How to Win Against Anxiety (with Reid Willson) | Ep. 485
In this episode, I sit down with anxiety expert Reed Wilson to talk about why recovery is not about getting rid of anxiety, but learning how to change your relationship with uncertainty, fear, and resistance.
In this episode, I discuss:
- Why anxiety and OCD are fueled by resistance, and how shifting your attitude can completely change recovery
- What Reed means when he says we should “want” anxiety and uncertainty instead of fighting them
- How to stop getting stuck in the content of fears and start treating the actual disorder underneath
- The powerful mindset shifts that can help with OCD, panic disorder, health anxiety, and intrusive thoughts
- Why waiting to feel ready keeps people stuck, and how to start doing hard things even when doubt is present
- The simple, practical self-talk strategies Reed teaches clients in moments of panic, fear, and uncertainty
Why We Do Hard Things When Anxiety Shows Up
I had the absolute honor of sitting down with Reed Wilson, PhD, a brilliant anxiety expert whose work has helped so many people feel more empowered in their recovery.
At CBT School, we often say, “It’s a beautiful day to do hard things.” But in this conversation, Reed helped us take that idea even deeper.
Because when anxiety shows up, the goal is not always to make it disappear.
The goal is to change our relationship with it.
Content
Anxiety Wants You to Resist
One of the biggest messages Reed shared is that anxiety and OCD thrive on resistance.
Resistance sounds like:
“I don’t want this feeling.”
“I can’t handle this thought.”
“This uncertainty has to go away.”
“I need to figure this out right now.”
And while that response makes so much sense, it often gives anxiety more power.
The disorder wants us to fight the feeling, push away the thought, solve the uncertainty, and focus on the content. But recovery asks us to do something very different.
What If You Wanted the Anxiety?
This may sound strange at first, but one of Reed’s most powerful strategies is learning to say:
“I want this feeling.”
Not because we enjoy anxiety.
Not because the fear feels good.
But because wanting it is the opposite of what anxiety requires from us.
Anxiety says, “Get rid of this.”
Recovery says, “I can allow this.”
Anxiety says, “This is dangerous.”
Recovery says, “This is uncomfortable, and I can practice.”
That shift in attitude matters.
It Is Not About the Content
When anxiety or OCD grabs onto a topic, it will try to convince you that the topic is the problem.
The door.
The symptom.
The relationship.
The intrusive thought.
The possible mistake.
The contamination fear.
But Reed reminded us that the real issue is often not the specific topic. The deeper issue is uncertainty and our distress about not knowing for sure.
This is why we can get stuck trying to solve one fear, only to have another fear pop up later.
Recovery becomes more powerful when we stop chasing every topic and start treating the pattern.
The First Step: Step Back and Label It
When fear shows up, one of the most important skills is learning to step back.
That might sound like:
“Oh, I’m doing it again.”
“This is the disorder trying to pull me in.”
“This is noise, not a signal.”
That pause matters.
Without stepping back, we often automatically engage, check, reassure, research, ruminate, avoid, or try to figure it out.
Stepping back gives us a moment to choose a different response.
Health Anxiety: Signal or Noise?
Reed gave a helpful example with health anxiety.
If a new or concerning symptom appears, it may make sense to speak with a physician. We are not trying to ignore genuine medical concerns.
But when the symptom has already been checked, reassured, and repeatedly pulled into the anxiety cycle, the work becomes different.
Then the practice is:
Notice the symptom.
Label the anxiety pattern.
Treat it as noise.
Turn your attention back to your life.
And if the thought returns eight seconds later?
That is not failure.
That is another opportunity to practice.
“Oh Good, There It Is Again”
One of my favorite parts of this conversation was Reed’s attitude toward symptoms returning.
Instead of saying, “Why is this back?” or “I’m failing,” he encourages us to respond with something like:
“Oh good, there it is again.”
That does not mean we like it.
It means we are changing our posture.
Every time anxiety returns, we have another opportunity to practice responding differently.
Panic: Prepare Before You Step In
When it comes to panic, Reed emphasized the importance of preparing before entering a triggering situation.
If you know an elevator, airplane, meeting, presentation, or crowded space may trigger panic, take a moment beforehand to set your intention.
You might remind yourself:
“This may feel uncomfortable.”
“My body may give me symptoms.”
“I am practicing allowing these sensations.”
“I do not need to escape this feeling to be safe.”
When panic hits, the mind can feel like mush. That is why simple, clear self-talk matters.
Doubt Is Part of the Practice
One of the hardest parts of anxiety recovery is that we often have to do the work while still feeling unsure.
We may not feel certain that the content is irrelevant.
We may not feel certain that we are safe.
We may not feel certain that we are doing recovery “right.”
And that is exactly where the practice happens.
Recovery is not waiting until doubt disappears.
Recovery is learning to move forward with doubt present.
“I Can’t” Might Mean “I Don’t Want To”
Reed also spoke about one of the most common forms of resistance:
“I can’t.”
Sometimes, “I can’t” may actually mean, “I don’t want to.”
And that is okay to be honest about.
This work is hard. Facing fear is hard. Allowing uncertainty is hard.
But if we want to get stronger, we have to be willing to move toward the hard thing, not because we feel ready, but because the life we want is on the other side of that practice.
Choose an Outcome That Pulls You Forward
Reed reminded us that facing fear is incredibly difficult if we do not have a meaningful reason for doing it.
So we need an outcome picture.
What are you practicing for?
More freedom?
More presence with your family?
Less time spent trapped in rumination?
The ability to travel, work, love, parent, rest, or live with more flexibility?
When the discomfort rises, that outcome can help pull you forward.
A Beautiful Day to Do Hard Things
By the end of our conversation, Reed agreed with the phrase we say so often here:
It’s a beautiful day to do hard things.
Because this phrase represents an entire recovery mindset.
It reminds us that we do not need to wait for fear to leave.
We do not need perfect confidence.
We do not need certainty.
We can be anxious and still practice courage and self-compassion.
We can feel doubt and still move forward.
We can want our lives back and be willing to do the hard things that help us get there.
Final Thoughts
Anxiety recovery is not about never feeling anxious again.
It is about learning how to respond when anxiety shows up.
It is about stepping back, changing our attitude, allowing uncertainty, and choosing actions that move us toward the life we want.
So today, if anxiety shows up, maybe the goal is not to say, “How do I make this go away?”
Maybe the goal is to say:
“Good. Here is another chance to practice.”
Because it really is a beautiful day to do hard things.
Transcription: How to Win Against Anxiety (with Reid Willson)
Kimberley: All right. Well, welcome. We are totally lucky today to have the most amazing guest, Reid Wilson. I’m so thrilled to have you here with us, so welcome.
Reid: So thank you. Yeah, glad to be-
Kimberley: Would, would you like… Would you like me to call you Dr. Wilson? How would you like me to address you?
Reid: No, Reid is fine.
Kimberley: Reid is fine.
Okay. So I know you have some incredible wisdom regarding how to approach anxiety. Everyone I know who has been treated by you or has heard you speak said they left feeling incredibly empowered, and that would be my biggest goal for today. So I really want to get your personal approach when you’re with your clients on- Why do we do the hard thing?
We’re always talking about it’s a beautiful day to do hard things over here at CBT School. So what’s your approach? Why do we do the hard thing when it comes to anxiety?
Reid: Well, let’s get it over with. Uh, you, you know, uh, um, I do work differently than a lot of folks do, and I don’t do exposure and response prevention, which makes me, um, maybe weird or different.
Um, but you know, I, I wanna jump the hierarchy if we can. If we can, if there’s an opportunity for us to go as high up in the hierarchy as we can during a practice and take down the bully, well, there’s a great deal of placebo that goes along with taking down the bully. And if I, you know, go after the bully and I fail, well, what did you expect?
I was, you know, doing a really tough thing, and so it’s kind of a win-win. It’s not, you don’t, it’s not as painful. Um, but I, I think, you know, if we go all the way back to Sir Isaac Newton and, uh, his three laws of motion and inertia, what, what he talked to us about 355 years ago, which is still in place today in mathematics and physics and so forth, is that especially when you’re talking about an object with big mass, you know, so with people we’re working with, typically the mass is about my belief.
You know, I can’t do this. This is too dangerous. Uh, w- I could get my children sick if I don’t wash my hands thoroughly and they’re gonna have salmonella beyond me, uh, those things. So, you know, the bigger the mass, the more we have to use force with it. You, in California, when the Highway 1 collapsed and you had these huge boulders up there- Right
nobody came out with chisels- Right … to move all of that stuff. But I think part of what happens with us as therapists at least, is that when we work with clients who are in a more difficult strait or are up against some large mass, their belief system, is that we go more carefully with them, and that is not the most effective way to produce change, and that’s what Sir Isaac Newton would say.
He would say the most effective way is hard and fast. You have to come in and you have to pull or push in a direction that is opposite of where it’s been going. So, you know, if you think about… I know you don’t think about this, but, you know, you think about ships in a harbor. If you’ve got a big freight ship in a harbor, how do you turn it around?
They have to turn those ships around on a dime. Well, what do they do? They put a tugboat on the, on the bow and they put a tugboat on the stern and they go in opposite directions and they spin it right in place, and that is hard and fast. That’s what we wanna do, is, you know, so much of this is run- I think by belief systems that let’s go after the belief system, alter at a big level, and then we’re gonna be able to turn the ship much more easily.
Not saying everybody’s willing to do that, but that would be my objective. Okay, I’ll stop talking for a minute.
Kimberley: No, I want you to talk. How, how do you move that ship? How do you do the hard and fast?
Reid: Well, I, you know, as I’m saying, we don’t … I wanna go up a level of abstraction, one or more levels of abstraction.
I don’t wanna work with my client about a specific event that is in their way. I want to look at what’s driving that specific event. Because if it’s driving that specific event, it’s probably driving others as well. The anxiety disorders and OCD tend to run the life cycle. And if we do a great job and finish up treatment with our clients, and then they leave, but we’ve worked on one specific issue, when they have another breakthrough of symptoms and another issue rises up, they have to traipse back into our office and work with us again.
And I just think that’s … There are far too many people with mental health problems in the world for us to have to be working one-on-one with individuals every time there’s another breakthrough. I want us to go up a level and impart that With them in a set of principles so that, you know, when you’re better, when you’re stronger, the first thing that, you know, somewhere down the line, you’re gonna start dropping your skills because you don’t need to pay attention to your skills.
You’re doing okay. Then you get hit again, and you get knocked back because you don’t have your skills in place. We want them to then kind of go back and brush those skills off and bring them back in place. So I go up at a higher level, and one of the main higher level issues is around resistance. And, you know, if in many ways resistance is everything.
If we can get resistance out of the way and then have them do what we tell… You know, I’m, I’m bossy. I, I know- … I don’t sound bossy, but I’m bossy. I’m, I’m gonna tell, I’ll tell you what to do. I don’t mind telling you what to do. It’s, it’s fine. Here, this is what to do. If you will do this, you will get stronger.
I, I guarantee you, you will get stronger. I’m not… You know, you’re going to get better if you’ll do these four things or whatever. I’m not saying you’ll be best, but you can’t help but be better. Because if you’ll do these things, you’ll be moving in the direction opposite of what the disorder requires of you.
Anxiety disorders and OCD require the client to respond in a specific way, and if we can change our response to the symptoms, then we’re gonna start winning. You know, most of the symptoms and the, the fears, uh, that come are, they’re unconsciously mediated. They, they happen spontaneously. We can’t stop that.
And I think that’s part of what, you know, the, the mistake people make when they come into therapy is, like, I’ve hired you to help me get rid of those symptoms. They’re bad. I want them out of here. Please tell me how to do that. And this is paradoxical treatment. The whole idea of, “I want that gone,” is working in service of the disorder.
And so if we can turning that ship around is to go, is for them to have- you know, we gotta explain it to them, give them… You know, again, I don’t do exposure. The work I do has a lot more to do with insight. Now, that sounds like what psychodynamic psychotherapy, but no, it’s… No, we’re just like, how is the disorder dominating me?
What does it do? And what strategies is it using? And what strategies do I need to use in order to change things? Well, it’s gonna throw me these frightening thoughts and images or impulses, and that’s not the end of it. It requires me to hate them, not want them, and need to push them away. So therefore, I’m gonna do the opposite of that.
So, uh, you know, I’m gonna play big as an authority figure, and then I’m going to play small, which means, you know, I, I know these disorders. I know how to treat the disorders. I don’t know you, to my client, so I depend on you to help give you what you need. And so as I explain things, I’m constantly turning to my client and saying, “Does that make sense to you?
What do you think about that? Tell me, you know, respond to what I’ve been saying.” I gotta keep them connected with what I’m imparting because I have no interest in them complying with an instruction. I want them to take this in and metabolize it and make it their own and have ownership with it. And so, you know, blah, blah, blah.
I can keep talking. Do you wanna ask me something?
Kimberley: Well, I, I, I love what you’re saying. I, what I’m really curious is every person I know who’s seen you speak said they walked away with a new way of conceptualizing that they w- should want to have anxiety. Not should. That’s a piece of the work that you do.
So what is your, how
Reid: do you- Oh, you can say should. Okay. You can say should about that. Okay. And it’s funny because as you were formulating that, I just wrote down on my paper, want it. Yes. In other wor- that I wanted to talk about that. And that, that was what was on my mind, and I wanted to stop and take a breath and let you- Yes
ask me that. Yes. And but I think this is the core piece. I mean, again, one core piece, what I started with, was resistance. Well, what is resistance? I don’t want this. I don’t wanna do this. I don’t, right? Underneath that is I don’t understand this. You know, I have resistance ’cause I don’t see how that’s gonna work and so forth.
So of course, we as therapists need to be able to be, you know, I often call this as persuasive therapy. My job is to change your mind as a client. Mm. That it is what I wanna do because the disorder has taken over your mind and has, you know, if you’ve got a client with, um, OCD and fear of asbestos, you know, I, I want them to say, “Asbestos is none of my business.”
You know? Right? Because asbestos has, although it’s real, and I just spoke to somebody who is a contractor who’s removing asbestos from a building, you know, c- c- construction in, in his work, so it, it does exist, but when you have OCD and you’re caught up in asbestos- Yeah … the disorder now owns that topic.
Kimberley: Right.
Reid: And I gotta get off that topic because there is nothing there for me. So again, I have to get up above that topic and go, “This has nothing to do with asbestos.” Well, okay, well, what does it have to do with? Well, it has to do with uncertainty and the distress that comes from that uncertainty. That’s what I want, and I argue this point often.
You know, this is all I do every day, so I see people… Uh, since I’m a specialist, I see people who’ve seen other therapists, including therapists who’ve done exposure and response prevention, because that is the gold standard, and everybody does that, and I’m- To do something other than that. But nonetheless, they come in and, and they go, “Oh, I, I, you know, I know about this uncertainty thing ’cause like, you know, I have
Around driving if, you know, or, or locking the door, you know, my, my … I’ve worked with my therapist and what I say is, ‘Uh, maybe I locked the door, maybe I didn’t lock the door.’ I can handle uncertainty.” Now, to me, as a therapist, I think that’s nuts to say. I just think it’s totally wrong because maybe I locked the door, maybe I didn’t lock the door is about content.
It’s about the topic. OCD, if we’re talking about OCD, we’re not, but now we are, OCD has nothing to do with the topic. So for me as a therapist to train my client to say, “Maybe I locked the door, maybe I didn’t, I can handle uncertainty,” keeps them stuck on the topic. So here I am driving down the road, feeling a bump, wondering if I just ran someone over.
Maybe I killed someone just then, maybe I didn’t. I can handle uncertainty. I’m walking through the mall and I brush up against, I think, maybe, I’m not sure, that child as she went by with her parents. Did I do that on purpose? Could I be … Am I a pedophile? Well, maybe I’m a pedophile, maybe I’m not. I can ha-
You see, it just seem, to me, when you start looking at it, it’s, it’s nuts. Uh, what I want, when we get back to want, is I want to feel the uncertainty that I’m feeling right now at this moment, right? So I’m not like, “Oh, I want it later. I want to spend 45 minutes generating this feeling and sitting with it.”
Okay, I don’t work like that either. If we can work naturalistically with someone, that’s what I want to do. Instead of sitting down for 45 minutes four days a week or whatever and listening to something and trying to make my s- self as distressed as possible, I would rather step into a scene that tends to provoke my symptoms, knowing that my symptoms are going to come.
And the reason I’m going to do that is I’m gonna receive what’s happening and learn to sit with it because it’s about generic uncertainty, not specific uncertainty. And that is the piece that I’m constantly coming back to people with. These disorders have nothing to do with the topics. They need you to focus on the topics because it’s like The Wizard of Oz.
If you look behind the curtain, there’s just this old guy pulling these levers, and the levers are just about generic uncertainty, but if you discover that, he’s not gonna dominate you anymore. So it’s, he’s got to keep you down here looking at all these specific things. If I go up here and go, “Oh, it’s all about uncertainty,” I’m not treating my phobia of spiders or whatever.
I’m Not treating this obsession around this particular topic, I’m treating the disorder. And if I’m treating the disorder, it’s only about uncertainty. I want that feeling. Why do I want that feeling? Well, it’s the opposite of what the disorder needs me to be saying. That’s important. I want it because I have to experience it in order to modify it.
We have to generate the neural pathway of fear that’s connected with a specific circumstance to modify that pathway. So I wanna have that feeling in order to modify it. Now, the interesting thing is, by want- honestly wanting it, I am not only wanting it because I want that neural pathway, but I am already influencing the neural pathway because my automatic response is, “This is bad.
I don’t want it.” So I wanna bring that negative feeling up, and on the heels of that, bring in a positive feeling or an opposite feeling, which is what we’re talking about now of, of wanting to putting that on top of it. And I mean, you know, figuratively on top, not parallel to it, but above it. And so, you know, we go back to people having two voices.
Right? I’ve got the voice of fear, and then I have my therapeutic voice. And when they sit across from us in the office, typically the voice that’s present is their therapeutic voice. They’re trying to learn, understand, get what the strategies are, and so forth. When they leave the office and go into the scene, the therapeutic voice is not the voice that shows up.
It’s the fearful side. And so when the fearful side shows up, we need to help them step back in that moment with that therapeutic side and have another stance to invite themselves into. It’s like, you know, “Oh my God, here it is,” stepping back, going, “All right, now I’m facing… Here’s what I need to be doing.”
Right? So, to literally be giving myself instructions in those moments, and they need to be very simple because as you and I know, when you are in a threatening situation, your mind turns to mush, and you don’t wanna be talking a lot to yourself Right? You wanna understand all of that, and then have a couple of little phrases that you say in the moment, right?
If my client’s, you know, feeling contaminated and wants to go over and wash her hands urgently, and she’s trying to resist that, right, you know, she’s trying to step back, she can say inside her head whatever she wants. But if she says something like, “I want my life back,” that’s not an instruction. That doesn’t tell her what to do.
But it is a message in the moment that is a manifestation of a principle of the treatment. So I’ll wrap this little l- long soliloquy up to just say we wanna figure out what the strategy is. It’s going to be based on principles. And then once we comprehend what those principles are, we bring them down to the moment.
That’s how I work, moment by moment. I bring it down to the moment, to a self-talk really, that directs my action as I’m facing my threat. All right, I’m quiet.
Kimberley: No, please don’t apologize. I could listen to you all day, really. Um- So what
Reid: do you think? What’s
Kimberley: your response? I, I- Where do we go next? … I mean, it’s exactly the message that I use with my clients as well, in terms of this-
Reid: So
Kimberley: you don’t
Reid: need me.
Kimberley: I… No, but we really do. Okay. You have a message, and I love it. So- Tell, talk me through your way of saying, okay, so you’re in the moment, you are, you know that you’re being triggered, you know it’s not about the content. So you’ve caught that piece. You and your therapist have worked through that. The biggest- Okay.
Reid: Hold on. Hold on. I gotta interrupt you around that, because that’s not really necessarily true. Because I’m… Again, if we just think a little bit figuratively of two voices, I’m going to come in and operate as though the content is irrelevant- Mm-hmm … even though I’m feeling unsure whether it’s relevant or not.
Mm-hmm. Mm-hmm. Actually, both of those are going on at once. So I’m not going to know. And the interesting thing of trying to go to, “I know this isn’t important,” is actually not helpful- Mm-hmm … because we’re trying to sit with doubt. And so if I reassure myself over and over again, “It’s nothing about the… No, I’m fine.
My hands are not… You clean-” Right. “I’m sure there’s not really… The door…” You know, whatever. So I… Right? And so it, you have to do the work when you simultaneously feel doubt about whether it’s the right work. That’s the cunning nature of these disorders, which is they don’t let you know. So I interrupted you, but I wanted to clarify that around knowing that the content- No, I-
is irrelevant.
Kimberley: I actually think you hit the question on the head in that. So we’ve practiced not engaging in that content, right? Yes. So the biggest question that I get from listeners and followers and clients is that feeling in that moment feels like I wanna jump out of my skin, whether it’s a thought or it’s physical panic, right?
Reid: Yeah.
Kimberley: What is the, this conversation? that you’re talking about that, you know, between these two?
Reid: Well, so first let’s back up. If I… You know, obviously some of the stuff happens spontaneously. We don’t know it’s gonna hit us, and then it does. But to the degree either I am purposely stepping into a scene to do practice or I kind of know as I walk into this circumstance, you know, a, a party or whatever it may be, that I’m gonna have trouble here, step outside of that, that circumstance before I step in it and let me get my head straight around this.
Let me remind myself of what my intention is. Let me get my intention set. “Okay, I’m gonna go in here. I’m probably gonna get provoked in this manner. This is how I wanna respond to it. This is probably what’s going to happen when I try to do that.” You know, again, “Here’s what I wanna say. Here’s what I wanna do.”
Get that set before you step in there. Because if you step in there, again, you get hit so quickly by the symptoms that your mind turns to mush and you can’t figure it out in, in time. Um, so now you’re asking this question, but you’re gonna have to give me a context of what kind of disorder are we talking about.
Kimberley: Well, I think h- here there’s a, a big range, so I think you could answer it in any way that you feel comfortable or give a couple- Well, pick one … of examples.
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Kimberley: So let’s first start with, um, health anxiety. You know, that’s a common one. So they have a physical pain, right? Something has flared up, or there’s a sort of a miscellaneous symptom- Okay,
Reid: got it
Kimberley: and they’re stuck on that.
Reid: Okay. So, you know, a few things. One is, uh, so I’ve got, you know, I’ve got health, severe health anxiety. I’ve got what we used to call hypochondriasis, uh, which is more of a somatoform, um, disorder. But I th- how I treat health anxiety is the same way I treat OCD because the content is irrelevant.
So now, if I, you know, I already know I’m prone to all this kind of stuff, but I wake up and all of a sudden I’m having a symptom I’ve never had before. Boy, I’m, I’m having this throbbing headache over my left ear, you know, is this something serious or isn’t it? We’re going to get thrown by novel experiences, and so, you know, you’re probably gonna lose that one a little bit.
And one of, you know, if you’ve have that concern, you got two choices. Either I am going to go get reassured by seeing my physician, and who cares? You wanna go see your physician, go see your physician. I, to me, I don’t care. You wanna do it, it’s maybe cost you money or your physician’s gonna be going, “Honey, I’ve told you you don’t have any trouble.”
But if you are confused about a particular symptom and need reassurance, well then, go ahead and get that. Now, let’s talk about symptoms that have been recurring. You have been reassured. You have decided that I wanna do the treatment, and the treatment is this has nothing to do with an illness. This has to do with a fear response.
Then when that occurs and I start obsessing about it, I need to step back and label it. If I don’t step back, I’m not gonna change anything. And so all I gotta do is step back and go, “Oh, I’m doing it,” right? If I don’t do that, then- There’s nothing else to do. So the first step is kind of step back, and then part of what I wanna do is, you know, lay– decide is this a signal?
Is this something I need to pay attention to or is this noise? Well, I already know this is noise because this is my typical focus that I have. And so now I’m gonna treat it as noise. Well, how are you gonna do that? Well, I’m gonna have the symptom and have an urge to, you know, worry about it and check it and be concerned, and I’m gonna drop that.
I’m going to let that go and turn away from it and bring my attention to something else. As the therapist, I don’t care if eight seconds later it comes back. That doesn’t bother me. That’s, that’s fine. I– you know, w- how I shape it is I s-say if the, if the thought comes back, because what we talked about is we’re not in control of it popping back up.
Why wouldn’t it pop, pop back up? It’s the disorder. It needs to keep your attention. So it’s gonna pop back up, and I’m totally fine with it popping back up. I don’t wanna get frustrated about that. I’m not trying to get rid of it. If it pops up, it’s another opportunity for me to practice my skills. So that’s how I wanna look at it.
So w-we’re talking about wanting it, so one of the responses I can have is, “Oh, good. There it is again. Oh, great.” You know, sometimes I’ll say to people, “So imagine every time it pops up, I’m gonna put a gold coin in your safety deposit box.” Treat it like, you know, let’s shift attitude because again, you know, resistance and all that kind of stuff, the other big thing I push is shifting my attitude.
So I’ve got an attitude of I’m looking for an opportunity to practice. Oh, good, here’s another opportunity. As though I– if I respond this way, I’m go– Reid’s putting a gold coin in my safety deposit box. I like that, and now I, I wanna do that. So great. I’m gonna greet it like that. That’s great. And again, what I wanna do is have a single transaction, whether I talk to the disorder or I talk to myself, right?
So I can say, “Oh, thanks for, you know, scaring the heck out of me, and see you later,” and then I’m done, and I turn away, and I go do something else. Comes right back. “Hey, nice. You really, like, you really wanna talk to me now, don’t you? Well, um, thanks for showing up. Goodbye.” You know, over and over again. I’m just…
You know, something like that or I’m gonna talk to myself. It’s like, you know, you special people who are seeing this on video, you– if you were seeing my gestures, you’d see my hand coming up as like a stop sign. It’s like, “None of my business. Not going there. Not, not now. Forget it.” You know, something like that, then I– and I just turn away.
Sometimes because, you know, I was talking to somebody the other, other month around, uh, I was doing a demonstration at a conference, and he was feeling stuck. And I said, “If you had a little puppy and the puppy is coming over right now and chewing on the leg of your chair, what would you say to him?” And he said, “Well, I would say, ‘Please stop chewing on my chair.'”
I said, “You would not say that.” You would say, “Stop. Get back. St- stop that.” Right? So these disorders come in like ogres controlling people, and you, you feel shrunk down and small. We wanna shift that role and get you to be big and shrink down the disorder going, you know, like, “Bad dog, not, not going there.”
You and I, Kimberly, as the therapists, need to be big first because we have to model for them how to get big. But if we’re doing our job, we’re gonna transfer that to them so they learn to get big. So few ways to respond to this example of health anxiety, but you’re gonna see whatever you do next, it’s gonna look a little similar to what we just talked on, right?
Kimberley: Exactly. Exactly. And would you… I know you have books on panic. Do you do the same when it comes to… So we could do all that. We could sort of look at all the subtypes and apply that the same, but would you do the same for panic in that response?
Reid: Well, I, certainly, if I know I’m gonna put myself in circumstances that might provoke my panic, I wanna get oriented to the can.
So if I’m gonna go choose and do, do the big stuff, uh, I, you know, I don’t have to, with panic, go doing the top thing on my hierarchy necessarily. What I would, what I often say when I’m talking to- therapist of constructing, and I’ll get back to panic, um, constructing what do you do in the session? Well, I wanna talk and orient them in the session to such a degree that at the end of the session, we will talk together about between now and I, when I see you next, how can you generate some degree of uncertainty about your theme, period.
You know, and especially initially with people, it’s like, “I don’t care how much uncertainty you generate. You want me to go ahead and step in that elevator and provoke my panic in the elevator, right? That’s what you want me to do.” No, I absolutely do not want you to do that. What I want is for you to want to do that.
That’s what I want as a therapist. I don’t want you to comply. I want you to w- I want you to want to, and want to because you get what you’re about to do and what you’re trying to accomplish with that attitude. And so I want you to want to step in there, but if you got panic disorder and you, that happens in claustrophobic circumstances, and then we can pick working on an elevator, well, then let’s pick on working on an elevator, and if you only have to go up one floor to provoke your panic or just thinking about it to provoke your panic, well, then let’s do that.
Do that for yourself, and then, you know, obviously we’re educating them about everything, and they need to understand that the symptoms of panic are not the symptoms of having a stroke and so forth. That is what has to get ruled out, and if they’re confused in any way about why am I having these symptoms, and maybe it’s something physical, then they gotta go get that ruled out because we’re not gonna do anything helpful to anybody if they think the symptoms are dangerous.
You know, I worked with a woman a while back who was like she’s having panic attacks on planes and various enclosed spaces ’cause she’s got more claustrophobia than anything, but her concern is, “I’m afraid that I’m damaging my heart by the degree of distress that I’m having,” and, you know, I’m trying to educate her about that, and she’s going…
And I said, “You know, your heart’s working well. This is what it’s supposed to do in, in emergencies.” And, and so her, ’cause she’s bright, you know, her response was, “Yeah, but that’s the fight or flight response. You’re supposed to either be fighting or running, but if I’m on the plane sitting there with this, I’m afraid I’m going to be damaging my heart.”
Well, again, she and I are gonna go nowhere if that is her belief. And I, you know, I’m not gonna argue with her about that. I said, “Go see your physician. You know, check that out, um, ’cause if you’re right- And you’re not. But if you’re right, I literally said it like that. Uh, you know, if you’re right, well then, you know, you wouldn’t, why would you wanna do what we’re talking about?
Just, just stay off, don’t fly anymore. You know, the world can get away with you not flying anymore. It’s inconvenient for you, but, right? And so, but however, by the end of that session, she, uh, then did a practice around her heart, and her heart was racing. I think we were breathing through a straw or I had a pillowcase over her head with ducking, duct tape or something provocative.
And I was asking her how her number was, numbers were, and she said, “Well, about, you know, 50 out of 100, and my heart’s beating pretty fast, but that’s okay.” What do you mean it’s okay? You haven’t even seen your doctor yet. “Yes, I haven’t, but you said…” You know, so I’ll you know, so sometimes we, as therapists, don’t wanna start digging in to convince somebody.
That’s not my job. You know, at some point- It’s not … you gotta cut, cut your losses and go, go figure that out. Right. Um, so again, to just summarize around panic disorder, you, you need to understand what the symptoms are going to be, and you gotta be able to go, “I can handle this.” I often use interoceptive exposure, so we bring people in the room and, and, you know, spin them in a chair or breathe through a cocktail straw or…
It helps to be sadistic as a therapist, really, to do some of that stuff. And so fortunately for me, that’s comes easy. Um, but you know, I was working with a kid the other w- w- a while and, and he was having panic attacks while he’s doing sales presentations, and he’s in the medical equipment business. And so he was in another state doing the sales thing, and all of a sudden he had this full-blown panic attack, and now he’s lying on the ground, and the physicians and nurses are over him and, you know, perfect place to have this occur.
But after that happened, he stopped. He didn’t, you know, he took leave, and he stopped doing his presentations and was out, and he was on medical leave for all of this. And, and so we’ve been working around with the interoceptive exposure. And I, and I was trying to say I did a combination of having him hyperventilate and spinning him in a chair for a minute, and then I wanted him to pop up and walk over to the windows and just, you know, find out what happens.
Well, you know, he did that and was disoriented, walked over to the windows and, and then, you know, a light bulb went off just, just like that for him, which is, “Oh, interesting. I felt, just like you said, I felt awful. And you’re gonna feel awful when you hyperventilate for a while. You know, we’re looking for difficult feelings.”
He said, “I just, I felt awful, but I walk, you know. But after about eight to 10 seconds, that dissipated. You know, if I can manage the first 10 seconds, I think I’ll be okay.” So out of doing that little practice in the room with me, that gave him this insight, which is what we’re looking for. I don’t wanna do exposure and response prevention for 12 weeks with somebody in order to have them 12 weeks from now have the insight that they can not do their compulsion and their obsession will actually quiet.
I, I don’t wanna do it that way. I want them to have … Why, why would we wanna wait 12 weeks for insight? Let’s have insight up front, and then do the practice, you know, and/or, and do small little things to get that insight going on. So anyway, blah, blah, blah, lots of things I can say about panic, so.
Kimberley: Mm. I love it.
So let me throw, like, the most common resistance that I see, which is, “I can’t.” I think it’s sometimes code for, “I won’t.” But what are your thoughts on that?
Reid: You c- you can’t do it? Well, then, okay. Well- What would you like from me? I’m not gonna go, “Oh, yes you can. I know you can. You gotta give yourself a chance.”
I’m not playing that role, ’cause if I play that role, that allows them to play the role of resistance. I don’t care whether you do it or not. I don’t care. I mean, I care about you, but I don’t care. If you don’t want to do the work, don’t do the work. If you don’t wanna practice, don’t pra- If you don’t wanna be in treatment, don’t be in treatment.
I don’t care. What the corollary of that is, which I want you to understand is, if you wanna get stronger, you have to want to do the hard stuff. But if you don’t wanna do it, say I’m gonna move I can’t to I don’t want to, I won’t, right? If you don’t want to, then fine. You know? Again, back to the initial response was they say, “I can’t.”
I’m going, “Okay.” I’m shrugging my shoulders. “Well, remind me again why you’re here or what is it you want from me?” You know? So.
Kimberley: I think it’s beautiful because there are cases, I, particularly I have this more with my younger clients, where you are sort of talking them into doing exposure. But then you, like you said at the beginning, and please correct me if I’m getting this wrong from your- Oh, I
Reid: will
Kimberley: is you’re not teaching them the lifelong lesson. You’re just teaching them how to deal with that one thing, right? Oh,
Reid: for sure.
Kimberley: And so, so you’re
Reid: teaching
Kimberley: people- Yeah, but let me just
Reid: interrupt to say what I, I’m, yes, but there’s a lot of things around that. So if we suggest an assignment to them, we’re not, we’re not saying, “Here’s how to fix your problem.”
Again, I’m, I’m a cognitive therapist, so we do behavioral experiments. You know, you’re saying this, I’m suggesting that. Let’s see if we can construct some experiments to find out what is true here. This is not how you fix the disorder. This is what I am suggesting we see if you can experiment between now and when I see you next, um, and just see how it goes.
Or, you know, sometimes we get people who are, you know, have relationship OCD. And it’s like, “Oh, I’ve gotta figure out what, you know, is he the right man for me? Should I marry him? Do I really love him?” Blah, blah, blah. So, you know, the disorder gets them. These are important questions, and that’s how the disorders get them, which is I’m looking for, as the disorder, I’m looking for your values so that I can manipulate you with your values.
I love my children. I wanna pick the right man to marry, and so forth. So if we’ve got somebody who is, you know, obsessing regarding relationship OCD, you know, should I, shouldn’t I? So, you know, one of the things I will suggest is let’s have a moratorium on trying to figure that out for Two months. You know, this is March.
What do you think that between March and May we say, “Don’t figure that out,” and in May, you know, you can resurrect that again. Why are we doing that? In order to practice handling an obsession. You’re confused whether this is an obsession or not, let’s make it an obsession, and the way we make it an obsession is by you saying, “I am not addressing this topic for two months.”
Now, when you make that decision, and we’re throwing the symptom cluster a bone because I’m not saying, “Don’t have that thought anymore,” I’m saying for this designated period, then you can pick it up again. Once I make that decision and lock it in, then in those two months, every time the obsession comes up, is he right for me, that is automatically an obsession, and my job is to go, “Oh, I’m doing it again.
Drop it. Move over here and do something else.” So I have no idea what you asked me, but that’s the answer.
Kimberley: I was ans- I, I think you, you did answer it beautifully, which was- Oh … what, what do you do with the people who say, “I can’t/I won’t”? Oh,
Reid: yeah, that’s where we went from. Okay.
Kimberley: Which is it? I mean, I think you said is you just said don’t, and I, I sort of was really looking at you’re teaching us as a community that the approach is I want, I wanna have the anxiety, and therefore I will not- It’s, it’s not up for discussion ultimately.
Would you agree? No.
Reid: The reason I’m saying I want the anxiety is because my therapist and I have worked out how I’m gonna respond to it when it comes. Right. So you gotta… You can’t start with I want it. Mm-hmm. You’ve got to start with, okay, I’ve got some pl- things in place to manage these things, and then I want that.
I’ve gotta go towards I want that. I want it first, and then I’m gonna step forward with that attitude. It’s all about- Mm … attitude. Yeah. Um, and so yeah, we’re gonna orient like that, and then let’s get going. Yeah. And I’m gonna want to do it, which means I’m gonna be confronting uncertainty. You know, I often say to people, “Does, has anybody mentioned to you, you have a mental health disorder?”
Mm. “Let’s treat the disorder.” So as you go forward, of course, you’re not gonna wanna do this, and you gotta also wanna do that. We’re not killing off the side of you that says, “I don’t wanna do this.” Everybody knows what that’s like. You know, if you go on vacation for a week, if you’re me- … then on Sunday night you start thinking, “Why am I still in practice?
Couldn’t I take some more time off?” You know, ’cause I’ve been out of the rhythm, and I don’t… You know, but then I, you know, straighten it out. So I, I don’t have to kill that voice off. You just have to have another voice that comes in that helps lead the discussion. That’s the voice that needs to be the executive, right?
You gotta have that top dog. Underdog has to be, you know, your executive voice versus your, the part of you who is frightened and vulnerable to the disorder.
Kimberley: I have two more questions. Um- Okay … so I love that you’re talking about doubt, you know, and allowing doubt as you go, right? And that you need to have sort of an attitude with that.
What is the attitude you have about doubt? Is it just to make space for it? ‘Cause you have a really powerful attitude, um, and, and a message. So what, what’s your advice and w- how do you model that? Well,
Reid: it, it’s competitive. You know, I’m, I’m looking for this doubt. I want this doubt. Look, if I have to take what you’re dishing out, give me two servings and give them to me now.
Mm. I mean, that’s your attitude too. Let’s get going. You know, if I have to go through this to get… You know, I wanna make sure my clients have an outcome picture that’s important to them because this is difficult, and just standing rawly facing my fear is very hard. I better have an outcome picture that helps pull me through that.
I don’t like this, but I want that outcome. And I, if I have to go through this to get to that outcome, then I want to go through this. If I can go around it, I’ll go around it. But apparently, I have to go through that. And so now if I have to go through it to get here, then I’m gonna do that. And so we’re stepping up and being more…
This is an aggressive sport. It’s not for the faint-hearted here. And, and I, you know, again, there’s a lot of people in our field who have come out of having OCD or an anxiety disorder, and some of them get it and are pretty darn aggressive with people. And other people haven’t finished some of the work that I think they need to do with themselves.
Pardon me if I’m talking about you, anyone here. But, but, you know, it, which is that they are more delicate and careful. And I absolutely wanna have rapport with people, and I’m not gonna, you know, try to any way pretend, you know, you know, suck it up and do it. I’m gonna get rapport around what their suffering has been like.
None of us who’ve been in this field for any length of time have any question about how much suffering is going on, and let’s get going. Right. So the attitude is much more aggressive. And l- l- you know, where we started from, it’s like it’s this big mass, I gotta get going. Best way for me to produce change is hard and fast, not slow and careful.
Kimberley: I love it. Okay, last question, really easy. So we say here on the podcast, “It’s a beautiful day to do hard things.” Would you put your brand on it? Would you change that to, “It’s a beautiful day to want to do hard things”? Like, how would you reframe that? ‘Cause-
Reid: I like, that’s fine. Uh, it’s a beautiful day to do ha- hard things.
Again, it’s just like somebody saying, “I want my life back.”
Kimberley: Yeah.
Reid: It manifests a point of view.
Kimberley: Right.
Reid: So I don’t have to do a self-talk that explains everything about what I have to do. I’m looking to have a short… You know, I just talked to somebody this, this morning, and where we got to, the message he needs to say is, he, he, his example is he, he’s just retired, and, and all of a sudden he’s got all these to-do lists and he, you know, he’s back into, “I haven’t accomplished.
Oh my gosh, I’ve been retired for a week.” “And look, I, I, I haven’t done this, this, and this.” And, and he started going, “Then I kinda stepped back, went like, ‘Where am I?’ You know, you know, “Why do I… You know, Scott, you just need to chill out.'” Right? And so we, you know, truncated that back down to, you know, what, what could you say in the moment that represents that?
And how about just saying, “Chill”? Mm. ‘Cause chill, chill is it, and, and that’s enough. And so, so I think beautiful day to do hard work represents what they have been learning with you. Mm. Or what all of you have been learning together. So I’m, I’m not into changing it.
Kimberley: What, but what, what is, what would yours be?
I, that’s what I want, I want your piece of it. What would you- Oh … what’s your phrase that you say to yourself? Or what, what’s the thing that really empowers you?
Reid: It’s a beautiful day to do hard work.
Speaker 3: I thought you were gonna say, “You’ve got to want to do hard things.” I swore you
Reid: were gonna say that. Ah, okay.
A- all right. Well, I c- if you want me to say that, I can say
Kimberley: that. I love it. Thank you. I feel like that is exactly what people have been asking for, is to really closer to understanding why and, and that w- willingness piece that I think that you speak so beautifully to. So I’m so grateful for you coming on and sharing your knowledge with us.
Reid: Great. I will throw out that I have a website which is a free self-help site called anxieties.com, plural, A-N-X-I-E-T-I-E-S.com. And if you just go on the homepage, there’s probably 12, uh, video clips, free clips that you can just watch and learn some things. And I’ve got a whole self-help program for all the anxiety disorders.
People can walk through that. Does… Again, you don’t have to sign up for anything. You don’t have to pay anything. It’s there to, for you to learn. So it’s a resource for- Right … people if they want. So-
Kimberley: We’ll add that in the show notes, and I can really say to everyone, please do go on that because the video content is brilliant, and you really do a great job of addressing so many different areas of anxiety.
So I’m so grateful for you offering those resources out. It’s all good. And also, I will link in the show notes the links to all of your books, your many, many books that are brilliant. Okay. So thank you again- That’s great. Well, thank you for doing that … for all of your amazing work. It’s incredible.
Reid: All right.
See you.
Speaker 3: Please note that this podcast or any other resources from cbtschool.com should not replace professional mental health care. If you feel you would benefit, please reach out to a provider in your area. Have a wonderful day, and thank you for supporting cbtschool.com.
