I get to do that.

Over-responsibility of thoughts about the future
A few weeks ago, we focused on over-responsibility in both the present and the past. Several people asked about over-responsibility in the future. Thanks for the reminder. I forgot to worry about the future. The short answer is that it’s the same answer minus content plus anticipatory anxiety and emotional perfectionism. Got that? 

Thought-action fusion review
So, remember that over-responsibility of thought is when you have thought-action fusion. You have a thought that arrives with a spike of uncertainty and you interpret the thought as meaningful because of the accompanying feeling. 

For instance, I might have the thought “What if my mom dies?” and then no spike of anxiety, uncertainty, guilt or sadness.
“Not an important thought,” says my mind, “she’s not going to die. I don’t need to worry. Back to my other thoughts.” 
Notice that I have no more or less certainty about my mom’s mortality now than I did before I had that thought. I just had a thought about it. That’s a catastrophic thought without thought-action fusion. 

Comparatively, I might have thought, “What if the barista put drugs in my coffee?” and then a SPIKE! of anxiety and uncertainty. 
“Very important thought,” says my mind, “Did you see that spike? I NEED to check. I don’t care that it has never happened. I don’t care that it’s very unlikely. I’m so anxious! Come on. Check. Ask. Get a new one. Just a little check. I got all the feels now. Just do it to make the feeling stop.” 
This is a catastrophic thought with thought-action fusion. 

Notice that the content doesn’t matter here. The process of having a thought that arrives with a spike of uncertainty and then responding to it as though it is important is what keeps this suffering going. 

Thought-action fusion about the future
What were we worried about? Oh right. The future. Thought-action fusion about the future is usually about anticipatory anxiety and emotional perfectionism. It’s less about the content in the sense that you know your triggers and your content areas. You mostly don’t believe that the thought is a threat, fact, or prediction about you. You just HATE the process. You are having anticipatory anxiety about being triggered and then getting caught in the OCD loop, rather than being triggered about the meaningfulness of your actual feared content. You hate that you’re having a great day and then BAM! Trigger, sticky thought, urge to compulse, fight with self, compulsion or continued fight with self or both. You lost the day.
OCD – 1, you – 0. 

Emotional perfectionism
You likely have some mental stickiness and fear about the content, but you should focus on your emotional perfectionism more than creating the perfect exposure hierarchy if this is you. In fact, one cue that anticipatory anxiety and emotional perfectionism are the cognitive mechanisms that maintain your OCD is when you’ve tried exposing yourself to your content areas in all kinds of ways and you still suffer. Exposure and response prevention hasn’t failed you and you aren’t a lost cause. You are exposing yourself to the wrong thing. Emotional perfectionism is the belief that you should be thinking or feeling in a certain way. Judgment, frustration, and anxiety about not thinking or feeling correctly causes a lot of suffering. 

Compassion is the answer.Your frustration, shame, and guilt about having OCD and getting stuck in the OCD process is re-sensitizing you. Compassion isn’t some warm and fuzzy thing people do in a circle in the park. Compassion is the opposite of criticism. Compassion is a real-time decision you make when you observe suffering and take an action to alleviate it. It is both an attitude and an action. It’s a skill you can acquire and if you don’t have the skill, you need to get training in it and practice it. 

Self-compassion in a real-time moment of anxious suffering starts by reminding yourself of the truth about the anxious experience. You are not weak, crazy, or making it up. Anxiety is a feeling that occurs when you perceive a threat that gives your mind the urge to avoid. Sometimes people feel anxious even though they aren’t in danger, but the feeling itself is a very real physiological experience. When you are in an anxious state, first ask yourself,“Is this signal or noise? Do I have a problem to solve here or is this a feeling to let pass?”

“I get to have this experience.” Next, shift your attitude about having this experience. Yes, there is anticipatory anxiety. Don’t let yourself be backed into a corner with dread. You’re going to go do that thing you want to do. Either you feel great about it and it works out or you feel anticipatory anxiety, you go towards it, and you had the opportunity to relate to anxiety more effectively. Win, win! Everything either goes well or it’s exposure. Something goes poorly. Your thinking is “Great. Good practice!”You always win. 

You lose when you fight with yourself about how you feel. You lose when you avoid something you wanted. Both of those are within your control. You don’t have to fight with yourself. You don’t have to avoid. You might feel anxious, but it could be an opportunity if you shifted your attitude.

Refocus on your values and your task.What were you doing before you started feeling anxious? Or, if you weren’t feeling anxious, what would you want to be doing? If you don’t have an answer here, we need to talk about it. That’s a problem. It’s really, really hard to want the experience of anxiety. If you’re having trouble coming up with activities that are meaningful to you regardless of how you are feeling, we need to talk more about your values. It might be painful to discuss, but don’t worry. You have values. Struggling against anxiety and depression makes people distant from their values sometimes, but we can find your path together. 

How do I know what to do for exposure?
Great question. You are looking for internal and external stimuli that will trigger the feeling of uncertainty. An internal stimulus would be having a thought on purpose. An external stimulus would be doing something you typically avoid or have the urge to avoid on purpose. When you work with me, you never have to do something that is outside of your values for exposure. So many Huddle.care members have Harm OCD, meaning you have the feeling of uncertainty and guilt when you think about harm to yourself or others and it gives you the urge to avoid stimuli that provokes those thoughts and feelings. It’s okay to have thoughts about molesting your kids or your students or your patients. You have intrusions about doing all kinds of other bad things. I know. Your thoughts don’t scare me at all. I’m actually pretty bored by it. I hear it all the time. I think you are spending too much time trying to come up with the perfect exposure scripts about these  thoughts and you’re getting all tangled up in it. As a reminder, if your thoughts feel important to you, your exposure is to disengage from them while you still feel uncertain. That is, you don’t like your thoughts, but you don’t feel like it’s okay to let them go because they might be meaningful in some way, your exposure is to redirect your attention to something that is actually important to you. Let the Harm OCD playlist be on in the background of your mind, and compassionately come back to the present. This is the attitude you want. We can talk specifics about how that would play out in your life in group.

Cool off when you are Big Mad.
Sometimes we all feel Big Mad. You know what I’m talking about. Not a little annoyed. Not frustrated. Big Mad. If you were four and your parents told you to go to your room, not only would you not go to your room, but you would strip naked and have a tantrum in the kitchen. That’s Big Mad. Come on. Calm down. Don’t show everyone your butt. You’re at work. You have a prefrontal cortex these days. If something is making you Big Mad, there’s probably some other stuff going on for you. Try not to act on it when you’re in that state. Notice that it’s happening. Write down what you’re thinking if you have the chance. Delay until you get to group, okay?