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Your Anxiety Toolkit - It's a Beautiful Day to Do Hard Things

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Now displaying: November, 2021
Nov 26, 2021

SUMMARY:

In today’s podcast, we take a deep dive into a common question I get from followers and CBTschool.com members. HOW MUCH ERP SHOULD I BE DOING DAILY?  Because ERP is such an important part of OCD treatment and OCD therapy, I wanted to outline how you might set up an ERP plan for yourself and how that can help you with your OCD treatment.

In This Episode:

  • What is ERP (exposure and response prevention)?
  • What an Exposure and Response Prevention plan looks like.
  • How to determine how much ERP you should do each day
  • Why it is important to practice ERP for OCD, health anxiety, and other anxiety disorders.
  • How to taper off doing ERP once your obsessions and compulsions have reduced.
  • How to practice self-compassion during ERP

Links To Things I Talk About:

How much ERP should I do each week OCD therapy Your anxiety toolkit

Episode Sponsor

This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more.

Spread the love! Everyone needs tools for anxiety...

If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two).

EPISODE TRANSCRIPTION

This is Your Anxiety Toolkit – Episode 212.

Welcome. I am so thrilled today to talk to you about a question I get asked all the time, which is, how long should I be doing exposure and response prevention per day? So we are going to go all the way through that here in just a sec. But before we do that, we always start the show with our “I did a hard thing.” Now, each week people submit their “I did a hard thing” and we share it because we want to spread the word on all of the hard things that people are doing to inspire you, to help you realize you’re not alone and to help give you that little bit of motivation to face your fears as well.

Now, what we usually do after that is we do the review of the week as well, which is where people leave a review on iTunes for this podcast, Your Anxiety Toolkit. But today, somebody left a review that was also the “I did a hard thing.” So I thought, no better opportunity than to do both at once. This is from Jayjenpeezy, and they said:

“Right on time! I cannot even begin to say how helpful this podcast is and I have incorporated into parts of my daily meditations and/or listen to it on my walks. A few weeks ago I was admitted to the ER and kept overnight for an observation and what the doctors originally thought was tachycardia turned out to be a panic attack which I had never experienced to that degree before. I spent the next few weeks even more anxious at the thought that it would happen again and thought I’d lost my mind and began taking antidepressants as a quick solve which now I know is not the solution I truly needed. (Mind you, I am speaking only for myself and understand that not everyone is able to be off their prescription meds.)” I love that you included that.

“After doing some research I learned about this podcast and ERP and am starting to feel much better about a lot of things. I’ve also changed my diet to be more alkaline, incorporated daily meditation, gratitude journaling and have been able to finally leave my house to take daily walks. The journey is different for everyone but as she continuously reminds me that “it’s a beautiful day to do hard things” and that panic attacks are not actually attacking you it’s your adrenaline rushing through you and in time comes to pass when you are able to meet it eye to eye. I also learned to look at it as willful tolerance,” we have a whole episode on that “and it is not so scary anymore. I am taking it one day at a time and am mindful of being present as possible. Ending up in the emergency room while my children were left at home at night was enough for me to take any and all necessary steps to not allow my anxiety control me. Sending love to all and may the force be with you.”

I love that. Let’s just say that is the perfect marry between “I did a hard thing” and a review. So thank you so much to our reviewer, Jayjenpeezy. I am in such admiration of you.

So let’s get over to the show. Today, we are talking specifically about how long or how frequent your ERP should be. Now, when I say “should,” I’m going to disclose here, it’s different for everybody, but I’m going to tell you just briefly what I would tell any of my clients. And then from there, you get to go and decide what is right for you. Okay? So, let’s go over to that topic.

When someone asks me how long or how frequent and what duration I should do for an exposure, I almost always tell them the same thing. In ERP School, the online course for OCD, and in my new book, The Self-Compassion Workbook For OCD, I say exactly the same thing in both, which is ideally, you should practice exposures for around 45 to 90 minutes per day. Now, I know that doesn’t work for everybody. So you have to go and do and find a balance of what’s right for you. But let me show you how you might incorporate that 45 minutes to 90 minutes per day.

While it’s totally fine if you do this, in fact, I applaud you if you do this, but I don’t suggest that you do it just in one lump sum time. It’s hard to schedule 45 to 90 minutes if you have a job, a family, or you go to school or you have another mental illness that you’re working through. What I encourage people to do is to displace that time throughout the day. Again, you can follow my rule. I did a whole episode about scheduling and how it’s important for your recovery. You can schedule it into your day in blocks, like for 15 minutes after breakfast, you do an imaginal, or for 15 minutes before lunch, you’d go and face something that you’re afraid of. For 10 minutes before you go and make coffee, you may do some of your homework. You can schedule it in blocks. I like that. That’s my preference if it were me.

But a lot of people, what I encourage them to do is pair it with activities you’re already doing, or you would already be doing had you not had OCD or this fear. So an example might be, as you’re driving to work, you could be listening to your scripting in ERP School, our online for OCD, and in The Self-Compassion Workbook For OCD. We explain extensively how to do scripting and imaginals. You can do that while you drive to work. You can do that while you make your breakfast. You can do that while you wash the dishes. You can do that while you walk around the block. You can do it while you stretch. You can do it while you’re in the shower. These are activities where you don’t actually have to stop what you’re doing to do exposures. You can do many exposures in your normal daily life.

In addition, let’s say you have the fear of contamination or doing some activity and fear of what thoughts you may have. I would encourage you to try to go about your day, having the thought on purpose. So you don’t have to, again, stop your day and stop your schedule and your normal functioning. You could start to implement these things that you’re afraid of throughout the day. Or if again, something you’re avoiding, you may then want to practice implementing that back into your day, particularly if it brings you fulfillment and wellness and more functionality into your day. Instead of, let’s say, you have a compulsion where you ask somebody to accommodate you, you might actually choose to do it yourself. You get points for that. That is an exposure. That should go towards your 45 to 90 minutes per day.

Now that being said, that’s just exposures. The response prevention is something that you do throughout the entire day. For those of you who don’t really understand the difference, an exposure is where you face yourself to your fear or your obsession. You face that fear of obsession. Response prevention is then not engaging in a compulsive behavior to reduce, remove, or eliminate the discomfort, uncertainty, or feeling that you’re experiencing. Some form of discomfort it usually is.

The response prevention is something you will practice for the whole 24 hours as best as you can. Now, does that mean you need to do your exposure? Let’s say your exposure is to touch a certain object or face a certain object or have a thought. Does that mean you need to go completely cold turkey from your compulsion? No. In a perfect world, yes, that would be the case, but we don’t live in a perfect world. You don’t have super powers. I wouldn’t expect my clients, myself, or you to go from 0 to 100.

What we can do there is we can practice it in small baby steps. You face your fear and you say, “Okay, I’m going to try and do response prevention for the next five minutes.” Then you move it up to 10 minutes. Then you move it up to 15 minutes. Then you might move it up to an hour or whatever feels right to you.

What we’re talking about here is, do as much response prevention as you can, work your way up. As we say in ERP School, ERP is really like a ladder building hierarchy. You start small and you work your way up slowly. Preferably you have a plan. You know what the plan is, you know what the first step is, you know what the second step is. Life isn’t perfect, like I said, so I don’t expect it to be perfect. But I think with that model, where you first practice accumulating 40 to 90 minutes of exposures, and then you practice response prevention as much as you can, as you build up and build up and build up steps, you have a great ERP plan right there, an amazing ERP plan.

One thing to consider. When my husband came on the podcast, it’s episode 99. He talked about his panic attacks that he had an agoraphobia he had on airplanes. He brought up the concern of, it’s not like he could get on a plane for 10 minutes and then get on a plane for 15 minutes and then get off. There are certain situations where you have to go from 0 to 100. So you have to get on the plane and stay on the plane. In his case, it was 17 hours to Australia.

So there will be situations where you have to take that huge leap. That is okay. You can still tolerate that. I still want to reinforce and empower you to believe you can still tolerate those big, big exposure jumps from 0 to 100 or from maybe four or five to 100. You can still tolerate those. I don’t want you to feel like it’s not possible. Anyone can face their fear. It just depends on how willing they are to be uncomfortable.

But what he did as he led up to that is find creative ways to practice the scenario and simulate the scenario as best as he could. He took the train. He took little buses. He took the trolley. There’s a small trolley back and forth from the mall, so he practiced on that and practiced tolerating his panic. So you can find ways. Even if it’s not the specific fear, you can find other ways to simulate that fear or that thought or that sensation so that you can practice building up to those bigger, longer exposures where you don’t get to choose how long you do the exposure for.

So there are some ideas on how you can practice ERP, what frequency, what duration. Now the other question I commonly get is, do I have to do it every day? No, you don’t have to do it every day, but I always encourage my patients to do it as much as you can. This is like building a muscle. So the more mental push-ups you do, the better and stronger you get.

Now we also know that you can do too many pushups and burn out. And so it’s important to keep an eye on that. I always try to talk about balance. So try to find a plan or a system or a routine in your calendar that is sustainable, that you can continue to do over time. Some people have written in and said, “I went full gung-ho, went hard, burnt out. The idea of ERP was so overwhelming after that. So I stopped.” So I really discourage you from going that kind of way.

You don’t have to be perfect. Please don’t do this perfectionistically. Find little baby ways to implement it throughout your day so you don’t burn out. That is how you do this work for a long period of time. That is how you get better. That’s how you do it in a healthy, compassionate way.

So that is how we do it. You don’t have to do it every day. In fact, some of my patients schedule different obsessions on different days. Other patients take a six-day exposure and take Sunday off or one day off a week. You could do whatever feels right to you. Just be really honest with yourself. When you schedule your ERP, are you scheduling it because of your values and your self-compassion or are you scheduling it because you’re secretly afraid? Even if it’s that, even if it’s the letter and your scheduling because you’re secretly afraid, no problem. We are doing the best we can with what we have. Just be really honest with yourself, and look and work on that if that’s the main issue.

Thank you so much for being here today. I am honored to spend this time chatting with you. Hopefully, you got a ton from this episode. I love when I get questions from you guys. If you are, go over to Instagram and you can chat with me there. I’ll leave the link in the show notes. You can always ask me questions there. I often do Q and A’s and I’d be more than happy to answer your questions.

All right, you guys know what I’m going to say. It’s a beautiful day to do hard things. Go and do the hard thing. You will not be sorry. You will be so empowered. You will feel so much better. It is hard work, so be gentle with yourself. But I believe in you. Have a good day.

Nov 19, 2021

In this week’s podcast episode, we have the amazing Shala Nicely, author of Is Fred in the refrigerator? and Everyday Mindfulness for OCD.  In this episode, we talked about people-pleasing and how people-pleasing comes from a place of shame, anxiety, and fear of judgment from others.  Kimberley and Shala share their own experiences with people-pleasing and how it created more shame, more anxiety, and more distress.

In This Episode:

    • The definition of people-pleasing
    • How it is common for people who have OCD and Anxiety disorders.
    • How people-pleasing impacts people’s self-esteem and their wellbeing.
    • How people-pleasing anxiety keeps us stuck.
    • How to manage people-pleasing in daily life.
    • How self-compassion can help to manage people-pleasing.

Links To Things I Talk About:

Episode Sponsor:

This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors. Go to cbtschool.com to learn more.

Spread the love! Everyone needs tools for anxiety...

If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two).

Episode Transcription

This is Your Anxiety Toolkit - Episode 211.

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.

Welcome back, everybody. This is an episode I am so excited to share with you. Maybe actually “excited” isn’t the word. I feel that this is such an important conversation. Today we have my amazing friend and someone I look up to and I consider a mentor, the amazing Shala Nicely. She’s been on the podcast before. Everybody loves her, as do I. And interestingly that I say that because today we are talking about people-pleasing—the act of getting people to like you. Shala is very easy to love, but we are talking about how invasive people-pleasing can become, how problematic it can become, our own personal experience with people-pleasing, and what we have done and are continuing to do to manage people-pleasing behaviors. It is such a wonderful, deep, comprehensive conversation, so I cannot wait to share that with you in just a few minutes.

Before we do that, I would like to first, of course, share with you the “I did a hard thing” for the week. This is from Jack, and I’m so excited because Jack said:

“I haven’t been able to drive on the highway since I had a severe panic attack a couple of months ago. I have felt trapped and it has put a strain on my life. I recently drove on the highway for an hour by myself. I felt anxious during it, but I was able to calm myself down. It was a huge step for me.”

Amazing work, Jack. This is such a hard thing and you totally did it. This is so inspiring. You got through it. You actually stand your fear right in the face. So cool. Just proof that it is always a beautiful day to do hard things. 

Let’s move over to the review of the week. This is from YFWWFH, and this review said:

“Life-changing in a meaningful way. I found Kimberley’s podcast through another psychology podcast I’ve been listening to where she was a guest. I started listening to hers and was so happy. I found it. The insight this podcast offers and the expertise she shares are incredible and truly make a difference in the way you think about things and feel when struggling with some of the topics talked about. I truly love this podcast and the effect that it has.”

Yay, that brings me such joy. Thank you so much for sharing that review. You can leave your reviews on iTunes. Please go over to iTunes to leave a review. The more reviews you leave, the more people we can reach, which means the more people I can help with this free resource. 

That being said, let’s move over to the show, such an important interview. I am so excited and I’m so curious to see what comes up for you as you listen. I hope it’s helpful. I hope it gives you food for thought. I hope it gives you direction. And I just can’t wait to share it with you. So let’s go straight to the episode. I will see you guys next week. Have a wonderful day. It is a beautiful day to do hard things.

People Pleasing OCD Anxiety Perfectionism Your Anxiety Toolkit Podcast

Kimberley: Okay. So, you guys know that I love Shala Nicely, and today I have the one and only Shala Nicely talking with us about people-pleasing. And this whole conversation came organically out of conversations we’ve had recently. So, welcome, Shala.

Shala: Thank you, Kimberley. And as you know, the love is mutual. So thank you for [04:42 inaudible] me again.

Kimberley: Okay. I have so many questions and this is probably the most relevant topic to me in my stage of my recovery. You can share as much as you want to share, but I’m so grateful that we’re talking about people-pleasing, because I feel like it runs rampant for those who have anxiety. Would you agree?

Shala: Absolutely.

Kimberley: How would you define people-pleasing? 

Shala: People-pleasing to me is putting your own needs in the backseat so that you can do things that you think will make others happy or like you. You’re not quite sure about that. You’re mind-reading, you are estimating what other people might want or what society might want. I think people-pleasing is not just, “I’m pleasing the individual person.” It could be, “I’m pleasing a culture, a society, a family.” But I think it’s all about putting your own needs in the backseat and doing what you think other people want in order to make them happy, but really it’s in order to reduce your own anxiety.

Kimberley: Right. So, there’s so much there you said that I want to pull apart. So, you emphasized “You think,” and I think there is a major concept there I want you to share. We want to please people. Of course, we want to please people. We like seeing smiley, happy faces. I don’t like seeing sad faces and angry faces. But so much of people-pleasing is based on what in our minds we think they want. Can you share your thoughts on that?

Shala: If you look at people-pleasing behavior–I’ll take me as an example–obviously, it starts with an intrusive thought, “What if they don’t like me? I’ve not done well enough. They’re going to think less of me, drop me,” et cetera, et etcetera. So, I think it starts with some sort of intrusive thought like that. And from there, it goes into how to answer that what-if. And the what-if is made up. We don’t actually know it’s a real problem. It’s an intrusive thought that has come in. It may or may not be a problem. And so, if we engage in this, we’re trying to figure out, “Well, how can I make sure that what-if doesn’t happen?” And so, you’re dealing with a really made up situation. And so, there’s really no data there for you to know what to do. And so you’re guessing. “Gosh, what if this person isn’t getting back to me because I did something wrong and they don’t like me? And I need to do something to show them how much I like them so that they’ll change their mind about me.” The whole thing is based on the premise that what if this person doesn’t like me, which is probably 99% of the time not even a premise. So, we’re guessing all over the place in both guessing there’s a problem we have to solve. And then guessing how to solve that because we don’t really know if there are problems. So we have to whack it together, you might say.

Kimberley: Right. I remember early in my marriage, me getting my knickers in a knot over something, and my husband saying, “What’s happening?” And I’m like, “Well, you want me to do such and such this way?” And he was like, “I’ve never said that. I’ve never even thought that. What made you think that I would want you to be that way?” And I had created this whole story in my head. For me, that’s a lot of how people-pleasing plays out, is I come up with a story about what they must want me to be, and then I assume I have to follow that. How does it play out for you?

Shala: I think “story” is the right word to use there. You create this whole story in a scenario. It’s got main characters and a plot and the ending is always horrible, and it becomes very believable in your mind. The thing is it’s in your mind. We’ve made it all up. But those stories convey very powerful emotions and then we’re acting to somehow get rid of those emotions, which were created by the story that we made up in the first place.

Kimberley: Right. And that was the second thing that you said that I think is so compelling, is for me in my life goal of reducing people-pleasing behaviors, I will be on this journey for the rest of my life. I’m pretty confident of it. It’s a matter that I have to learn how to sit with the feeling instead of just going into people-pleasing to remove that feeling. Is that how you would explain it for yourself as well?

Shala: Yes. And I will echo your sentiments. I will be right alongside you on this journey of trying not to people-please the rest of my life. And I think it’s sitting with some uncomfortable emotions and it’s really sitting with the uncertainty of “we don’t know” what other people think. And it’s easy, especially if you have anxiety to assume the negative because that feels like some sort of certainty. “Oh, they must not like me.” That’s actually sometimes a more comfortable thought than “I don’t know,” fit with “I just don’t know.”

Kimberley: Right. Because when we tell ourselves “They mustn’t like us,” at least then we don’t have a place to work from. We can gain control back. Whereas if we are not certain, that’s a really uncomfortable place. I know as we were talking, do you think this shows up the same for folks with OCD as it does for folks who don’t have OCD? Do you think there’s a difference or do you feel like it’s the same?

Shala: That’s a good question. I might only be able to offer a biased answer because I have OCD and I work with people with OCD. So, that’s going to be the frame of reference that I’m coming from most often. I think that with OCD, it could come from a foundational place of really thinking that you’re not worth very much. I think that comes a lot because OCD spends its days if you’re untreated, yelling at you and telling you are horrible and nitpicking every little thing that you do wrong. And it’s like living with an abusive person when you have untreated OCD, especially when it goes on for years and years, which happens to so many of us with OCD. And if you hear that for however long–months, years, whatever–you start to believe it. And then you don’t think you are worth pleasing, and you almost feel like, “Gosh, maybe if I made people around me happy, maybe if I got this positive feedback from other people that they think I’m worthwhile, then somehow maybe all this in my head will stop.” 

I think people-pleasing for people with OCD can come from that place where they just have internalized years of abuse by their own mind that they feel like they can’t escape until they find exposure and response prevention and work through all that. But even after that, they can still have this foundational belief that “I’m just not worth anything.” And that can drive a lot of people-pleasing behaviors that can linger even after somebody’s gone through what would be considered a successful course in ERP.

Kimberley: Yeah. That’s really interesting. As you were talking, I was comparing and contrasting my eating disorder recovery. I was thinking about this this morning. My eating disorder didn’t actually start with the wish to be thin. It started with pleasing other people. So, my body was changing and I was getting compliments for that. And then the compliments felt so good. It became like something I just wanted to keep getting, almost compulsively keep getting. And so then, it became, “How can I get more?” People-pleasing, people-pleasing. “Oh, they liked this body. Well, I’ll try and get that body. Oh, they complimented me on how healthy my food was. Okay, I’ll do that more in front of them.” So, it’s interesting to compare and contrast. People-pleasing was the center point of my eating disorder and the starting point of my eating disorder. So, that’s really interesting. You talked about people-pleasing behaviors. What do you think that is for you? What would that look like?

Shala: People-pleasing behaviors can be big or small. It could be something like a friend calls you to go out to dinner. You don’t really want to go out to dinner. You really want to sit in and watch your latest Netflix binge show, but you feel like you can’t say no. So you go out to dinner. That could be something on the smaller end, I think. Then there’s on the really large scale, which I’ve done, and I talk about in more detail in my memoirs, Is Fred in the Refrigerator? about my journey with OCD, which is not breaking up with somebody because you’re afraid to hurt their feelings. And you can take that all the way down the aisle, which I did. 

And so, I think that people-pleasing behaviors really can run the gamut from small seemingly innocuous things. “Oh, it’s just an evening,” to life-changing decisions about your partner, about how you live your life, about where you live, about your work, about how you approach, all of that. And that I think makes people-pleasing sometimes hard to identify because it doesn’t fit neatly in a little box.

Kimberley: Yeah. That’s interesting. And I love the way that you share that. What’s interesting for me is that most of my people-pleasing in the past have been saying yes to things that I don’t want to do or things I want to do, but I literally don’t have time for. So I’m saying yes to everything without really consulting with my schedule and being like, “Can I actually fit that in on that day?” Just saying yes to everything, which I think for me is interesting. A lot of the listeners will remember, is I got so the burnt out and sick, because I’d said yes to everything six months ago. Because six months ago I agreed to all these things, now I’m on the floor, migraines or having nothing because I just said yes to everything. And so, for me, a lot of that, the turnaround has been practicing saying no to plan for the future, looking forward, going, “Will I have time for that? Do I want that? Does that work for me? Is that for my recovery?” How have you as either a clinician or a human started to practice turning the wheel on this problem?

Shala: It’s hard for me to think how to the answer to that because there are so many ways to approach it and it’s a complex problem. And so, I have approached it in a number of ways. The first thing that comes to mind is really boundaries because a lot of this is about setting boundaries to protect your own time and to protect what you want to do. So, that’s one of the things that I have really worked on, is becoming clear on what I think is acceptable for me to be doing and what is not acceptable for me to be doing in terms of my own physical and mental health. It’s so easy to say yes to things, especially if it’s months down the road, “Oh, that’ll be fine, I’ll have time to do that.” And then you get to, you’re like, “Okay, I don’t have time to do that.” And then you’re wearing yourself out and all of that. And I think that happens a lot with people-pleasing because again, you’re putting your own needs, especially for rest and recovery on the back burner in order to do things that you think will make somebody else happy.

 And so, I think really working on boundary setting. So I’m coming from a perspective of having OCD and treating OCD. Boundary setting is an exposure. So, it is about creating an uncomfortable situation because it involves saying no. And if you say no, sometimes you’re going to disappoint people. And if you’re just getting into the process of saying no, and people are expecting that you’re going to say yes because you say yes to everything, you can often get some pretty negative feedback. “What do you mean no? You’ve always said yes.”

Kimberley: You’re the “yes” girl.

Shala: And so then, that feels even more jarring, like, “Oh, see, it’s coming true. People don’t like me.” And so, that becomes even more anxiety provoking and thus an even better exposure, but even harder. And I think that thinking of it as setting boundaries to protect your own times so that when you do say yes to something, you are there as fully as you can be because you’re well-rested in terms of your body and your mind and your health and all of that. When you don’t have good boundaries, you end up feeling very resentful because you haven’t been able to take care of yourself. And so, in fact, by not setting good boundaries, you can’t actually be there for people when they need you because you’re too run down. And that is, I think, the big lie about these people-- one of the many big lies about this people-pleasing thing is that, “Well, I got to do all this to make people happy.” Well, in essence, you’re not putting your own oxygen mask on first. And so, you can’t. Even if there was something you really could do that would really help somebody else, you don’t have enough energy to do it. 

So, I think really realizing that boundaries are the way to not have that resentment, to allow you to be fully there with the things you do want to do with all your heart and energy. And so then, you are actually really achieving your goal because you can really help people, as opposed to saying yes to everything and you’re spread so thin, you’re not enjoying it, they’re not enjoying it, and it’s not achieving the goals that you had in mind.

Kimberley: Yes. It’s so exactly the point. So, boundaries is 100%, I agree. I’ll tell you a story. You know this story, but the listeners might not. Once I did a podcast that got some negative feedback and I called you, understandably concerned about getting negative feedback, because I don’t like-- I’m one of those humans that don’t really love negative feedback.

Shala: I’m one of those humans too.

Kimberley: I had said to you, this is literally my worst fear. One of my worst fears is being called out and being told where you’ve made a mistake. What was really interesting for me is going through that and saying, “Okay, but I did, it is what it is. I wouldn’t change anything. And here’s what I believe.” I came out of that instead of going and apologizing and changing everything. I came out of that actually feeling quite steady in my stand because I had acknowledged like, “Oh, even when things don’t go well, I can get through it. I can stand on my two feet. I can get through those,” which is something I hadn’t ever really had to practice, is really standing through that. And I thought that that was a really interesting thing for me, is a lot of the reason I think I was people-pleasing was because the story I was telling myself was that I wouldn’t be able to handle it if something went wrong, that I wouldn’t be able to handle people knowing that I had made a mistake or so forth. But that wasn’t true. In fact, all of a sudden it felt actually a bit of freedom for me of like, “Oh, okay. The jig is up. I can chill now.” Have you found that to be true of some people or am I rainbow and unicorn?

Shala: I love that because I think it’s like what we do with people with social anxiety. They are afraid of going out in public in certain situations and having somebody evaluate them negatively. And one of the things that we do with those exposures is actually, let’s go out and create some of these situations that your social anxiety is afraid of. Let’s go into a shopping mall in the food court and spill a Coke on the floor while everybody’s looking at you. And then process through, what was that like? Well, I just stood there and they came and cleaned it up and everybody went back to their meal and we went on. Huh, okay. That wasn’t as bad as I thought it was. 

And I think that’s very akin to what you’re saying, is we build this up in our head that if we’re rejected, if somebody doesn’t like us, if we disappoint somebody, that’s going to be catastrophic. And inevitably, it is going to happen unless you isolate yourself in your house, that somebody is not going to like you, somebody is going to give you a bad review, and being able to say, “Yup, that is okay. I don’t have any control over that. And I can handle that. That doesn’t devalue me as a person because they gave me a bad review or bad feedback or whatever.” Because if we think about what we each do, like I’ve bought products before that I’ve written bad reviews for because I didn’t like it or it didn’t work for me. I think everybody has. And even if you didn’t write a review, you thought it in your head. So, all of us have things we like and don’t like, and that’s okay. 

What you’re talking about is you have those experiences and then you realize, “Wait, that is okay.” And then you feel free, like, “Okay, look at me. I can make mistakes.” You’re less compelled. Continue doing this because you’re like, “Wait, there’s freedom on the other side of this where I don’t have to try to be pleasing people all the time.”

Kimberley: Right. Or in addition to that was-- and this is true in this example of, I think it was a podcast that I had put out, was people cannot like what I did but still like me in other areas. That blew me away. I think that in my mind it was so black and white. It’s like, if they don’t like one thing, they’re going to knock you out, where it’s like no. People can hold space for things they like and things they do like.

Shala: That is such important.

Kimberley: Right. You also just said something and I want you to speak to it, is some people people-please by going above and beyond, but you also just brought up the idea of some people just don’t leave their house. What would that look like, because they’re people-pleasers?

Shala: Well, I think that is the extreme case of any kind of anxiety-driven disorder, where you’re trying to avoid having to be in a situation where others have expectations of you that you feel that you can’t meet, and so you narrow your world down to avoid those situations to avoid the anxiety. And I don’t think that’s just with people-pleasing. That’s obviously what agoraphobia is about—people not leaving their homes because they’re trying to avoid situations that are going to trigger panic attacks. But I think people with anxiety disorders in general can start making choices to avoid anxiety that end up not allowing them to lead the lives they want to lead or to take care of themselves.

Kimberley: Yeah. I mean, I think that’s the question for everybody, even for those who are listening, I would say. If you’re thinking, “Oh, this doesn’t apply to me,” it’s always good to look like, “What am I avoiding because of the fear that I’ll be disproved?” or someone will give you a bad review and so forth, because I think it shows up there quite often.

Shala: Yes. And in fact, there is a really good article—maybe we can put a link in the show notes—that Adam Grant from Wharton Business School wrote in the New York Times about what straight A students get wrong. And I think it goes right to the heart of what we’re talking about because he referenced people who are looking for straight A’s, which is an institutionalized form of approval, will potentially take easier classes that they can get an A in versus something they really are interested that they might not do as well in. And so, they are not pursuing what’s important to them because they’re pursuing the A, and therefore head in a direction that maybe isn’t the direction that would be best for them to have.

Kimberley: Right. And you just hit the nail on the head because so much of recovery from people-pleasing is actually stopping and going, “Do I want this? Does this actually line up with my values? Am I doing it for other people?” I’ve heard many clients say, “I do what other people tell me to do and what they want because I actually have no idea of what I want.” That’s scary in and of itself.

Shala: And that is a really tough problem for people with anxiety disorders because when you have an anxiety disorder, you’re used to doing what the disorder says and the disorder can really run your life. When you get better from the anxiety disorder, it’s easy to keep doing the things that you were doing that didn’t necessarily seem compulsive but may have been because they’re just part of your life, without ever stopping to step back and say, “Well, do I need to be doing this?”

I’ll give you a personal example. I live in Atlanta and there’s lots to do in Atlanta. I’ve lived here for a long time. I think I felt a need that I “should” be out and doing things because I live in a big city and there’s so much to do and I need to be doing it. And so I’d have this story in my head that I need to be out and visiting attractions, the aquarium, the restaurants. We have this really cool food court called Ponce City Market. While those things are fun and I do enjoy going to them sometimes, it almost felt like I should do this because this is what people do. They’re out and about and doing things, almost like I’m pleasing a societal norm, like this is what you do if you live in a big city. 

Well, COVID actually has really helped me recognize, “You know what, I actually don’t need to get up on Saturday morning and pack my schedule full of all sorts of things that I think I should be doing. I can actually just sit in my house and do things that I might want to do.” And so as you know, I’ve been doing all sorts of things lately just to try stuff out. I’m taking an oil painting class, which still scares me to death. And I’m taking French lessons because I want to learn how to speak French. And I’ve bought these art magazines because I really like art and I just want to look at it. And I’m just letting myself explore these various things to find out what I do like.

And then once I’ve been through this process and find what really floats my boat, then maybe hey, one weekend I can go to the aquarium because I want to, because it meets some value or need I have and do some painting instead of trying to meet this idea of what I should be doing that’s trying to please society and what my role in society should be, which I think is very easy for people with anxiety disorders and OCD to do, is let other people make the rules, the disorder, your family, your spouse, the society in general, as opposed to just sitting back and saying, “What do I really want?” And the answer to that might be, “I don’t know.” And instead of rushing out to do something because it feels better to just be doing something than to sit with the uncertainty of “I don’t know,” letting yourself sit in that and go, “Well, what can I maybe try to see if I like it?”

Kimberley: Right. And I will add to that because you and I have talked quite a bit and I’ve learnt so many inspiring things from you as I’ve watched you do this. What was interesting for me is, a part of that for me was choosing things that people don’t actually like. Some of the choices I’ve made–things I want to do with my time or that I’ve said no to–do disappoint people. They do disappoint people and they might tell you you’ve disappointed them. And so, for me, it’s holding space for that feeling, the shame or the guilt or the sadness or whatever the emotion is, but still choosing to do the thing you wanted to do. It’s not one or the other. You don’t do things just because you haven’t disappointed someone. You can also choose to do something in the face of disappointing other people, right?

Shala: Yes. And I think it’s inevitable. You’re going to disappoint them.

Kimberley: It sucks so bad.

Shala: Because you’re not going to have the same wants and needs as everybody else. And so, it’s inevitable that if you start figuring out what you want to do and trying some things out, you can’t do all the other things everybody else wants you to do.

Kimberley: Yeah. I know. And it’s so frustrating to recognize that. But as you’ve said before, tens of thousands of people could love a product and tens of thousands of people could hate a product. Lots of people will like me and lots of people won’t like me or the things that we do or the places we want to go and so forth. I think that’s a hard truth to swallow, that we won’t please all the people.

Shala: Yeah. And I’ll tell you a story that I think illustrates that, is I read this book for a small book club that I’m in, and one of the members had suggested it. I just went and grabbed it, bought it. I didn’t really read what kind of book it was. And I was loving it. It was really good. It was like this mystery novel. And then we get to the last, I don’t know, 20 pages. And it turns into this psychological thriller that honestly scares the pants off me, but it was wrapped up so well. I was just sitting in shock on the floor, reading this thing, like, “Oh my gosh.” It was so good, yet so terrifying. So I got online on Amazon just to look at the book because it had just gone right over my head that this was a thriller, and I don’t normally read thrillers. I just wanted to go on and see. And I was expecting, because I loved this thing, to see five-star reviews across Amazon for this book because I thought it was so amazing. And I got on, and the reviews for it were maybe three point something stars. I started reading and some people went, “I hated this. It was horrible.” They hated it as much as I loved it. And that to me was just a singular example of you cannot please everyone. I love this book, other people hate this book. There were lots of people that were in between. And that doesn’t say anything about the writer. The writer is a whole complete awesome person, regardless of what any of us think about what she wrote.

Kimberley: Right. And she gets to write what she wants to write, and we get to have our opinions. And that’s the way the world turns.

Shala: And I think recognizing she doesn’t have any control over what I think, I might even write a five-star review just for whatever reason and really hate the book. So, even if you get a positive review, you don’t actually know that it’s true. I think this is all about understanding that it’s not about not caring about what people think because that’s really hard. It just numbs you out and cuts you off. I think it’s about going into the middle. It’s not about people-pleasing. It’s not about not caring. It’s about recognizing you don’t have control over any of that and living in that uncertainty. I don’t know what people think. I don’t have control over what people think. And even if they tell me one thing, that could actually not be what they think at all. And that’s okay.

Kimberley: Right. Such an amazing point. I’m so glad you brought that up because I actually remember many years ago saying to my husband, “I’ve decided I don’t care what people think.” Well, that lasted about 12 and a half seconds because I deeply care what people think. But it doesn’t mean that what they think makes my decisions. And I think that’s where the differentiation is. A lot of the people who are listening, there’s absolutely no way on this world they could find a way to not care and not want to please people. It’s innate in our biology to want to please people. However, it gets to the point where, is it working for you? Are you feeling fulfilled? Are you resentful? These are questions I would ask. Are you fulfilled? Are you resentful? Are you exhausted? What other questions would you maybe ask people to help them differentiate here or to find a way out?

Shala: Am I really enjoying this? Do I really want to do this? Why am I doing this?

Kimberley: Yeah. What emotion am I trying to avoid? What would I have to feel if I made my own choice? Yeah. There’s some questions I would have people to consider. Okay. So, one more question. You make a choice based on what you want. You do or you don’t please people. Let’s say for the hell of it you dissatisfy somebody. What do you do with that experience?

Shala: First, I think you recognize. You go into this, recognizing that is almost certainly going to happen. There are very few certainties in life. That’s probably one of [35:11 inaudible].

Kimberley: You will disappoint people.

Shala: Yeah. You’re going to disappoint people. And then I think really going to a place of self-compassion. And I’m going to turn it back over to you because you just published an amazing, amazing book that I cannot recommend enough about self-compassion in the treatment of OCD with exposure and response prevention. And I’d love to hear what you think about how you could incorporate self-compassion into this, especially when you do disappoint somebody because I think that’s so important. 

Kimberley: Yeah, no, I love that you swing at my way. I think the first thing is to recognize that one of the core components of self-compassion is common humanity, which is recognizing that we’re all in this together, that I’m just a human being. And human beings aren’t ever going to be perfect. Only in our minds that we create the story that we were going to be. So, a lot of self-compassion is that common humanity of, I am a human, humans make mistakes, humans get to do what they need to do and want to do and that we’re not here to please people, and that our worth is not dependent on people enjoying and agreeing with us. And I think that’s a huge reason that my people, like you’ve said, people-please is they’re constantly trying to prove to themselves their worth. So, I would recognize first the common humanity. 

And then the other piece is it hurts when you disappoint someone. And so, I think it’s being tender with whatever emotion that shows up—sadness, loss, anger, frustration, fear. A lot of it is fear of abandonment. So I would really tend to those emotions gently and talk to them gently like, “Okay, I notice sadness is here. It makes complete sense that I’m feeling sad. How can I tend to you without pushing you away?” Again, I think sometimes-- I’ve seen this a lot in my daughter’s school. I’ve seen this sometimes, the school has said, “When you’re feeling bad about yourself, just tell yourself how good you are.” And I’m like, that’s really positive, but it actually doesn’t tend to their pain at all. It skips over it and makes it positive. 

So I think a big piece of this is to just hold tender your discomfort and find support in like-minded people who want what you want and who are willing to show up. You and I have said before the Brené Brown quote like, “Only take advice from people who are in the ring with you.” And that has been huge for me, is finding support from people who are doing scary things alongside me. Do you have any thoughts? 

Shala: Yeah. I think the more that you do this, the more that you’re willing to take care of yourself, because I really do think working on people-pleasing is learning how to take care of you. And that’s so important. And the more that you will do that and go through these very hard exercises of saying no and disappointing people, and then compassionately holding yourself and saying, “It’s okay,” like using the common humanity, recognizing we’re all in this together. Everybody feels like this sometimes. I think the more you do it, then you start to disconnect your worth from other people’s views. And that is where a whole new level of freedom is available to us. 

I think that sometimes people-pleasing, because it can be so subtle, isn’t necessarily addressed directly in therapy for anxiety disorder. Sometimes it is when it’s really over. But a lot of times it’s not, and that’s not the fault of the therapist or the client or anything. It’s just, it’s so subtle. We don’t even realize we’re doing it. And so, we finish therapy for anxiety disorders, we feel a lot better, but there’s still a lot of this “should” and “have to,” societal expectations or expectations of other people, which we feel we’re driving our life and we don’t have any control over. And really working on this allows you to recognize that you are a whole good, wonderful person on your own, whether or not other people are pleased with you or not. But that takes a lot of consistent work, big and small, before you can start to see that your worth and other people’s thoughts about you are two separate things that aren’t connected.

Kimberley: Right. Oh, I’m going to leave it there, because that’s the mic drop right there. I love it. Shala, thank you for coming on and talking about this. I really wanted your input on this instead of it just being a podcast of mine. So, thank you. I love your thoughts on this. Where can people hear more about you, your book? Tell us all the things.

Shala: Sure. So, my website is shalanicely.com. So, anyone can go there, and I have three different blogs that I write, all sorts of information about how to manage uncertainty and OCD because that’s my specialty. My memoir, Is Fred in the Refrigerator?: Taming OCD and Reclaiming My Life, in that I talk a lot about how I dealt with people-pleasing. And in fact, the chapter called Shoulders Back, which is one of the techniques—I said there were many that I used for people-pleasing, that’s one of the techniques that I use—that chapter talks about my journey in learning about how to work through some of this by really putting your shoulders back and acting like all that stuff you hear in your head is relevant. So, that could be a resource for people as well. Everyday Mindfulness for OCD, which I co-wrote with Jon Hershfield, that also has some information on self-compassion as well if people want to learn about writing self-compassion statements. But again, I would also send people to your amazing brand new workbook, which is the only workbook that I know of, the only book that I know of, that talks about doing ERP in a self-compassionate way. So, it’s completely integrated together. And I think that is so important for building a foundation for a good OCD recovery. So, I would definitely send people your way.

Kimberley: Thank you, friend.

Shala: You’re welcome. 

Kimberley: Well, there are so many parts of the people-pleasing and the tools in your book as well. I know we’ve talked about that and it’s one of my favorite books of all time. So, definitely for listeners, go and check that out. I am so grateful that you came on. 

Shala: Well, thank you. I’m just so honored to be here. It’s always so much fun to talk with you about these topics. So, thank you.

Kimberley: So important. Thank you so much, and I just am so grateful for you.

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

Have a wonderful day and thank you for supporting cbtschool.com.

Nov 12, 2021

SUMMARY:

Quite often, my clients forget to recognize avoidance as a compulsion.  While you might be spending a lot of time in your recovery reducing compulsions such as reassurance-seeking compulsions, behavioral compulsions, and mental compulsions, it is important to recognize that avoidance is also a compulsion.  In this episode, we address why it is important to address the things you are avoiding and find a way to incorporate this into your OCD treatment.

In This Episode:

  • Why Avoiding your fear keeps you stuck in the obsessive-compulsive cycle
  • What is an avoidant compulsions?
  • How to manage avoidant compulsions?

Links To Things I Talk About:

Episode Sponsor:

This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more.

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Avoidance OCD Compulsions Your Anxiety Toolkit Podcast

EPISODE TRANSCRIPTION
This is Your Anxiety Toolkit - Episode 210.

Welcome back, everybody. I am so thrilled to have you here. How are you doing? How is your anxiety? How is your depression? How is your heart? How is your grief? How is your anger? How is your joy? How are you? How is your family? All things that I hope are okay and tender, and there’s a safe place for all of those things to be.

Today’s episode is in inspiration of a session I recently had with a client—a client I’ve seen for some time. We are constantly talking about safety behaviors, ways that we respond to fear. I had mentioned to him that of course, one of the safety behaviors we do are from fear, and in response to fear is avoidance. We avoid things. And he had said, “Oh, I completely forgot about avoidance. I completely forgot that was one of my safety behaviors.” Sometimes we put so much attention on the physical behaviors and the mental compulsions that we forget to check in on what are you avoiding and how avoiding things and fear keep us stuck. So, that’s what we’re talking about today.

Before we do that, let’s first do the review of the week. This is from Ks Steven, and they said:

“Short and sweet. This podcast is one of my highlights of the week. It is short, sweet and so helpful. I look forward to each new episode. Episode 99 on self-compassion has transformed my relationship with myself. As I start each day to face my obsessions, I remind myself it is a beautiful day to do hard things.”

I love that review. Thank you so much. I love that. It basically is exactly what I want this podcast to be. I want it to be short, I want it to be sweet, I want it to be helpful, and I want it to remind you that it is always a beautiful day to do hard things.

Before we get into the episode, we have one more part of the episode that we want to do, which is the “I did a hard thing,” and this is from Anonymous. They said:

“My husband and I have been going through infertility treatments for years. This year, we did IVF and it was triggering, maybe because it felt more “real.” I was panicking that I didn’t feel perfect enough since I struggled with some mental health issues earlier this year. I had the false narrative in my mind and major intrusive thoughts about not being a good mom, ruining my children, fearing postpartum mental health issues. I wanted to cancel our embryo transfer because of all of these intrusive thoughts and fears. But on Monday, I did it afraid and we transferred our embryo. We’ll find out next week if I’m pregnant and I’m so glad I did it.”

Oh my goodness, I cannot tell you how impressed I am. I wish nothing but joy for you. You did that hard thing, and I hope that however that turned out that you are standing by yourself and you are gentle and kind and reminding yourself that you never have to be perfect. Never, never, never. We are not meant to be perfect.

Okay, here we go. Let’s talk about avoidance. I mean, listen, that “I did a hard thing” is exactly what we’re talking about, so we’ll even use that as a reference today.

Fear is scary. Nobody wants to feel it. It’s not fun at all, and instinctually, we go into fight or flight, and flight is a normal human response to fear that has us avoid danger. Now, this instinctual response is what keeps us safe. If a bus is coming for you, you run off the street. That’s what we do. It’s the right thing to do. However, if you are using avoidance on repeat, and if you’re using avoidance to avoid the sensation of fear, not an actual current, real imminent danger, well then chances are you’re going to get stuck.

So I want to be really clear, if you are actually in physical danger, avoidance is not a compulsion. It’s not a safety behavior. But if you’re avoiding thoughts about things or you’re avoiding things because there is a small or a medium probability of something happening, or even maybe even a large probability in some situations, chances are in this case, you’re going to walk away quite unempowered. Because the truth is, life is scary. Life doesn’t always go well. Bad things do happen. It sucks to say, but it’s true. Bad things do happen. And so, it makes sense that we naturally want to avoid lots of things to avoid bad things from happening. But what happens when we do that is life starts to get really, really small. We have to be willing to take some calculated risk, and ideally, the calculating part doesn’t take too much of your time either because we can spend a lot of time ruminating about potential risks, probabilities, uncertainties, and so forth.

So what we want to do and what I want you to do when you’re listening to this and after listening to this is reflect on, what am I avoiding? Is the avoidance helpful and effective? Or is the avoidance impacting my ability to live my life? Is the avoidance impacting my ability to grow and thrive? Is the avoidance impacting my family and their ability to grow and thrive? That’s a big one, because sometimes our fears impact the people we love by no fault of our own. It’s not our fault, but we always want to check in on this stuff.

When you avoid, ask yourself, what specifically am I avoiding? Am I avoiding actual danger? Or am I avoiding fear or other sensations? Because if you’re doing the avoidant behavior to avoid sensations or an emotion or some thoughts, the problem with that is what you suppress often comes more, what you resist often persists. So even your attempt of avoiding it so that you’re not having to endure the discomfort often only increases the frequency and duration of the discomfort or the thought or the feeling or the sensation or the urge. And so, therefore, it’s not effective.

Some people avoid because they don’t want to feel humiliated or embarrassed. But the problem with that is, once we start avoiding, what often happens is people start noticing that you’re avoiding and then you end up feeling humiliated and embarrassed anyway.

So what I’m trying to show you here is, while avoidance does give you some pretty immediate relief, it often has long-term outcomes that aren’t that great that keep you stuck. As the “I did a hard thing” segment that we feature each week and as we see even in the reviews often or almost every time, people who face their fear, even though it’s so painful and so uncomfortable, they leave that experience feeling empowered. They leave the experience saying to themselves, “That wasn’t fun, but at least I know I can do it. Now I have proof that I can. Now I have proof that I survived it.” And with that comes powerful cognitive learning.

One of the best outcomes of ERP (Exposure and Response Prevention) is learning that you can survive really hard things. When we avoid that most of the time, the main thing we learn is when I can avoid bad things for you, but I can’t handle hard things. That’s what we really walk away learning. And our brain knows this. It’s keeping an eye on this. Our brains are very, very smart. They’re keeping track of this. And the more that we avoid, the more disempowered we feel and the more alert and hypervigilant the brain feels. “Oh, I avoided that. What else can I avoid? What else can I avoid?” So that next time you’re put in a situation where you can’t avoid, the chances are that you probably will panic even more.

Panic is a huge one for people where avoidance shows up. It’s a huge time where naturally of course—this is where I want you to practice compassion—you don’t want to have a panic attack. Of course, you don’t want to be uncomfortable. Of course, you want to avoid the discomfort because it’s not fun. No one wants to go through that. I don’t blame you. I do it myself. So we’re never going to be perfect at this. I wouldn’t expect you to be perfect at this. But there is this beautiful inquiry that we can deal with in ourselves or with a therapist or a loved one to go, “This isn’t working for me anymore. I deserve to live a life where fear isn’t running the show. So I’m going to choose to face this fear.” It is a fierce, compassionate action. It is a badass, shoulders back. “I’m going to show up for myself behavior and action.” It takes courage. It takes bravery. It takes a small amount of grit, I’m not going to lie.

But I really want today to be about reminding you that you can do the hard thing. You can ride that wave of discomfort. It will be temporary. It will be hard, but it will rise and fall on its own. And with repetition, if you can gift yourself with the repetition of facing your fears, not avoiding them, you will feel so strong. You will learn that you can tolerate discomfort, that you are able to get through hard things. And so, next time, when you have to do a hard thing, you’ll feel a little less afraid, or in many cases, you’ll feel a significant degree less afraid.

So, I’m going to leave you with that. Compassionately do an inventory on where avoidance shows up in your life. And then do your best to work through each and every one. This is what we do in ERP School. One of the first few modules is identifying what you avoid and then takes you through the steps of one by one by one. We’re going to face each and every one of those fears. You don’t have to have a therapist to do this. It’s ideal, but you don’t have to. We had an episode last week about people who do it on their own. It’s so cool.

So I want to really empower you to, number one, face your fears, but just always remind yourself, avoidance is a safety behavior or a compulsion as well.

All right, I love you. It is a beautiful day to do hard things. I believe in you. I really believe you. I really want you to understand that you have everything you need. It doesn’t have to be perfect. You don’t have to show up perfect. You can face your fears imperfectly and you don’t have to have it all figured out first, just give it a try. Throw yourself in there a little. Be kind. And I hope that this inspires you a little and reminds you that it is a beautiful day to do hard things.

I love you. I believe in you. I hope you have a wonderful day. I hope you’re being tender with your heart. I’m sending you all the love I have from my heart to yours. I’ll see you guys next week.

Nov 5, 2021

SUMMARY: 

There is nothing I love more than sharing the success stories of people who are using ERP to manage their OCD and intrusive thoughts.  In this week’s podcast, I interview Taylor Stadtlander about her OCD recovery and how she used ERP School to help her manage her intrusive thoughts, compulsive behaviors.  Taylor is incredibly inspiring and I am so thrilled to hear her amazing ERP Success story.

Ep 209 An ERP Success Story with Taylor Stadtlander Anxiety Toolkit Podcast

In This Episode:

  • Taylor shares how she learned she had OCD 
  • Taylor shares how she created her own ERP recovery plan and the challenges and successes of her plan 
  • Taylor shares how she used ERP School to help her put her ERP recovery plan together and how she now uses her skills in her own private practice.

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EPISODE TRANSCRIPTION

Kimberley: Welcome. I am so excited to have here with me Taylor Stadtlander.

Taylor: Yes. Thanks. I’m so excited to be here.

Kimberley: Oh, thank you for being here. I am so excited about this interview. You’re someone I have watched on social media, and it’s really cool because out of there, I realized you were someone who had been through CBT School and I just love hearing the story of how you things get to me. I love that story. So, thank you for being on the show.

Taylor: Of course. Thank you so much for having me.

Kimberley: Tell me a little bit about you and your mental health and mental wellness journey, as much as you want to share. Tell us about that.

Taylor: I’ll start with, I am an OCD therapist right now. And I start by saying that because, honestly, if you were to tell me when I was in high school, that I would have become an OCD therapist, I would have laughed at you because I, at that time, was really when my OCD started in high school. Of course, now, knowing what OCD is, I can look back and I can see definitely symptoms back as young as eight or nine years old. But when I was in high school, it was really when I had my sophomore year, pretty intense onset of compulsions. And then, of course, the intrusive thoughts, and it really was all-consuming. But the interesting part, and I’m sure a lot of people can relate to this, is it was something I kept very hidden, or I at least tried to. So, a lot of the earliest compulsions I had were checking compulsions. So, it was these intense, long rituals before I would go to bed, checking that the door is locked, the stove was off, all safety things. I felt this immense amount of responsibility. And I remember thinking like, where did this come from? One day I was just so concerned with safety and all these different things. But no one would have known other than, of course, my family, who I lived with, and my sister, who I shared a room with, who of course saw me getting up multiple times at night to recheck things. But from the outside, it looked like I had everything together. I was the A student, honors classes, volleyball captain, lacrosse captain, and just kept that façade of that picture-perfect high schooler.

I did end up going to a therapist and she wasn’t an OCD specialist, but I have to say I got very lucky because I actually have some of the worksheets that she used with me back when I was 15. And it is in a sense ERP. So, I was very lucky in that sense that even though I wasn’t seeing a specialist, because I don’t think any of us knew what was going on, to even see an OCD specialist, I did get to-- and it helped. And that’s where I was like, “Okay, you know what, I’m going to go to college and become at least major in Social Work.”

So, I went to college, majored in Social Work, got my Master’s in Social Work, and my OCD pretty much went away and I thought I was cured or whatever that means. And I thought that, “Okay, that was a chapter of my life. And now for whatever reason, I had to go through that. Now I’ll become a therapist and help other people.” I say that because I had no idea what was coming. My first year out of grad school, I began working and I had the most intense relapse of OCD ever. It came back stronger than ever this time. We call it “pure O.” So like mainly intrusive thoughts. And I had no idea what ERP was. It’s sad because I went through grad school for Social Work and we never talked about that.

I remember this one day, and this is circling back to even how I found you, I had stayed home from work because I was just for like a mental health day, and I didn’t want to be on my phone because going on social media was triggering, watching TV was triggering, all these different things. But I was like, you know what, I’m sitting at home. I might as well turn on the TV. So, I turn on the TV, and an episode of Keeping Up With the Kardashians is on. I am a fan of that show, so shout out to them. And I remember watching and I was listening half not. I think I was trying to take a nap. And one of the family members had this OCD specialist on the show. And I remember pausing the TV because they had the name of the OCD specialist on the TV. And I wrote it down and it was Sheba from The Center of Anxiety and OCD. So I was like, “Okay, let me Google that.” That was the first time I’ve ever even heard of an OCD specialist. So, I stopped watching the show, went on my phone, Googled her name and her Instagram came up and I just started scrolling. It was like my world, my eyes were just open and I was like, “Oh my gosh, other people have OCD, and there’s a treatment, ERP.” Then I just kept scrolling. And then funny enough, I came across your page, Kimberley. And through that, that’s where I discovered CBT School.

Anyway, long story short, at that time, I wasn’t able to afford an OCD specialist. So, I was seeing a therapist, a different therapist from high school because now by this time I was married, on my own insurance, trying to navigate that. In the back of my head, I knew that I needed to see an OCD specialist. I just, again, couldn’t afford it. So, I had a conversation with my husband. I’m like, “Look, I’m going to pay for this, the CBTS course.” And I said, “I know it seems like a lot of money, but it’s really not. If I was going to see an OCD specialist, this is probably what one session would cost.” And that’s how I learned about ERP. That’s your course. It’s how I learned about ERP. So, it honestly traces back to Keeping Up With the Kardashians. I love telling that story because it’s so weird. And honestly, that changed my life because learning ERP, it finally clicked that, okay. Because I was just applying CBT techniques. Like, think of a red stop sign when you have an intrusive thought, thoughts popping, and things like that. And as we know, that was making it so much worse. So, I just dove into your course and taught myself through your course what ERP is, which then led me to seeing that at work, and then wanting to specialize in ERP, and now working with clients who have OCD. So it’s really been an amazing journey, to say the least.

Kimberley: I’m nearly in tears hearing this story. Oh my goodness, how funny, your story has gone from reality TV to here, and that’s so cool. That just blows me away.

Taylor: Well, and it really goes to show. I know that there can be negative sides, like technology and Instagram, but for me, most of, if not all of my education, initially about OCD and ERP was from Instagram accounts, like yours or Sheba’s. And it was like, again, I knew that, okay, this can’t replace therapy, but it was such a good in-between for me, especially being in the place where I was, where I was trying to navigate. Because it can feel like you’re stuck when you either can’t find an OCD specialist or you can’t afford it. And I know what that feels like. So, to have that in between, not as a replacement, but just as a bridging point was so helpful for me.

Kimberley: Wow. And for the listeners, I have not heard that story. This is new to me. So this is so cool. So, actually really, I’m so curious. So, when you took ERP PA school, were you like, “She’s crazy, I’m not doing that”? Or what was your first take on that?

Taylor: I think I was at the point where I was so determined to find relief, I was willing to do anything. And I had researched about ERP before I took your course. I wasn’t like, “Oh, I’m just going to trust this randomly.”

Kimberley: Random lady.

Taylor: Right. So, I did do my own research obviously. And again, I’m in the field and I have a degree in Social Work. It’s just so interesting to me that that was not discussed, and I think that’s lacking in a lot of programs. So, once I researched it myself, I was like, “Okay, this is the evidence-based treatment. This is the gold standard. It looks like I got to do this.” I just remember I would come home. I was working at the time at a partial hospital program and I would come home from work. And that would be my routine. I would get my little notebook out, I’d pull my laptop out, and I treated it as if I was-- again, I know it doesn’t replace therapy, but I treat it as if I was in an intensive program. I would spend an hour or so going through your videos and then printing out the worksheets. And that’s just what I did. And I just started to do it.

I had had before that a brief, very minimal understanding of exposures. And I think I was trying to do them on my own. But through your course, I was able to understand the response prevention piece. I was just exposing myself to all these things and then leading myself in a tailspin. But yeah, I see this again, even in my own clients now that there’s just I think a certain point that you reach, that yes, it’s scary to take this step, to start ERP, but because we’re so determined to not feel the way we’re feeling, it makes it so worth it.

Kimberley: Wow. Oh my goodness, I’m seriously close to tears listening to your story. So, thank you for sharing that with me. I mean, wow, what an honor that I get to be a part of your journey, but how cool that you were the journey. You deal with these works. So, what was that like? Okay, so you said you would come home from work and you would sit down and you would go through it. Tell us a little bit about how you set your own.

Taylor: I think I mentioned this, I was still seeing a therapist. What was funny is, I would come to my sessions and be teaching her about ERP, because in a way I was becoming this mini expert. And as I think a lot of our clients do, because it is such a unique treatment, you do have to become an expert. So, yeah. I mean, I remember using that worksheet where, okay, identify the what-if fear then list out the compulsions. I remember at the time I was like, “All right, I need to print out 10 of these because I have so many themes right now.” I remember doing that. And then, yeah, I would just pick away-- I would write them and then go through the whole process really as if I was going through ERP treatment. That’s what I was doing. Like the same process I do now with my clients is just what I did. And I’m so lucky and blessed to have a background in mental health to have that. And even the resources that I could have had self-taught myself ERP because I know that that’s not everyone’s situation.

And then what was really helpful, and I think this is really important to mention, is my husband. And I think a lot of people can relate to this. We all have our one person who we seek reassurance from. So, when I was still living at home, that person was my mom. Once I got married, it became my husband. And so, he had to learn a lot about OCD treatment and ERP and not providing reassurance. So, the poor thing, I would have him sit down and watch your video, and he would. And he is amazing and just the best support system. But that was really helpful because again, even if you are in therapy and doing this as a supplement to therapy, to be able to have those resources to watch again and again, once you buy the course, you have it. And I still reference it to this day if I am for myself or even if I’m working with something with a client. So, that piece was huge because then I could say, “Hey, look this is the science behind what I’m doing. This is why you can’t give me reassurance and things like that.”

Kimberley: Right. This is so cool, and it’s so cool that he was able to watch it and wasn’t intimidated by the whole process. I mean, he probably was, but he still went through with that, which was so cool.

Taylor: 100%. Yes. This was about two years ago almost to the date actually. And because now I can look back on it, I think I do lose the anxiety that I had with starting it. And I’m sure him wondering, “What the heck are you doing?” But I think that’s so important to have your partner or just your support system understand ERP because it can be very confusing to the outside. If you’re doing exposures. What was very upsetting and hard for me that I really had to come to accept is, a lot of my harm obsessions were unfortunately targeted around him. So, I’d be writing these scripts and I would feel this guilt, this horrible amount of guilt and shame, similar to what I felt back in high school when I was trying to hide my compulsions. Here I have this amazing supportive husband and I’m writing these scripts. So, I would want to try and explain that. And him understanding it, I think made the whole process so much easier, for sure.

Kimberley: Yeah. And those scripts can be hard, right? I even remember--

Taylor: I think that’s the hardest part for me.

Kimberley: Yeah. I even remember recording that and looking into the camera and saying, “You need to write a story about this.” And I do these with my patients all the time, but thinking like, “Why would anyone trust me?” That’s a hard thing to do when you haven’t-- so that’s really amazing that you did that. The good news, and I’ll tell you this, you’re the first person to know this, is we just renewed the whole imaginable script module. They’re three times as long now.

Taylor: Oh, amazing.

Kimberley: Yeah. So, you’re the first to know. By the time they start, everyone will know, but yeah, we tripled the length of it because people had so many questions about that process.

Taylor: In fact, I had a session yesterday with one of my amazing clients and she’s fairly new in the treatment and we were introducing the idea of scripts. And you’re absolutely right. When you’re describing it, you’re like, “What am I saying? This sounds horrible.” I was like, “All right, we are going to pretty much write out your worst fear coming true in as much detail as possible.” And she was like, “What the heck is going on?” And sometimes I have to take myself back to that starting point, especially with working with clients, because now I’m like, “I have an intrusive thought come up. All right, I know I have to go write a script when I get home.” So for me, it’s become second nature. But I think remembering how painful it was the first several times to actually write down those thoughts and then not only write down them but say them out loud and look into them, that-- I was reminded yesterday, I can’t lose sight of how painful that is initially, but then how rewarding it is once you realize it works.

Kimberley: Yeah. You get so much bang for your buck, don’t you, when you use those. This is so cool. You’re obviously a rockstar. So exciting. I can’t tell you how much this brings me such joy to hear. What would you say to somebody who’s starting this process? What was important to you? What got you through? Tell us all your wisdom.

Taylor: I think the biggest thing would be to know that you’re not alone because I remember that was the biggest thing for me. Before I knew what OCD and ERP were, I thought that I was the only person on the planet experiencing these intrusive thoughts, these horrible, violent images or sexual intrusive thoughts or whatever it was. So, first and foremost, knowing that you’re not alone, that there are so many of us who have experienced this, not only experienced the pain of it, but have gone through and are now in recovery. And that you don’t have to let fear dictate the choices that you make because that’s how I lived my life. I avoided things because of my OCD. So, I wouldn’t be triggered. I let fear make the decisions for a lot of my life. And when you do go through ERP treatment, you get to be in control again and you get to live again according to your values.

For example, I’ve always wanted to be a mom and I’ve always dreamed of having kids. And I remember so many times OCD in so many different ways that I can’t even get into, say, “Oh, you could never do that.” Actually, I’m in my first trimester right now, which is so exciting and has been such an incredible journey. That’s a completely different topic for another day. I’m handling my OCD attached to that. But I was thinking and reflecting about it the other day of just like, wow, I now get to live life according to my values and not let fear and OCD make the decisions.

Even though the treatment seems so scary and weird at first, it is so worth it because it works. And that’s why I wanted to become really a specialist in this specific field because I fell in love with the treatment. I fell in love with the fact that it gives people their lives back. And that’s so cool to witness.

So, you’re not alone. You’re also not a bad person because of the thoughts that you’re having. And I’ll briefly share, I’m a Christian and I know that a lot of the thoughts that I’ve had for a long time, I just thought, okay, I’m a horrible person, or I’m a sinner. And whatever your faith is, whatever spirituality or anything, whatever morals you have, just know that you’re not your intrusive thoughts. You are just a person with thoughts and that’s it.

Kimberley: Yeah. That’s so powerful. So, number one, congratulations. I just love when people say, “I have OCD about it, but I did it anyway.”

Taylor: I know. Talk about facing your fears, it’s like--

Kimberley: Right. And then the second piece where you’re really, again, speaking from a place of values, even your religion, I’m sure got attacked during that process. And it’s really hard to keep the faith when you’re being harassed by these thoughts. So, I just love that. What motivated you to keep going? Besides you said just the deep wish to be better and well, how did you keep getting up? Was there lots of getting up and falling down or did you just get up every day?

Taylor: Oh my gosh. In fact, there’s times where I still feel like I am picking myself up because-- I’m so happy you brought that up because that was something that I wasn’t prepared for, the feelings of relapsing I call it, where you feel like, oh my goodness, my symptoms have gone away, whatever. And then it hits you like a ton of bricks. And I always find that it comes back so strong. And it can be really discouraging at first. And I’ve even experienced that with the first couple of weeks of this pregnancy of just like, “Wow, I thought we were over this.” Even themes coming back from when I was 15 or 16 and like, “Okay, looks we have to deal with this again.” I’m able to laugh about it now, but in the moment, it’s really hard.

And so, I think the biggest thing for me that I try to keep myself reminded of in those moments where I do feel like I’m-- because it feels like you’re taking a step backwards in a sense sometimes. And I always try to remind myself that so much can change in a matter of a day and that this is temporary. And even the worst moments of my ruminating or obsessing or the nights where I would literally spend hours completing compulsions, they always passed, if that makes sense. It sounds so cliché, but the sun always rose again. I always got another chance. And I would say that I am a naturally driven and motivated person. So I think that definitely did help me. But that’s not to say that there weren’t times where it’s a hopeless feeling when you are living in your own personal hell of intrusive thoughts. The way I remember describing it to the first therapist I went to is that I was, and I don’t play tennis by the way, but I was like, I pictured myself in a tennis court with a tennis racket and someone just throwing balls at me. And those are the entries of thoughts. And I walk one away and another one comes back. It was exhausting. But being reminded that--

And also now too, and I wrote this down, I definitely wanted to talk about this, was you have to find the community support and that has been so vital for me. And again, thank you, Instagram, I’ve been able to connect with so many people who have OCD or a related disorder who I text or DM and are now some of my closest friends. And we hold each other accountable on days where it’s like-- because OCD can be really weird sometimes. And it’s really nice to have people who understand and have been there. So, that’s really helpful for me too on days where it’s like, man, it just feels like I can’t pick myself up.

Kimberley: Yeah. It’s so important. In fact, I’ll tell you a story. A client of mine, who I’ve been seeing for a while, could do the therapy without me. And she knows it as well as I do. And we hit a roadblock and it kept coming up. I just feel so alone. And not having support and other people with similar issues, it was a game-changer for her. And I think we’re lucky in that there are Facebook groups and Instagram and support groups out there that are so helpful.

Taylor: Yes, totally. And that’s one of the reasons I actually decided about a year ago to create a mental health Instagram because I knew how much Instagram and using that platform helped me. I literally remember saying, “Even if it helps one person.” And at first, it was really scary sharing some of the things, talking about the more taboo themes and different things like that, and thinking like, oh man, what are my coworkers thinking of me or my family members when I post this. But what’s been so rewarding is countless people have reached out to me who either I know and I’ve either grown up with my whole life or people across the globe really of just saying, “Hey, thank you for letting me know I’m not alone.” And to me, that makes it totally all worth it. So, it’s so important to find that connection.

Kimberley: Yeah. And is there anything else that you felt was key for you? Something that you want people to know?

Taylor: I think that it’s so important to-- a huge piece of it too was incorporating act, like acceptance and commitment therapy, which I also believe I learned from one of your podcasts. So, thank you. And that was a huge piece for me too, because again, I think that-- to be very honest, I didn’t even say the words “OCD” until two years ago. I knew in my head that I met the criteria in the DSM, but I never-- that label for me was so scary. I don’t really know why, looking back, but maybe because it was just so unknown. So a lot of the work that I’ve had to do personally that’s been really helpful is just acceptance of any emotion really, especially learning that acceptance doesn’t mean that you have to love something, and it ties into tolerating uncertainty. Tolerating, I was talking about this with a client yesterday. Tolerating is not an endearing word. If someone says, “Oh, I tolerate that person,” that’s not a compliment. We were not being asked to love uncertainty or love the fact that we have OCD or whatever we’re struggling with, but just learning to sit with it and tolerate it has been an absolute game-changer for me. As much as the exposures and response prevention was so new to me, that whole piece too was a game-changer.

Kimberley: Yeah, I agree. I think it’s such an important piece, because there’s so much grief that comes with having OCD too, and the stigma associated. I’ve heard so many people say the same thing. They had to work through the diagnosis before they could even consider--

Taylor: And I also had a lot of anger in two ways towards the fact that I had to deal with this. I always thought, and of course, I think a lot of us think this about anything else, I was like, “If only I just “had” anxiety and not OCD, or just had depression, that would be so much easier to deal with,” which I know is ridiculous. But in the moment, it’s like, I think whatever we’re going through seems so impossible. And then the other piece of the anger was just the misuse of people saying, “Oh, I’m so OCD,” or seeing it displayed on TV or on social media in the wrong way. And I’m like, “Oh my gosh, if only you knew what OCD was, you would never say that.” So now, it’s been cool because I can turn that frustration more into advocacy and education, but that was a huge hurdle to jump to.

Kimberley: Yeah. Well, especially because you’re over here tolerating OCD. And then other people are celebrating and it just feels like taking the face.

Taylor: Oh my gosh, yes.

Kimberley: Yeah. I love all of that. Thank you so much for sharing that story. Number one, it brings me to tears that we get to meet and chat. I think that that is just so beautiful and I’m so impressed with the work that you’re doing. So, thank you. Tell me where people can hear more about you or follow you and so forth.
Taylor: Sure. So, my Instagram is acupofmindfultea, and there you can also find-- I definitely share my personal story, but just also ERP tips. I’m also very big on holistic findings. So, obviously, medication has been a huge part of my story as well and helpful, but I also love finding natural ways and different ways that have helped my anxiety and just building my toolkit. So, I share a lot about that on there as well. So, yeah, I would love to connect with you guys on social media, for sure.

Kimberley: Yeah. I would have to admit, when I saw your pregnancy announcement, I was with my kids and I was like, “Woo-hoo!” And they were like, “What?” And I’m like, “Oh, it’s just somebody I’ve never met, but I’m so excited for her.”

Taylor: Isn’t that so great? I know, I love it. I feel the same way for other people.

Kimberley: Yeah. Well, thank you so much. Number one, thank you for coming on the show. I love how that creates itself organically. And number two, thank you for sharing this because I think this will hopefully give some people some hope. We were overwhelmingly encouraged to have people with stories of their recovery. So, I think this is a really wonderful start of that.

Taylor: Awesome. Well, thank you so much. I’ve been listening to your podcast for two years now, and it’s been such an encouragement for me and such a huge form of education and help. So, this was truly special. So, thank you.

Kimberley: Thank you.

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