I am honored to share with you a recent interview I did with OCD ROCKSTAR and dear friend, Shala Nicely. Shala is a Licensed Professional Counselor in Atlanta and treats OCD and OCD Spectrum Disorders using Cognitive Behavioral Therapy.
I briefly outlined the conversation and left all the links discussed during the podcast.
Enjoy!
Shala recently wrote an awesome blog post article about a top women’s magazine that posted an article encouraging readers to “be a little OCD!” Shala declared enough was enough and got writing. Shala and her ROCKSTAR mom are doing so much to advocate for the OCD community. See the below link to check it out.
How do you respond when people say, “I am SO OCD?”
Shala reports that she always aims to never shame anyone. For this reason, she talked about polite and non-shaming ways to educate others on what OCD and how painful and debilitating it can be.
How does it feel when you hear someone say “I am so OCD”?
“First, frustration”, but then desire to educate others about the severity of OCD and other mental health disorders.
Are people with OCD, “SO OCD?”
In today’s society, being “SO OCD” is generalized to describe someone who is meticulous and likes symmetry and neatness. This is not typical for someone with OCD. Someone who has severe OCD might be entirely ok with a dirty bedroom and not need symmetry or cleanliness at all. It is important that we educate people about the specific sub-types of OCD so that people better understand the complexities and variety of OCD symptoms.
Go to Iocdf.org for more information
How can we manage the shame and guilt that comes with having OCD or another mental health disorder?
Brene Brown has written some AWESOME literature and has done amazing research about shame and guilt. Because Shame and Guilt are so common amongst those with OCD, Anxiety, Eating Disorders and Body- Focused Repetitive Disorders, we both strongly encourage listeners to read any of her books.
Kimberley also discussed Brene’s explanation of how to identify if you can trust someone. Check out the link below to watch.
I am excited to share this months podcast, as we are joined by what I call a CBT SUPERSTAR, Sara Vicendese. Sara is a Licensed Marriage and Family Therapist who specializes in Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) in addition to traditional PsychoDynamic therapy.
This podcast is based on the phrase, “It takes a village to raise a child“. This phrase is used often to explain the importance of community when raising a thriving and successful child. We believe that you can create your own “micro-village” to help you along with your recovery.
Today we talk about ways to create YOUR “Village” (in whatever form you think is helpful) to help you with your on personal recovery. We discuss how to find the correct treatment, access the most helpful resources and how to include your family members, friends or partners in your recovery, in a healthy and helpful way.
Below is a basic layout of our conversation. Enjoy!!!
Today we talk about ways to create YOUR “Village”. What is the most effective form of treatment for OCD, and how do I find a therapist who provides it?
Sara talks about the difference between Cognitive-Behavioral Therapy (CBT) including Exposure and Response Prevention (ERP) and psychodynamic “talk” therapy, specifically focusing on:
How to interview your therapist: what questions to ask, how to ask them, and the importance of interviewing therapists without assuming that everyone with a degree is going to be the right fit.
How to know what kind of therapy you’re in.
How do you find a good ERP Therapist
Check out IOCDF.org for a list of therapists who are trained in CBT and Exposure and Response Prevention (ERP).
Once in contact with a therapist, ask if they know what ERP is?
Ask what books they rely on when treating OCD? (This might allow you to screen them for their knowledge)
Ask if they have they worked with OCD before and for how long? Where did they get their training
How do you know your current therapy is or isn’t working?
Sara writes,
“A lot of dynamic therapists will stress that things can “get worse before they get better,” encouraging clients to wait months – or even years – to see the benefits of their work. It’s true that in any therapy, including ERP, you will likely feel worse before you start to feel better…but if months go by and you aren’t experiencing any reduction in symptoms OR if you notice – at any time – that you are getting significantly worse, it is likely time to move on.”
What advice do you have for those who cannot find an ERP therapist in their area? Or, for those who can only afford a therapist in-network who does not know about ERP?
Ask your non-ERP therapist to read these workbooks (depending on your symptoms) ahead of time and go through them together in session.
There are also so awesome online forums (Yahoo groups are GREAT) or online resources such as IOCDF.org, OCD stories etc (See my resources page for more info)
Also consider the potential for Skype or teletherapy (always ask the therapist if they are legally allowed to see you from the state they are licensed in, depending on where you life)
What advice do you have for those who want to start ERP treatment, but currently have a non-ERP therapist?
Sara writes:
“There are really two options here; you can leave your current therapist and start with an ERP therapist, OR you can explore the potential of seeing both at the same time.”
Sara discusses the importance of collaboration and making sure that both therapists are in regular touch with each other – to prevent each therapist from working against each other. Sara encouraged therapists to coordinate care and maintain the effectiveness of both.
What advice do YOU give to the family members of those who are struggling with mental health issues such as Obsessive Compulsive Disorder (OCD) and Body Focused Repetitive Behaviors (BFRB’s) or Eating disorders?
Living with, and loving, someone with these disorders can be extremely challenging and it’s critical that all members of the family are as healthy as possible for everyone to thrive.
Jon Hershfield’s book is great in this situation, as psycho-education is so important. Sara discusses the importance of involving family in treatment as appropriate (assuming family is supportive and including them wouldn’t be detrimental to treatment).
Sara also discussed how she often recommends that family members seek out their own support – either through support groups or personal therapy. Kimberley discusses to use of the Family Accommodation Scale (FAC) to identify ways the family are accommodating the OCD compulsions.
Click here for a link to the Family Accommodation Scale.
Is there a kind of therapy can benefit the spouse or parent or family member of someone with OCD or other anxiety disorder, or a BFRB?
Individual therapy (and/or support groups) for the family member can be very successful. In addition, there is great benefits from continuing to be educated about the loved ones disorder and get consultation on the best ways to support them though their recovery process.
What can a sufferer do when their family member or friend is not supportive of their recovery?
This is a tough, but important, question. Being unsupportive can take many different forms, from simply not understanding / participating in treatment to (on the other extreme end) working against treatment or purposely interfering with it. Someone who is not supportive of treatment is someone who is, in some way, colluding with the illness. Maybe recovery would mean that their life will be more difficult for them, or perhaps the treatment itself is hard to tolerate.
Sara discusses how she often see families where more than one member is suffering from the disorder – however, only one is diagnosed and in treatment. If one partner is going through ERP, that can stress the relationship if the other partner has similar undiagnosed issues.
Sometimes people aren’t supportive of recovery because it is hard at first and requires more energy/work than they are willing to put in. I can think of an example where a parent consistently disrupted treatment for their child because they didn’t want to see them in distress and the increased anxiety in the household during exposures made them uncomfortable. A highly anxious parent may have as much trouble with their child’s exposures as the child – for their own reasons.
In most cases, most people get on board given enough time and education. That said, we are faced with tough decisions if our loved ones / friends interfere with treatment. Again, it is important that loved ones be brought into treatment, encouraging them to get their own support, and even the option of moving on from the relationship if it is keeping the sufferer stuck.
Sara Vicendese has a private practice in Westwood, CA. Learn more about Sara on her website at http://saravicendese.com/
You may also see the unedited video interview here
There is an urgency that is ruining us in today’s culture. We must have everything right away and we get upset when we don’t get our way. When I catch myself in these behaviors, and I am mindful enough, I ask, “Why am I behaving this way?” The answer is always FEAR! We are afraid of being late. We are afraid someone will judge us or be upset at us for being late. We are afraid of not checking off everything on our list of things to do, which will make us feel unsatisfactory. We are afraid if we don’t do it fast enough, we won’t get home early enough to have a moment to ourselves, where we can breathe and find some peace. So, we clench our teeth, take the corners too fast and we fail to take in any of the joy of that moment.
We keep forgetting is that peace lies in this moment. The problem here is that rushing and insisting things go to our expected timeline is setting us up to have discomfort.
Patience requires us to accept and tolerate difficulties and delays, without getting angry or upset. So, how do we practice patience when we are being followed by anxiety all day, every day, particularly for those who have an anxiety disorder such as Obsessive Compulsive Disorder (OCD), Panic Disorder, Generalized Anxiety (GAD) or a specific phobia? This questions also applies to those who have other disorders such as and Eating Disorder (Anorexia Nervosa, Bulimia Nervosa or Binge Eating Disorder), or Body Focused Repetitive Behavior (hair pulling or skin picking)?
Lets take a look at a few examples of how anxiety requires patience.
“I want anxiety to go away now”
Patience involves the practice willingness to feel anxiety. Patience is going about your day while experiencing the anxiety you have. This is the golden rule for managing anxiety. If you are running from anxiety or pushing too fast through it, you are creating an anxiety monster. Patience is willingness and compassion all rolled into one.
Patience will involve not getting angry or condemning yourself for having this fear. We tend to play the blame game when we are struggling, thinking that an appropriate amount of blame and shame will teach us to no longer feeling this way or prevent feeling it in the future. This also applies to not blaming others. Our anxiety is ours. We cannot blame others for it. Even if someone does something that makes us anxious, we must work to heal our own hearts and learn how to manage it.
I want to solve the problem RIGHT NOW! I need to know the answer RIGHT NOW!
This is where patience is needed most; when you want something you have not got. This is where you have to loosen your grip and make a lot of space for uncertainty.
We have to develop a deep respect for the natural unfolding of time. Just because it is unknown, does not mean it must be known. Your job is to be patient with the feeling of “un-knowing” and trust that things will happen at their pace.
Again, loosen your grip, or loosen your reins and take a look around. Consider, that the answer is right in front of you. If you have Obsessive Compulsive Disorder (OCD) or anxiety, and you are on a mad rush to find the answer to an obsession you are having, it might be that patients IS the answer. It might be that madly finding the answer IS the problem. We must slow down. You take a breath and you take note of all the other things that are going on. You notice that the clouds in the sky remind you of a warm winters day when you were a kid. You actually taste the food you are eating. You really look your partner in the eye. You slowly take the corner in your car.
Maybe you are overwhelmed with the societal pressure or self-imposed pressure to be better, faster, smarter, better looking, healthier, free from anxiety.
Sometimes the faster you try to achieve something, the longer it takes. If you choose the fast, wont-stop-for-anyone pace, I can almost guarantee you that you wont make lasting relationships. Its really hard to get to know someone and connect with them when you are living a rushed life, unless they are running at the same pace and enjoy the direction you are heading. The trick here is patience and compassion. We must slow down and acknowledge that we are growing at a pace that is just right for us. You are exactly where you need to be and the pace will find you. This might be hard to take, but that’s where compassion comes in. With compassion, you acknowledge how hard this is for you, right now. You accept that many others (basically any human with a heart beat) must accept that we don’t get everything we want right away, nor should we want to. There is no shame is slowing down.
General life
With patience, we get to slow down and see that a lot of what we own in our house and in our life is filler to make us feel like we are going places faster. When we are patient and mindful, we can observe ourselves better and begin to see a lot of our pure and natural beauty. We get to notice all that we are. It was there all along. We were just speeding, too fast to see it.
Patience is willingness to be uncomfortable and compassion for self and others, all rolled into one ball. It is a skill that will reward you greatly, if you learn to make friends with it.
This is a message to you, for those times when you feel like you are failing.
This is a little bit of a verbal manifesto for you, if you feel like you are not winning the fight against anxiety and you are lost on where to go next.
Maybe you feel like you can’t seem to get relief from your anxiety. Or you are unable to do something that is super scary for you. Possibly you have mastered one struggle and then you have found that a new anxiety or struggle has risen. In this moment, you may feel like you cannot seem to get “control” over whatever it is that you are dealing with. Because of this, your emotions might be raging, despite your attempts to calm them.
Below are my favorite FIVE points to remember when you think that you are failing, or not winning. I hope they find you some peace and give you some ideas to help you keep moving forward.
FIVE things for you to remeber when you think you are “failing”
Thing #1
You cannot “fail” if you are trying.
If you are trying, you are being willing Failing is if you stop trying. There will be times when you have to slow down and stop your work for a moment. You may need some time to reflect (see Thing # 3 for more information on this). That being said, try to remember that slowing down is not failing either.
Thing #2
This struggle is real and IMPORTANT. You are not making this struggle up. If it is hard for you, it IS hard. Just because it isn’t hard for others, does NOT discount that it IS hard for you. Be gentle with yourself. You are not dumb, or stupid, or messed up because this struggle is so hard for you. There is no rhyme or reason why this struggle chose you. All I can say is that it is yours and you are correct. IT IS HARD.
Thing # 3
Make the “fail” or the struggle count. There is knowledge in each struggle. I can be helpful to ask yourself, “What message is there that we could learn from?” Possible obstacles that might be getting in the way could include concepts such as-
I cannot let go of control.
I am struggling with concept of uncertainty
I am struggling with accepting my physical discomfort
Once you have identified the obstacle, you might review (by yourself or with your therapist) if it would be helpful to go back to identifying and correcting your irrational thoughts about your fear. You might also want to revisit your willingness tools. An important tool that we often forget is to apply TONS of compassion. Or maybe just a little bit, if compassion is a hard tool for you to access. You could use this “fail” to dispel the misconception that you should be ashamed of having this struggle. Can you share it with someone your trust? We all, even those who seem happy and lucky, have struggles. You are not alone. Don’t hide it all to yourself. Reach out and ask for a hug. Allow yourself to be comforted. Brene Brown’s research on trust has shown that others trust us more when we share our own struggles with others.
Thing #4
Beating yourself solves NOTHING. Do you look back on past events and say, “I am so glad I beat myself up over that!” I am sure you do not. J Could you allow this struggle to be hard just for the present moment? Sometime when we allow things to be hard, miraculously, they become jus a little easier, or the heaviness of them becomes less.
Some Yoga Instructors say that there are some advanced moves that require you to fall 1000 times before you can master a pose. If you didn’t know that it took 1000 falls to master the pose, you would probably give up pretty fast. I like to use this as a metaphor for dealing with anxiety. Remind yourself that you will have to fall a few times at least (more likely 1000) when dealing with anxiety. If you find that infuriating, try not to judge the process. Allow yourself to fall, knowing that the falls are accruing towards a great outcome.
Thing #5
“Failing” is a point of view. Remember, you cannot fail if you are trying. If someone tells you your trying is not enough, that’s ok. They can have that opinion. However, no one knows your struggle. No one gets to tell you how your recovery should look. Just keep looking at the steps you are taking.
Be SUPER careful of looking too far ahead. If you are climbing a mountain (which I am sure this is how it feels to you right now if you are listening this far into the podcast), just focus on the steps you are taking. If you look too far up the mountain, you WILL trip and then you will feel like you are “failing”. Sound familiar. Try to just stay here, on this one step. Master this one step and give yourself time and compassion for how hard this step is.
Consider “failing” as proof of bravery. If you are listening to this, in my mind,
YOU are a winner. You are brave, just for trying to conquer something hard. It takes courage to admit to having struggles. It would be so easy to go and hide and let whatever it is that you are dealing with just keep happening. It takes a lot of courage to fight through something instead of run away or fight it with anger or self-criticism. Open yourself to allowing the struggle to be a part of your story, instead of fighting it all the way. Every good story or movie needs a struggle. I see your strength. I see your possibilities. Keep your fire alive.
I believe you can do this. I have seen some pretty amazing stuff in my career. I’ve seen people tell me they “will never beat this” and they did. Keep trying!
When your physical symptoms of anxiety are high, you may feel like nothing works. You may have moments when you feel like you can’t come back to your rational brain. When we are all wound up on anxiety, fear can run the show. You know what I am talking about, right?
Despite there being some great tools out there, but one of the most difficult parts of having severe anxiety or panic is the comprehending what IS real danger and what IS NOT.
Last month we talked about R.A.I.N, which is an acronym that helps us use some of the most important mindfulness tools. There is also non-judgment, acceptance, willingness, bringing our attention to the present moment. These are all wonderful tools.
For me personally, if I can understand the mechanism behind what is happening, I can handle it better. That is why understanding what was happening in my brain was SO helpful.
Today we are going to delve deeper into understanding our brain and what happens when we experience high anxiety.
The problem with the anxious brain is that it often sets of an alarm, making us feel like our lives are at risk, danger is ahead, when really there is no danger at all. This is a mistake our brain makes, particularly when we have an anxiety disorder like Obsessive Compulsive Disorder, Generalized Anxiety Disorder, Panic Disorder, Social Anxiety or Specific Phobias.
Sometimes just understanding a little bit about what our brain is doing can help us with awareness and then allow us to implement the tools better.
A Simple way to Understand YOUR Brain and Anxiety
I want you to think of the brain like a house.
This house is a two-story house, with a stairway that leads us to from upstairs to downstairs, or vice versa.
Dan Siegel and Tina Payne wrote a wonderful book called, The Whole Brain Child that coined this concept, but I have shifted them a little to specifically address the management of anxiety.
**Please note that scientifically, this is not perfect. It would take hours for me to explain the intricacies of the brain and all the areas that provide different functions. For the purpose of getting a basic understanding, we will use this simple metaphor.
The Upstairs of the brain is where we do most of our Executive Functioning. What this means is, in the upstairs brain lives the “Thinkers”.
Functions of the upstairs brain allows us to
Regulate our body (speed up or slow down)
Tune in to someone else or something else.
Balance our Emotions and use Empathy and compassion
Have response flexibility (slows down the time between impulses or urges and an action). Basically, this means that we don’t respond based on pure emotion.
Calm our fear: There are inhibitory peptides called gabba that tame our fear and help us interpret the stimuli in a rational, appropriate way. This occurs in the Prefrontal Cortex at the front of the brain.
For kids, I love Hazel Harrison’s idea of giving each of these functions a character name. Hazel Harrison is a blogger for Mindful.org, if you are interested. You can be super creative with this process and make it silly and fun.
In our upstairs brain lives:
Creative Cassidy
Problem Solving Pete
Patty the Planner
Reasonable Renee
Calming Catarina
Kind Kelly
Flexible Felix
The downstairs area of the house lives the Basic functions. While these might not seem as sophisticated as the upstairs of the brain, the downstairs helps us to stay alive.
Downstairs brain controls
Bodily mechanisms that are automatic (Breathing, Digestions and Blinking). It is really quite incredible that our whole body can function without us needing to do anything at all.
Fight, flight and freeze mechanisms. This is the most important, for today‘s discussion. The downstairs is the Emotional hub of the brain. We need to be thankful for this part of our brain, as it keeps us safe from real danger. This downstairs area of the brain is what keeps us from touching the hot plate on the stove or not walking out onto a busy highway.
For the kids (and for use Adult Kids!), our downstairs brain is the home of:
Fearful Frannie
Panicky Pete (Fight flight or freeze)
Sad Sandra
Furious Frank
Bossy Benjamin
In the downstairs brain lives the Amygdala, which interprets the current stimuli, past memories about such stimuli and the general environment to determine if there is danger or not.
If there is danger, the Amygdala sends out a message to the body to prepare for flight, fight or freeze. This message may cause a bunch of bodily sensations that will prepare you for survival. Your heart rate might go up, which is your body preparing to be able to run a long distance in a short amount of time. This message may cause you to have stomach issues such as diarrhea or vomiting, which is your body’s way of emptying its contents, again, so you can be lighter and get away from such danger.
Using the metaphor of the house representing the brain, the stairway of the house helps the upstairs and the downstairs communicate together. The upstairs and the downstairs work together to think and feel in a way that is regulated and reasonable.
If there is a real danger, let’s say there is an earthquake, the downstairs brain (specifically Fearful Frannie and Panicky Pete) take over to make sure they can send all the messages necessary to keep the body safe. An example of this is, if there was in fact an huge earthquake, the upstairs “Problem Solving Pete” would not stop to pick up the stray shoes that have been left in the middle of the lounge room in case someone trips. Or, “Reasonable Renee” would not signal for us to stop to say goodbye to the people we are standing with before we ran for safety. Our downstairs brain works very hard so it can get us to the safest place in the fastest possible time. Once the danger has gone, we go back to using a more balanced distribution of the upper and lower brain.
What happens when we have an Anxiety Disorder?
In some cases, as mentioned above, our brains interpret that there is danger and sends out these messages when there is, in fact, little or no danger at all. This is VERY common in anxiety disorders. We could say that our downstairs made a mistake and set off the alarms, signaling to the whole body that is must prepare for fight or flight.
When I am using the metaphor of the two-story house, I often call this “lockdown”. Sometimes, just as our brains do where there is a REAL danger, when our brains mistakenly set off the alarm bells, it “locks down” the downstairs brain and won’t allow us to access our upstairs brain in a reasonable way. Problem Solving Pete and Rational Renee have no way of communicating with Panicky Patty and this keeps us from questioning if this danger is, in fact, a danger.
There is great benefit from knowing this information and being able to notice and observe when your brain is sending you into “lockdown”. Just understanding and observing this can allow us to reset. In fact, identifying that we are in lockdown and that our downstairs brain is being activated instantaneously opens up the stairway a little and allows reasonable Renee to begin doing her work. It is Reasonable Renee who allows us to say “OK, I am in lockdown right now”. Isn’t that SO cool?!
Dan Siegel uses the quote, “you have to name it to tame it” and I cannot agree more when it comes to anxiety. When you (or your little ones) can name what is happening in their brain, it helps them to feel in control and then are able to tame their heightened sense of danger.
Now, don’t get me wrong, knowing this information will not make anxiety go away completely. But, the more we can identify when our downstairs is in lockdown mode, the more likely we are to use our mindfulness and Cognitive Behavioral Therapy tools.
Another tool is to practice using you upstairs brain when you aren’t in automatic lockdown. By exposing yourself to the very things that set off the downstairs brain in to lockdown (when there is, in fact, no danger at all), you can re-train your brain to reassess the danger appropriately. You will use your upstairs brain to regulate your downstairs brain when it wants to send you into lockdown.
It is important to know that the upstairs part of the brain isn’t fully built until sometime in a child 20’s. This doesn’t mean that this tool isn’t helpful to those who are children or adolescents. In fact, it is even more important for those who are younger. Understanding your brain can help develop the use of the upstairs brain and can benefit then in many, many ways. The goal is to have an upstairs and downstairs brain that communicate and work together.
Discussing Anxiety and the Brain with your Kids
If you are working with young children, try to make it fun. If your child is in lock down, have Bossy Benjamin tell Panicky Pete to “scram!!!!”. You could say, “You don’t belong here Panicky Pete!” You might also ask the lovely Calming Catarina to help with breathing and doing a fun activity that engages your child.
For little kids (and us big Adult kids), you might ask Reasonable Renee to keep and eye on Worried Wanda. Worried Wanda often spends too much time worrying about the future and all the bad things that might happen. Reasonable Renee can help remind Worried Wanda that her imagination has gone a little wild. Reasonable Renee might also sit down and come up with some activities that your child can do when Worried Wanda talks too loud and starts to become a bother. Ideas might include arts and crafts, take a walk, build a lego castle, do a jigsaw puzzle. The trick is to get hat upstairs AND downstairs brain engaged and communicating together!
Play around with some of these ideas and please let me know if you have any great ideas or questions.
Today we are discussing a very valuable mindfulness tool called RAIN. It can be a super helpful way to manage strong emotions and sensations. RAIN can help manage anger, shame, guilt, sadness, depression and pain. I have found this tool to be a particularly helpful tool for those experiencing anxiety or panic, but is also a very helpful tool for strong hair pulling or skin picking urges.
RAIN is an acronym. Each letter represents one step and is a part of a 4-step mindfulness tool.
R is for RECOGNIZE:
The first step is to recognize what is going on in this present moment.
Recognizing gets us to slow down, or stop.
Often, we are so reactive that we don’t stop to notice if there might be another solution or another was to respond.
An example of this might be “Oh, I am feeling hurt right now” or “Oh, I am having a thought about the possibility of me panicking very soon”
We stop to recognize things for how they really are.
A is for ALLOW or ACCEPT:
First, start by saying “YES”
Do not fight that this is what is happening.
By allowing, you are not denying it. You are making room for it in your day
By allowing, you are also not invested in its removal or exit. You are staying present.
An example of allowing and accepting is, “I am going to allow the sensations of anxiety in my body right now. They will not hurt me” or, “This urge to pull my hair is very strong, but I am going to just allow it to come and go. I wont last forever”
I is for Investigate:
When we investigate, we take note of what is going on
We become aware of the real details.
It is IMPORTANT to know that this does NOT mean that you should be thinking about the perceived problem. This does not mean that you should be trying to figure out the perceived problem.
Let me explain using a few examples
E.g. #1. Lets say you have OCD and you have had the thought “What if I go crazy and go on a shooting rampage” (a typical harm OCD thought). Before using this tool, you might immediately feel anxious, and then go into a long process of trying to get rid of that thought and find proof that you would NEVER EVER, EVER do such a thing. You might spend hours going over and over in your head if that would appeal to you or if others would think you are capable of such an act.
Using the I of RAIN, which is investigate, you would investigate what it feels like to have that thought. You would NOT investigate the validity of that thought. The goal is to investigate by saying something like, “Oh, I notice that thought makes my anxiety increase. Isn’t it interesting that my brain and body is responding to this thought this way?”
Example #2: Lets say you have an Eating Disorder such as Anorexia Nervosa, Bulimia Nervosa or Binge-Eating. It is common for someone with an eating disorder to “feel fat”. When someone “feels fat”, they immediately feel fear, guilt and shame about this experience. Using RAIN, the goal would be to Recognize, “Oh, this experience is here again”. Then, one would work on allowing that experience to be present. Using I for investigate, one who experiences the feeling of “being fat” would then investigate what sensations come along with this experience? Do I feel a sense of my body that is different to normal?” or “Do I notice that this feeling immediately makes my heart begin to race?” The goal of investigate is NOT to investigate if that feeling has any validity by checking in the mirror or body fat checking. Investigate is about asking yourself, “what’s going on for me right now? “How does this feel in my body in this moment?”
N: Non-identify:
Non-identify is the act of not taking the experience personally.
When we are uncomfortable, we often identify with the emotion
If you felt anxiety, you might say, “I am an anxious person”
Instead, say, “I am anxious in this moment” or even better is. “There is a lot of anxiety here”
If you feel sad and depressed, you might non-identify by stating, “I notice sensations of sadness” instead of, “I am depressed”
A trick here is to notice if you ever label yourself as one thing. We are never one emotion or one identity. Our work is to not put ourselves in an identity
One last time, RAIN is a super helpful mindfulness tool.
YOUR MINDSET MATTERS: How being in “Yes Mind” can be a game changer for you!
My main goal for this podcast is to create a new approach for handling Anxiety and other difficult emotions and sensations.
During today’s podcast I am talking about being in YES mind, NO mind and MAYBE mind and what that all means in relation to how we approach anxiety and other emotions.
We will conclude with a short mindfulness meditation to help you take on some of the mindfulness skills discussed today.
Some may have heard me speak about this idea of YES NO and MAYBE, but during this podcast I am going into greater detail and discuss why this concept is so important when you live with anxiety, depression or other similar struggles such as eating disorders and BFRB’s.
In order to make this easy to understand, lets pretend you have been asked to present at the annual conference for the industry you work in and you are terrified of public speaking. You can insert your own story into this story (Contamination OCD and you have to go to the hospital for a family member, for example)
You have 3 OPTIONS:
You could say YES:
PRO to saying YES: You might meet new people or make new connections in your industry, it looks excellent on your resume, and MOST importantly, you are not letting anxiety make your decisions.
CON: You have to prepare, and have to manage and tolerate your anticipatory anxiety until the event occurs and the emotions related to worrying how it will go
You could say NO:
PRO: You get the relief of not adding this challenge to your plate.
While that is a pretty sizable PRO, given that anticipatory anxiety can be hard to manage, try to stay open minded about the fact that saying no gives your short term comfort, but leads to longer term discomforts.
CON: You miss out on a huge opportunity to build your public speaking skills and your reputation in your industry. Colleagues might stop asking you to these events and not give you these opportunities in the future.
Biggest CON is that Anxiety wins. Anxiety makes your decisions.
You could say Maybe:
We end up spending the entire time mentally ruminating
You go back and forth, with no real relief from your emotions and feelings and no real success.
Its Repetitious and exhausting.
For those of you who have heard this concept before, or for those of you who are guessing, I am hoping that we can agree that of all the choices, MAYBE is the most dangerous.
For those who thought Maybe was a good choice, lets take a closer look at each option.
When dealing with emotions such as fear, anger, sadness or physical discomfort, even pain, when we choose NO or to be in “No Mind”, we push away our feelings as if this will allow us to move away from the “problem”. The problem isn’t the conference. The problem is that we are saying NO to the conference
There is little mental rumination or review about the decision and if this was the correct decision.
While saying no to going to the conference might seem harmless (no one needs to know), it is an avoidant behavior (one that is quite problematic when you have disorders like OCD, or Panic Disorder, Social Anxiety, Anorexia or other eating disorders), it saves you from having to face your fears or other emotions or sensations. The biggest problem is that your emotions make your decisions and before you know it, the emotion has won. Fear or sadness or anger or even guilt and shame decides where you go, who you meet and prevents you from having many wonderful experiences.
Saying MAYBE is SUPER problematic because it gives you ample opportunity to go BACK AND FORTH and back and forth on the pros and cons of the decision. While some may argue that this is a good thing, it is not for those with anxiety. I like to call this back and forth, “MAYBE mind”.
Maybe mind is
exhausting, time consuming and doesn’t encourage the skill of positive self-assurance (E.g. “I can do this”).
leaves us spending the entire week going over the pros and cons of saying YES to going to the party and the pros and Cons of saying NO to going to the party.
The truth is, when it comes to anxiety, the pros and cons are often the same, no matter what the feared event or situation is.
As mentioned above, the pros of saying “yes” are that you get to live your life, experience more and not let fear make your decisions. The cons are that you having to be willing to experience anxiety. The pros of saying no is that you DON’T have to feel anxiety for the short term, but the con is that you sided with fear and let fear make your decisions (log term consequence).
If you are wondering how this applies to you, lets take a closer look at Yes mind and see how it can help you manage fear, pain, or other uncomfortable sensations. To use the example, saying Yes to speaking at the conference allows you to commit to a life where anxiety doesn’t make your decisions.
Being in “yes mind” doesn’t mean you just say yes to all events that scare you. It is you saying YES to anxiety in general. It is an offering to let anxiety come with you on your journey. It is the commitment to welcoming fear, which is a human experience, into our days and lots getting side tracked with its presence. Being in “Yes Mind” is a mindset. It moves us closer to acceptance of our discomfort and improves our ability to just be in our experience, without fighting it, resenting it or pushing it onto other people.
Why is acceptance and willingness important?
Studies suggest that accepting your discomfort will actually reduce your perceived discomfort.
Some studies have even concluded that when studying patients with severe pain, the acceptance of pain resulted in reports of lower pain than those who were medicated for pain. While these studies are very complex with many complex components, the point is, acceptance works!
When we accepted fear, we use our energy appropriately and productively, instead of wasting energy going over and over how terrible things are (or might be). PS: Remember, this is “maybe mind”.
So, lets try to catch ourselves in NO mind and MAYBE mind. Lets try to stay in YES mind as much as we can, OK?
This months podcast is a guided relaxation meditation. I ADORE this meditation and is one that I have adapted from several meditations that I love. It is super easy and doesn’t require a lot of effort, except just staying with me.
It is particularly easy to use before, during or after doing exposure for OCD or other anxiety disorders. I also encourage this when practicing mindful eating or intuitive eating. It is a great way to direct your attention back to your body and into the moment.
Halloween is just around the corner and we are moving into the holiday season.
You may notice that you can go the whole day without noticing. You are in what I call Autopilot. Much of the time we are so in our head, we forget to be aware
When we experience stress, we assume that something fundamentally is wrong or that a disaster will happen. We become disconnected. We avoid situations. We stop taking care of ourselves. We get irritated. We mentally ruminate. We judge ourselves negatively.
For those who have OCD, you have more obsessions and do more compulsions
For those with an Eating Disorder, you might restrict more, or binge more, or purge more. If you have a Body Focused Repetitive Behavior (BFRB), you will spend more time in a “trance” state.
Awareness can be a VERY helpful tool to protect us against these behaviors.
What is Awareness?
Definition
knowledge or perception of a situation or fact.
concern about and well-informed interest in a particular situation or development.
I particularly love the second definition.
“concern about and well-informed interest in a particular situation or development”
Concern:
Sometime means anxiety or worry (but this is not the way I like to look at it)
Also means interest
The goal is to take more interest in your surroundings or notice the atmosphere of your brain.
“well-informed interest in a particular situation or development”
Well informed:
Rational, reasonable, objective
If I think it, it must be true
Eg: “I can’t do this” (test, get up, stop a behavior that is problematic, get a new job, go to a party etc).
Thoughts without anxiety= no big deal
Thoughts with fear/anxiety: Must be a sign of trouble to come
Being well informed allows us to identify what is a thought and what is a fact, despite what emotion or feeling it is coupled with.
Often, we have thoughts about events of developments that have not even occurred yet. We try to use our thinking as a way to confirm certainty or find the solution.
Let me ask you?
How successful and productive is your thinking about this not-yet-occurring situation?
Could there be peace in not going over every last detail of the possible disaster?
Are we using up THIS present moment to find solutions, without recognizing that RIGHT NOW is still and quiet and safe?
One of the main reasons we mentally ruminate is FEAR. It’s everywhere.
If you have fear, it may not feel safe, but your job is to watch how caught up you get with it. Become more aware of the unrealistic and irrational places it takes you.
You can practice awareness simply by bringing your attention to your surroundings. The 5 Senses Meditation is an easy way to practice this tool.
One of my most favorite ways to managing this is with the following meditation.
The more you practice it formally, the better you become at it.
The better you become at this awareness practice, the more you are able to use it during your busy day, or when distressed, or even panicking. It is an amazing tool. I hope you enjoy it.
Meditation:
Find a position that is comfortable
Put your feet flat on the ground
Slowly close your eyes,
Soften your eyebrows, your jaw, your shoulders, your stomach, your hands, your feet.
Breathe in
Breathe out
Bring your attention to your breath
Notice the rise and fall of your chest
Imagine that your breath is like a swinging door. Each time you breathe in, the door swings to the left. Each time you breathe out, the door swings to the right.
Continue to follow this pattern, just keeping your minds eye on the swinging door.
You may find that your thoughts wonder off. That is ok.
Just gently bring yourself back to the image of the swinging door as you breathe in and out.
Continue to breathe, allowing your breath to decide its own rhythm, and while watching the swinging door swing back and forth gently and evenly.
It is important to remember that it is natural for your thoughts to go off towards something completely unrelated. You may notice that your thoughts often go to very scary or disturbing subjects. You may start to go over all the things you have to achieve later today, or in your life.
When you become aware of this, just come on back. Come back to your breathe, as your anchor. Gently come back to the swinging door.
You may find that you have to do this “coming back” quite a lot. Again, this is totally normal and healthy, showing us that your brain is alive and well. Try not to be hard on yourself for this. The goal is to learn the great discipline of coming back to our present moment and not get caught up in thoughts that are not helpful.
Continue to practice this, noticing your breath and the swinging door.
Slowly, bring your attention back to your body
Slowly open your eyes
Congratulate yourself for trying as hard as you did.
May this practice bring you strength and compassion with the thoughts that you have.
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I hope you have enjoyed this episode of My Anxiety Toolkit. My name is Kimberley Quinlan.
This podcast is not intended to replace correct professional mental health care. Please speak to a trained mental health professional if you feel you need it.
Self-Compassion is a helpful tool for managing shame and blame and negative self-talk. It is particularly, in my experience, helpful for those struggling with OCD, Panic Disorder, Phobias, Health Anxiety, Body Focused Repetitive Behaviors, Eating Disorders and Depression.
The Center for Mindful Self Compassion (centerformsc.org) describes self-compassion in the following way-
“Self-compassion involves responding in the same supportive and understanding way you would with a good friend when you have a difficult time, fail, or notice something you don’t like about yourself.”
Self-compassion is Kindness, Warmth, Gentleness and Care.
When I talk about the practice of self-compassion, I use the metaphor that self-compassion washes away shame and blame like the rain washes away the dirt on our cars. As the rain gently falls, the dirt slowly falls away. Once the rain has come and gone, there is less heaviness and dirt on the car. It is easier to see out the windows and now you can see the beautiful fields and trees that you pass on your way to work or school.
A part of this metaphor includes this final sentiment. Even though the rain has come and gone and the car is mostly cleansed of its dirt, there is still slight streaks of the dirt left behind.
As much as I would love to say that self compassion will wash away all of the dirt and dust on the car, this is not realistic. The tiny little streaks left behind is a reminder that compassion is a job that is never over. It must be practiced over and over, for the years to come.
This podcast offers a meditation that uses the basics of Kristin Neff’s self compassion research, including the three elements of self compassion. For more info go to selfcompassion.org Check out this episode!
Shala recently wrote an awesome blog post article about a top women’s magazine that posted an article encouraging readers to “be a little OCD!” Shala declared enough was enough and got writing. Shala and her ROCKSTAR mom are doing so much to advocate for the OCD community. See the below link to check it out.
This podcast is based on the phrase, “It takes a village to raise a child“. This phrase is used often to explain the importance of community when raising a thriving and successful child. We believe that you can create your own “micro-village” to help you along with your recovery.
What advice do YOU give to the family members of those who are struggling with mental health issues such as Obsessive Compulsive Disorder (OCD) and Body Focused Repetitive Behaviors (BFRB’s) or Eating disorders?
This struggle is real and IMPORTANT. You are not making this struggle up. If it is hard for you, it IS hard. Just because it isn’t hard for others, does NOT discount that it IS hard for you. Be gentle with yourself. You are not dumb, or stupid, or messed up because this struggle is so hard for you. There is no rhyme or reason why this struggle chose you. All I can say is that it is yours and you are correct. IT IS HARD.
