Your Anxiety Toolkit - Anxiety & OCD Strategies for Everyday

Your Anxiety Toolkit Podcast delivers effective, compassionate, & science-based tools for anyone with Anxiety, OCD, Panic, and Depression.
RSS Feed
Your Anxiety Toolkit - Anxiety & OCD Strategies for Everyday








All Episodes
Now displaying: May, 2021
May 28, 2021

This is Your Anxiety Toolkit - Episode 191.

Well, welcome friends. How are you? How are you doing really? I want you to reflect for a second on just that... on just that question. How are you?

I have not prepared for this episode. I just thought I would sit down and take some time to reflect some of, I’m sure, what I reflect on will be the first time I’ve reflected on it and not just that for reflecting with you.

episode 191 image of seashore

So what I wanted to talk with you guys about is life with a chronic illness or a disability. This is something that has shaken me a lot over the last, I would say two to three months. A lot of you have the background story with me, but if you’re new here, welcome, and I’ll tell you a quick background.

In 2019, I got very sick. Through that process, I also got very... not just medically, but mentally struggled because of the symptoms that were incredibly debilitating. After pretty much every single medical test under the sun, I was diagnosed with a lesion in my brain, that they still don’t know what it is, and a disorder called postural orthostatic tachycardia syndrome.

It sounds scary and it can be scary, but mostly, it’s a disorder to do with your autonomic nervous system and it basically involves lightheadedness and fainting and headaches and overall exhaustion and nausea and very, very big degree of brain fog. It can be mild and it can be very severe and extreme to the point where you can’t stand up.

For months and months and months, particularly throughout COVID, I have been doing my very best to manage this disorder and this syndrome and have been doing really, really well. I’m not going to lie, I thought I’d mastered this disorder. I really did. I think there was a cocky piece of me that was like, “Oh yeah, look at me.” Once again, hard work pays off. And yes, it does. Hard work does pay off.

But recently, I have been hit with another... I call it an event, another wave of POTS – POTS is the acronym for postural orthostatic tachycardia syndrome – and it has knocked me off my feet literally. Not figuratively. I think both.

For those of you who don’t know, I was, two weeks ago, taking a tennis lesson, a part of my attempts to take care of myself as I have cut back immensely with work. I’ve mentioned my kids are gone back to school and my husband’s gone back to work. And so I really decided, I made a conscious decision to put my mental health first.

I had started taking tennis lessons, and in the middle of my tennis lesson, it was very hot. I collapsed and had to go to the hospital. I’m sorry if this is scary for some of you. It had to be monitored and got IV bags and medications and all the things. Again, once again, I really thought this was a short-term thing.

What I am reflecting on today is the realization that I’m not going to manage this. I’m not going to master it. This is something I will probably have to handle for the rest of my life. I was expecting to bounce back and I didn’t. I’ve had many days of not being able to stand. I’m not able to drive. I can drive on certain days, depending on how busy I am, but I have mostly not been able to drive. I am unable to work out.

I wear these most fabulous compression socks right now, the compression socks I’m wearing. I have bright colors in stripes. I have ones with spots and reindeers and all of the things. So, that’s very fun. But no matter how much I hydrate, I’m struggling to eat and so forth.

The reason I wanted to share this isn’t just to... of course, I can share. I want to share with you. But the main reason I wanted to share with you is to talk about what it’s like to wrap your head around long-term suffering. I’m really interested in this because I’ve been really mindful and watching my thoughts about this syndrome. I wonder if this resonates with you guys because a lot of you are dealing with either. A lot of you have reached out and said you have a chronic illness too, or chronic mental illness, anxiety, depression, or any of the disorders.

What has been really interesting for me is to catch the thoughts I have around disability. now, the first thing – and I’m really open about this, and I’m really happy to share how far I have to go – is I didn’t realize I had all this stigma around the word “disability.” I have a career in people with disabilities or struggles or long-term chronic stuff. I wouldn’t judge anybody else, but interestingly, as soon as I had to recognize, I kept saying, “I don’t know why this happened. I don’t know why this happened. Why did this happen? This shouldn’t have happened.” My doctors said, “No, you’re going to have really big ups and really big downs. That’s going to happen. That is a part of this disability.” I really was able to observe how judgmental I was about that in myself.

The word “disability” was not okay with me, the word “long-term chronic illness.” I was like, “Uh-uh, no way, I will solve this,” until I had to be like, “Wait, that’s a lot of energy, negative energy on something that does not serve me and is built around a stigma and a judgment of me having a disability.”

It’s so painful folks to observe that. Thank goodness I have those skills to be able to go, “Okay. That was judgment. Interesting.” I encourage you guys to take that approach when these types of thoughts come in. Because again, I’m always working with my patients and clients and people on social media around the stigma of the word “disorder” or “disability” or “mental health” or “mental illness.” It’s important that we catch those judgments.

Now, once I caught it, to be honest, I didn’t do much with it because I really just had to hold some space there to wrap my head around, “Whoa, okay. This is a long time for me now.” I thought I was the special one who could get through it and it’s not going to bother me again, but it’s not. It’s going to come back. This one has been particularly painful, physically 100%. This was probably my most serious event or wave of POTS. But also, just to be able to really look at how it has impacted me mentally.

Now, here’s the thing. Once I came to the understanding, not just the acceptance yet, but the understanding that this is long-term and something I have that I will have to continue to manage, it was so interesting how my thoughts wanted to go to hopelessness. “Okay, well, now my life’s going to suck,” or “I should give up. This is going to impact my life and terribly impact my life. This is going to ruin my life,” and so forth.

Again, it was being able to observe and catch and watch myself go into hopelessness and be able to... If you could see me, I would smile and go, “Ah, okay, interesting.” That’s the story I’m telling myself because here’s the thing, I’ve had this since 2019. I’ve been managing it this whole time with the thought “I can manage this.” And therefore, I was happy.

Now, nothing has changed. I’m still having POTS. I had another incident. The only thing that changed was now that I had a recognition of this being a problem long-term and I started to think negatively about it. That’s the only thing that changed. I’ve had POTS this whole time. I’ve had good days and bad days this whole time. I happened to have a significantly bad period and I’m still in that. The only thing that’s changed is the story I tell myself, and I have to keep catching the story, catching it, catching it.

Now, I know some of you are saying, “No, but my disability is making my life have a lower quality.” I’m not saying that’s just a story. I understand that it’s a situation and a circumstance. So I’m not discounting that. But what we need to do, and this is why I wanted to reflect with you, is to catch the story we tell ourselves about things that are not true, like the future, because we don’t know. We don’t know the future. There may be a POTS drug that comes out and I take it and I’m happy for the rest of my life.

I am going to recognize that having this disorder has had some benefits. It’s forced me to slow down. It’s forced me to be grateful for my medical health, for my legs and my arms, and for my heart and my brain.

This is where I ponder how wonderful that our body tells us what to eat. How wonderful is that? Because when you have POTS, you have nausea. And when you have nausea, nothing feels good to eat. You have to force yourself to eat. Every meal, I have to force myself to eat. Sometimes, I have to tell you guys, I was cracking up. I eat mostly healthy, meaning I ate all varieties. There is no good or bad food. I have a very good relationship with food. I love food. Food brings me incredible amounts of pleasure. I never judged myself for what I eat.

I was telling my sister, who’s a doctor, she was like, “Well, are you eating?” And I was like, “Yeah, I had chicken nuggets for breakfast.” And she was like, “Why?” And I was like, “It’s literally the only thing I could eat. That’s the only thing I could get down. It’s the only thing that sounded good.” And she was like, “Okay, what did you have for lunch?” And I was like, “I had ribs.” And she said, “Kimberley, what is happening?” And I said, “No, this is how it is. I have to...” It’s so hard. And I’m now so grateful for the pleasure around food that I have experienced and hopefully, we’ll experience it again here very soon.

I really want to watch (1) the story I tell myself and (2) the hope catch the hopelessness in its tracks. I know a lot of my patients and I know a lot of you because you’re going through a particularly difficult season like me. You’re telling yourself this season will never end, and it will. Seasons come and go. Some last for longer than others. Sometimes it’s a particularly chilly season, sometimes it’s not. The main piece here is for me to catch the judgment, the stigma.

Here’s another one guys and I hope this resonates. It’s so humiliating. I collapsed right at the entry of the tennis. People were walking past me, and my instinct was to say sorry to every person that passed by. Even though I was pretty much not in consciousness, I was frequently apologizing to my tennis coach, my husband. My tennis coach called my husband. I frequently apologized to him. I apologized to anybody who saw it. “I’m so sorry. I didn’t mean to scare you.” And how much that apologizing was embedded in shame around suffering.

I’m on the floor, completely limp, but I’m apologizing to other people. That is completely related to the shame I noticed that I am carrying around suffering and struggling and not being super, super-duper high functioning. This is dangerous. We have to check this. I’m going to encourage you to check this because the problem with that is it stigmatizes disability in general and it stigmatizes you being a human who suffers, and you will. You’ll have illnesses or struggles like seasons that are difficult. It’s so important that we break down that judgment we have around suffering and disability, meaning when you don’t have the ability to do things. So important.

When we break that down and we work through that, then when we do struggle, there’s not this second layer or fifth layer of pain. It’s just like, “Oh no, I’m just suffering. I’m suffering right now. This is a difficult season.” Instead of, “This is a difficult season. I’m suffering. It’s never going to go away, and I’m weak and dumb and stupid and inconveniencing other people for suffering.”

So, I really want us, hopefully, to learn from my own experience here. Hopefully, this resonates with you where you can really break down the stories and the beliefs and the judgments we have about disabilities. I think it will make a safer place for those who do have a disability. I think it’ll make a safer place for you when you’re suffering. I think it’ll make a safer place for us as a human race around the idea of suffering. It’s so, so important.

The last piece here is when we’re suffering, I noticed this whole back and forth on the solution. Should I do this? Should I go on this medication, that medication, that treatment, these treatments, see that doctor, see this doctor? I’m sure a lot of my patients are like, “Am I doing the right thing? Have I got the right treatment? Have I got the right therapist? Have I got the right medication? What’s happening?” There’s so much indecision around seasons that are filled with suffering.

I just want to validate that. I don’t want to give you advice. I don’t want to guide you in any different direction. I think all I want you to do is to recognize that indecision and not punish yourself by staying there too long. Consult with your doctors. Consult with your therapist. Talk with respected people or people you trust. Be careful of how much mental space indecision takes when you’re in a difficult season because you’re suffering. It’s enough. We don’t need to add. We don’t want to add. We don’t want to make more problems and more suffering for you because you matter and your recovery matters and your healing matters. That’s just something I’m noticing.

It’s funny, every morning, I am negotiating with myself in terms of like, “Will I take my meds today?” I mean, I always take my meds. So I’m not going to ever discard someone from making a medical decision without seeing your doctor. I always do, but I really catch myself going, “Maybe I won’t take it today. This is just too much. It’s too hard. It’s too many side effects. It’s too difficult, too painful, too scary.” And I have to go, “Okay, Kimberley, get your head out of your indecision. Honor what’s right. If you really need to do that, be effective and call your doctor. Don’t spend time in your head.” So, that’s just where I’m at.

What I will say, just in case any of your worries, I am okay. I have a great team. I have tremendous support. My husband, oh my God, he’s just amazing at showing up when things fall apart. He is incredible. I’m so, so lucky. I hope that I don’t worry you with me sharing this.

Someone asked me the other day on social media, “Is it hard for you as a clinician to share this?” And I said to them, “No, really not.” A part of my mission is to de-stigmatize therapy, to take the stigma out of going to therapy. I think a really big part of how to do that is for the therapist to show up as real humans. I think when we do that, when therapists show up as real humans, in the process, we do this stigmatize mental health and therapy because we don’t see the therapist as this person who holds all the secrets and is the knower of all things and is analyzing you instead of just seeing them as humans. You’re just going to therapy to talk to a human who also suffers. I just wanted to share that with you because I think it’s important that I model that to you. That’s one of the things that I hold very strong in my values.

So that’s that. There are my thoughts on struggling and going through a chronic illness and wrapping my head around the stigma of the word “disability” and the concept of disability. So, that’s it. That’s all I have to say.

I hope this has been helpful. I hope that you feel seen and you feel heard. Maybe you have some insight as I spoke. If that’s the case, we’ll then, I’m a happy girl.

All right. Thank you so much for listening. I do know your time is precious, so I’m so grateful to have this time with you. I will continue this conversation as I continue to unpack my own many layers of stuff, of glug around it. I’m very open to continuing to learn. I’m really, really looking and learning around the stigma of disability because it’s something that I have been privileged up until now, not to have to really wrap my head around. So I’ll do the work. I will stumble bravely through this, as I’m sure you are too.

All right. I love you guys. Please go and leave a review. The reviews help other people see this podcast as something of quality. When they see other people’s reviews, they are more likely to click on it, which means I get to help more people, and that is just a blessing. So, thank you. Please do go leave a review.

Please take care of yourself. Please take some time to hold your heart tenderly and nurture whatever suffering you’re going through because you’re not alone and we’re in this together. Okay. All my love to you.

Be on the show

May 21, 2021

This is Your Anxiety Toolkit - Episode 190.

Welcome back, everybody. Hello, Happy Friday, for those of you who are listening on the release day, and happy day to you who are not.

Okay. Well, how are you? How is everybody doing? I am sitting in my bedroom. We’ve actually had to completely rearrange because our life is changing so much here at the Quinland house. Kids are at school and people are in and out of the house, and it’s very, very different.

So I’m coming to you from my room, and life just continues to change. Have you guys noticed that? It does continue to change. I cannot keep up with it. We embrace. We adapt. We are flexible. We keep trying. We are gentle with ourselves, and that’s the best we can do.

Today, I wanted to talk with you guys about questions.

episode 190 image

I have been sort of... What I would say is ‘reflecting,’ but I would actually say, a better word is ‘studying’ the art of asking better questions, and this has been life-changing to me. It has been a practice that I have adopted as per advice of a colleague and a friend in terms of catching the story you tell yourself and asking better questions. Catching the poorly written questions that we now ask ourselves on habit, right? We just habitually ask ourselves not very skilled questions.

Let me explain to you more about this.

When something happens – and you can even do it here together – when something happens in your life, let’s say in the last week or so, something unexpected, unwanted, maybe not so ideal happens, I want you to check in and say, “What is the question I ask?” Some of you may say, it’s a really simple what-if thought question. Like, what if such and such happens? What if ABC happens? What if XYZ happens?

Not a super-skilled question mainly because it’s so open-ended and it’s so in the pursuit of removal of that discomfort. We’ve talked a lot about being uncertain. We’ve talked a lot about willingly allowing discomfort.

Other questions that I have observed my patients asking themselves or reflecting on lately are questions like: What is wrong with me? So they have an uncomfortable, unexpected, not-so-great experience, and their immediate question is: “What’s wrong with me?” And that question never ends. Well, rarely would you have the thought “what’s wrong with me,” and then you respond by going, “Nothing is wrong with me, I am a normal human being responding in the way that any other human being would respond.” We don’t answer those questions. The question sets us up for a failure, just like what-if.

Another one is: “How can I make this go away?” Now, in some cases, this would actually be a really adaptive question. So, let’s say you have an ant invasion in your house. It makes sense. Because we’re highly functioning human beings and we have adapted over time, it makes sense that our question would be: “How can I make this go away?” That in and of itself could be a good question, a solid, skilled question. But when it comes to our emotions, it’s really not. It actually gets us into tons of trouble. Asking ourselves how we can make this go away usually means we’re going to probably have more of it and we’re going into resistance mode.

Another one, which I see a lot of, and I’ve actually done a whole podcast on this one before, which is: “Why is this happening to me? It’s such an innocent question, but yet it gets us into so much trouble because the answer isn’t that great. Why is this happening to me? Nobody knows. It’s not the answer we are looking for. Or the answer you probably catch giving yourself is, it’s because there’s something wrong with you. Go back to the first question because you did it wrong or because you shouldn’t have, or because you’re bad, or because you’re weak, or because... The list goes on and on and on. It’s rare that you’ll go, “Why is this uncomfortable thing happening? Oh, because uncomfortable things happen sometimes.” Again, none of these are bad questions. They’re just not super effective.

Another one, and this is the last one I’ll use as an example, is: “What does this mean?” Oh, that’s a really bad one. It can get us into so much trouble. “What does this mean?” And before you know it, you’re 20 minutes in going around and around, trying to give meaning to something, which probably has no meaning at all.

The reason I really want you to first reflect on what questions are you asking yourself is you’ll probably find that the questions you’re asking yourself are setting you up for self-criticism, self-doubt, punishment, a lot of negativity, maybe for some really unhelpful emotions, and we want to get better at asking better questions. We want to be skilled at asking skilled questions. The questions we ask ourselves can then move us to and into an action that helps us and is beneficial and effective and kind and less work. Less work is good. We don’t want questions that, again, can give you more work. Go back to “How can I make this go away?” Oh my goodness. That’s a lot of work.

Okay. Let me give you some questions that I am practicing when uncomfortable things happen, events, experiences, emotions, and so forth.

Okay, first question. What emotion right now am I not willing to feel? So, let’s say somebody you love has judged you. Okay, that’s not going to feel good. Your instinct is to make it go away. But we’re going to say, “What emotion am I not willing to feel here? Oh, it’s embarrassing. It’s vulnerability. It’s sadness.” Okay. That’s the emotion. At least now we know, we know what it is.

Again, what emotion am I not willing to feel? Let’s say you did an exposure and you tried so hard and it fell apart and you had a big panic attack and you couldn’t back out. Okay. Your question would be: What emotion am I not willing to feel? Maybe it’s fear. “Oh, I totally backed out because I didn’t want to feel fear. I didn’t want to feel uncertainty. I didn’t want to feel doubt. I didn’t want to feel dread, impending doom.”

Next question: Is it true? Let’s say you... This was me the other day. I’m unpacking the groceries and I’m so happy because we picked them up and we didn’t have to go into the grocery store. I just love this. It’s one of the silver linings of COVID – the grocery stores are so good at doing drop-offs. I bring in this huge bag of groceries, and off the counter I fell a spaghetti sauce bottle and glass and spaghetti sauce is everywhere. Your original thought again is like, “What’s wrong with me?” And then my next question is, “Uh-oh,” instead, “is it true?” The thought I had is like, “You’re so stupid. Why are you going to be so clumsy? Is that true?”

Now, I’m not asking that question to invite a long layer of rumination. In dialectical behavioral therapy, it’s called checking the facts. When you say a negative thing to yourself, check the facts. If I said that in a court of law, what would the jury decide on? “Kimberley is an idiot. She should have known better.” I’m pretty sure the jury would say, “There’s no way Kimberley would have known the specific weight of that jar, and the edge was so close and that it was going to fall at this angle. We’re actually going to probably let her off.” Is it true? Check the facts.

Now, a quick note there. If you’re having OCD obsessions, we don’t need to check the facts of those because that could become compulsive. I’m talking more here about things we say to ourselves like, “You are bad. You are dumb. You are stupid, what’s wrong with you?” Those kinds of comments and more depressive thoughts like, “The world is bad. My future is going to suck.” You may want to ask yourself, is it true?

Now, if your instinct is to say, “Yeah, it’s true. My past has been crappy. So, therefore, my future will be too,” I’m going to say, “I don’t know if that’s going to stand up in a court of law. Because they did it once does not hold you guilty. If it’s happened a hundred times, it still doesn’t give me enough evidence to convict that your future is going to be bad.” So let’s just stop and check in with what we’re saying.

Another question. This is my favorite, guys. This is the king of all questions. I really want you to get good at asking this one – what in this situation would the non-anxious Kimberley deal? What does the non-anxious you do in this situation or with this emotion? Best question ever. That’s a really solid question right there. It doesn’t mean you have to do it all perfectly, but it at least let you inquire as to how you would act, given that fear wasn’t there to make your decisions. How would your values have you act? How would your character have you act in this situation?

So, if I, let’s say, was going to take a test and my fear was saying like, “What if you fail? What’s wrong with you? You should be better than this. You should be fully prepared. You’re asking not-so-great questions,” and you said, “Okay, what would the non-anxious Kimberley do right now?” It would be: “Okay. She would get a drink and get a piece of fruit and eat it and then go and take the test. She would be kind and she wouldn’t be ruminating about how it’s going to go bad.” Okay, go do that. That’s your blueprint on how you should be acting. That’s the skills and the perfect outline of what direction you might want to go into. Fabulous.

And the last question... You can have more, you can add more to this. I want you to really think about it because I want this to be specific to you. But the last question I want you to ask, the question I think is a really good question, which is: What do I need? Not what do I want, but what do I need? What will help me here? What will help me get my long-term benefit here? Get me to long-term recovery? What do I need?

Let’s use a couple of examples. You’ve just spilled spaghetti sauce all over the fridge and the counters and everywhere and there’s glass everywhere. What do I need? I need to be kind to myself. I need to take my time cleaning this up because my instinct was to clean it up in a rush because I was like, “Oh, this shouldn’t have happened. What’s wrong with me? I’m going to clean it up in a real rush so that I can get to my happy things.” But the problem with that is, it only ended up making me more aggravated because I was rushing. So what do I need? I want to clean it up gently and slowly, compassionately.

Let’s say you’ve just done an exposure and it didn’t go so well and you had a massive panic attack. What do I need? I need to slow down. I need to celebrate my attempt. I need to breathe. I need to reflect on how that went and what got in the way. I need a nap. Sometimes when we do exposures, we need big naps, and that’s fine. What do I need?

Someone just said something really unkind to you. What do I need? I need to cry. I need to feel my feelings. I need to give myself permission to be sad. I need to call a friend. I need to maybe set a boundary with that friend. Much better than saying, “Why is this happening? What’s wrong with me? how can I make it go away? What does all this mean?”

So what I want you to do is I want you to leave today’s episode and I want you to spend the day or the week or the month thinking about what are good questions, how can I ask myself really good questions, better questions? Be really intentional about this.

I often say to my patients, if your thoughts are a dog and you’re the owner of the dog, sometimes we let our thoughts just go all over the shop. We just let them go. We follow them. If the dog is sniffing into one corner, you go with it and you sniff into one corner. Sometimes with our thoughts, not so much the intrusive thoughts, but the thoughts we say about ourselves, the criticisms, the stories we tell ourselves, sometimes we’re going to yank on that chain a little bit, on its leash, and be like, “Come on. No, no, no.” We’re not going over into that corner and sniffing out that horrible hole. No, we’re not doing that today. We’re asking better questions.

You’re allowed to do that. That’s not thought suppression. That’s being skilled with your cognitions. We’re not trying to prevent thoughts. We’re just catching when you’re spiraling on them and you’re yanking on the chain. And then come on back. You’re going too far. You’re resisting too much. Let’s lean in.

I hope that’s helpful. Ask better questions.

Thank you so much for listening. I am going to ask you for a favor. Would you please leave us a review? It would help us so much, us meaning all the team at CBT School. We are working really hard to expand our reach to help more people, provide free content. So if you would be willing, I would love nothing more than for you to leave an honest review on Apple podcasts or wherever you listen. We are going to give away a free pair of Beats headphones once we hit a thousand reviews. So I’d love for you to be in the running for that. Thank you.

All right. I love you guys so much. I hope you’re doing well. I’m thinking of you always. I’m so grateful I get to spend this time. Thank you. I know your time is valuable.

Have a wonderful day. It is a beautiful day to ask better questions and do hard things. Let’s do it.

Have a wonderful day, everyone.

May 14, 2021

Welcome to Your Anxiety Toolkit. I’m your host, Kimberley Quinlan. This podcast is fueled by three main goals. The first goal is to provide you with some extra tools to help you manage your anxiety. Second goal, to inspire you. Anxiety doesn’t get to decide how you live your life. And number three, and I leave the best for last, is to provide you with one big, fat virtual hug, because experiencing anxiety ain’t easy. If that sounds good to you, let’s go.

Hello friends, you are going to love this episode. Holy smokes, I just recorded it, so you’ve got me fresh, and I’m so excited. I just had such an amazing conversation with Mike Heady. He is an LCPC and he treats OCD and anxiety disorders. We talked about shame and shame and shame and shame, and he brought so much wisdom. You guys are going to love this episode. It is packed full of all the good stuff. So, I’m not going to waste your time. I just want you to get straight there and listen to it.

Before we get started, if you haven’t left a review, please do so. I love getting reviews from you. When we get good reviews, it doesn’t just stroke my ego. That’s not the point. It is because the more reviews we get, the more people will come and listen to the podcast, which means then I get to help people with these incredible tools, these science-based tools. Hopefully, even just from today, if you’re first time listening, welcome. We are talking about shame, and you are going to get so much from this. So if you are listening, please do leave a review. I would be so grateful. And enjoy the show.


Kimberley: Welcome. I am so excited to have with us today, Mike Heady. He is an LCPC. That’s correct. Right?

Michael: That is, yes.

Kimberley: Yes. We’re going to have a conversation that actually might be my favorite topic in the whole of the podcast. We’re talking about shame. So, welcome.

Michael: Thanks for having me. I share your passion for the conversation.

Kimberley: Yes. Not that I love shame, but I like talking about shame.

Michael: Yes. I agree. It’s hard to say you love shame. It’s like saying I love fear.

Kimberley: Exactly. So, why are you interested in this topic?

Michael: It’s been a professional evolution for me, originally being trained to treat anxiety disorders and OCD. We talk a lot about fear and uncertainty and we have a ceremonial way of responding to shame. We’re like, “Oh yeah, and there’s a shame too.”

In the last couple of years, I’ve really done a deep dive into like, “Well, what is this?” Because a lot of clients are having a hard time getting better. I don’t think it’s the fear that’s hard for them to get past sometimes. I don’t think it’s the uncertainty. I think it’s the shame. I think it’s a different animal. When I started doing a lot of digging, I realized there’s a whole world of shame out there in the literature, and how it applies to OCD fascinated me. So, that’s my new passion project.

Kimberley: Yeah. Same. Exact same experience. Also seeing how much fear in and of itself is a generator of suffering. But as you said, there’s this shame that’s generating suffering at exponential levels. So, I’m so grateful to have this conversation with you. for those who are listening and who might not really understand shame, would you be interested in giving me your working definition of what shame is?

Michael: Sure. Are you okay if I elaborate on it a little bit?

Kimberley: Yeah. Go for it.

Michael: Okay. I think a good definition is that shame is a really painful, aversive, unpleasant emotional experience. Fear or disgust, it’s natural or instinctive for us to want to back away and get rid of shame. Shame is often brought on by some kind of real or perceived violation of a social norm that we actually believe in. So it’s not this mystical emotional thing. It’s a thing either real or perceived occurred. And then I experienced this negative, painful emotion of shame. That’s the short version of the definition.

I think it’s worth talking about shame as having two levels of shame. We might call an adaptive kind of shame, the shame where we view it as a response to a specific episode, rather than some generalizable character flaw or full-on assault of our identity. I violated something I believed in, I feel bad, which is different than guilt because guilt is about apologizing to the other person for something you’ve done. But I might feel bad for violating a norm I believe in. Okay, there’s nothing toxic about that.

There’s another level of shame that we tend to want to talk about more. It’s the toxic shame. That’s the shame that is unworkable. It’s always unhelpful. It is a response to a perceived or real violation of a norm that has broad sweeping characteristics to it. It is a full-on assault on our identity. It is a condemnation of the self. That’s the toxic shame.

I can wrap up this as saying, what was incredibly helpful for me when I was going deep dive into what shame was is, yes, shame is an emotion. We know what emotions are. We all feel emotions. We’ve all felt shame.

You and I, as therapists, spend our careers trying to help our clients have a different relationship towards painful emotions, and understanding what an emotion is, specifically around shame, I think was really enlightening for me. I derive a lot of this understanding from some work that occurred in the sixties and seventies, probably before then, but the work from the sixties and seventies is what brought it to my attention, that emotions are an emergent experience constructed by an interaction between our biology and our biography.

The biography piece comes out of Silvan Tomkins work in the late sixties where he suggested that, yes, there’s a universal kind of biological experience that contributes to an emotion. But the part that completes it is our own narrative, which is unique to us.

My interaction with the world, as I develop from a child to an adult, the experiences I have, my environment, that’s the secret ingredient to my shame. So what makes me feel shame isn’t necessarily what makes you feel shame.

For instance, if I were to, while talking to you, suddenly break out into a red flush on my face, start sweating, and my voice start cracking, I might experience that as an embarrassment, like a small shame. But if you perhaps had terrible social anxiety disorder and the same thing happened to you, the same exact event, you might see that as a humiliation. Both are derivative emotions of shame. But humiliation is different from embarrassment in orders of magnitude of pain. Humiliation is closer to trauma than it is to anxiety. This is anyway my long-winded way of saying, yes, shame is a complex animal, and that’s the working definition I tend to have.

Kimberley: Yeah. It’s a different way of explaining it. This opportunity makes me so happy. What you’re saying is, it’s on a spectrum, would you say?

Michael: Oh, absolutely. Yeah.

Kimberley: Now, let’s play that out. We’re talking about the biology, and then there’s the story we tell ourselves. Would you give an example for you? You and me, let’s say we both got embarrassed. Let’s say we both made a mistake or something. We embarrassed ourselves in front of each other, which is not going to happen here. But if we did, what might be a difference in the story we told each other which would indicate that higher level of shame or toxic shame?

Michael: Sure. Let me clarify the story. It’s not just how we appraise the shame itself. That’s a part of it. But the story is like my upbringing. I was brought up in a blue-collar family. There wasn’t a lot of room for emotions, especially for the male members of the family. So if I encountered a situation where I felt vulnerable or sensitive or hurt, the expression of that emotion could be shut down. That expression of that emotion could be punished, ridiculed. Not that I was ridiculed, but it could have been.

Someone’s narrative about a negative emotional experience could have been that and ongoing. They could have been bullied for being a sensitive kid, whereas you may not have. now you both may experience the same thing as a generic sense of shame. “I wasn’t the way I wanted to be. I wanted to be put together and intelligent and I made a stupid GAF, and I came across looking silly.” One kind of embarrassment for one is not necessarily the embarrassment for the other. That’s what I mean when I say “the narrative.”

Kimberley: Yeah. Okay. This is wonderful. I think that maybe we want to take a look at, and I know I have a few questions. What I’d love to take a look at is, why would, let’s say someone feel shame for having a mental illness?

Michael: Well, yeah, that’s a great question. I think there’s a whole lot of reasons why someone might feel shame. One of them could be, I feel shame because the mental illness – we can say OCD in particular since this is one of the things I primarily treat – is that the content of my obsessions themselves could have a taboo theme or they could be otherwise conceived as bizarre. That’s going to create a sense of “I shouldn’t have this thought, there’s something wrong with me I have this thought.”

The helping field, in general, commonly misinterprets and doesn’t understand OCD. If you present this set of thoughts to them, you’re going to get a sense of judgment and rejection or humiliation, and that’s not made up fear. That’s a real fear. That stuff happens to people. That’s an example of how someone with a mental health issue can develop shame. It’s because they may have gotten that feedback or fear rightfully so that they would get that feedback.

Another way of looking at it is just, “I shouldn’t have this because having this means I’m not working properly. I’m otherwise defective or broken.” It’s a silent problem for people – these emotional and psychological things. We have a lot more empathy and understanding for people with a physical problem than we do for someone who has a psychological or emotional problem. So, I think that there’s this built-in--

Kimberley: Stigma.

Michael: Yes. Stigma. Right. Thanks. Yeah, exactly. And then there’s the people who’ve tried to get better. I’ve certainly seen a number of clients who’ve gone through years of therapy. They’ve worked diligently with great therapists, all very well-intentioned, and they failed to get better. “What’s wrong with me? I must be really broken.” I’m sure there’s countless other ways, but I’ll pass that off to you, I think.

Kimberley: Yeah. I mean, I think these are all societal expectations that are placed on us. It’s funny, you brought up the question about the concept around being humiliated for having an emotion. Somebody had written a question like: How can I be considered “the man of the house” if I have anxiety? I mean, there’s so much shame in that question. There’s so much societal expectations in that question and stigma in that question.

I think it’s definitely there, and I think you’re right. For the things that are unknown, I see that to be more shame. I think everybody understands sadness. So we don’t feel so much shame around it. But fear of harming your baby – let’s not talk about that. You know what I mean? Let’s push that down.

Michael: Right. And not only because it’s universally taboo. We know that instinctually. We don’t need to really be told that. We know that, because that’s our response if we were to hear that from someone else. Until we have that intrusive thought ourselves and they’re like, “Oh, me too?”

Shame, I think it’s distinguishing shame from the other negative emotions that people have, because I don’t think they’re all the same. Oh, negative emotions or negative emotions – let’s just learn how to handle them. Fear, that’s a tough one. But shame? Shame is the most painful.

Kimberley: It’s ouch because it’s in silence too, I think. My thing I say all the time is that shame thrives in secrecy. One of the best things you could do is to tell it out loud.

Michael: I was having a conversation with colleagues about this a couple of weeks ago, and someone brought up a slogan that comes from AA, which is, “We’re only as sick as our secrets.” It’s such a powerful message. The idea that speaking that secret allowed, speaking that shame aloud can be healing. Now it can also be traumatizing. We can probably get into that later in the episode. But I think that there’s discernment about how and who we share with, and us as therapists creating a space where that’s good and healthy for the person. But you’re right. Absolutely. The things that thrive in darkness are painful.

Kimberley: Okay, so you have a client and they have just very typical symptoms of OCD, even if it’s very typical taboo, obsessions – this is for people listening – any disorder, depression, BFRB, eating disorders, how do you work with that shame with your patients?

Michael: That’s a fantastic question. I’m always evolving on how I figure that out with a particular client. I think if I were to try to distill that down to something helpful to the listeners, I think as a therapist, it would start with the very first interaction I had with the client. The first contact is the first opportunity, probably the best opportunity to provide a safe space that’s understanding, validating, authentic so that the client can then experience this interpersonal interaction that they’re having with this therapist as welcoming towards disclosure of a secret or their shame.

I think that that first contact is vital. You can come across as the kind of person they want to talk to and try to set the stage and make that an effort, build that therapeutic alliance, continue to work on a therapeutic alliance because if you don’t, it might be a lot harder to build the work to let them disclose that shame.

And then from there, I think education about what shame is, like I brought up in the beginning, that shame can exist on this continuum, that there is actually an adaptive kind of shame. We don’t tend to talk about it. We don’t tend to see it because we talk about the toxic and the pathological shame, the one that keeps people stuck in hurt. Through that education, through a demystifying of it, I think, is incredibly valuable.

I’ll talk about the compass of shame in a minute. I don’t want to steal all the time from you. It’s like I talk a lot.

Kimberley: Go for it. No, do.

Michael: I’ve been thinking about this in preparation for our conversation today. I was thinking like, how would I want to set up an ideal way of dealing with shame with a client and again, creating that therapeutic space that they’d want to share that. And then if we have this experience that once we hand our secret or shame over to another person like, “Here you go,” that’s what the clients are doing to us, they’re handing it to us.

If we receive it and hold it with compassion and understanding, if we hold it with acceptance of them as a person, I think we introduced them to common humanity – one of the three things that show up with self-compassion, that common humanity – perhaps for the very first time in their life. Because this is such a secret, quiet problem, this might be the first time they’ve ever been met with common humanity and acceptance when they’ve revealed this. I think that’s immeasurably powerful for the client. I think it helps them create a healthy distance from that narrative that’s been telling them to keep it a secret, keep it a secret, or else you’ll get rejected. “Wait a minute. I wasn’t rejected.”

Kimberley: Yeah. It normalizes it too. Right?

Michael: Yeah.

Kimberley: Sometimes when I hand over the why box that has all the different obsessions, that in of itself can be a shame killer because they’re like, “Oh my goodness, all of the things I have are right here on this piece of paper and you don’t seem alarmed at all.”

Michael: Yeah. I’ve had email interactions with clients who are like, “Have you ever heard of this kind of presentation?” I’ll shoot them links to three books written about it. They’ve written entire books about this so you’re not alone. It’s so helpful for them.

Kimberley: Yeah. Tell me about the compass.

Michael: Yes. I was introduced to this through one of my mentors, and it really rang true for me as a useful concept. The compass of shame was developed in the 1980s by a psychiatrist by the name of Donald Nathanson. I don’t want to bore the audience with the history, but he researched shame basically that was his career. Nathanson had found through his research that there are four predictable and common unhelpful responses to shame. I’ll say toxic shame. We’re all talking about toxic shame. Those four represented the four points of a compass – north, south, east, and west. It doesn’t matter where they go.

One of the points is withdrawal. Withdrawal is when we get quiet, silent, small. Like a dog who got caught chewing on the cash knows they did wrong. They get small, they get quiet. They try to disappear into the moment. That’s one common response to shame.

Another one is avoidance, behavioral avoidance of situations and people and circumstances, but also through substances, through food, through sex, through anything that would be a direct response to a cue, “I’m going to avoid this feeling.”

Then another part of it is to attack others. This shows up when you felt humiliated or embarrassed by someone else. Someone made you feel this way, so you’re going to lash out verbally or physically. In a sense, the way I think of it is in the sense of trying to balance the scales. “You’ve made me feel small and vulnerable and insignificant. I’m going to try to balance that out by making you feel the same way.”

The last one I think by far the most common in the people that we’re going to be working with is attack the self. This is self-criticism, this is berating ourselves, self-condemnation, degrading ourselves. It’s often seen as “I’m going to be holding myself accountable for this failure real or perceived,” and that’s going to make it better, that there’s somehow a utility to this attacking self-response. But when you poke at it just a little bit, it’s completely unhelpful. It’s just a massive perpetuator of the problem.

So, that’s Nathanson’s Compass of Shame. I think his point in bringing this up is, look, everyone’s toxic shame response is going to fall probably into one of those four. Where do yours? if we can bring awareness to that, maybe we can learn to pivot to a more functional or helpful response instead.

Kimberley: Right. I think that that awareness, again, it’s validating and it’s normalizing the normal response to shame, which helps the shame, I think, in and of itself. Okay, so let’s play this out. If something happens, you’ve made a mistake or you’ve had a thought that you’ve deemed unacceptable, or you showed up in a way that created shame, you did all four of those things, what do we do from there? Or you did one of them. Now that we have this awareness, how might we meet shame instead in your thoughts, in your mind?

Michael: I think hearing that from a client and I was watching it unfold in the moment, I might say, “Can we pause for just a minute? I think shame showed up for us.” He might even be able to see some of the behavioral changes in their eye contact and the postures. I think shame showed up. What are you doing with that right now? Because again, it’s silent. It’s not broadcasting this out loud. It’s silent. What are you doing? What’s going on in your mind?

Probably reveal what you said, they did one or all four of those things – I would point that out, give it a name. We understand this process. This is somewhat of a predictable response. Can we hit the pause button and can we now make a choice to pivot to a different response. Pivot to what? Pivot to self-compassion maybe. That might be a teachable moment. What is self-compassion? Can I give you an experiential exercise on meeting this moment with self-compassion? I can model meeting this moment with you with compassion so you can see what that looks like and feels like.

Instead of spending time in the head, in the verbal, in the ruminative come back to the feeling, because that’s what we’re trying to avoid. When we criticize ourselves, we’re trying to avoid and escape criticism, or using criticism to try to avoid and escape shame and humiliation. Okay, let’s come back to that. That’s painful. We can learn how to sit with that without having to beat ourselves up or escape it.

I think people can sit with it in different ways. You can use it as an exposure opportunity for people who are feeling smaller kinds of shame, like embarrassment, like let’s do some exposure towards what it feels like to be embarrassed. If we’re dealing with a much more painful kind of shame, that humiliation kind of shame, let’s meet that with more direct self-compassion in this moment.

I think it gets sticky a little bit when we introduce self-compassion, if we haven’t already introduced it, because like any intervention, it hinges on the client buying into it and thinking that they deserve to receive it.

Kimberley: Right. I’ll give you my personal experience with this because I think, and I see a lot and I would add a fourth point to the compass, which is, now as you’re talking, I think this even different than what we talked about in previous conversations, just the two of us, is I think if I were really to track it, I think that another thing that I did when shame showed up is I swing into perfectionism. The stronger shame was, the more I would do good or be good. It’s an interesting reflection for me because I think the more I felt imperfect and the more shame that brought up, the more it’s like compulsive do good kind of thing, which I think again, might be why some of our clients get stuck around shame because there is that sort of self-punishment. “Well, I did a bad thing. Well, I have to neutralize that with a positive, good thing.” I don’t know. Just something I’m thinking about.

Michael: No, I think that’s really great. I’m sure a lot of people listening are thinking right now, nodding their heads, “Yup, I go into perfectionism.” If I can channel Nathanson for a second, I imagine he would say, “That’s a type of avoidance. It’s an avoidant behavior. You’re doing this thing and it’s a compensation to numb, or to balance the scale.” If I do enough good, it cancels out the bad. The message is that that thing is intolerable to feel, and it’s not.

Kimberley: Good catch. That’s true. It is. It’s like neutralizing the compulsion, right? Yeah. Okay. This is amazing. I have some questions from the audience that I think is a perfect segue, and there’s one that really hit me, really deepened my heart and I wanted to ask your opinion on. Somebody had asked, how do I manage shame for having symptoms? They didn’t express which ones, but I’m assuming it’s having symptoms of being a human of some respect. But I also have privilege and resources and the ability to get care, how do I manage shame when I have privilege?

Michael: That’s a really great question. I think if I can flip that around a little bit, I can say that the cost of your privilege towards access to care, towards a good community of people, the cost of that isn’t more shame. We don’t want to shame ourselves for having opportunities. In a way, it moves you away from doing something about that, about that privilege. If you recognize I have privileged shaming yourself is useless. Who’s that for? That’s a silent response to try to balance out this. It’s an avoidance. It’s a running away from.

So can we try to meet that? I’d say first with patients and then recognition, yeah, there is some privilege here and I feel bad about that, and then move into a “what’s next” kind of a mindset. Like, I still need to work on my own shame about having these symptoms. It’s not like I have to suddenly stop working on that because I also happen to have the privilege and the capacity to work on those.

But I think we throw it into the same mix. It’s like, okay, so you’re shaming yourself. Which one of the four points of the compass are you doing now in recognition of a privilege? Once we get off of that unhelpful response, we can then maybe find a more helpful way to recognize the privilege, to speak out against the privilege, to prop other people up and help other people have access, things like that. But we can’t do that if we’re shaming ourselves, because shaming yourself, criticizing yourself, avoiding isn’t workable.

Kimberley: Yeah. There’s so much of this like self-punishment involved as a response to shame. Like, okay, so I have this one privilege, so I must be punished for that before I can address the problem that I have almost. I’m so grateful that you answered that because I have seen that multiple times, many, many times with my patients and I’m guessing you too.

You’ve talked about shame around lots of emotions. Interestingly, there were two very common questions, and I’ll leave these as the last two questions for you. There was a lot of questions around having shame for anger and there was a lot of questions around having shame for having a “groinal response,” which I’m assuming is in relation to some kind of sexual obsession or maybe even sexual orientation as well. Can you share your thoughts on those?

Michael: Sure. Shame around anger, I think... I’m trying to interpret the question a little bit. I imagine it goes beyond just the feeling of being angry, but maybe the act of being aggressive, if I can make some interpretation there. I helped the client recognize that anger, like any other emotion, is universal. It’s an emergent experience. It’s not really up to you about whether you get angry or not. We don’t have to act on the anger. We don’t have to become aggressive either passively or physically aggressive about it. So, teaching them that there is some workability in our response to anger and that if we accept anger as an emotion, if we make room for anger as an emotion, we don’t need to have a response to it in the same kind of way. We can let it in.

Susan David, in one of her Ted Talks, she said that emotions are data, not directives. I love it. Super helpful way of organizing your thoughts around that. It’s just, let the emotion be data. It’s if you’re responding to something in your life, something happened that it shouldn’t have happened and it wasn’t fair, and then you felt angry. Okay, I understand that process. I don’t need to do something about it to get rid of it because there’s that relationship to an emotion that can be unhelpful. Now I have to find a way to control or get rid of it. Notice we only do that with the negative side of emotions. We don’t tend to be like, “I have to get rid of my joy.”

Kimberley: Too much joy.

Michael: Too much joy.

Kimberley: Unless we feel privileged, so then we’re not allowed to have too much joy.

Michael: Right. Yeah. In response to the groinal stuff, I think, again, it comes down to your biological, your physiological, your groinal response isn’t really up to you. I think Emily Nagoski does a really great job in her talk about unwanted arousal, and such a powerful Ted Talk and really great education around that. Your body’s going to respond, whether you like it to or not. I used to joke around and say, the reason why the 13-year-old boy isn’t standing up at the end of Spanish class is because he wants to get more lessons. It’s because he’s waiting to not be embarrassed when he stands up. It’s not that he’s attracted to Spanish as a language –maybe he is – it’s because he had a response and it wasn’t really up to him.

Okay, so bodies respond to things. Can we separate that out from the thing that was in our mind? Bodies respond to sex generically. It doesn’t matter who it’s with, what it is. Just the idea of it, the notion of it, the hint, and it response. So even people listening to us now, using the words like sex, might respond to the word, and that doesn’t mean you’re attracted to the word or to this podcast. Maybe you are, but it’s probably not. It’s that your body responded to things because of all these associative learning cues that are going on. That education is powerful.

And then, of course, I treat shame the way I treat any toxic shame, which is, the response to it is the biggest problem that needs to try to meet it with something a little bit more akin to self-compassion and common humanity.

Kimberley: I love it. Thank you. Oh, you nailed it. Is there anything else you want to share?

Michael: I mean, not off the top of my head. I’m sure that we could dive into so many different rabbit holes on the subject, but I think this was a good intro to it.

Kimberley: Yeah. Intro, but also with depth. I’m really grateful. I love to give as many applicable tools as we can. I feel like there is some better understanding. The compass is so good. It’s so helpful to be able to deconstruct it that way.

Michael: Yeah. That was a game-changer for me when I heard about that too. I will add a couple of things, just in passing other ways of therapeutically addressing shame. Once we’ve agreed that those four points in the compass are not the way we want to handle it, we have to have a new way. There’s a, what used to be, I think, a Broadway show called Get Mortified. It’s now a podcast, and it’s people sharing humiliating and mortifying personal stories. Again, this is going out to strangers and this is an idea that I’m normalizing these experiences in my life. Maybe someone else can relate to it and maybe we can bring some humor to it. It’s not about making fun of the person or the situation, it’s about saying, can we all just laugh at the fact that we’re busy concealing something that is so universal and ubiquitous.

Kimberley: Yup. Life happens, right? It doesn’t go to plan.

Michael: Yeah. I think that’s the other piece. Once you’re ready for it, humor is hard to think of a more helpful response to shame.

Kimberley: I’m holding back every urge right now to be like, “What’s the most mortifying thing that’s ever happened to you?”

Michael: That’s a different podcast.

Kimberley: I was once on a podcast where he asked that, a very similar question. It was on OCD and he asked me a similar question. I think I completely went into your shame compass, like all the things, “What can I do to avoid this conversation?”

Michael: Yes, yes. I think that would be like a few cocktails and we’re going to record a podcast and maybe we can talk about that. But again, you can see, you can notice how even here, I could easily come up with two very shaming experiences in my life, and the difficulty of sharing that when I think that other people are listening to it. Why should I care? It’s because it’s a painful emotion. So even us therapists have a lot of work to do with personally so that we can show up with the client in a way that’s helpful.

Kimberley: Right. When I was doing one of the Mindful Self-compassion intensives, this is with Kristin Neff and Christopher Germer, one of the activities where we had to stop and do activity with the puzzle we came with if you came with someone. And then you had to turn to a person you didn’t know, and you had to tell them one of the most painful things that’s ever happened to you. They didn’t really give you a lot of choices either. They were like, you’re here, you’re going to do it.

The whole act was there was tears everywhere, flying across the room. But the thing was then, the person who’s listening was not allowed to say anything, except “Thank you for sharing.” It was so powerful. It was so powerful. They weren’t allowed to say, oh. You weren’t allowed to touch them. You weren’t allowed to say anything, except “Thank you for sharing.”

Michael: And again, an immeasurably effective and important thing. That wasn’t self-compassion. That was compassion, right? This is why I think like you with your Instagram work and people like Chrissie Hodges and OCD peers, and anyone who’s an advocate for OCD that is building a community of people where they can interact like OCD has a community of people. These communities allow other people who are struggling with OCD to interact with each other. You create this group acceptance. The group has accepted you in, shame and all. You no longer need to conceal or keep secret this thing. The weight, the anvil that gets lifted off your shoulders, you no longer have to be weighted in the past.

It’d be nice if we could generalize that outside of an OCD community and just say, the community at large has now been sufficiently educated about what OCD is and isn’t, what depression is and isn’t, what eating disorders are and are not, trauma, so we can be a lot more understanding of one another. Perhaps that’s a little Pollyanna-ish to hope for, but I think that that’s the direction we should head on.

Kimberley: That’s the mission. Yeah. Well, I actually think that this is a perfect place for us to end because I think that that is where we’re at. That common humanity, we all have it. You’re not alone. Yes, it’s the most painful thing you’ll feel. You’ll feel like your heart is breaking at the time. All of these things are so normal and part of being a human. So I love that that’s where we’re at. Thank you.

Michael: Thank you for indulging the conversation.

Kimberley: Easily, so easily. Tell us about where people can hear more about you and know about you.

Michael: Sure. As you mentioned, my name is Mike Heady. I’m the Co-Director of the Anxiety and Stress Disorders Institute of Maryland. I work with my other Co-Director, Dr. Sarah Crawley, who’s a Child and Adolescent Psychologist. The Executive Director and Founder is Dr. Sally Winston. She’s written a number of books on OCD. We’re in Baltimore, Maryland. We’re an outpatient, private group practice. We have over 20 clinicians that specialize in depression, OCD, anxiety disorders, and other related conditions. Yeah, that’s us. That’s me.

Kimberley: Amazing. Well, thank you. I really am grateful. I feel so calm after these conversations too because I feel like it’s the more you guess, you get to settle into it. So thank you. I’m so grateful personally, and for the community here, who sounded like they were very excited about this episode.

Michael: Well, thank you for having me on.

Kimberley: My pleasure.


Please note that this podcast or any other resources from should not replace professional mental health care. If you feel you would benefit, please reach out to a provider in your area.

Have a wonderful day, and thank you for supporting

May 7, 2021

Welcome to Your Anxiety Toolkit. I’m your host, Kimberley Quinlan. This podcast is fueled by three main goals. The first goal is to provide you with some extra tools to help you manage your anxiety. Second goal, to inspire you. Anxiety doesn’t get to decide how you live your life. And number three, and I leave the best for last, is to provide you with one big, fat virtual hug, because experiencing anxiety ain’t easy. If that sounds good to you, let’s go.

ep 188 image How to Tolerate Uncomfortable SensationsWelcome back, everybody. Thank you so much for joining me. I know your time is very valuable and precious, so thank you for spending your time with me.

Oh goodness, I have so much to reflect on with you today. I’ve had a few aha moments, which I wanted to share with you because I wondered if I’m having these aha moments, maybe you are too.

Let’s just actually get straight to it. Shall we? Because it’s funny for me to say this to you. I’m sort of embarrassed to say this, but I also think it’s very hilarious.

I consider myself to be a very mindful person. I really do. When I’m struggling, I always practice what I preach. I observe that I’m struggling. I bring my attention back to the present. I engage back into the present and I usually feel better. This has been a profound practice for me in my life. I teach it to you guys because of how much of a huge difference it has made to me.

What has been really interesting is, I have taken some time off. I’m slowing down with work. My children have gone back to school. To adjust, we’ve had some massive, massive adjustments in our family. My husband took a year off work to be with the kids, so he could be their teacher. I, when COVID hit, went deep into just so much work and was really working to support the family in a way that I hadn’t had to do before. I’m so grateful and I really recognize how privileged we were to have this environment and this experience because I was writing a book and I had my clients and there’s just no way he could have gone to work.

So, he’s gone back to work. My children have gone back to school. I’m still finishing up the final stages of the book. So, it’s been such a huge difference for me. Because of this, I actually have been working with a coach, which usually I go to therapy every week. My therapist and I agreed that I would take some time off because I really felt like I was doing everything that she had given me. I was really feeling like my mindfulness skills are really helping me.

What was so interesting was that my coach – and this is not a coach for anxiety, this is more of a life coach – brought to my attention – and this is where it’s really funny – that even though my mindfulness skills are really effective and so healing and wonderful, he felt – and I thought it was shocking to start with, but I think he’s right– that I’m using it to avoid feeling my feelings and avoid feeling the sensations of anxiety.

Now, when he told me this, I’m not going to lie, I wanted to smack him upside the face. I was just really mad about it. I was like, “What? You’re telling me, I’m just this girl of mindfulness?” I don’t really see myself as a girl, but my ego was like, “I’m a guru at this. I’m so good at this. You’re telling me that it’s not effective?” I took some time. I shook off the pride, the pride issues that I was having, and I really let what he was saying to sink in. He’s 100%, right.

I really am so grateful for this opportunity to be called out on this one. So here I am sharing with you that I too am going through a layered experience of recovery. As many of you know, I’ve had an eating disorder, I’ve had anxiety my whole life. I have struggled with depression. I have struggled with medical issues that have been really, really stressful on myself and my family. I have handled them mostly really well, I think, but it never occurred to me in this idea of recovery that I may be bypassing the opportunity to really do some work around uncomfortable feelings and uncomfortable sensations.

Here I am. I’m going to teach you what I’m practicing.

Now, I’ve made some adjustments. Instead of noticing my discomfort and suffering, I tend to it with mindfulness and self-compassion. But instead of jumping straight into those skills, which are so good, by the way, I’m not discounting. These skills are gold. If you have mindfulness skills, it’s better than gold. It’s more valuable than gold or anything else that you could get. So I still am going to use those, but there’s this teeny tiny little space before that where I’m actually practicing feeling, allowing, and tolerating uncomfortable sensations, allowing uncomfortable feelings to be there.

Now, I know the title of this episode is How to Tolerate Uncomfortable Sensations. The reason I’ve done that is because even though I realized emotions was the thing I was avoiding, really when I get down to it and we break down a feeling, a feeling is just a combination of a thought with a sensation.

I’ve done episodes on how to tolerate thoughts, but I really wanted to really practice, and this is what I’m doing: Okay, I’m feeling sad. I’ve had a lot of sadness lately show up in my body. Where does it show up? For me, it’s right at the front of my shoulders. I want to just pull my shoulders forward and curl my spine into a C-shape and just contract and go into fetal position. When I feel sad, I just want to drop my head down onto the table. I want to drop the muscles in my face and I just go exhausted.

Instead of going, “Oh, I’m noticing that I’m sad,” be compassionate to your sadness, but bring it straight back to the present, pull your shoulders back. I’m actually just making space for the sadness. I don’t slump and jump into bed and stay there all day. Not that there’s anything wrong with that, but I’m not engaging in sadness. I’m not just responding to sadness with apathy or depression, but I’m actually just spending time there and just going, “Yes, Kimberley, this is sadness. This is the sensation of sadness. It’s okay to have these.” Let’s stay with them. We don’t have to stay with them all day, but let’s just honor them first. Let’s stop jumping to mindfulness and compassion really fast. Let’s actually stay in the sensations. You can still go about your day. You can still be highly functioning. We still want you to be doing those mindfulness and those exercises. But my question to you is: Are you really allowing that to be there or are your emotions holding you hostage? – which I think is what was happening.

As I’ve always said to you, if you have a fear, stare it in the face. That’s how you get empowerment over that fear. If you avoid the fear, that fear has power over you. And then you’re always going to feel like your fear controls your life.

The same goes for sensations. If you have uncomfortable sensations and you immediately remove your attention from them to the present or other things, now your sensations have control over you. You’re giving them all the power and you’re afraid of them.

This is where I pose another question: Are you afraid of your uncomfortable sensations? If so, let’s practice feeling them as an exposure. Without knowing it, my coach who is not an exposure therapist is technically giving us a mini-exposure by saying, “No practice staying in the sensations of sadness or anxiety or happiness or exhaustion or whatever it may be. Practice tolerating and staying with them and still doing what the non-anxious you would do, or the non-sad you would do.”

Like I said, I’m not going to say, “Oh, I have to feel my sadness. I need to stop what I’m doing, stop this podcast and go and lay in bed.” I’m still going to talk to you guys and do what lines up with my values, which is to talk with you guys, connect with you guys, and so forth. But I’m going to say, “Okay, I’m observing that my shoulders feel that heavy feeling or my head feels that heavy feeling or my heart hurts. Can I just breathe into that?”

Now you may want to set some timers for this and say, once you identify it, “Okay, for the next 15 seconds, I’m going to just do this for 15 seconds.” Then you may say, “Okay, let’s try it for 30 seconds.” While I feel this anxiety – shortness of breath, tingling, tight chest, derealization, lump in your throat, panic sensations, racing thoughts – while I tolerate these sensations, can I practice coupling them with my life? So, while I’m feeling the emotion and the sensation, can I type up my email? Can I couple those two together? And when I do that, I might even say to myself, “Okay, this is me doing an email, writing an email while having the sensations of sadness or anxiety or anger or shame or whatever it may be.” Just by that, you’re having this experience of learning how to have emotions and sensations and you’re learning a sense of mastery over them.

Now, some of you have probably thought like, “Well, she’s told me this before,” which is why I said I’m slightly embarrassed because I know this stuff and I’ve probably said it on this podcast before, but I wasn’t practicing it.

Now, humbled to say that we’re all working this out. We’re all figuring this out. I was just listening to this wonderful meditation from my meditation teacher. He was saying that meditation is really like a huge Ashram. If you had the job of cleaning a large Ashram, you’d start in one room and you’d go to the next one, you’d go to the next one, and you’d go to the next one. You’d slowly get it done. By the time you finish, the first room you cleaned is dirty again. So you got to start again.

He’s like, the goal of meditation is not to get the house clean and be like, “Good, I’m done. I’m all done,” slapped my fingers together. “It’s all good.” That’s not what this is about. That’s not what recovery is. I really resonated with that. I feel like I have to tell my clients these stories as well because recovery isn’t a one-and-done. For me, literally, that’s me. I’ve cleaned every room in the house. I’ve circled back. And now I’m like, “Oh, there’s another thing. There’s another area of improvement for me. Oh no. Oops.” You know what I mean? My son always goes, “Oops.” It is total “Oops, okay.” This is a wonderful opportunity for us.

This is not about learning how to be uncomfortable and you’re done. This is about really having mastery over any sensation, any thought, any feeling that you may have. Any urge, any image, anything – having mastery over that. Not even mastery. Let’s just actually scale back. Let’s actually say, “Just knowing you can,” that’s enough. Let’s not talk about mastery. That sounds too big for me right now. Let’s just talk about knowing that I can. If I had to have anger or I had to have sadness or had to have anxiety, I know I could. Let’s stay there.

I hope this has been helpful. I am more than happy to share with you my shortcomings because I think that it makes me very human. It gives you permission to be very human. You guys know that I try not to take myself too seriously. I am on a journey with figuring this out too.

Hey, let’s just keep cleaning one room at a time and enjoy this learning.

Thank you so much for listening. Please do leave a review if you enjoy the show or not. Please leave an honest review. We would love to get a review from you. I’m just sending you much love. Take care, everybody. These are difficult times. I want to really offer my loving-kindness to you, offer a gesture of kindness and warmth and compassion to you if you are struggling.

Have a wonderful day. I will talk to you soon.

Please note that this podcast or any other resources from should not replace professional mental health care. If you feel you would benefit, please reach out to a provider in your area.

Have a wonderful day, and thank you for supporting