mindful observation. If self-monitoring sounds like a good idea while you’re reading about it right now, but practicing it in your real life is a challenge, you’re in good company. It isn’t because you’re lazy, you don’t understand, or it doesn’t work. You don’t need the perfect explanation or the …

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