Managing the “Build Up” of Anxiety and Uncertainty | Ep. 395

If you’ve ever felt overwhelmed by anxiety and uncertainty, leading to an emotional explosion, this one is just for you. Today, we’re diving into a listener’s question about handling the buildup of uncertainty and anxiety.

The Listener’s Question: Dealing with Uncertainty

A listener asked, “How do I manage the discomfort and uncertainty that builds up in my body while resisting compulsions?” This question highlights a common experience among those dealing with anxiety and OCD: the feeling of pressure building up until it seems unbearable. Let’s explore how to handle this.

Embracing Discomfort: A Key to Recovery

First, it’s crucial to understand that discomfort and uncertainty are normal parts of the recovery process. When we practice facing our fears without running away, it’s natural to feel overwhelmed. The key is not to pathologize this experience but to see it as a normal part of the process. The challenge is to stay with the discomfort without giving in to compulsions or avoidance behaviors.

Mindset Shifts: From Fear to Curiosity

Often, people give up when things get tough, thinking that the discomfort means they’re doing something wrong. However, this is a normal roadblock in recovery. The difference between those who succeed and those who don’t is the willingness to keep trying, even when it’s hard. It’s about experimenting with new strategies and being open to failure as a part of learning.

Practicing Mindfulness: Staying Present

Mindfulness is a powerful tool for managing anxiety. It involves being present, non-judgmental, and non-resistant to our experiences. Ask yourself how you’re relating to your discomfort. Are you resisting it, judging it as bad? Instead, try observing it with curiosity. Notice your physical sensations and thoughts without trying to change them. This approach can help reduce the intensity of the buildup.

Emotional Regulation: Opposite Action

Another helpful strategy is practicing emotional regulation. One technique is “opposite action,” a concept from Dialectical Behavioral Therapy (DBT). When feeling anxious, identify the opposite emotion—like relaxation—and act accordingly. This might involve engaging in activities that promote calm, such as deep breathing, stretching, or doing something enjoyable.

Extending the Time Before Relapse

If you often find yourself relapsing into compulsions, try to delay this response a little longer each time. This could involve setting small goals, like waiting an extra minute before giving in. Over time, these small steps can help you build resilience and reduce the frequency of relapses.

Creativity in Coping

Recovery often involves creativity. It’s about finding what works for you and being willing to experiment. This might mean trying new hobbies, adjusting your routines, or seeking support from others. The goal is to create a plan that helps you manage anxiety and uncertainty in a way that feels sustainable.

Observing the Experience: Be a Witness

Finally, practice being an observer of your experience. Instead of getting caught up in the narrative of “Oh no, here it comes,” try to watch your thoughts and sensations like a movie. This can help you detach from the intensity of the experience and see it more objectively.

Conclusion: You Can Do Hard Things

Managing the buildup of anxiety and uncertainty is challenging, but it’s possible with practice and perseverance. Remember, it’s okay to struggle, and each effort you make brings you closer to mastering these skills. As always, today is a beautiful day to do hard things. Keep going, and don’t give up. You’ve got this!

Thank you for joining me in this exploration of managing anxiety and uncertainty. I look forward to our next session together. See you then!

 

Transcript

If you are managing the buildup of anxiety and uncertainty and then you explode, this is going to be the episode for you. 

My name is Kimberley Quinlan. I am an anxiety specialist and an OCD specialist, and I help people overcome these conditions. I help them learn new strategies and skills and how to be the most effective, compassionate version of themselves so that they have a long-term recovery plan. 

Today we actually have a question that was written in by one of our students. If you don’t know, we have a lot of online courses for different conditions and different disorders to help teach you exactly how to create a step-by-step plan so that you can create this plan and go ahead and move in that direction all by yourself. Sometimes we get really great questions, and I do my best to answer them as well as I can. But this one specifically spoke to me, and I felt like I wanted to talk to everybody and really address this because my guess is we’re all dealing with this in some way or another. Today we’re going to talk about managing the buildup of uncertainty and anxiety. Let’s go.

Here is the question, and I’m going to read it directly. They said:

“I have a question about accepting discomfort and uncertainty. I often find myself building up this uncertainty in my body while I ignore the temptation to do compulsions and seek security.”

Number one, yay. This is exactly what we teach in all of our courses. We talk about not running away from fear or our emotions. We really talk about the importance of allowing that discomfort and knowing that it will rise and fall on its own. But a lot of my one-on-one clients have reported that it does feel like it builds up in their bodies. It does feel like it’s going to explode. 

Now, we talk about this specifically in ERP school. That’s for people with OCD who want to create a step-by-step program for OCD. We also talk a lot about this concept in Mindfulness School for OCD. All of these links, if you’re interested, are at CBTSschool.com. Mindfulness is actually a lot of what we’re going to talk about here today, but we also talk about it in terms of managing anxiety, generalized anxiety, and panic, which is another huge one. If you’re someone who struggles with panic, we have a whole course called Overcoming Anxiety and Panic that may be helpful for you, and we also talk about this in regards to hair pulling and skin picking, because often people with hair pulling and skin picking practice this amazing skill of writing an urge to pick or pull. Their goal is to allow that urge to rise and fall on its own. But sometimes it can build up and build up and build up and build up as well. These are all concepts that we have to look out for in these many different conditions. All of those resources are there for you in the show notes, or you can go to CBTSchool.com. 

Let’s look at the rest of this student’s question. They said:

“The longer I go without giving in, the stronger the buildup until it reaches a point where I just lose it and I get a huge rebound and relapse and go back to my compulsions. And this time, it’s even harder than ever to give up.”

They’re really saying, “What can I do in this situation?” They’re using the skills, but it might feel like they’re hitting a brick wall. Exactly the point I want to talk about here today. There are some key, important points we want to address here. Number one, there are some mindset shifts that need to happen. In addition, there are some tactical skills and strategies that need to be applied in order to overcome this roadblock, may you say.

The last piece here is this is a massive opportunity for you to practice kindness if you’re struggling with it. This is a normal part of recovery. I just want to normalize that and let you know it’s a totally normal part of recovery. It’s a normal roadblock. It doesn’t mean you’re doing anything wrong per se, but again, we do have to apply some mindset shifts and some tactical skills, so let’s get to it.

There are a few specific things I’m going to encourage you to examine as you address this particular problem. You may find that some of these apply to you, all of them apply to you, or maybe none of them apply to you. That’s okay. We are here to explore some options for this specific roadblock. 

Number one, the first thing I want us to explore is maybe this problem is completely okay for now. This is a normal part of the process. Really, it is. When we do these practices, we’re experimenting. We are practicing being uncertain, or we’re practicing having an emotion. It makes sense that it’s going to feel overwhelming, and your body’s going to build up and want to explode. That’s a normal response for the human body. We don’t even want to pathologize that, really. What we want to do is maybe just see this as a normal part of the process and then pivot to saying, maybe with more practice and repetition and small baby pivots of strategy and tactical skills, that this is just a temporary part of the problem. 

Now, often, what I find with clients is at this point, they want to give up. They say, “This isn’t working. This is making it worse. I give up.” This is exactly where I slow down and say, “It is working. You are just having to work through the next step.”

Let me use a metaphor here. As I have learned in my life, particularly more in the area of business, things start like I’m growing two businesses. I have you guys, I have a podcast. I wrote a book. In every single hard thing I’ve ever done in my life, there is a point where it gets to an apex where it’s so hard and nothing’s working that you want to give up. But the difference between those who succeed and those who don’t? It’s the ones who don’t give up. It’s the ones who are willing to fail many, many times in order to make some change. 

I want to encourage you, keep failing at this a little bit more. Again, we’re going to make some small pivots and changes as we go, but don’t go into giving up mode. What we want to do here is look at the fact that, okay, I can practice these skills: being uncertain, tolerating discomfort, being willing, all the things. I can do that until a point. We want to actually explore how far into it it is at that point. You might even want to document. It’s like six hours, or maybe it’s six days, or maybe it’s six minutes, or maybe it’s 60 seconds. Look at that and then go, “Okay, can I just improve that time a little longer? Can I hang on a little more using the skills that we’re going to discuss? Can I do just a little bit more? Maybe I’ll still explode and have a relapse. Maybe I’ll explode and yell. Maybe I’ll cry, fall on the floor. Maybe I fall flat on the ground and take a nap. All of those are fine options for now. But can I just make it a little longer? Can I hang on a little longer?” And maybe through practicing that, you might find that with fail, after fail, after fail, you actually succeed. And that’s what I have found to be very, very true. 

The second point here is, once we look at it that way, we can actually slow down and go, “Okay, what can I do during those extra 10 seconds? How might I shift my experience of this present moment to make that a little easier?” Often, let’s say I said to you, for the next hour, you’re going to have to tolerate the uncertainty. You’re going to be really uncomfortable. You’re going to feel like it’s “building up.” How can we be more effective in that hour? How can we actually reduce our suffering? How can we be as kind as we can during that hour? 

I’m going to push heavily towards practicing mindfulness skills. Now, mindfulness is the practice of being present, non-judgmental, and non-resistant to the present experience. I want you to examine and ask yourself some questions here. While you’re noticing this buildup, how are you relating to it? Are you saying, “This is bad, this is wrong. I shouldn’t be having this. This is going to end badly”? If that’s the case, well, yeah, the buildup is going to get really strong and really uncomfortable, and probably more than it would if you were to instead go, “Okay, I’m just observing it right now. I’m noticing this experience of buildup. But that’s not a problem. This is a part of the process.” When we ride a wave of discomfort, yes, there will be an experience of discomfort that rises. There will be a feeling of maybe tightness in the chest, racing thoughts, or whatever the physical sensations are. And that’s not a problem. 

Now what we also want to look at is, how are you holding your body while you’re in this hour-long? Let’s say we’ve given a quantity. You’re in this experience. What is your physical body looking like? Are you tensing up? Are you clenching your teeth? Are you clenching your fist? Are you squeezing your shoulders? Are you physically in resistance to this experience? If so, you’re adding to the discomfort. You’re adding to the buildup. So soften everything. I know that actually can sometimes feel very vulnerable, but it’s actually a tactical skill. 

Now, what about mentally? Are you trying to, like, boom, boom, trying to fight off all of the thoughts and all the discomfort? “I don’t want to feel it.” Mindfulness is about willingly allowing discomfort and being curious about it. In Mindfulness School for OCD, we talk a lot about beginner’s mind. Beginner’s mind is looking at something as if you’ve never experienced it before, looking at it with a degree of awe or curiosity. Like, “Oh, okay, I’m noticing I’m short of breath. Interesting.” Again, non-judgment. We’re not going to judge it as good or bad, but all right, what does that feel like compared to when I feel ease in my breath? How can I actually relate to that? Not as if it’s a disaster, but it’s just a different feeling. Just like when I get on the treadmill, while I’m running, I have shortness of breath, but I don’t go, “Oh my gosh, what does this mean? This is terrible.” I go, “Yeah, that’s a normal part of being on the treadmill.” What if tightening of the chest was a normal part of you riding this wave, and we didn’t respond as if it was a problem?

The most important piece of mindfulness is really identifying that this is just temporary and that it will pass. And as I pivot into engaging in the present moment, I actually put less attention on this discomfort. It might be me noticing while I notice that my discomfort is high in my body, what else do I notice? Oh, I notice the sun is out. I notice the floor under my body. I notice that the air is very warm. I notice a breeze on my face. I notice the feeling of a keyboard. We’re just becoming very curious about the other parts of our experience. And that can be really important because if we’re zoomed in really close on the problem, we’re only going to notice the problem. But if we zoom out, take a look around and go from there. 

The third thing I want you to remember here is while we’re uncomfortable, we do have to practice emotional regulation. Now, this is going to be the majority of the work—mindfulness as well—being present, being willing, being nonjudgmental. But emotional regulation is also finding specific things that help with discomfort. 

Here is an example. When I feel a buildup in my body, one emotional regulation skill I like to practice is called opposite action. Opposite action is a behavioral concept. It’s actually a DBT skill (Dialectical Behavioral Therapy). It’s about identifying what the opposite emotion is to what I’m feeling right now. If it’s buildup, I’m guessing the opposite for me would be relaxed. I’d go, “Okay, if I were relaxed, what would I be doing right now?” Oh, I might be swinging my arms a little more as I walk. Or I might have, again, that drop in body tension. I might laugh. I might bake. I might read. I might play with my kids. As I’m feeling this buildup and as I’m tolerating this uncertainty, I’m going to engage in opposite action, which is behaviors that are the opposite of what I would normally do in this experience. 

You might want to do an inventory of, as you notice this buildup for however many hours or days it takes, how are you interacting with the world, and is there action, a behavior you can do that’s different? Some people call this “faking it till you make it.” That’s fine. Again, we are experimenting here. We are just practicing with what works and what doesn’t and play around with this. I’ve had lots of clients tell me that engaging in a hobby like paint by number, crocheting, or gardening really helps with this feeling of buildup because they’re fully invested in something they value, not invested in fear and discomfort, and getting rid of this discomfort.

Now, the fourth thing I want you to think about here is really thinking about this core question. How can I work to delay this relapse, rebound explosion? What can I be doing to extend it just a little bit more? Again, we’re going to use a lot of that opposite action. We’re going to use a lot of those mindfulness skills. We’re going to practice a lot of compassion, and we’re going to start to be very practical and strategic in what we can do. 

I’ve had patients who’ve said, “Okay, I’m going to actually get a drawer, and I’m going to tidy that drawer. Or I’m going to focus on one action and one target activity and see if I can just delay the rebound a little bit more.” When you have the rebound, again, that’s fine. We are all doing the best we can. It’s a normal part of the process. Once you do that, could you set a timer so that you can catch it a little bit more in time and have a protective process ready to catch you, whether it be once you start doing those compulsions or you start getting back into it? Is there someone you could reach out to? Is there a little fact sheet, a cheat sheet of what you could be doing, or skills you could engage in to help remind you of what you can be doing? Is there a specific set of routines you can do once you’re in them—things that you know can help you and that have helped you in the past? Practice those. Again, we are just here to look at what has worked in the past and how I can practice that and experiment with other ideas. There’s no one way to fix this. You could white-knuckle your way all the way through this, but you’ve already proven that doesn’t really work. We’re really here to be very creative. 

Believe it or not, a lot of what I do with my patients is creativity. It’s a lot of creative work. It’s looking at, “Here is what you do. How can we be creative in creating another plan or experience for you? And then you come back, we see what worked, we see what didn’t, and we tweak it again.” That’s what we do. It’s beautiful, actually. It’s super, super fun. 

Number five, what I want you to think about is, is there a chance that you’re putting too much emphasis on what’s going to happen? Is it that you’re too engaged with the, “Oh no, here comes the buildup. Oh no, it’s going to happen. I’m going to explode”? Because If you’re putting a lot of emphasis on that and you’re building that story or that narrative, you can bet that it’s going to feel a lot worse and a lot more dramatic in your experience. 

We don’t want to actually expect it to happen. We want to say, “We’ll see. Let’s just see what happens. Maybe this is the one time it won’t happen. Maybe this is one time where I’m actually going to do this really well, and I’m going to handle this better than I have in the past.” You’ll be shocked at how much your anxiety hates when you’re positive. You’re allowed to practice that as an exposure. You’re allowed to say, “Maybe this is the one time where I do this actually pretty well.” Positivity can go a long way here as well. 

The last thing I want you to think about is, how can I be an observer of the buildup as it rises and falls? Again, can you just be someone who notices. We do this a lot when it comes to panic. When we’re experiencing panic, it’s, “Oh, here it comes. Here it comes. Here it comes. Oh no, oh no. Ah.” And then we panic. 

What we want to do is actually, as we ride this wave of panic, be like, “I am 100% committed to this wave. I’m just going to notice it, notice it, notice it. I’m about to feel like my body’s about to explode. Maybe it will. I’m hanging in there. I’m going to let it explode. What will be, will be. Here it comes. Bring it on. Let’s go. Let it explode, let it explode.” And then usually, “Hmm, okay, it’s still dissipating a little. It’s coming down a little. Hmm, interesting.” And then over moments, hours, or minutes, it does come down. Being an observer to it, watching it like it’s on a movie screen instead of narrating it like, “Oh no, here it comes,” is going to be so important.

There you have it. There are some strategies and skills to help you manage the buildup of uncertainty and anxiety. I get it. This is so hard, you guys. In no way am I saying this is easy. In fact, it’s really hard. However, for myself, speaking from experience and from seeing so many students and thousands of students and clients, they’ve all said, the most empowered they’ve ever felt is when they ride these waves and they come out on the other side. The most in control they’ve ever felt is when they ride these waves and come out on the other side. 

Hang in there. Keep going. Don’t give up. It is really, really hard. But, as I always say, today is a beautiful day to do hard things. I can’t wait to see you next week. See you then.