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Hi there, Huddlers. We start Community Time sharing a moment from the week where we are proud of how we related to our private experience. This week, I want to elaborate on why we do this.

The Huddle.care schedule this week is:

Community Time - Mondays at 8pm CT

Any and all content - Tuesdays at 4 pm CT

Any and all content - Tuesdays at 7 pm CT

Any and all content - Tuesdays at 8 pm CT

Any and all content - Wednesdays at 7 pm CT

Any and all content - Thursdays at 7pm CT

Any and all content - Fridays at 2 pm CT

If you try to sign up for a group, but the sign-up is closed, email me so I know that there is extra interest in that time.

Content for review: Donate to Get Peace, Give Peace

Listen to my interview on The OCD Stories PodcastReview the Huddle.care Core ValuesReview the Huddle.care Curriculum infographicReview the Huddle.care Self-monitoring infographic

MoreEffectiveMoments When you click on the button below, you'll be redirected to a secure form where you can share your moment. Follow the prompts when you submit your moment and explain how what you did was effective. I'll give you an animated character and post it to Instagram.

Edited transcript:

The interpretation of a moment of high physiological arousal as a threat or danger is an experience that your mind is co-creating with your brain. You aren’t making up what you feel. Those sensations and feelings are very real. You are making up what it means. Sometimes a racing heart is a good workout and sometimes it’s a reason to panic. Sometimes when your stomach aches you are hungry and sometimes you miss someone. Even feelings that seem objective, like hunger, are dependent on how you’ve responded to it in the past.

We have to stay awake to our experiences to understand what’s happening within us and respond effectively. Notice that I’m using the word effectively, not accurately. We are not striving to respond to ourselves and our environment accurately, as if there is an objective reality. We are co-creating reality with our environments. In striving to respond effectively, we can use the human proclivity to add meaning to experience to create lives that are more and more values-driven. Put another way, if you pay attention and learn to read your feelings well, you can add meaning that helps you build your life in a way that is more and more meaningful to you over time.

Your interpretation matters

Here’s an example of how interpreting your experience with shame will impact you:

You experience anticipatory anxiety before something you care about.

You add the interpretation: “This feeling means I can’t do it. I shouldn’t have this feeling. I’m not good enough. I should feel confident and competent. I don’t feel that way so I should quit. I’ll never be happy as long as I have this feeling.”

You avoid the thing you care about or you bear it with dread and fear. You add self-criticism for avoiding or for not doing your best. You lose motivation to do the thing you value in the future. You are further from valued-based behavior in the future.

Here’s the same experience interpreted with pride:

You experience anticipatory anxiety before something you care about.

You add the interpretation: “Yes! Look at me! I found something that I care enough for my body to pump me with adrenaline to prepare for it. This is great! What an opportunity for me! I’m going to do my best and see what opportunities this creates for me.”

You then try as hard as you can at your valued-based behavior while feeling anxious and uncertain. You learn whatever skills are relevant while you’re practicing the thing you value. You gain new opportunities because you have new skills. It’s easy to feel compassion towards yourself for the way your body reacted before the valued-based behavior. Your insomnia and diarrhea and muscle tension and catastrophic thinking were just the result of the extra adrenaline your brain gave you. It’s easy to feel proud because you know your own experience and you can tell that that moment was the next step for you. Great job. Keep going.

Shift from avoidance and shame to connection and pride

Bringing us back to Community Time, we’re trying to shift from feeling ashamed about moments of anxiety, OCD, and depression to interpreting these experiences as opportunities for connection and pride.

Some of you have known each other for years. Isn’t it awesome to hear how people grow? It feels great to hear when someone without work finds a job they like or when someone who was struggling with dating finds someone they love. It feels great to hear people who used to be totally stuck in worry, OCD, or depression describe how they got out. You might notice that your feelings towards fellow Huddlers when they describe progress are more positive than hearing the same thing in everyday life. How come? It’s because you heard their internal process.

As you hear the details of other people’s experiences, you had two experiences: Some of what they said totally resonated with you and it felt very human and connecting for you. Some of what they said didn’t resonate at all and you realized that your life path is completely different and incomparable to them. The combination of these two experiences made it easy for you to feel connected without comparison or competition.

In everyday life, most people don’t describe their internal experience unless you know them really well (and ask them about it with curiosity and acceptance). One way to understand the urge to compare and compete is that it’s a misunderstanding that everyone is on the same or a similar path. That’s not true. Once you start to see the subtle differences between your path and that of those around you, comparison isn’t useful or relevant.

Hopefully, you have friends and family who share their ups and downs of their internal process in a way that gives you a genuinely positive feeling when you see them grow. Children often naturally provoke this feeling in us. You know the baby not walking, so walking is just miraculous. You know the child not talking, so reading is miraculous.

I’m trying to provoke this same type of experience in you, towards yourself. You know yourself stuck in anxiety, OCD, and depression. I feel proud when I see you taking steps to get out. If you let yourself interpret that experience the same way — with pride — you’ll have natural motivation to keep going.

When we share what we are proud of in Community time, we are celebrating progress. We are giving each other ideas for how to respond to anxiety, OCD, and depression effectively. Most importantly, we are learning to accept ourselves exactly where we are. We are developing self-trust, self-esteem, and self-confidence from owning our own process.

So, what are you proud of this week?

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Hi there, Huddlers. Great week. This week, we’ll discuss Strategies Module 6: Redirect rumination.

We’ll discuss rumination and how it compares to worry this week. Here are some dimensions about which you can think about rumination to get us started.

Ego-orientation: Ego-syntonic, meaning that ruminative thoughts seem believable to the thinker.

Time orientation: Past

Content: Churning through memories to figure out why you feel helpless, hopeless, worthless, sad, guilty, lonely, or angry.

Beliefs that maintain it: “If I feel hopeless, helpless, or worthless, that means that I am.” “Feelings mean something. I wouldn’t be feeling this if it wasn’t true.”

The function that maintains it: Helpless, hopeless, and worthless feelings arrive and the thinker buys into and expands on the thoughts that come with it.

The Huddle.care schedule this week is:

Community Time - Mondays at 8pm CT

Any and all content - Tuesdays at 4 pm CT

Any and all content - Tuesdays at 7pm CT

Any and all content - Tuesdays at 8 pm CT

Any and all content - Wednesdays at 8 pm CT

Any and all content - Thursdays at 7pm CT

Any and all content - Fridays at 2 pm CT

If you try to sign up for a group, but the sign-up is closed, email me so I know that there is extra interest in that time.

Content for review: Donate to Get Peace, Give Peace

Listen to my interview on The OCD Stories PodcastReview the Huddle.care Core ValuesReview the Huddle.care Curriculum infographicReview the Huddle.care Self-monitoring infographic

MoreEffectiveMoments When you click on the button below, you'll be redirected to a secure form where you can share your moment. Follow the prompts when you submit your moment and explain how what you did was effective. I'll give you an animated character and post it to Instagram.

Edited transcript:

Rumination as a repetitive negative thinking state is triggered by pervasive negative beliefs. It is a sticky thinking pattern that shows up habitually when triggered by certain environmental or internal states.

Pervasive negative beliefs and rumination

High anxiety isn’t the consequence of lots and lots of anxiety, but rather an anxiety state plus a secondary interpretation of the state as a threat itself (also called second fear). Similarly, depression isn’t lots and lots of sadness, but rather an uncomfortable feeling (like sadness, guilt, loneliness, anger) plus an interpretation of that feeling that you are hopeless, helpless, or worthless because of it.

As an example, everyone feels lonely sometimes. Loneliness can be a clean or clear emotion if you notice it, and think “Everyone feels this way sometimes. It’s painful to feel isolated and disconnected.” If you don’t add any more to that, the feeling is likely to peak and pass or to give you information on an action that might be beneficial for you, like reaching out to a friend.

A more common experience of loneliness is that when the feeling of loneliness shows up, you think “what is wrong with me? why do I always feel this way? I’m such a loser for feeling like this…” These thoughts are likely to trigger feelings of hopelessness, helplessness, or worthlessness. Specifically,

Helplessness – “There’s nothing I can do to make this better.”

Hopelessness – “Things will always be this way.”

Worthlessness – “This is because of me. I am worthless and unlovable.”

Behavioral activation is the main intervention for these types of thoughts and feelings because we want to give your body and mind the opposite experience. We want you to experience behaviors and feelings that make you think: “Things in my life change. My life can change based on my action. People like me and I feel connected to them when I take effective action.”

That said, I am aware that worthlessness often feels like a blanket. If you are starting to or have lost interest in activities you usually find pleasurable, it is the feeling of worthlessness that is clouding your interest. You often have to act as though you aren’t feeling hopeless, helpless, or worthless over and over until those feelings actually fade. Think of it like doing lots of anxiety exposures before a trigger no longer gives you anxiety.

What can we learn about rumination from worry?

Rumination is to your past what worry is to your future. When anxious, you are prone to ask, “what if?” When hopeless, helpless, or worthless, you are likely prone to ask “why?” You will have the urge to replay past memories in an attempt to figure out why you feel the way you do, and whether or not you deserve it. This is called rumination.

Worry is a repetitive negative thinking state triggered by anxiety sensitivity and intolerance of uncertainty (and often other mechanisms too). When you perceive a threat, your body experiences fight-or-flight sensations and catastrophic future-oriented thoughts. To overcome worry, you have to predict that it is coming and then be ready to get distance from your catastrophic thoughts. If when a “what-if” thought shows up, you engage it and keep it going, you are going to fall into a worry spiral.

We want to learn to use the same skills with the urge to ruminate. That is, we want to try to predict the triggers that provoke feelings of hopelessness, helplessness, and worthlessness, and then have a plan for redirecting your attention back to the present moment, rather than ruminating about the past.

What’s the difference between rumination and introspection?

Introspection is a chosen thinking state. Like choosing to be in a conversation with a friend and choosing to either discuss a certain topic or change the topic, introspection is a chosen conversation with yourself. You can keep it going or choose to think about something else. You don’t need to figure out whatever you are thinking about at the moment. Reflective introspection starts and stops based on your decision.

Reflective introspection is different than rumination the way that problem solving is different than worrying. During both reflective introspection and problem-solving, you are choosing to bring your attention to the relevant topics and your attitude towards them is one of curiosity and hopefulness. Put differently, attempting to problem-solve or reflect assumes that your action will have positive consequences. It is an assumption of hope.

Overcoming rumination

Here’s your plan for overcoming rumination. Let’s discuss where you get stuck in Community Time.

Self-monitor to figure out what triggers feelings of hopelessness, helplessness, or worthlessness.

Use behavioral activation to redirect yourself to the present moment when depression zaps your energy.

Write out the memories that your mind often uses against you when you are ruminating.

Make a plan to discuss content about which you actually feel hopeless, helpless, or worthless in therapy.

We can’t prevent feelings like sadness, loneliness, guilt, or anger from arising, but we can work on how we respond to those feelings. You are on your way towards overcoming depression if, when you feel these feelings, you challenge the urge to ruminate in both your thoughts and your actions. If you’re having trouble consistently challenging the beliefs that maintain rumination, group is a great place to discuss where you are getting stuck.

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Hi there, Huddlers. Great week. This week, we’ll discuss Strategies Module 5: Mental compulsions function like behavior.

Once they learn about cognitive behavioral therapy (CBT), most people can immediately tell that how they think impacts how they feel, how they feel impacts how they behave, and how they behave impacts how they think. OCD treatment, in particular, has a heavy emphasis on exposure and response prevention (ERP). The goal of ERP is to expose you to anxiety-provoking stimuli and get you to refrain from doing anything to manage the anxiety. Instead, you wait for the anxiety to pass. That moment of ERP is uncomfortable, but in the future you will get relief. You, Huddlers, know this and have already worked on it with physical compulsions. Let’s talk more about this so you understand how to use the same technique for your mental compulsions.

The Huddle.care schedule this week is:

Community Time - Mondays at 8pm CT

Any and all content - Tuesdays at 4 pm CT

Any and all content - Tuesdays at 7pm CT

Any and all content - Tuesdays at 8 pm CT

Any and all content - Wednesdays at 8 pm CT

Any and all content - Thursdays at 7pm CT

Any and all content - Fridays at 2 pm CT

If you try to sign up for a group, but the sign-up is closed, email me so I know that there is extra interest in that time.

Content for review: Donate to Get Peace, Give Peace

Listen to my interview on The OCD Stories PodcastReview the Huddle.care Core ValuesReview the Huddle.care Curriculum infographicReview the Huddle.care Self-monitoring infographic

MoreEffectiveMoments When you click on the button below, you'll be redirected to a secure form where you can share your moment. Follow the prompts when you submit your moment and explain how what you did was effective. I'll give you an animated character and post it to Instagram.

Edited Transcript:

The nature of obsessive thoughts is that they are unwanted and intrusive. They arrive with a spike of anxiety or uncertainty and the urge to do something that makes them stop. Behavior that you feel compelled to perform, against your conscious wishes, with the sole intention of ending a thought, feeling or sensation is a compulsion.

Let’s discuss the nature of compulsions in greater detail so that we have shared language to understand mental compulsions.

What is a compulsion?

Here is a list of common physical compulsions:

Excessive hand washing or bathing

Checking locks or appliances

Checking that you haven’t made a mistake

Checking that you did not or will not harm yourself or others

Checking your body for sensations or your mind for thoughts and feelings

Rereading or rewriting

Repeating routine activities like moving a chair up and down

Counting

Excessive list making

Needing to tell, ask, or confess what you are thinking

Needing to touch or tap

Needing to arrange or order objects

Hand washing and all other behaviors listed above becomes excessive and problematic when the function of the behavior transitions from problem-solving to anxiety reduction. When your hands are visibly dirty or your body is sweaty or smelly, washing is problem-solving. When you have the thought that you are contaminated and the feeling of anxiety and you feel compelled to wash until the anxiety is gone, washing is a compulsion. Some people follow rules like “It’s okay for me to stop washing after I repeat my ritual 3 times or after a certain amount of time.” Other people wait for the just-right feeling to stop washing. Many people who engage in compulsive behavior have rules for some situations and use their feelings as criteria for when to stop in other situations.

Here are some common misunderstandings about obsessions and compulsions:

How do I know I’m having an unwanted intrusive thought? If you have been stuck in a particular content for a long time, you may feel confused by the “unwanted” part of the definition of an obsession. For instance, those suffering from OCD with sexual orientation content might think, “how do I know if this is unwanted? What if I want to be having this sexual thought and that’s why it’s so frequent?” This can make it challenging to take the leap of faith and label the thinking pattern as OCD. If you are stuck wondering whether or not your thought is unwanted (and what it means about you if the thought is or isn’t unwanted), try asking yourself, “Did I choose to think about this? If I could think about anything in the world right now, would I direct my attention at this? Would I purposely choose to talk about it and google this rather than all other things that interest me?” If your answer is no, you wouldn’t choose to think about it, then you are suffering from unwanted thoughts. Everybody sometimes has unwanted thoughts, but not everyone has unwanted thoughts that trigger anxious sensations, create preoccupation, steal time and energy, and compel them to act in ways to make the thoughts go away. It’s really challenging to get out of this type of mental trap. I hope you don’t feel self-pity, but you do feel self-compassion about suffering in this way.

What is problematic about rule-based or feeling-based compulsive behavior? We talk a lot about flexible behavior in Huddle.care. People who don’t engage in compulsive behavior have “flexible” behavior in the sense that the function of their behaviors are problem-solving and the solution is different every time. As an example, in some bathrooms, you have access to soap and paper towels. At other times, you don’t. Can you problem solve with whatever the situation calls for and redirect your attention to the present moment if you aren’t able to use your rules for getting clean? The problem with using rules or just-right feelings to make decisions is that unless you rigidly narrow your life options, you will face situations where your rules don’t apply or your just-right feelings feel more and more elusive. You also miss out on the opportunity to become confident in yourself and your ability to adaptively problem solve, if you are drawing your sense of security from rules.

What’s the difference between compulsive feeling-based behavior and intuition?Some people believe strongly in making decisions based on feelings and intuition and don’t like the idea of giving up “feeling-based” decisions. The problematic form of feeling-based decisions is when you are rigidly trying to achieve a certain feeling state, specifically the certainty feeling state. When you are open and accepting to all feeling states, then your feelings can actually be data and you can make intuitive decisions based on the information you receive from your feelings. For instance, if you befriend the feeling of anger without judging, resisting, or fueling it, the feeling of anger can give you important data about your environment and your relationships. If you are trying to control your behavior to achieve certain feeling states and calling that intuition, it will be hard for you to develop a deep confidence in your ability to respond well to all feeling states.

What’s the difference between addictive behavior and compulsive behavior? Compulsive behavior is differentiated from addictive behavior based, per usual, on its function. Addictive behavior may also eliminate or reduce thoughts, feelings, or sensations, but its primary function is to achieve the state to which you are addicted. Just like compulsive behavior, addictive behavior is defined by impairment and distress. Washing your hands is workable until your hands are dry and sore and you are late for other commitments. Eating sugar or drinking alcohol can also workable behaviors, until they are not. In both compulsive behavior and addictive behavior cycles, you will feel an urge to engage in the behavior. When you have an addictive urge, you typically want to engage in the behavior, although you might not want the consequences of the behavior. For example, you want the drink or the cigarette, but you don’t want the health or social consequences of drinking and smoking. Comparatively, when you have the urge to compulse, you don’t want to engage in the compulsion. You feel compelled to either out of fear of the potential consequences of not compulsing or because of the anxiety you’d have if you didn’t compulse.

What do you mean by flexible, adaptive problem solving, rather than compulsing? How do you know when to stop washing your hands? Stop washing your hands when your hands aren’t dirty, as opposed to when your anxiety is gone or after you followed your rule. Fear of contamination is an easy example to explain. Can you see the parallels to other content areas like fear of harm to self or others or perfectionism about performance, emotions, relationships, and life choices? In all cases, we’re trying to problem solve, rather than reduce anxiety.

How do you know whether you made a mistake or hurt someone? Well, did you hurt someone? Make a decision about this question and live in it, rather than replaying it until you have certainty. In group, I asked everyone about this one, including those that don’t have OCD about it. “How do you know you won’t hurt a kid?” Think about your answer for a second. Your answer — like everyone else who doesn’t purposefully hurt kids — is “I don’t know.” You just don’t fear and resist the fact that you don’t know and in turn, your body doesn’t give you the feeling of uncertainty. You feel like you know only because you don’t resist against feeling like you don’t know.

How do you know whether you are spending your time, energy, and resources correctly or with the right person or people? First, there isn’t a right answer to this question. Second, any answer can be workable. Are you willing to accept your actual life choices in the presence of uncertainty? Notice how many opportunities for happiness open up when you give yourself permission be present in your actual life rather than trying to figure out whether that is the right decision.

Mental compulsions

Now that we’re on the same page about compulsions overall, a mental compulsion is a compulsive thought pattern that you feel compelled to engage in with the function of reducing your anxiety or uncertainty, just like physically counting or checking.

The texture of mental compulsions is uncomfortable, sticky, and anxiety-provoking. You don’t really choose to think like this, although it may feel like you want to keep doing it, because of how you’ll feel if you don’t do it. It’s different than worrying, where you’ll notice more what-if thinking about the future. It’s different than ruminating, where you’ll notice negative self-beliefs, self-criticism, and guilt and shame. When people who engage in mental compulsions describe their experience, it sounds like this, “I’m afraid of this very specific possibility and I’m going to think about it in a really specific way to make my fear and uncertainty go away.”

If you mentally compulse a lot, you probably have rules for it to cut it short. An example is replaying your drive or some other experience quickly and in a certain way to get the feeling of certainty that you didn’t hurt anyone. Even if this doesn’t take up a lot of time or energy, every time you engage in this type of compulsive thinking, you miss an opportunity for more flexible problem solving and you miss an opportunity for an increase in self-confidence. Plus, you reinforce the idea that you have to think like this in similar situations in the future.

To overcome it, go back to the basics with exposure and response prevention. Once you figure out what triggers your mental compulsions, you’ll want to expose yourself to that trigger on purpose and then specifically refrain from your mental compulsion by redirecting your attention. If it feels anxiety-provoking to distract yourself away from your mental compulsion, you’re doing the exposure correctly.

In Community Time this week, we’ll discuss your examples of mental compulsions and how to design an exposure and response prevention strategy to overcome it. Can’t wait to see you!

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Hi there, Huddlers. Great week. This week, we’ll discuss Strategies Module 4: Play with worry.

What if hanging out with your mind was fun? What if it felt like playing? You can get your mind back. Your thinking process is made up of beliefs and habits. Some habits are automatic. Some habits are functional. Worry can be a habit and it can function as a way to reduce uncertainty and painful emotions. We’ll talk about all of it, so you and your mind can go back to playing.

The Huddle.care schedule this week is:

Community Time - Mondays at 8pm CT

Any and all content - Tuesdays at 4 pm CT

Any and all content - Tuesdays at 7pm CT

Any and all content - Tuesdays at 8 pm CT

Any and all content - Wednesdays at 8 pm CT

Any and all content - Thursdays at 7pm CT

Any and all content - Fridays at 2 pm CT

If you try to sign up for a group, but the sign-up is closed, email me so I know that there is extra interest in that time.

Content for review: Donate to Get Peace, Give Peace

Listen to my interview on The OCD Stories PodcastReview the Huddle.care Core ValuesReview the Huddle.care Curriculum infographicReview the Huddle.care Self-monitoring infographic

MoreEffectiveMoments When you click on the button below, you'll be redirected to a secure form where you can share your moment. Follow the prompts when you submit your moment and explain how what you did was effective. I'll give you an animated character and post it to Instagram.

Edited Transcript:

Hi there, Huddlers. Thanks for your time. I appreciate the chance to spend time with you. Today we are going to play with worry by sorting through all the ways it is maintained.

Let’s talk cognitive process. Your process for any task is your series of steps to achieve your end. Your process for brushing your teeth or cleaning your kitchen may seem to you like “that’s just how you do it,” but if you surveyed the next 10 people you encounter it is very likely that their process for those tasks are not as similar as you were expecting.

For worriers, the mental process of worrying might otherwise be described as thinking. Where does your worry end and your thinking start?

To sort this one out, first off, bring attention to and get control over any functional worry that you experience.

Worry as a function is a cognitive form of experiential avoidance, similar to thought control or thought suppression. In thought control and thought suppression, individuals make active attempts to stop thinking about the stimulating topic and distract themselves. When worrying as a cognitive avoidance, you might feel like you are thinking a lot about the topic and even feel completely preoccupied with it. This form of worry is problematic when you don’t feel like you get to choose to think about it and when the thinking you are doing is not becoming problem-solving. If you have fallen into the habit of worrying as experiential avoidance, you probably don’t know what you feel about the content that preoccupies you. Another clue is that you can’t stop thinking about it, but you don’t want to talk about it. You feel an aversion to anyone asking you about it, you don’t want to discuss it in psychotherapy, and if you were to try to write out what you are worried about, it would either be very hard to do or feel very uncomfortable for you.

Here are some questions to ask yourself if you are experiencing worry as experiential avoidance:

If I didn’t feel anxiety, what would I feel? (examples: sadness, anger, guilt, fear, regret, jealousy, embarrassment, NJR)

If I was going to take action on this topic, rather than worrying about it, what is my next step?

Is there anything I can actually do differently?

We’ll also discuss mental compulsions, rumination, and post-event processing over the next several weeks. These are triggered thinking patterns. There are external circumstances or internal thoughts, feelings, and sensations that make these responses more likely in your thinking. To overcome mental compulsions, rumination, and post-event processing, observe what triggers it, what keeps you fused to the content when it arrives, and what you feel. We can work together to challenge the beliefs that keep you fused to the content and to stay present to the feelings. You’ll need to be ready for trigger, ready to get distance when the fused thoughts show up, ready to show compassion to your feelings, and ready to bring yourself back to the present moment.

Finally, let’s sort through what maintains the rest of your worrying. This part is some combination of habit and belief in the utility of worry.

Here are some possible beliefs that maintain worry:

Worry reduces painful emotions. (This is functional worry.)

Worry increases my self-esteem, by making me feel in control.

Worry prevents catastrophe, because I have control over what I worry about.

Worry helps me solve problems.

Worry motivates me, because it makes me aware of everything that could go wrong.

Her are some workable functions of worry:

Short-term reduction in painful emotions.

Short-term reduction in uncertainty.

Short-term increase in self-esteem.

Short-term increase in self-efficacy.

Here are some unworkable functions of worry:

Long-term increase in painful emotions.

Long-term increase in sensitivity to uncertainty.

Long-term reduction in self-esteem.

Long-term reduction in self-efficacy.

Long-term narrowing of options.

To break the habit of worry, you have to work at it and you also have to have compassion on yourself during the process. If your teeth-brushing process did not involve flossing and your dentist told you to floss, would you think, “Well, that’s your opinion…” or “I’m just a bad person for not having this step in my routine?” I hope not. The more helpful response would be, “That seems like it would be helpful, and it will be challenging to change this habit. But, I care about my health, so I’m going to try. What can I do to help myself be most likely to change this habit?”

Try to think about your mind and your mental habits this way too. There is nothing inherently wrong with you if your mind happens to worry a lot. But, it is a habit that causes a lot of suffering and sensitizes you to other suffering-inducing response mechanisms, like avoidance and rumination. The habit or process of worrying can also just make life feel more urgent, less safe, and more stressful than it needs to be.

Worry can occur when you have the feeling of uncertainty about an unanswerable question and you try to make the uncertainty dissipate by answering the question. Worry is productive when the question is answerable and the attempts to answer it result in problem-solving. Worry is not productive when the question is unanswerable and the attempts to answer it creates more questions plus worry about worry (that is, “what if I can’t stop worrying?”). Read more about productive and unproductive worry here.

Scheduled worry time is the most of effective intervention for worry as a function.

When the main function of your worry is to avoid or suppress uncomfortable sensations and feelings (that is, experiential avoidance), the best thing you can do is go towards it until it is boring. Write out all of your fears and then say them over and over until it is no longer distressing.

Notice the dimensions above. Scheduled worry time should challenge the idea that worrying is reasonable. The time orientation and content don’t matter. If your worry is not also maintained by actual problems to solve or beliefs about the utility of worry, scheduled worry time should challenge the function of your worrying and break your habit.

Scheduled worry time involves setting aside 10 minutes per day twice per day to worry aloud. During this exercise, you should plan what you will worry ahead of time, writing down everything you worry about in the format:

“What if _(catastrophic thought)__?”

Do not problem solve or answer the question, just write a list of the things you worry about. As an example, the list might include:

What if I don’t get where I need to be on time?

What if my car breaks down?

What if my child gets sick?

What if something terrible happens to me?

What if there’s something wrong with my mind?

What if I feel embarrassed at the upcoming event?

What if I’m not prepared for the thing I need to prepare for?

What if ____ is mad at me?

What if I do something that causes people to dislike me?

What if I fail?

What if I make a mistake at the thing I’m trying and maybe I don’t fail but it has some other catastrophic consequence?

What if worrying so much means something bad about me?

What if anxiety isn’t my problem?

What if I’m anxious forever?

What if this technique doesn’t work?

Your list can be as short or long as you want it to be and you can add to it over time. It’s important that you continue to worry out loud, in a mirror for 10 full minutes, even if you only have a minute or two of worries. By repeating the worries over and over you will likely start by feeling anxious, but finish the task feeling bored.

The point is four-fold:

Contain the worries to one part of the day and have a place to “put” worries that pop up in the middle of the day, thinking “Oh. Let me get back to whatever I’m doing. I’ll worry about that later.”

Desensitize yourself to the thoughts themselves, by hearing them out loud in your own voice.

Learn to see your worries as chatter, that just pops up when you feel anxious, not as content that is important to respond to.

Cue yourself to respond to the thoughts as worry when they intrude in your mind at other times, not as content that is important to respond to.

When you’re ready to commit to breaking the habit of worry:

1. Start with scheduled worry time and observes in your experience over 5-7 days.

2. Identify the beliefs you have about worry and the workable vs. unworkable functions it has in your life.

3. Once you are tracking your worries, differentiate between answerable and unanswerable questions, in order to turn unproductive worry into productive worry.

4. Take action on answerable questions that have solutions.

5. In everyday life, notice worries as they arrive and redirect your attention back to the present moment.

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Hi there, Huddlers. Great week. This week, we’ll discuss Strategies Module 3: Embrace fear of evaluation.

That’s right. Don’t challenge it. Don’t restructure your thoughts. Embrace your fear of evaluation, like it’s an adorable puppy. You might be judged. Great! It might be embarrassing. Awesome! Welcome to humanity! Sounds like you’re following your values. Go after stuff you care about and live with the chance that others don’t like it.

The Huddle.care schedule this week is:

Community Time - Mondays at 8pm CT

Any and all content - Tuesdays at 4 pm CT

Any and all content - Tuesdays at 7pm CT

Any and all content - Tuesdays at 8 pm CT

Any and all content - Wednesdays at 8 pm CT

Any and all content - Thursdays at 7pm CT

Any and all content - Fridays at 2 pm CT

If you try to sign up for a group, but the sign-up is closed, email me so I know that there is extra interest in that time.

Clinicians, I’m hiring group leaders at a competitive hourly rate. Interviews begin in October. Email me at maggie@huddle.care for more information.

Content for review: Donate to Get Peace, Give Peace

Listen to my interview on The OCD Stories PodcastReview the Huddle.care Core ValuesReview the Huddle.care Curriculum infographicReview the Huddle.care Self-monitoring infographic

MoreEffectiveMoments When you click on the button below, you'll be redirected to a secure form where you can share your moment. Follow the prompts when you submit your moment and explain how what you did was effective. I'll give you an animated character and post it to Instagram.

Edited Transcript:

Hi there, Huddlers. Thanks for listening. I appreciate the chance to spend time with you. Social anxiety is maintained by resistance to the possibility of judgement and rejection, due to intolerance of the feeling of embarrassment and shame and/or catastrophic thinking about the consequences of judgment. Let’s call this fear of evaluation.

Notice my focus on the possibility of judgment and rejection. It’s always a possibility. Remember from our discussion last week that one form of inflated responsibility is trying to control what other people think, feel, do, or say. One thing none of us can control is how other people perceive and respond to us. All the time. It’s always uncertain. We never have any control over it.

Some of us persistently having the feeling of certainty about relationships. What a gift. My sense is that a lot of people don’t have the good fortune to persistently feel safe and certain about all of their relationships across their life. As you reflect on it, can you tell that in some relationships, you do feel persistently comfortable? Do you have any relationships where you feel like you always know the type of interaction you are going to have and in that relationship you will feel safe? I hope you have that template somewhere, if only at Huddle.

I’m constantly thinking about the interaction between your biological vulnerabilities, your life experiences, and your present day cognitive and behavioral patterns. Your biological vulnerabilities make you vulnerable to sensitization. Your life experiences will make some situations more sensitizing than others. Your present day reactions to your biological vulnerabilities and your current life circumstances will play out as cognitive and behavioral patterns that either maintain and intensify your suffering or alleviate it and reduce it in the future.

Let’s apply this to fear of evaluation. Biologically, if you are sensitive to the feelings of embarrassment, shame, and loneliness, the possibility of those feelings is going to seem like a threat. Everyone feels embarrassed sometimes and everyone sometimes feels lonely. If, when you feel those feelings, you criticize yourself, these feelings become bigger threats. If you avoid experiences that might make you feel embarrassed or lonely at all costs, situations that could trigger those experiences will give you anticipatory anxiety and begin to feel like triggers.

Thinking about life circumstances, fear of evaluation can be prominent for both people who have been judged and rejected a lot and those who have never beeen judged or rejected.

Notice that your reaction to your own history of rejection matters more than your actual experience.

You could think, “I’ve been rejected so many times that I just can’t bear it again.”

OR, you could embrace it as an opportunity:

“I’ve been rejected so many times… And, here I am! I can handle it! Rejection doesn’t scare me!”

Similarly, you could think, “I’ve never been judged or rejected in a significant way before. If it were to happen, it would ruin my life. I can’t make mistakes because I can’t risk being rejected.”

OR, embrace that as an opportunity:

“I’ve never been rejected, so I wonder what would happened if I tried? If I tried something uncertain, where I might not success, would something catastrophic actually happen or would I just handle it?”

The important message here is that your response to your present life circumstances is more important for overcoming social anxiety than “processing” the emotions from your history. And, social anxiety is common for those without traumatic interpersonal histories, too.

That said, if you’ve lived through traumatic interpersonal experiences — including but not limited to persistently critical, rejecting, or emotionally neglectful parents, bullying, ostracization, shaming, and discrimination due to factors like gender, sexuality, race, religion, nationality or political beliefs — new experiences where you might feel judged might, understandably, give you some anticipatory anxiety. Before, during, or afterwards you might have memories of previous experiences and ruminate about them.

It’s still important for you to notice your catastrophic thinking about being rejected and the sensations and feelings that show up as the consequence of those thoughts. Allow the sensations while getting distance from the thoughts. If you automatically ruminate or start building a case, you are likely feeling angry. Let’s talk more. If you automatically have memories that are intrusive to you, let’s talk more about all of the different feelings you have about those memories. As you identify and accept those feelings, those memories will start to feel like memories, not intrusions that can attack you at any time.

Let’s discuss some of cognitive and behavioral patterns that maintain or intensify social anxiety.

When you notice that you feel sensitive, insecure, or embarrassed about something that someone else could judge:

Don’t minimize and don’t hedge. Refrain from making a joke about yourself, your appearance, or your performance at the task. Making fun of yourself before others due does not protect you from embarrassment.

Don’t try to figure out what other people are thinking. Whether through the questions you ask or the replay in your head, it might feel like you have more control if you think you know what others are thinking. You don’t know. You can’t know. Act how you want to act and let go of trying to control how others respond.

Don’t ask for reassurance and don’t check messages or social media. You can tell by the feeling in your body whether the texts you are sending or what you are posting on social media is a preference or a compulsion. If it feels urgent, and like you need to do it, slow down. Observe what you are thinking and feeling. What do you fear? Is it actually happening? If it happened, what skills do you need to access to handle it?

Fear of evaluation is a complex mix of your biological sensitivity to embarrassment, shame, and loneliness + your reactions to your previous experiences + your cognitive and behavioral responses to your current life. Let’s talk more about all of it.

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Hi there, Huddlers. Great week. This week, we’ll discuss Strategies Module 2: Inflated responsibility is excessive.

Inflated responsibility occurs when you take too much responsibility for an internal or external state due to the feeling of guilt. Your feeling of guilt is excessive. It is a feeling, not a fact, message, or threat.

The Huddle.care schedule this week is:

Community Time - Mondays at 8pm CT

Any and all content - Tuesdays at 4 pm CT

Any and all content - Tuesdays at 7pm CT

Any and all content - Tuesdays at 8 pm CT

Any and all content - Wednesdays at 8 pm CT

Any and all content - Thursdays at 7pm CT

Any and all content - Fridays at 2 pm CT

If you try to sign up for a group, but the sign-up is closed, email me so I know that there is extra interest in that time.

Clinicians, I’m hiring group leaders at a competitive hourly rate. Interviews begin in October. Email me at maggie@huddle.care for more information.

Content for review: Donate to Get Peace, Give Peace

Listen to my interview on The OCD Stories PodcastReview the Huddle.care Core ValuesReview the Huddle.care Curriculum infographicReview the Huddle.care Self-monitoring infographic

MoreEffectiveMoments When you click on the button below, you'll be redirected to a secure form where you can share your moment. Follow the prompts when you submit your moment and explain how what you did was effective. I'll give you an animated character and post it to Instagram.

Edited Transcript:

Hi there, Huddlers. Thanks for your time. I appreciate the chance to spend time with you this week.

We're discussing inflated responsibility. There are two types of inflated responsibility.

The first is thought-action fusion.

The second is taking responsibility over something you can't control

Thought-action fusion occurs when having a thought feels like an action. Thoughts and actions feel fused together. This is common in Harm OCD. You might have the thought, “What if I hurt someone?” which gives you the feeling of guilt and makes it feel like you actually did it. Having the feeling of guilt doesn’t mean you’ve done something wrong.

Here are some examples of thoughts that could give you the feeling of guilt and make you feel like you've done something wrong.

“What if I hit someone with my car?”

“What if I left my stove on?”

“What if I said something inappropriate that offended someone?”

“What if I forgot to say something kind?”

“What if I wanted to harm that person?”

“What if I wanted to harm myself?”

“What if I wanted to do that sexually inappropriate act, like molesting a child, that I don't really want to do?”

“What if I could have helped and I didn't?”

“How do I know that my motives, intentions, and actions are good, kind, and pure?”

These are all thoughts that give people with inflated responsibility the feeling of guilt and make them feel like their thoughts are important.

The function of the feeling of guilt is to cue you to make amends. Real guilt tells you that you should apologize or do something to repair whatever mistake you made. If there's nothing to apologize for or nothing to fix — because it was just a thought — then you're experiencing excessive guilt as the consequence of inflated responsibility.

Label the guilt.

Accept it as a feeling.

Refrain from fueling the thought.

Rather, redirect your attention away from it.

You might feel guilty when you let go of the thought. Good! You're doing your exposure practice correctly.

You might also have inflated responsibility if you attempt to take responsibility over something you can't control.

You can't control what other people think, say, feel, and do.

You can't control outcomes within systems that are bigger than you.

You can't control the sensations, feelings, and thoughts that show up in your body and brain.

You can control your response to both your internal and external environment.

Figure out what you can control. Figure out what you value. Focus your energy on acting on your values.

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Hi there, Huddlers. This week, we’re discussing the first Strategies Module, Challenge Perfectionism. Looking forward to discussing this with you.

Also, my birthday is coming up this week on Wednesday. If you’d like to give me a gift, tell me what I sound like to you. Several people have mentioned that they frequently think about what I would say in their every day life. If this is true for you, and you’ve written it down, send me your self-talk. No need to edit it in any way. Just send me an email with either notes you have on your computer or a picture of what you have handwritten. I really enjoy working with you and would love to see how my words impact you.

The Huddle.care schedule this week is:

Community Time - Mondays at 8pm CT

Any and all content - Tuesdays at 4 pm CT

Any and all content - Tuesdays at 7pm CT

Any and all content - Tuesdays at 8 pm CT

Any and all content - Wednesdays at 8 pm CT

Any and all content - Thursdays at 7pm CT

Any and all content - Fridays at 2 pm CT

If you try to sign up for a group, but the sign-up is closed, email me so I know that there is extra interest in that time.

The Huddle for Clinicians schedule is:

Tuesdays at 12 pm CT

Wednesdays 1 pm CT

Thursdays at 11 am CT

Content for review: Donate to Get Peace, Give Peace

Learn more about Huddle for Clinicians

Listen to my interview on The OCD Stories PodcastReview the Huddle.care Core ValuesReview the Huddle.care Curriculum infographicReview the Huddle.care Self-monitoring infographic

MoreEffectiveMoments When you click on the button below, you'll be redirected to a secure form where you can share your moment. Follow the prompts when you submit your moment and explain how what you did was effective. I'll give you an animated character and post it to Instagram.

Edited Transcript (Thanks to Dr. Jenna Sheftel for help editing my transcripts):

Hi there, Huddlers. Thanks for joining me today. I appreciate the chance to spend time with you. Today we're going to talk about perfectionism. Perfectionism is a cognitive pattern, with behavioral implications, that maintains many different responses leading to anxiety.

You can think about perfectionism as a problem of strategy, not outcome. Many perfectionists struggle to challenge their perfectionism because they're afraid that it will lead to dropping their standards. They will no longer be striving for excellence. The most important concept here is: We are challenging the strategies you use to strive for excellence. We are not challenging the idea that you should strive for excellence.

When your strategies for trying to arrive at excellence are undermining your goals, then we consider that perfectionism. The goal is to be on the lookout for anxiety driven behavior that undermines your overall goals, it is not to make your work mediocre.

We're still striving for productive work. We're still striving for excellence. We're just trying to use strategies that actually allow us to get there in the long term. When I'm thinking about clinical perfectionism, I'm going to start with the underlying fears that drive the compulsive behaviors.

There are four main fears that I see most frequently as the drivers of perfectionism.

The four main fears are:

Fear of evaluation

Inflated responsibility

Intolerance of uncertainty

Perfectionism about the “just right” feeling

These should be pretty familiar concepts to those of you that have been with me for a while, but let's just apply a perfectionistic lens to them.

If your underlying fear is a fear of evaluation — either fear of failure or fear of success — then you might think, “I want perfect performance in order to avoid a judgment, rejection, or the feeling of embarrassment.”

If you have this fear and this thinking pattern, then the behavioral manifestations or implications of it would likely show up as checking and rechecking your work, getting reassurance from your co-workers, avoiding tasks, or doing tasks at the last minute. When you are doing tasks at the last minute, you avoid them up to the point where you have to do them, rather than having a priority-based effort that is not contingent on the deadline.

The next fear is inflated responsibility. This thinking for this one is more like, “If I make a mistake, will it harm someone? I want to avoid — I want to be perfect — so that I don't harm anyone.” This might show up in behavior similar to fear of evaluation. It could be checking and rechecking work, getting reassurance from co-workers or your manager, doing tasks at the last minute, or avoiding tasks altogether.

The difference would be the exposure. For inflated responsibility, you want exposure to the feeling of guilt and to the thinking of the possibility of harm. For fear of evaluation, you want exposure to the feeling of embarrassment and to thinking of the possibility of judgment and rejection.

The next use of perfectionistic strategies is to reduce uncertainty. This might sound like, “If I could just make the perfect decision, then I wouldn't feel so uncertain.”

In this case, my response is, “No, no, no, the decision is inherently uncertain. For most decisions in life, there's no clear right answer. The more that you try to be perfect the more uncertain you're going to feel.” The exposure would be to try to see what parts of any given decision are inherently uncertain. Then do the best you can to problem-solve the things that can be problem solved and let go of the things that you can't control.

Finally, the fourth form of OCD perfectionism is seeking the “just right” feeling. In this case, exposure is not typically to a fear. People won't describe any type of catastrophe that they fear. They just want the “click” of a task feeling complete. I've noticed that people who experience this tend to feel ashamed of it or experience it as ego-dystonic, especially when it really gets in the way of their life. They might even notice that they have tasks where they either have diminishing returns or they’re not able to execute and complete things in a timely way, because they’re trying to get the feeling of it being complete. They think, “Why do I have to keep going? Even though I really want this feeling, I don't like it that I have to keep going!”

A good way to get through this is to validate the skills and the values behind it.

For instance, people that have OCD tend to value and behave in a detail-oriented, creative, persistent and conscientious manner. It is not OCD that makes you this way. You still have all of these values and attributes without your OCD. That said, you don't have to do what your OCD tells you to do in order to live these values. In fact, you can get control of these attributes by challenging the OCD when it tells you that you have to finish something to completeness.

The way to challenge the OCD is to say, “I still am striving for excellence. I still want to be detail-oriented but I don't have to get the “click” feeling. In fact, waiting for the click or the feeling of completeness is actually undermining my striving for excellence.”

To review the self-talk:

If your fear is evaluation, then your self-talk is going to sound like, “I want to be embarrassed. I want to live with the possibility of rejection. I'm going to go towards situations where I can see that the chance of rejection is possible.”

If your underlying fear is inflated responsibility, you want your self-talk to be, “The feeling of guilt doesn't mean I've done something wrong. I can live with the possibility of making a mistake that harms people in order to live by my values. I want to be able to do this action and live with the possibility that I'm going to harm someone and so even if I have the feeling of guilt, it doesn't again mean that I've done something wrong.”

If the fear is intolerance of uncertainty, then you want to live in your decision. Your self-talk will be, “I'm making a decision and I'm living in it. Uncertainty is evidence of my growth, not a problem for me to solve.”

If the fear is based on the need for a just right feeling, your self-talk is going to be, “It's okay for me to have this ‘just right’ urge right now. I'm going to have diminishing returns if I keep going, though. So, it's an exposure or it's a value based behavior for me to not get the click.”

Generally speaking, perfectionistic work sounds like, “I must do this urgently. I must do it perfectly. I'm not going to stop until it feels just right.”

Productive work sounds like, “I'm going to prioritize based on my values and accept that I have limitations. Just because my mind thinks I can do something better doesn't mean I have to do it. In fact, it definitely doesn't mean I have to do it. If my perfectionism makes it hard for me to know when to stop, I'm going to use a conscientious model, which is a person who I respect doing the same type of task. I'm going to use what I know about how they behave as an example for deciding when it's okay for me to stop. I’m willing to experiment and take risks knowing that I have to accept where I am to get where I'm going next. Rather than avoiding or bracing against feedback, I want collaboration so that I can grow.”

So that's it for today. Looking forward to talking to you guys more about perfectionism. Thanks.

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Hi there, Huddles. Great week. This week, we’ll discuss Core Principle Module 6: Float through experiences mindfully.

Dr. Claire Weekes was an Australian physician and an anxiety treatment pioneer who started writing about acceptance-based methods for relating effectively to anxiety in the 1960’s. She used the concept of floating through anxiety, as opposed to swimming through it, to emphasis the need to let go of control, rather than focusing on coping with it. The concepts “don’t just do something, sit there!” and “let time pass” come from Claire Weekes.

This week in Core Principle Module 6, I teach you more about paradoxical effort. I also explain how metaphors can help you internalize key concepts and how compassion can help you access your capacity to observe what’s happening during anxious moments.

The Huddle.care schedule this week is:

Community Time - Mondays at 8pm CT

Any and all content - Tuesdays at 4 pm CT

Any and all content - Tuesdays at 7pm CT

Men only - Tuesdays at 8 pm CT

Women only - Wednesdays at 8 pm CT

Any and all content - Thursdays at 7pm CT

Any and all content - Fridays at 2 pm CT

If you try to sign up for a group, but the sign-up is closed, email me so I know that there is extra interest in that time.

The Huddle for Clinicians schedule is:

Tuesdays at noon CT

Wednesdays 2 pm CT

Thursdays at 11 am CT

Content for review: Donate to Get Peace, Give Peace

Learn more about Huddle for Clinicians

Listen to my interview on The OCD Stories PodcastReview the Huddle.care Core ValuesReview the Huddle.care Curriculum infographicReview the Huddle.care Self-monitoring infographic

MoreEffectiveMoments When you click on the button below, you'll be redirected to a secure form where you can share your moment. Follow the prompts when you submit your moment and explain how what you did was effective. I'll give you an animated character and post it to Instagram.

Edited Transcript (Thanks to Jenna Sheftal for help editing my transcripts):

Hi there, Huddles. Thanks for your time. I appreciate the chance to spend time with you today.

In Core Principle Module 6, we discuss Float through experience mindfully

Here are the three main concepts:

Paradoxical effort is a trap.

Metaphors facilitate your internalization and ownership of your growth.

Compassion reduces secondary processes that undermine your growth.

First, before we talk about paradoxical effort as a trap, let me tell you a joke.

Paradoxical effort is a trap.

What do overcoming anxiety, falling asleep, sneezing, feeling happy, and having an orgasm have in common?

Wait for it…

They all require surrender! You have to surrender to the process to allow it to either pass or to happen.

The opposite of this is called paradoxical effort, where the more effort you put towards a certain outcome, the further you get from it. Paradoxical effort undermines people and keep them in their stuck places, unable to move through uncomfortable thoughts, feelings, and sensations.

Let’s use sensations as an example: Panic attacks occur when you perceive a threat, have the fight-or-flight response, and add an “oh, no, I shouldn't be having these sensations!” reaction. When this happens, your amygdala will give you some more adrenaline. You'll keep having more and more of those sensations until it subjectively feels out of your control.

In this case, paradoxical effort is: the more you try not to have sensations, the more sensations you have.

As you're learning to work through panic attacks, you might learn that you need to invite in your sensations in order for them to decrease. Yet, if you secretly hope that when you invite in your sensations, they go away, you will get caught in paradoxical effort and have more sensations.

This also happens with sleeping. One thinking pattern that maintains insomnia is thinking, “I need to sleep tonight or I will be exhausted and unable to perform tomorrow.” If you worry and worry about this as you try to sleep, you won’t be able to relax enough to fall asleep. Paradoxically, you have to let yourself surrender to the possibility that you might not sleep, you might be exhausted tomorrow, and you might not be able to perform in order to relax enough to sleep. If you try to trick yourself into thinking this, but you are not actually willing to surrender to being tired tomorrow, you won’t be able to relax enough to sleep.

My final example is happiness. Happiness is also a paradox. The more that you're striving for the feeling of happiness, the more elusive it becomes. Oftentimes when people are saying that they're striving for happiness, they might actually be striving for the feeling of pleasure or joy.

Acceptance and commitment theory teaches us that the trick is to strive for psychological flexibility. The three components of psychological flexibility are:

Show up to the present moment.

Let go of unhelpful thoughts and feelings.

Do things that you value.

If we, regularly committing to things that we value, are able to do those things with present moment awareness, and allow any thoughts or feelings that are uncomfortable as we engage in our valued action, then we might not feel happy every moment, but we'll have all kinds of different thoughts and feelings. Within our varied thoughts and feelings, there will be more likelihood of moments where we feel happy.

The paradox is if you strive to feel something all the time, it's going to feel more and more elusive. But if you commit to things that you care about and live with the possibility that your thoughts and feelings change, then, over time, you’re likely to feel as though your life is rich, full, and meaningful.

Metaphors facilitate your internalization and ownership of your growth.

For the next concept, as we're striving to float through our experiences mindfully, we want to use metaphors to facilitate our personal internalization of relevant ideas, frameworks, and concepts. While the concept of going towards our internal experiences is theoretically simple, it's not easy to do and there are numerous nuances to it that can make it hard to remember.

Metaphors fall into two major categories.

One category includes personifying the different internal experiences. Personification of our internal experiences helps us to notice the different voices, in real time, and decide how to respond to each particular personified voice.

Examples of personification of our different internal voices includes Worried Voice, False Comfort, and Wise Mind. Once personified, we can notice the voices as they happen, label them, and respond to them more effectively. For instance, we know to challenge Worried Voice, particularly when it's urgent and spiraling. We also want to intentionally access our Wise Mind to help us defuse from the back and forth between worried voice and false comfort. Many people in group have created different names for Worried Voice, False Comfort, and Wise Mind. You could also have the voice of Depression, the voice of OCD, the voice of Mania and the Self-Critical voice.

All these examples can help you personify your experience and help you remember that just because a certain thinking pattern arrives in your mind doesn't mean you have to follow it.

The other category for metaphors includes processes. If certain processes get you stuck, you can use a metaphor to help you remember what to do differently.

For instance, inflated responsibility is a process that many people get stuck in. Inflated responsibility occurs when you take as much responsibility for a thought as you would for an action (e.g., thinking about hurting someone is equally as terrible as actually hurting someone). The other form of inflated responsibility is taking responsibility for something that we don't have control over, like how other people think or feel.

One example of a metaphor that could help you remember what inflated responsibility is:

“My OCD has a Rolodex of bad memories. Whenever I feel guilt, it starts thumbing through that Rolodex.”

You could use this as reminder that having the feeling of guilt is making the thoughts seem true or seem like you’ve done something wrong. Rather than engaging it, you could think, “I'm going to throw away that Rolodex.”

The next metaphor is for intolerance of uncertainty. The metaphor is:

“My OCD is like a congresswoman filibustering any decision I try to make.”

When you notice the filibuster, you can think, “Quit the filibuster, Mind. I should make a decision and live in it.”

Here’s a third metaphor:

“My worry is like a faucet. I'm trying to contain it before it spills over.”

This metaphor could cue you to use scheduled worry time to contain your worrying.

Compassion reduces secondary processes that undermine your growth.

We talk about compassion all the time in Huddle.care. I want to emphasize that we're not just talking about the sort of formal compassion practice done while sitting on a cushion, although formal compassion practices are also great.

When I think about compassion, I think about it as an intervention that targets a secondary process that's very common in anxiety, OCD, and depression.

The secondary process that keeps people stuck is shame and self-criticism. As you start to learn more about CBT and how anxiety disorders operate you might be thinking, “Well, I theoretically understand how this operates. Why does my anxiety keep coming back? Why do these intrusive thoughts keep coming back?” If your “why?” is very critical and brings up the feeling of shame(e.g., “because I’m truly a horrible person”), then it might be difficult to observe and stay with what's happening long enough to not do anything to avoid it or to reinforce it.

From that perspective, compassion is a skill you can learn.

It can help you stay with the process of whatever's happening. Regardless of what you know, anxious sensations or intrusive thoughts can show up at any time. Just having information about what's happening doesn't mean it's not going to happen. In any given moment having a compassionate stance that allows your mind to observe what's happening is going to help you get through it faster. And that doesn't mean that the sensations and the thoughts are necessarily going to go away. You're just not going to do something that reinforces it.If compassion by definition is sympathetic consciousness of distress together with a desire to alleviate it, then self-compassion is turning towards yourself with concern and a desire to do something to alleviate your own distress.

When it comes to relating effectively to anxiety, turning towards your experience would be observing that experience mindfully — floating through it mindfully — and not doing something to make it worse. You don't have to be particularly warm and fuzzy about this. Just notice what's happening, don't criticize yourself, and don’t add anything that will make it worse.

Let's talk more in group about what helps you stay compassionate with yourself and what you do to facilitate self-compassion. Can't wait to see you guys.

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Hi there, Huddles. Happy Fall! I am off for Labor Day, so no Community Time tomorrow. We’ll discuss Core Principle Module 5: Avoid Avoidances in small groups.

The most important concept from this module is: The road to recovery is paved with details! We need to identify and observe the details of your anxious moment to know what to challenge, what to expose you to, how to do the opposite.

If we had Community Time, I would encourage you to reflect on a private effective moment from the week and practice self-monitoring to get the details of your moment of suffering. Here are the questions to ask yourself:

What triggered by anxiety? Was it internal or external?

What was my thought?

What sensations did I experience?

What feelings did I experience?

What urges did I have in response to my thoughts, sensations, and feelings?

What did I do in response?

Let’s talk about all of this in group!

The Huddle.care schedule this week is:

Any and all content - Tuesdays at 4 pm CT

Any and all content - Tuesdays at 7pm CT

Men only - Tuesdays at 8 pm CT

Women only - Wednesdays at 8 pm CT

Any and all content - Thursdays at 7pm CT

Any and all content - Fridays at 2 pm CT

If you try to sign up for a group, but the sign-up is closed, email me so I know that there is extra interest in that time.

The Huddle for Clinicians schedule is:

Tuesdays at noon CT

Wednesdays 2 pm CT

Thursdays at 11 am CT

Content for review: Donate to Get Peace, Give Peace

Learn more about Huddle for Clinicians

Listen to my interview on The OCD Stories PodcastReview the Huddle.care Core ValuesReview the Huddle.care Curriculum infographicReview the Huddle.care Self-monitoring infographic

MoreEffectiveMoments When you click on the button below, you'll be redirected to a secure form where you can share your moment. Follow the prompts when you submit your moment and explain how what you did was effective. I'll give you an animated character and post it to Instagram.

Edited Transcript (Thanks to Jenna Sheftal for help editing my transcripts):

Hi there, Huddles. Thank you for your time. I'm grateful for the chance to spend time with you. Today, we're talking about Core Principle Module 5, Avoid Avoidances. Anxiety disorders are created, maintained, and intensified by avoidance, and overcome with approach and exposure.

Let's start with understanding the difference between an anxiety state and an anxiety disorder.

Anxiety disorders are maintained by different avoidances

An anxiety state is a normal, natural, healthy and adaptive reaction to a threat or perceived threat. In the presence of a perceived threat, we get anxious sensations — the fight or flight response — as well as catastrophic thinking.

Your fight or flight response might include an increase in heart rate, sweating, blood rushing out from your stomach to your arms and legs, an increase in blood pressure, pupil dilation, and muscle tension. In the presence of muscle tension, people often take deeper breaths. As you breathe out, you experience a change in CO2. This is not dangerous to you, but can make you feel dizzy and tingly.

In addition to the fight-or-flight response, people often experience catastrophic thinking or worry thoughts. The various anxiety disorders are marked by the difference in the content of the fear. For instance, in the presence of their fight-or-flight response, some people will fear their sensations and then avoid in response to sensations. We call that panic disorder. Some people fear the feeling of judgment, rejection, or embarrassment and avoid in response to situations that could trigger those experiences. That’s social anxiety.

Generalized anxiety disorder (GAD) and OCD can be seen as existing on a spectrum of thoughts, from ego-syntonic to ego-dystonic. These are just fancy words for what seems reasonable versus unreasonable to the person having the thoughts.

A GAD (ego-syntonic) worry thought might be what if I lose my job? The avoidance behavior in response might be:

Checking and rechecking my work email

Checking and rechecking the reports I'm writing

Getting reassurance from my boss or my co-workers

Overworking

Comparatively, an OCD (ego-dystonic) thought would be something like what if the door isn't locked? Even when a person just watched their own hand lock the door, this thought would still give them a feeling of uncertainty. In the presence of the feeling of uncertainty, the avoidance behavior in response might be:

Checking and rechecking the door

Taking a picture of the door

Getting reassurance from a friend that the door is locked

All of these responses are examples of avoidance behaviors. Avoidance behaviors function to temporarily reduce discomfort, but just create more and more uncertainty over time. When you do something in response to a feeling of uncertainty, it makes the feeling of uncertainty more likely to occur in the future. If that becomes a frequently used behavioral pattern, we call this an anxiety disorder. In order to get through anxiety disorders, we have to do the opposite. It’s very important to identity the specific avoidance behavior we are engaging in and specifically choose to do the opposite of that avoidance. This is the basis of exposure exercises.

Experiential Avoidance

Another name for avoidance is experiential avoidance. Avoidance isn’t just situational avoidance (e.g., leaving a party where you feel uncomfortable or self-conscious). Other forms of experiential avoidance include:

Cognitive avoidance

Somatic avoidance

Emotional avoidance

Emotion-driven behaviors

We call it experiential avoidance because there are all kinds of ways that we can avoid our experiences.

Cognitive avoidance can include:

Worry

Rumination

Mental compulsions

Thought control

Thought suppression

Distraction

We discuss cognitive avoidance frequently in the process of overcoming anxiety because people experience many forms of cognitive avoidance for many different reasons. Sometimes you distract yourself because you are afraid of your thoughts. Sometimes you do mental compulsions because you are afraid of what it means if you don’t pay attention to your thoughts. Both of these can happen in the same person at the same time. Once you’ve learned about using exposure thoughts to avoid avoiding, it can sometimes be difficult to tell if the way you are responding to your worry thoughts is cognitive avoidance or a useful exposure exercise. When you can’t tell, look at the function of the thought. Ask yourself if the thought functions to reduce anxiety or allows you to move toward the anxiety? Another way to choose to avoid avoiding in any given is to ask yourself what am I afraid of thinking? Then, make the choice to think exactly that.

Somatic avoidance occurs when you avoid sensations.

Emotional avoidance occurs when you avoid emotions.

Emotion-driven behavior is marked by its urgency. Emotion-driven behavior can be compulsive and it can also be impulsive. You can have both.

Compulsive behavior feels like I don’t want to do this, but I have to.

Impulsive behavior feels like I want to do this despite the risks.

Examples of compulsive behavior include getting reassurance, checking, and washing.

Examples of impulsive behavior include substance abuse, risky sexual behavior, and emotion-driven shopping.

In both cases, you are avoiding the reality that a feeling is a feeling and a thought is a thought. When we see feelings as feelings and thoughts as thoughts, we have the freedom to act based on our values.

Get the details of the moment of suffering

So, with that in mind again, we’re trying to notice all these different avoidances and do the opposite. In their book, What Every Therapist Needs to Know about Anxiety Disorders, Marty Seif and Sally Winston explain how fear of flying can really be a catch-all for all kinds of different problems. They use this example to demonstrate how important it is to get into the specific details of a fear in order to make effective decisions about how to avoid avoiding.

Contamination OCD is another example. There are a number of different fears someone with contamination OCD can experience and a number of avoidances that could maintain their suffering. Some examples include:

Avoidance of the feeling of disgust

Avoidance of the feeling of uncertainty

Situational avoidance (e.g., avoiding places that are contaminated)

Worry about situations where they could become contaminated

Mental compulsions about situations where they could be contaminated

Hand-washing

Those are just a few examples of the many different avoidances that could maintain contamination OCD. All of this is to say that lots of people avoid in a number of different ways at the same time. In order to effectively avoid avoiding, it is critical that you understand the various forms your avoidance takes.

Although, the concept of exposure and response prevention might seem relatively easy and simple: go towards the thing that you fear and don't do anything to avoid, the reality is that the details are the difference between continuing to suffer and recovery. Your anxiety and OCD are as smart as you are. Oftentimes there are many different details going on at the same time. The details can be really nuanced. Let's talk more so we can observe those behaviors and you can recover.

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Hi there, Huddles. Great week. We’ll keep the podcasts going and the schedule the same this week.

This week’s topic is Embrace uncertainty with response ability. Here are a few questions to consider as you listen to me talk about it. You can read the transcript below.

In what areas of your life are you most sensitive to uncertainty?

Does the feeling of uncertainty make it difficult for you to identify how you can take responsibility? That is, does uncertainty make you feel like you don’t have the ability to respond when you do?

Does the feeling of uncertainty trick you into taking responsibility under conditions when you don’t have the ability to respond?

What would help you differentiate these two reactions to uncertainty more effectively?

The Huddle.care schedule this week is:

Community Time - Mondays at 8 pm CT

Any and all content - Tuesdays at 4 pm CT

Any and all content - Tuesdays at 7pm CT

Men only - Tuesdays at 8 pm CT

Women only - Wednesdays at 8 pm CT

Any and all content - Thursdays at 7pm CT

Any and all content - Fridays at 2 pm CT

If you try to sign up for a group, but the sign-up is closed, email me so I know that there is extra interest in that time.

The Huddle for Clinicians schedule is:

Tuesdays at noon CT

Wednesdays 2 pm CT

Thursdays at 11 am CT

Content for review: Donate to Get Peace, Give Peace

Learn more about Huddle for Clinicians

Listen to my interview on The OCD Stories PodcastReview the Huddle.care Core ValuesReview the Huddle.care Curriculum infographicReview the Huddle.care Self-monitoring infographic

MoreEffectiveMoments When you click on the button below, you'll be redirected to a secure form where you can share your moment. Follow the prompts when you submit your moment and explain how what you did was effective. I'll give you an animated character and post it to Instagram.

Transcript:

Hi there, Huddles. Thanks for listening. I'm grateful for the opportunity to spend time with you today. In Core Principle Module 4, we're going to talk about embracing uncertainty with responsibility. The three concepts for today are:

Uncertainty is an opportunity to take responsibility

Negative reinforcement maintains anxiety

Intentional and incidental practice should be frequent willing and flexible.

First when we think about embracing uncertainty with responsibility, let's differentiate between inflated responsibility and real responsibility. We've talked frequently about inflated responsibility and what we mean by that is when you take responsibility for something you don't have responsibility for.

So, you don't have responsibility for the thoughts, feelings, and sensations that show up. Other uncertainties that you don't have control over include

Other people's thoughts and feelings.

Some of the things that happen to you.

And, for instance, in the case of like harm OCD, you might have uncertainty like how do I know with certainty that I haven't thought, said, or did something that is harming someone right now or harmed someone in the past?

All of these are categories of inflated responsibility. You can think about real responsibility by thinking about the word itself. So, do you have the ability to respond to whatever it is that you have anxiety about? So, in the case of real responsibility, you have the capacity to respond. So, you might not have control over what happens to show up in your experience, but you do have the capacity to respond to it. Similarly, you don't have certainty over what other people think and feel, but you do have control over how you respond to what other people convey to you.

Other psychologists talk about embracing uncertainty as a neurological opportunity. The way I like to think about that is like the process of learning how to walk.

So, as a baby is learning how to walk they're going to take a few steps. Then, their brain is going to start making neurological connections that they didn't previously have before they took those steps. Along with those neurological connections, the baby's going to keep walking and their mind are is going to start to believe that they can do it.

There's going to be a loop between the neurological connections, the behavior, and their mind perceiving that they can do it, and they're going to practice in a number of different settings. They're going to fall sometimes. They're going to get back up and their mind and their brain is going to understand. They'll make some more neurological connections. Their mind will interpret that this is something that they can have confidence in until suddenly it's something that they can easily do.

So applying this to anxiety: We want to embrace uncertainty by taking responsibility when we have the ability to respond and then not try to take responsibility when we don't have the capacity to respond.

And so as that's happening, we want to remember what the neurological opportunities are: Behaviors are strengthened by avoiding a negative outcome. This is called negative reinforcement.

For instance turning off your alarm in the morning is a helpful use of negative reinforcement. You get up really fast because you want to turn off that loud sound. So negative reinforcement isn’t inherently problematic. It's just one way in which a behavior is strengthened. But in the case of anxiety, if you avoid to reduce the uncomfortable stimulus that is your anxiety, then the chance of avoidance is going to become more likely in the future. The neurological opportunity is that you've got to do the opposite to change that pattern. Not only should you do the opposite in the exact way that the avoidance is showing up, but this is why we want to think about exposure as something that is frequent, flexible, and willing. So, just like you learn to walk and then run by practicing, getting good at it, through your your brain doing behavior, then your mind interpreting it, then having the neurological connections. This all happening very quickly, but in a lot of different contexts until you had lots of confidence.

We also want to do this with your anxiety in your incidental and your intentional practice. Both the types of practices that show up over the course of your life without your choosing and the things that you intentionally go towards, we want to make your practice frequent, flexible, and willing. In a number of different contexts, you will learn that uncertainty is actually your opportunity and not something that you want to brace against.

In community time and groups this week, we'll talk more about this process of negative reinforcement and how your incidental and intentional exposures are an opportunity for you.

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I have two experiments this week:

I’m trying out unrehearsed 10-minute podcasts and only slightly edited transcripts rather than writing. If you would prefer to read over listening, the transcript is below. I hope you enjoy it. I think I said the word “opportunity” more than the word “so,” but I’m not certain.

I added some new Huddle.care group times. We accidentally had a few gender-specific groups that went well over the last few weeks. Let’s try some men only and women only groups. If you identify as non-binary, you are welcome at all groups.

The Huddle.care schedule this week is:

Community Time - Mondays at 8 pm CT

Any and all content - Tuesdays at 4 pm CT

Any and all content - Tuesdays at 7pm CT

Men only - Tuesdays at 8 pm CT

Women only - Wednesdays at 8 pm CT

Any and all content - Thursdays at 7pm CT

Any and all content - Fridays at 2 pm CT

If you try to sign up for a group, but the sign-up is closed, shoot me an email so I know that there is extra interest in that time.

The Huddle for Clinicians schedule is:

Tuesdays at noon CT

Wednesdays 2 pm CT

Thursdays at 11 am CT

Content for review Donate to Get Peace, Give Peace

Learn more about Huddle for Clinicians

Listen to my interview on The OCD Stories PodcastReview the Huddle.care Core ValuesReview the Huddle.care Curriculum infographicReview the Huddle.care Self-monitoring infographic

MoreEffectiveMoments When you click on the button below, you'll be redirected to a secure form where you can share your moment. Follow the prompts when you submit your moment and explain how what you did was effective. I'll give you an animated character and post it to Instagram.

Transcript using Descript:

Hi there, Group. Thanks for your time. I'm grateful for the chance to spend time with you.

This week, we're discussing how to prepare for the anxious moment. We've already covered the therapeutic attitude of willing acceptance and differentiating between anxiety and danger. Let's quickly review. Remember that for all techniques, we’re always trying to orient towards the therapeutic attitude of willing acceptance. When we think about how to get to the therapeutic attitude of willing acceptance, we want to be thinking of our Wise Mind.

So your Wise Mind is your internal compassionate parent, both participating in and observing you throughout your whole life. Wise Mind has more experience in the part of you that is reactively or fearfully responding to whatever is happening in this moment. Wise Mind has been with you observing you your whole life. She knows the moments you've shown up with courage. And also when you've lived less than your best life. Compassionate parents have time and space for all of it and want to be there with you. We all have an observational self. Some of us didn't know it was there and don't pay attention to it. You can strengthen your access to your wise mind by bringing attention to her. If it doesn't seem like your Wise Mind knows what to say to you, we'll teach you how to access that compassionate stance together. Sometimes wise mind uses coping skills to care for you but coping skills are not your path to recovery. Wise Mind is the part of you who relates to painful experiences with patience, perspective, and kindness. He doesn't prevent you from ever feeling pain, but a strong wise mine alleviates additional suffering and creates the space for variability flexibility and richness in your private experience.

When we think about anxiety versus danger, there are four different concepts that we want to remember. We want to remember that anxiety sensitivity is a biological vulnerability that some people have because of their biology. We also want to use urgency as a cue to slow ourselves down and differentiate between whether there's actually an emergency or problem to solve or if we're feeling uncertain and it's time to let that any problem solving pass when we feel urgency. We want to reason through stakes and odds because everything feels really risky when you feel anxious, so the stakes will often feel higher than they are. Finally, we want to sort through problems to solve and uncertainties to let pass. We can think about it as music or static and when you figure out what the static is, you want to try to let it go so you can focus on the problems you can solve right now.

As we shift our attention to preparing for the anxious moment, we want to:

identify triggers as opportunities to practice;

predict distressing thoughts, feelings, sensations and interpretations;

use our values to motivate commitment to the present moment;

use helpful self-talk to strengthen our motivation and commitment to practice before during and after the anxious moment.

So first, let's talk about triggers triggers can be internal and they can be external. External triggers are the things that show up in your environment that making anxiety more likely. Common triggers that come to mind include the kitchen, the door, any part of your home that reminds you that something could go wrong. It could be your car. It could be the bus it could be. Any part of your commute on your way to work, it could be showing up to work, being in a meeting, getting an email, having to give a presentation. There's all kind of external triggers that are frequent and common for many people. You could also have an internal trigger such as an intrusive thought or anxious sensation that doesn't necessarily have an extra predictable external trigger. related to it but the internal sensation or thought could show up at any time.

So we want to shift our way of thinking about those triggers away from bracing and avoiding and over into opportunity.

So in order to teach ourselves that we can handle the anxious moment. We actually need to go towards our triggers. Trigger those sensations and those thoughts on purpose. So really any time you have either an internal or an external trigger, that's a huge opportunity to practice and show yourself that you can relate to it differently rather than bracing. You want to see it as an opportunity in terms of predicting your distressing thoughts, feelings, sensations, and interpretations. You want to predict them ahead of time, not because you have to know exactly what's happening perfectly in your anxious moment. But the better that you predict what's likely to occur, then the easier it will be to get distance from it. So if your trigger often makes your heart rate go up or often makes you sweat. You might frequently have the same types of intrusions based on certain triggers. These are all helpful to identify beforehand so that when it shows up rather than thinking, “Oh, no, why am I anxious? What's happening?” You can think, “Oh, yeah. I was expecting this! This happens when I go towards my triggers and this is really my opportunity to practice.”

The secondary process that's very common, in terms of predicting distressing thoughts and interpretations, is that you may have sensations and you may have intrusive thoughts and then you may feel hopeless, helpless, or worthless because it's happening again. So even remembering that, you know, I have this type of thought I have this type of sensation and then my mind says, “oh no, it's happening again. This is going to happen forever. I'm never going to get out of this.” That's a common secondary process that you also want to predict because if you can say “oh, yeah, that's what happens when I do this type of activity” and not act as though it's truth, then you can get to the other side of it without it feeling true.

When we think about using values to motivate commitment to the present moment, you really want to just be thinking “why is it worth it to experience this moment?” And so if this whole concept of going towards your anxiety to get through your anxiety makes sense to you, then it's worth it to get yourself anxious and hang out there really for its own sake so that you can show yourself: Rather than needing to avoid, compulse, get reassurance, or otherwise neutralize your anxious experience, it can be an opportunity for efficacy, to feel strong, and courageous that you can go toward. You can predict what's going to happen. Go towards it on purpose, handle it yourself, and then get to the other side so it's worth it, too. Go towards that anxious moment kind of for its own sake. But then it's also worth it to think through the ways in which avoiding anxiety undermines the life that you want to live. Whether that's like not being able to spend time with people that you care about in the way that you want or do the work that you want to do. So reflecting on that and then remembering in the anxious moment that it's a real opportunity because you want to get to the other side of it and be able to do the things that make your life fulfilling can be a way to get through that distressing moment.

Finally, let's talk about some helpful self-talk that could strengthen your motivation and commitment in in the anxious moment. And so we want to break it down between three different parts:

your anticipatory anxiety

your situational anxiety

and your post event processing.

So in terms of anticipatory anxiety, you want to think about anticipatory anxiety as an indication of your past rather than a prediction of your future. Anticipatory anxiety is a feeling, not a fact or prediction. So what happened in the past in a similar situation, you braced and avoided and so now your amygdala is like “hey, watch out here. Here's that that triggers coming again. I'm going to give you some sensations so that you know to avoid” and you want to override your amygdala and actually say, “Hey, no, it's okay. We can hang out with this. This anticipatory anxiety is not predicting that anything is going to go wrong. It's just indicating that in the past. I've avoided.” And it's important to have some amount of self-talk around that anticipatory anxiety so that you don't avoid again, but rather you make it to the anxious moment where you have the opportunity to learn something new.

So when you get to that anxious moment again, you want to see it as an opportunity. So, “Great. I was hoping for this. This is my chance. I want to go after my anxiety. I want this to get worse. I want this too. I want this to make me stronger.”

You really just want to invite in all the sensations, whatever thoughts you're having, and whatever even secondary process you might be having about uncertainty of how long it will last, or whether it means anything about you, whether it will ever go away. Those interpretations are things you want to invite in.

Then finally after the experience, you can expect to be sensitized and expect to have the urge to replay. And so you can reframe that as “My mind wants to replay this because I'm doing something I value,” rather than getting caught up in all the self-criticism that often comes after an anxious experience. When people replay, they find things that they've done wrong and then use it to beat themselves up and an alternative is just to say, “Yep. I'm sensitized. I'm proud that I did something that I value and I'm just going to let any interpretation or urge to criticize that my mind has. I'm just going to let all of that pass.”

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