9 Ways to Stop Picking Your Skin This Summer

As summer approaches and the weather gets hotter, many of us are eager to wear shorter sleeves and enjoy the sun. However, this often leads to increased skin exposure and, unfortunately, a greater temptation to pick at our skin. In today's article, we'll explore nine strategies to help you stop picking your skin this summer. These tips have been helpful to many of my clients, and I hope they will be just as beneficial for you.

Understanding Skin Picking

Before we dive into the strategies, it's important to understand what skin picking is. Clinically known as dermatillomania, skin picking is a type of body-focused repetitive behavior (BFRB). People with this condition may pick at their skin, arms, lips, scalp, nails, and even more sensitive areas like the pubic region. It's similar to trichotillomania, which involves hair pulling.

It's crucial to note that skin picking and hair pulling are not forms of self-harm. People who pick their skin are not trying to hurt themselves or seek attention. They often do it because they are either understimulated (bored) or overstimulated (anxious or overwhelmed). Understanding this can provide insight into the strategies we'll discuss.

Strategy #1: Awareness Logs

Awareness logs are a powerful tool in any stage of recovery. By logging every time you have the urge to pick, noting how much you picked, where, and for how long, you gain a better understanding of how this condition impacts your life. Many people find that having to document their behavior reduces the frequency of picking.

Awareness logs are a key component of habit reversal training, a cognitive-behavioral therapy technique specifically designed for BFRBs.

For more information about BFRB School, our online course for skin picking and hair pulling, CLICK HERE

Strategy #2: Keep Your Hands Busy

Engaging in a competing response can help divert your urge to pick. Competing responses might include using fidget toys, holding a stone, or playing with soothing textures. You can find many affordable fidgets online or at dollar stores.

Create a basket of tactile items that you can use to keep your hands busy. Place these items around your house, in your car, and at work to ensure they are easily accessible when you need them.

Strategy #3: Create a Skincare Routine

A good skincare routine can help prevent irritation and dryness that might tempt you to pick. However, it's important not to overdo it, as too much attention to your skin can also trigger picking. Consult with your doctor to develop a routine that keeps your skin healthy without exacerbating your condition.

Strategy #4: Use Physical Barriers

Using physical barriers (called habit blockers) like gloves, band-aids, or long sleeves can prevent you from touching and picking at your skin. Some people find that keeping their nails short or wearing fake nails can reduce the tactile satisfaction of picking. Identify what works best for you and use these barriers consistently.

Strategy #5: Self-Compassion

Practicing self-compassion is vital. Beating yourself up for picking only increases negative emotions like shame and guilt, which can lead to more picking. Instead, practice radical acceptance and reduce self-criticism. This approach can help you feel more motivated and improve your overall well-being.

Strategy #6: Manage Stress and Anxiety

Managing stress and anxiety is crucial, as many people pick their skin to cope with these feelings. Cognitive-behavioral skills can help address faulty cognitions and behaviors that exacerbate stress. Consider taking an online course, like Overcoming Anxiety and Panic, to learn effective stress management techniques.

Strategy #7: Establish a Support System

Having a support system can make a significant difference. Whether it's family, friends, or online support groups like those at BFRB.org, having people to check in with can help you feel less alone and more accountable. Some people find it helpful to text or call a support person when they feel the urge to pick.

Strategy #8: Stay Hydrated and Healthy

Good nutrition and hydration can impact your skin's health. Speak with your doctor about how to maintain healthy skin through diet and hydration. Additionally, consider looking into over-the-counter medications like N-acetylcysteine, which has been shown to help with skin picking. Always consult with your doctor before starting any new supplement.

Strategy #9: Set Realistic Goals and Track Progress

Set achievable goals and track your progress. Instead of aiming to completely stop picking, focus on gradually reducing the behavior by a small percentage each week. Tracking your progress helps you see improvement and identify what strategies are working. Remember, small steps lead to significant changes.

Conclusion

These nine strategies can help you stop picking your skin this summer. Whether you use awareness logs, keep your hands busy with fidgets, or establish a support system, each step you take brings you closer to managing this behavior. Remember to practice self-compassion and set realistic goals. If you need additional support, consider enrolling in courses like BFRB School or Overcoming Anxiety and Panic.

Transcript

Today we’re going to cover nine strategies to stop picking your skin this summer. It’s getting hotter. You want to start wearing shorter sleeves or have your skin exposed to the sun more often, which means you’re more likely to start picking at your skin. Let’s talk about nine strategies that you can use right away. Hopefully, you find them as helpful as my clients have.

Welcome back. I am so excited to talk with you about nine strategies and skills that you can use to stop picking your skin this summer. But before we do that, let’s just first do a little deep dive into what skin picking is. Clinically, we call it “dermatillomania,” and it’s a kind of body-focused repetitive behavior. Often, people with skin picking will pick out their skin, their arms, their lips, their scalp, and their nails. There’s really no limit to where someone can pick their skin. Some people even pick pubic areas under their arms or around their genitals. There is, as I said, no off-topic area that people will pick. It’s completely normal for people to pick in one or all of these areas. It’s similar to a condition called trichotillomania, which is hair pulling. Again, hair pulling is another type of body-focused repetitive behavior, and people may pick at any area where there is skin on their body.

It is important for us to first highlight that skin picking and hair pulling are not self-harm. People who pick their skin aren’t trying to hurt themselves. They’re also not trying to just get attention. They do not want to be damaging their skin or giving their skin abrasions and such. It’s just a part of a condition, and we have a little bit of insight as to why they’re doing it. Often, people with skin picking, or dermatillomania, are skin picking either because they’re understimulated, they’re bored, or we know they may be overstimulated. Maybe they’re very anxious, they’re feeling hyper-reactive to feeling overwhelmed with either emotions, stimulation, or thoughts. We do know that people who engage in this skin-picking behavior are more likely to pick either when they’re overstimulated or understimulated. That’s something to think about, and there is a clue there into some of the strategies that we’re going to use today.

Let’s get to it. Let’s start talking about some of the strategies that you can use to stop picking your skin this summer.

Strategy #1: Awareness Logs

Awareness logs can be so helpful at any stage of recovery. An awareness log is either a piece of paper or a document on your computer or on your phone, where you log every time you have the urge to pick your skin, how much you picked your skin, where you picked your skin, and how long you engaged in skin picking. What this does is, number one, it helps us really understand to what degree this condition is impacting your life. Secondly, people often report that when they have to document it, they’re less likely to engage in the behavior because nobody wants to have to spend all their time logging it as something they don’t want to deal with.

Awareness logs can be a very helpful skill for us in understanding our own condition and our own symptoms, and in addition, they can help us with motivation to slowly reduce this behavior.

Awareness logs are something we use in a very well-known and researched way of using cognitive behavioral therapy, and the type of therapy is called habit reversal training. It’s the specific modality that we use for skin picking and hair pulling, and it is a key component of that cognitive and awareness work.

Strategy #2: Keep Your Hands Busy

Now again, when we’re using habit reversal training, we engage in something called a competing response. A competing response is a behavior that competes with the feeling of picking our skin. Now, a competing response might be fiddles or fidget toys. It could be holding a stone or maybe stroking a feather. It could be playing with other fidgets that we have. The cool news is that you can get so many fidgets online these days for a really low price, or you could easily go to your dollar store and look around for textures that feel beautiful to you, feel soothing to you, or help you with either the understimulation or overstimulation.

What we want to look for here is, what are the specific tactile experiences that you can use to keep your hands busy? We actually have an online course called BFRB School, which is a specific course for people with hair pulling and skin picking, using skills like habit reversal training and cognitive behavioral therapy. We talk all about the core importance of using competing responses.

I often tell my patients and my students to always have a bucket or a basket in the house of different tactile experiences, different tactile things that you can play with objects, so that at that moment, if you’ve identified in your awareness log that you’re feeling bored, you can engage in something that stimulates your creativity, stimulates your awareness. However, if you’re the opposite and you’re feeling overstimulated, you might dig into the basket and find something that’s quite soothing. Maybe it’s more like a silly putty, a gel, or something else that’s more soothing for you.

These competing responses are going to be so important for you in getting very clear on what you need at that moment and having it readily available. I often say to my patients and my students, don’t just have it in one area of the house because, in that moment, you’re still going to want to just pick your skin. What we prefer to do is to have little pieces over the house, in your car, or in your office so that they’re easily accessible. Some people have it on their key rings, some people have it in their purses—whatever works for you.

Again, that awareness log will help us identify specifically where you are when you’re having these urges to pick your skin. And then we can put in competing responses to compete with the skin-picking behavior.

Strategy #3: Create a Skincare Routine That Helps You

This is a little bit of a fine line, though, because we don’t want to engage in a skin routine that has you putting too much attention on your skin because, again, too much attention on your skin is going to mean that you’re more likely to pick your skin. However, we also want to make sure that we are not ignoring your skin, letting it get really dry, especially in the summer. Maybe you’ve had a sunburn or such, and you’ve got some wind chafing or something.

Again, if you have any irritation on your skin that isn’t taken care of with a skin routine, you are more likely to pick at that skin, especially if there’s already an open wound or a scab. If you already have an open wound that you’ve scratched or maybe you bumped into something and you’ve got a little scab there, we want to make sure that we’re engaging in a really healthy skin routine to help that heal and repair so that you’re less likely to go and pick that. I would encourage you to speak with your medical professional about skincare and what would be best for you. Maybe you have a skin condition. Very commonly, people with skin picking do. Speak with your doctor about a skincare routine that will help your skin picking but not be so extensive that it actually makes it worse. I would trust that your doctor will be able to help you in that area.

Strategy #4: Use Physical Barriers

Again, going back to the gold standard treatment for skin picking, which is habit reversal training, we use what we call a habit blocker. This is something that blocks you from the habit of picking, and this can involve anything that stops you from being able to touch your skin.

A lot of patients and students I have had have used things like gloves or band-aids to cover an area that they’re likely to pick. Maybe in the summer, they may wear longer sleeves even though it’s very hot because that actually stops them from getting to the area that they feel an urge to pick. You may also want to keep your nails really thin or cover your nails. Some people keep nails on, like actual fake nails, as a barrier to being able to touch the skin. Maybe it doesn’t give them that same tactile feeling of picking when their nails are medium-length.

What we want to do here is identify for yourself the specific barriers that are helpful. The thing to remember here about skin picking is that everyone is different. Not one strategy that I’ve used for one client is going to be the strategy we use for another client. It’s going to be very much dependent on those awareness logs that you logged out of in that first strategy. Getting clear on specifically what are the triggers that cause you to pick your skin and what specific behaviors and habit blockers are helpful to reduce the skin picking that you feel the urge to engage in.

Strategy #5: Self-Compassion

We have to engage in not beating yourself up, not judging yourself, not punishing yourself if, in fact, you have picked or recently picked despite all of these strategies. Beating yourself up actually does not motivate you to stop picking. In fact, it usually brings up more emotions such as shame, guilt, sadness, anger, and humiliation. Those emotions can send us into overstimulation, making us want to pick again.

Again, we want to engage in a practice of self-compassion. We want to engage in a sense of radical acceptance of ourselves, whether we pick or not. This is so important because we want to reduce our suffering, not make our suffering higher. We do find that people who practice self-compassion tend to have higher levels of motivation, decreased levels of procrastination. They tend to feel better about themselves and have higher self-esteem. They’re more likely to get out there and do the things that they love. Every moment that you’re engaging in in your life is a moment you’re less likely to be picking. It’s very, very important that you practice a self-compassion routine, even if it’s once a day. Anything is better than nothing to reduce that self-criticism where you can.

Strategy #6: Manage Stress and Anxiety 

I cannot stress this enough. It is so important when it comes to skin picking that we manage our stress. Again, a lot of people pick their skin because it is a way in which they can manage their stress. A lot of people with skin picking say once they start picking, they can exit out of reality and go into a trance-like mode where everything disappears and they feel relaxed and in the zone, and it takes away all of the stress. We can now understand why there is actually an urge and a pull towards picking and pulling, because who really wants to stay in stress and anxiety? Of course, it makes total sense. The more we can manage our stress using strategies, skills, and other tools like cognitive behavioral therapy, the less likely we are to use skin picking as a coping strategy.

When it comes to managing stress, again, the most important thing we’re going to do here is what we call cognitive behavioral skills. It’s going to be taking a lot of our cognitions that might be faulty, leading us to have more anxiety, and also looking at our behaviors and the things that we do that may be actually exacerbating the stress and anxiety that we experience.

If you’re someone who struggles with anxiety and stress, I strongly encourage you to check out our online course called Overcoming Anxiety and Panic. We go through all of these steps. You can do it from home, and it may help you to get an idea of what might be some of the things that are triggering your stress response, triggering your anxiety response so that you can manage that, so that then you can move on to manage your skin picking as well.

Strategy #7: Establish a Support System

We want to have a community of people who can support us as we go through these steps. It’s not an easy thing to overcome skin picking, so I really want to encourage you to find a support system, whether that be family or friends, or you can go to BFRB.org. They have a whole array of online support groups that you might be interested in looking at to get support, so you feel like you’re not alone and that you have the support that you need.

Another option here is to also look for accountability bodies. Somebody who mightn’t even have skin picking. They might be a loved one, a friend, a parent, or a sibling—someone who you can check in with when your urge is really high.

A lot of my students have said that it’s been very helpful when they have the urge to text somebody and say, “I have a strong urge. I’m texting you to let you know.” They may have already set up a plan on what to do. Maybe they jump on a phone call together, they might text each other throughout it to help the person ride that wave of the urge. Or maybe that person might encourage them to say, “Hey, you told me to remind you of this one thing if you have this urge.”

Really, the importance of a support group can help you, or a support person can help you not only with feeling less alone, not only with beating yourself up, but also with putting these strategies into action, especially if you let them know about the strategies.

Strategy #8: Stay Hydrated and Healthy

Now again, I’m going to encourage you to speak with your medical doctor about this, but I just wanted to mention because I try to look at you as a holistic, full person, someone who’s not just your skin picking, but also, we want to have a look at things like your health. Take a look at your nutrition. Take a look at your hydration levels.

Again, these things can impact our skin. If, let’s say, you’re having a lot of nutrition that’s causing a lot of breakouts and you’re someone who’s prone to skin picking, those two things together could become a disaster. You want to speak with your doctor or a professional in that area about specific nutrition, things you may want to avoid eating, and how hydrated you need to stay to keep your skin healthy, to reduce the chances of you wanting to pick and pull.

A lot of patients I see, and a lot of students that have come through BFRB School, our online course for skin picking, have reported having skin conditions, acne, or certain things that have impacted how much their skin is irritated, how many pimples they’re having. Now, I’m not assuming that nutrition and hydration are the solution to all of that, but I would encourage you to speak with a doctor and just inquire about what you could do to make sure we’re addressing those skin conditions.

Another thing to know here, and this is like an inside scoop, is that there are specific over-the-counter medications you can get that have been proven to help with skin picking. I’ll leave a link in the show notes for you to take a look, but there is a vitamin that’s called N-acetylcysteine. It is an over-the-counter medication that has very few side effects and has been shown to help people with skin picking. Now again, I’m not a doctor. I would strongly encourage you to speak with your doctor about that, but again, I’m trying to give you as many resources today as we can to help you get to the goal that you want. These are all things that you can take a look at and speak to your doctor about.

Strategy #9: Set Realistic Goals and Make Sure You Track Your Progress 

We want to set realistic goals. I always tell my patients at the beginning of treatment that the goal isn’t to completely stop skin picking, even though most people are coming for that goal. Because what I have found is, when you set that huge goal, it sets you up to fail. It makes you feel so bad if you slip. It makes you feel so much pressure. It’s such a scarier experience than if you say, “Hey, I’m just going to reduce this by 3 to 5 percent each week,” or month or day, whatever is right for you. We want to set realistic goals—goals that can help keep you motivated and goals that make you feel like they're achievable.

We also want to track progress. One of the most important parts of treatment, once we’ve done that first awareness log—and we do this in BFRB School, I do it with my patients as well—is that once we’re off and running, we then track how well we’re doing. How well did you use your tools? What tools didn’t work? How long did you pick for? Where were you? What went wrong?

We are not doing this to beat you up or to scrutinize you; we are doing it from a place of experimenting, gathering information to know specifically what’s getting in the way of your recovery and what your progress looks like. Some people may say, “I’m not making any progress,” but when we actually look at their logs, we’re starting to see progress in these small ways. Remember, small steps lead to medium-sized steps. Medium-sized steps lead to huge changes.

The last strategy is probably the most important. I could have spent a whole podcast episode talking about that. It’s about setting realistic goals and tracking your progress.

Again, if you are struggling with this and you want to take BFRBSchool.com, head on over to CBTSchool.com. You’ll get access to it there. It will take you through all of these steps. We also have modules on self-compassion, mindfulness, and healthy lifestyles that can really help you with this recovery as well. I’d strongly encourage you to consider that as a hopeful strategy as well.

All right, guys, thank you so much. These have been the nine strategies to help you stop skin-picking this summer. I hope you found it helpful, and I’ll see you next week.

Today, we’re diving into a topic on how to become more self-confident, especially if you struggle with anxiety. Self-confidence is a quality we all desire, but for those of us with anxiety, it can seem particularly elusive. Let's explore how to cultivate self-confidence, even when anxiety is a persistent part of your life.

Understanding Self-Confidence

First, let’s clarify what self-confidence actually is. Many people mistake it for arrogance or an inflated sense of self. True self-confidence, however, is a deep trust in your own abilities, strengths, and judgment, even when faced with adversity. Anxiety can often undermine this trust, making us feel uncertain and vulnerable. But self-confidence is not something you’re born with—it’s something you develop over time.

Debunking Myths About Self-Confidence

Myth 1: Self-confidence is Innate

One common misconception is that self-confidence is an inherent trait. This couldn’t be further from the truth. Self-confidence is a skill that can be nurtured and grown with practice and perseverance.

Myth 2: Success Equals Confidence

Another myth is that self-confidence only comes after achieving certain milestones or successes. While accomplishments can boost confidence, they are not the sole source. True confidence is built through the process, not just the outcomes.

Myth 3: Confident People Don’t Have Anxiety

It’s a widespread belief that confident people are free from anxiety. In reality, confident individuals often face anxiety just like anyone else. The difference lies in their willingness to face their fears and grow through the experience.

Building Self-Confidence: Practical Steps

Embrace Challenges

Self-confidence grows from facing and overcoming difficult situations. Initially, the thought of tackling a tough challenge can be overwhelming, but each experience strengthens your trust in your ability to handle adversity.

Practice Feeling Your Emotions

Confidence isn’t about the absence of fear but rather the ability to feel and manage your emotions effectively. By practicing feeling emotions like fear, inadequacy, or shame, you become more comfortable and resilient in facing them.

Identify Specific Scenarios

Pinpoint the situations where you feel least confident. Reflect on what emotions these scenarios evoke and work on becoming more comfortable with those feelings. For example, if public speaking makes you anxious, practice feeling that anxiety in smaller, controlled settings until it becomes more manageable.

Cognitive and Behavioral Strategies

Cognitive Restructuring

Changing your thoughts can significantly impact your confidence. Instead of telling yourself, “I’m going to fail,” try affirmations like, “I’m prepared and capable.” This shift in mindset can reduce anxiety and boost your self-assurance.

Behavioral Exposure

Facing your fears head-on through repeated exposure can be incredibly effective. For example, if public speaking terrifies you, join a group like Toastmasters, or practice in front of friends and family. Repetition helps desensitize you to the fear and builds confidence in your abilities.

Reflect and Learn

After facing a fear, take time to reflect on the experience. Ask yourself, “What did I learn?” This reflection helps you identify areas for improvement and reinforces your ability to handle challenging situations.

Embrace Failure as a Learning Tool

Failure is an inevitable part of growth. Instead of viewing failure as a negative outcome, see it as an opportunity to learn and improve. The more you fail and learn from those failures, the more confident you become in your abilities.

Conclusion

Self-confidence is a journey, not a destination. It involves embracing challenges, feeling your emotions, and learning from both successes and failures. Remember, today is a beautiful day to do the hard thing. Face your fears, practice self-compassion, and celebrate your progress along the way.

Have a great day, everyone, and keep building that self-confidence!

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TRANSCRIPTION: 

Hello and welcome back. I’m so happy you’re here. Today we are talking about how to become more self-confident, especially if you’re someone who has anxiety. 

Self-confidence is something that a lot of people talk about. It’s something we all want more of. But if you are someone who has anxiety, you might actually find that being self-confident is really, really hard. So I’m here today to talk with you about how you can become more self-confident even if anxiety is here. Let’s do it. 

First of all, what is this thing called self-confidence? Some people think that it’s like thinking really highly of yourself and that you think you’re the coolest—sort of arrogance—but that is not the definition of self-confidence. Self-confidence is a deep trust in your own abilities, your own strengths, your own capabilities, and your own judgment in the face of adversity. I get it. When we have anxiety, it’s very hard to feel that sense of trust. In fact, I think anxiety can sometimes make us feel like we can’t trust anything. We’re in a heightened state of fight, flight, freeze, and fawn. 

What we want to do today is take a look at how we can improve self-confidence in the face of anxiety. Now, in order to do that, we first have to look at some of the myths about self-confidence. A lot of people think that self-confidence is just something that you’re born with, and that could not be further from the truth. Self-confidence is something we grow over time. Other people believe that self-confidence is something you get once you’ve achieved something, like you’ve achieved some success, or you’ve lost enough weight. That was me when I had an eating disorder. When I’ve finished a course, then I can feel confident. Or, when I’ve done enough practice, then I can feel confident. I understand that. However, that if-then statement creates a lot of opportunities for us to feel out of control and like it’s something that we can’t create on our own. I actually want to really take that idea away and lean towards another strategy. 

Another common myth about self-confidence is that some people have it and some people don’t, and that it’s like an inherent piece of who we are—also not true. Anyone can work toward being confident. We have a lot of evidence. You probably know someone who’s really, really confident, and you don’t even think that they are warranted to have that much confidence—again, proof that we can grow self-confidence. It’s something that you can have that doesn’t require a certain accolade or level of success. It’s something that we can take on. Again, we are not using it in a way to hurt other people or to make other people feel bad. That’s actually not self-confidence. That’s usually coming from a place of insecurity. 

Another myth is that confident people don’t have anxiety—also not true. Confident people are as afraid, if not maybe even more afraid, than the average person on the street. I don’t want us to believe that confident people don’t bring anxiety to the table, and we are going to take a look at how we can work with that. 

Let’s now talk about how you can become more confident. Here’s the thing. As I have gone through some very difficult things, at the beginning of going through those difficult things, I too was overwhelmed with thoughts like, ‘I can’t handle it.’ ‘I don’t have what it takes.’ ‘This is going to destroy me.’ ‘This is going to ruin me.’ It’s like I’m just going to implode with this degree of suffering. 

But what I found was that once I had been through that difficult season, I felt more confident. It wasn’t that I succeeded in it, though. It’s not that I conquered all during that difficult turbulence season. There was a different shift towards, again, trusting that I could handle hard things. Often we go into hard, scary things, saying, “If I only had been through this before, well, then I would feel confident.” But that’s actually not true. 

A lot of self-confidence is your ability to feel the feelings you will have to feel when you do that hard thing, not the actual doing of the hard thing. The more we practice feelings of fear, threat, inadequacy, shame, or whatever it might be, the more we’re comfortable, open, and caring in feeling those feelings. That’s how we begin to feel self-confident in any situation, whether we’ve been through it before or not. 

I had a friend who once told me that a very, very dear loved one, actually a child, had been through cancer. I had said to her, “How are you doing?” She said, “Oh, I’ve been through cancer. Nothing can take me down.” But what she meant by that is that it’s not that everything was in comparison to cancer; it’s that she had mastered feeling her feelings as she navigated something really, really difficult. She could go through something completely different. But because she’s already committed and gone through the willingness to have some really uncomfortable feelings, she had a sense of self-confidence, like, ‘I could handle anything at all.’

What I want you to think about here is, what are the things that you don’t feel confident about? What specifically are the situations, the scenarios, and the times in your life where you don’t feel confident? And then I want to ask you, what would you have to be willing to feel, and what would you have to build comfortability feeling in order to feel confident doing that thing? It’s just a question. Sometimes it’s like, “Oh, to be confident doing my exposure, I’d have to be confident feeling uncertainty.” “Oh, to go through seeing my child struggle, I’d have to be confident feeling maybe guilt or maybe sadness.” “Maybe to handle my parents’ aging, I’d have to be able to confidently and willingly feel grief.” Ask yourself these questions because they can help us identify the emotion that we need to practice feeling on purpose. 

Now, when it comes to creating self-confidence, there are two ways we can target it. I talk to my clients about this all the time. We can create self-confidence by changing our thoughts, or we can create self-confidence by changing our behaviors. Let’s talk about creating or changing our thoughts. Let’s say you have something you need to do that’s creating a lot of anxiety. Maybe you have to do a public speaking event. You have a lot of anxiety. You could do some cognitive restructuring by changing your thoughts. Instead of saying, “You’re going to fail and this is going to be terrible,” you could practice saying, “It’s going to go great,” or “I feel like I know my stuff, I’ll be able to do it.” These are great strategies. We could use that. 

Another strategy would be, if you have a fear of public speaking, go and do lots of public speaking, Maybe you would join Toastmasters. Maybe you would rehearse it in front of your family, your neighbors, or your colleagues. You would practice doing this behavior over and over and over again with repetition. 

These are two very good ways to help with confidence building. However, let’s compare and contrast them. Let’s say that before this public speaking event, you spent a lot of time doing cognitive restructuring. “I’m going to do great. I’m going to do great. Nothing’s going to go wrong,” which we don’t actually know is true. But the thing is, when you walk up onto that stage, you don’t have a lot of proof that it is going to go well. You don’t have a lot of proof. If it doesn’t go well, you mightn’t leave there with a ton of confidence. However, if you’re somebody who instead practices facing that fear over and over and over and over again, as you go to walk onto that stage because you’ve changed your behavior repeatedly and you’ve practiced, you actually have trust in your ability. You have trust in your capability to feel fear. You know what fear feels like, you’ve practiced feeling it, and therefore you’re a little bit desensitized, or you’re a little bit feeling a sense of mastery over that feeling, and you are able to walk up onto that stage.

My advice is that the better way, the more superior way to build self-confidence, is to practice facing that emotion as much as you can. In exposure and response prevention, which we use as the gold standard treatment for OCD and many other anxiety disorders, we’ve practiced facing fears over and over. What clients often tell me is, “I actually start to feel confident doing that thing. I start to feel confident taking flights. I’m starting to feel confident going to the post office. I’m starting to feel confident driving my car by actually doing the thing.” 

The real moral of the story here is that confidence comes from repeatedly facing the thing that is hard for you. Identifying the specific emotion that makes it more difficult and practicing being willing to have that feeling.

Now, here is where, going back to that cognitive changing of your thoughts, it might be very, very beneficial, particularly at the end of when you faced your fear. Meaning, after you faced your fear, you can actually stop and go, “What did I learn? What did I learn about facing my fear?” Let’s say the public speaking example. You go up in front of your partner, your mom, or your dog, and you present your presentation. You might say, “I learned that I don’t know the script well enough,” or “I learned that I’m still anxious, but I can handle the anxiety.” “I learned that when I have anxiety, I beat myself up.” Oh, interesting. So we have an opportunity to make another tweak in behaviors because if beating yourself up doesn’t work—PS, it never does—then we might want to change our behavior in that area. The next time we’re going to go and do that presentation, we’re going to work at not beating ourselves up this time. What else did we learn? “I learned that my body didn’t explode when I gave the presentation to my dog and then to my mom and then to my neighbor.” We’re starting to learn things, and we’re starting to change the way we think because we changed our behavior. 

This is a really great strategy for anyone. There’s, again, an important cognitive era that we have that gets in our way of building self-confidence, and it’s this: “I’m a failure if it doesn’t go well.” This belief and this thought could create so much suffering. If I can leave you with one core thing to keep in your back pocket as you practice this, it’s that we need to fail a lot of times to get confident. We need to fail a lot of times to be good at something. That doesn’t mean there’s something wrong with us. 

I create these podcasts and these YouTube videos all the time. I sucked at them when I first started, but I didn’t stop, and I didn’t say, “That’s because I’m terrible at it.” It basically meant I had some learning to do. I had some practice to do, and it’s okay to suck at things until you get better. The only way I got better was by doing it over and over and over again. I got a little more comfortable and a little more confident in myself as I strategized how I could tweak it a little bit to be better and not be like, “When I’m better, I’ll feel good about this.” Again, that’s a myth. Self-confident people still have anxiety. They just bring it with them, and they know in their hearts that there’s no emotion I’m not willing to feel. Again, as we get better at this, we can start to have a sense of mastery over the emotions that we have to feel. 

Another thing I want you to think about here is if, as you do these scary things, you feel guilt, self-criticism, and shame. What we want to do is soften around that emotion, not add to it and be like, “Oh yeah, you’re right. I am the worst. I’m terrible. This is the worst thing ever. I’m bad and I shouldn’t be doing this and all the things.” Instead, we want to soften into it and change our belief around failure and learning and say, “It’s okay. I’m not bad at this. It’s okay that I’m not perfect at this.” 

Everyone starts at zero. The people with a million followers on Instagram originally started with zero followers. The people who win Olympic awards in races were once not the fastest runner. They were once in their school and maybe getting beaten by people in their elementary school, high school, or college. We all start somewhere at the beginning, so give yourself permission to start at the beginning. Don’t let yourself give up trying a couple of times, and expect yourself to feel confident. Confidence comes from the repetition of doing the thing and practicing having the emotion that is uncomfortable in relation to that task or activity. 

That is where I want you to change the way you think of self-confidence. It’s how I want you to change the way you lean into a task and an emotion as you do that task. I also want to remind you that today is a beautiful day to do the hard thing. This is why I say it on almost every episode. Today is a beautiful day for you to do the hard thing. I want you to go on after that thing that you want to do and practice this. Let the anxiety come, let whatever emotion come. I’m so impressed and proud of you for trying. 

Have a great day, everyone.

Health anxiety is a common yet often misunderstood condition that can significantly impact one's quality of life. Whether it's worrying excessively about potential illnesses or constantly seeking reassurance about your health, the effects can be overwhelming. Understanding the nature of health anxiety and learning effective strategies to manage it can make a world of difference. In this article, we explore five essential things you need to know about health anxiety and offer practical tips for recovery, with expert insights from Michael Steer.

1. UNDERSTANDING HEALTH ANXIETY: WHAT IT IS AND WHAT IT ISN'T

Health anxiety is a term often misunderstood by many. It's not just about being overly concerned with your health or frequently looking up symptoms on Google. Health anxiety can be categorized into two main disorders: Illness Anxiety Disorder and Somatic Symptom Disorder.

Illness Anxiety Disorder involves a preoccupation with health despite not having significant physical symptoms. On the other hand, Somatic Symptom Disorder includes severe and persistent physical symptoms that cause substantial distress. It's essential to understand these distinctions to recognize that health anxiety isn't simply a matter of being overly cautious or paranoid about one's health. Moreover, health anxiety can often intertwine with Obsessive-Compulsive Disorder (OCD), involving obsessive thoughts and compulsive behaviors centered around health concerns.

 2. NAVIGATING THE MEDICAL SYSTEM WITH HEALTH ANXIETY

Dealing with health anxiety within the medical system can be particularly challenging. One of the critical aspects to remember is the importance of finding a healthcare provider who listens and validates your concerns. If you feel dismissed or unheard, it is perfectly acceptable to seek a second opinion or switch providers.

Additionally, distinguishing between different types of symptoms can help manage health anxiety more effectively. Medical symptoms require immediate attention, such as severe chest pain or sudden numbness. Physical symptoms, like a sore back from yard work, are often benign and manageable with self-care. Psychological symptoms stem from anxiety and can include manifestations like tightness in the chest or dizziness. Understanding these differences can help reduce unnecessary panic and improve communication with healthcare providers.

3. TRUSTING THE RELIABILITY OF YOUR THOUGHTS

A common challenge with health anxiety is differentiating between real medical issues and anxiety-driven thoughts. Think of your anxious thoughts as spam emails—they're real, but their content isn't always reliable. Health anxiety often triggers false alarms that feel urgent and terrifying. Learning to question these thoughts and not take them at face value is crucial.

Techniques like cognitive diffusion can help change your relationship with these thoughts. For instance, if you've convinced yourself numerous times that you're having a stroke and it hasn't happened, the likelihood that your current fear is another false alarm is high. Questioning the reliability of these thoughts can help manage the overwhelming fear they generate.

4. THE ROLE OF COMPULSIONS AND SAFETY BEHAVIORS

Health Anxiety Compulsions and safety behaviors, such as constantly checking symptoms or seeking reassurance, often exacerbate health anxiety. One significant trap is becoming inwardly focused, constantly monitoring your body for signs of illness. This behavior leads to a vicious cycle where anxiety increases symptoms, which in turn heightens anxiety.

Shifting your focus outward and engaging in meaningful activities can help break this cycle. It’s essential to become more outwardly focused, enjoying life and participating in activities that bring you joy and fulfillment. This shift can reduce the power of health anxiety over your life.

5. EMBRACING LIFE DESPITE HEALTH ANXIETY

Health anxiety often steals the very things we're afraid to lose—time, relationships, and enjoyment of life. The constant preoccupation with health can make us miss out on living fully. Therefore, the goal isn't just to reduce anxiety but to reclaim your life.

Engage in activities you love and focus on adding value to your life. This shift in focus is incredibly powerful and can help you live a more fulfilling life despite health anxiety. It’s not just about feeling less anxious; it’s about living more fully and enjoying the moments that matter most.

CONCLUSION

Health anxiety can be overwhelming, but with the right strategies, it’s possible to regain control and live a fulfilling life. Michael Steer's book, "The Complete Guide to Overcoming Health Anxiety," is a fantastic resource for those seeking further support and information. Additionally, his website, overcominghealthanxiety.com, offers a wealth of resources, including a free virtual support group.

Remember, while health anxiety can take a toll on your life, effective strategies and a focus on meaningful activities can help you reclaim your joy and well-being.

TRANSCRIPT:

Kimberley: [00:00:00] Welcome back, everybody. Today I have Michael Steer here talking about the five things you need to know about health anxiety and how to recover from it. So welcome, Michael.

Michael: Thanks for me. I'm really excited to be here and talk a little bit about health

Kimberley: Yes. It's actually a very, very requested topic. It there's always questions about it. So I think this is really, really wonderful that we're doing it. Okay. So first of all, what is health anxiety? Let's just do a little bit of a, you know, intro, uh, tell me what it is and then tell me what it isn't. Cause that's point number one.

Michael: Absolutely. Yeah. So we'll jump into point number one, which is I kind of was breaking down if I could have people know five things about health anxiety, what would I want them to know? Or people that support people with health anxiety. And number one point that you're going to bring it up is the first thing that I would want [00:01:00] people to know is exactly what health anxiety is. I feel like health anxiety is one of those things where, you know, you see somebody on their phone looking up symptoms and everybody kind of knows, right? They're like, Oh, I've been there before, right? We all kind of know what health anxiety is, but sometimes we don't know exactly like what it looks like or even more so that there's actually treatment that people can get that actually works.

Not medical treatment, but maybe psychological treatment. So, um, I break down health anxiety in a couple of different ways, which is one is that. if you actually have a medical condition, so if you were diagnosed with cancer or, you know, whatever that might be. Um, there can still be anxiety around those types of things, but that's not exactly what we would be calling health anxiety. Uh, you know, kind of in a professional community, that would be an adjustment,

Kimberley: Yeah.

Michael: a massive adjustment, right? It's like you get this scary diagnosis, you're trying to go undergo treatment, those types of things. So that's kind of one category. And then, We also have this other category, maybe [00:02:00] what we would love them to call health anxiety, which actually is kind of awkward, too, because there's really no such thing as health anxiety, like, oops. Um, but there are some categories under health anxiety that we would say, these are actually what we're talking about. One of them is what we call illness anxiety disorder. Um, the other one is what we call somatic symptom disorder. And, uh, these are kind of the two things that we would call health anxiety. Now, Illness Anxiety Disorder is really a very basic way to break that down, is a preoccupation with your health, but you don't have a lot of symptoms that go along with it. I mean, you might have some here or there, and it's like, Oh, one day, like maybe my vision is a little bit more blurry, or I got a kind of weird pain over here. But the, usually the symptoms kind of come and go pretty, pretty quickly. Um, now, Somatic Symptom Disorder is still the preoccupation with your health. But the one big difference that people run into is usually the symptoms are pretty severe. They're [00:03:00] pretty significant, and they're usually a little bit long lasting.

So, you know, maybe people are dealing with, you know, chronic stomach pain or pains in their stomach that they really become preoccupied about, but those symptoms are pretty significant where it's like impacting life, those types of things. Um, and then the other category that we can just throw in there real quick is also OCD. Um, and what we'll talk about here and, uh, maybe towards the end of this part is a lot of times I put health anxiety and OCD kind of as hand in hand. Uh, they're not the same thing, but they share so many of the similarities and how they work. And, um, if you ever look through some of the OCD literature. OCD can have health themes and so those would be times where we can be very, become very, you know, have the obsession and compulsion cycle go around health. So that's, that's really what health anxiety is, is usually one of those three things, which is either you don't really have many symptoms and you really worry [00:04:00] about it.

You're actually having a lot of symptoms. you're worrying about it, or it may be a bigger dynamic of OCD, where maybe you have other obsessions and compulsions, and then maybe one of them is also just the obsessions and compulsions around your health.

Kimberley: Amazing.

Michael: yeah.

Kimberley: What about hypochondria? Do we, where would you put that?

Michael: So that's an older term.

Kimberley: Yeah.

Michael: So we've kind of, you know, and a lot of times, um, I feel like I'm kind of glad that that term has kind of shifted as just kind of like, you know, illness, anxiety, and somatic symptom. Um, just because there's a lot of judgment and a lot of negativity also around kind of, you know, as soon as somebody is like hypochondria, right?

And it's kind of like, it comes with this like really negative experience and like, Oh, you know, they're, they just worry about their health all the

Kimberley: Right.

Michael: it kind of gets dismissed pretty quickly. So, um, that's just, if you ever see hypochondria, um, it's just an older term or sometimes it's still used in the medical community. [00:05:00] I think it's, even when you look up in some of the, um, Um, things to, uh, you know, for some of the coding, it still comes up as hypochondriasis. Um, however, it's just, it's the same, it's a different terminology just for what we would now call illness, anxiety disorder and somatic symptom disorder.

Kimberley Quinlan, Thank you for sharing that too. Cause I think Googling, because that term has been used for decades, that is often what people are looking for. And I think, as you said, people get dismissed like, Oh, you're being such a hypochondriac about it. You know, that. I think is, I'm glad that you, you shared that. Okay.

So that was number one. Number two, um, what is the second thing we need to know about health anxiety?

Michael: So number two is kind of going right off of what you're saying is a lot of times, you know, what I would really want people to know is to, a lot of times people do get this mess. and even clients that I'm working with, because I work with a lot of health anxiety clients are still trying to navigate [00:06:00] that relationship between, they probably really do have some anxiety around their health, but they're also trying to work with the medical community. and that makes it quite challenging, um, because you know, there can, um, there can be some times where it can be challenging. People can get written kind of off of like, well, this person, you know, they've, they've been anxious about their health before, and then they've sort of become. Um, what could be an obsessive worry but also could be a very realistic worry of I go back into my doctor and they kind of know that I deal with anxiety around my health, they going to take me seriously?

Michael: know, if I come in and I say, wow, I've been really having a pain here or here, are they really going to be listening to me? Like really take me seriously and investigating this or are they just kind of writing it off You know, this is, you know, awful, you know, this person has been anxious about a lot of those different things.

So the one thing I, I think that we, um, that I think, I think is really important for people to know [00:07:00] is you're working with a medical provider and you don't feel like they're listening to you, they're not validating some of your concerns, they're, they're, you don't feel like they're really invested in some of these things. Um, it's always okay to go find somebody

Kimberley: Mm hmm.

Michael: That is totally okay to do. You can take it from me. Hell, like, you know, what I would, I don't know if there's no delineation of a health anxiety specialist, but I think there can be some of those times where things are not taken serious. So

Kimberley: Yep.

Michael: do feel like that is a relationship that you're having with a health provider, find somebody new. Go find somebody that really does listen to you, right? Now if you're also working with somebody that you feel like you really trust, you feel like They feel like they got your back, like they're, they're, you know, but maybe you're kind of running to the end of the road of like, I, don't know really what else we could test for.

That's something different, right? Because at least there's that level of trust. So the second thing that we like when it goes into this piece of, you know, like Val or validating people's [00:08:00] symptoms is we also have to realize that there is a difference between physical symptoms, medical symptoms and then also psychological symptoms. And so here's how I break these things down. Medical symptoms is usually the ones we're really afraid of. medical symptom could be like if I have chest pain. And a medical symptom would be I need to go to the hospital because I'm having a heart attack. That is an explanation, a medical explanation of a symptom that I'm

Kimberley: Mm hmm. Mm hmm. Mm. Mm. Mm. Mm.

Michael: ER, those types of things. one category or one bucket that sometimes we put those in. A second bucket is what we call physical symptoms. And a physical symptom is something that's actually really happening in our body, probably don't need to run to the ER or the urgent care because of that.

So like, for instance, if I went and did a bunch of yard work over the weekend, and my back really hurts, um, arguably because I'm getting [00:09:00] older or because I've done a lot of yard work, who knows? Um, Um, I don't, that's a real physical symptom that a lot of times our mind could try to catastrophize, but it's probably not something that I need to go and run to the doctor about. I probably need to take it easy, put a little bit of ice on my back, et cetera, et cetera. So we have medical symptoms, we have physical symptoms, but then also we have psychological symptoms and this is the way that our mental health can also affect our physical body. So for instance, if we're becoming anxious, I'm sure that, you know, if anybody has ever been anxious before, which I'm going to assume everyone has, If we become anxious, sometimes our chest gets tight.

That's a real physical symptom. That's a real symptom that we have. But the origins of the conclusions of that is from a psychological standpoint. Now, here's why I think these buckets are important, why I want people to know about them. Surprise, surprise, health anxiety always usually goes to one bucket. Medical symptoms, right? It's like, Lower back pain, medical. You know, my chest is tight, medical. This weird kind of [00:10:00] feeling in the back of my head, medical. You know, all of those different types of things. And one of the things is being able to have this context of if I could start to separate some of these symptoms out to maybe there are some symptoms that I could have that are medical, but maybe there's also physical symptoms that are just happening. There's a great article that I always like to give all my clients The Noisy Body by, uh, Abramowitz, that's just a wonderful handout, a wonderful article. And it just speaks to the nature of like, well, we get signs and symptoms and weird feelings and burps and farts and all these things all the time. The hard thing is, is when our mind gets really preoccupied and starts to put them into the category of, oh no, what if, could this be this really negative thing? So I'd like to, that's the second point that I would really want people to know is. We have to realize that even though there is always this scary explanation of symptoms, it's important to have this perspective of noticing that there could be, there could [00:11:00] be medical symptoms that I need to really do something about, physical symptoms that I need to do to some TLC, and then also psychological symptoms. And then one last thing I just throw in there real quick before we can go on to the third one is, um, the most important part about this is regardless of what bucket you put this in, all of them are valid and real symptoms. that's the other piece that we get into this kind of like stigma or negativity, that sometimes people will talk about a real symptom that they're having, and then they'll be like, Oh, well, that's just your anxiety as almost as if the symptom is not happening.

And so I think what I would really want people to know with health anxiety is regardless of what bucket it's coming from, it's always real. You're always valid and feeling it. The one question that we have to just ask, which is going to lead us into number three at some point is. Or can we trust that the explanation for the symptom that our brain has brought us really the explanation of what's happening?

Kimberley: Mm. [00:12:00] So, I have a question, which you might answer it in, you can even use this for the, for an example. So, a lot of my followers know that I, in, um, in 2018 was diagnosed with Postural Orthostatic Tachycardic Syndrome.

Michael: Mm. Mm

Kimberley: one of the main symptoms of that is that you faint and a lot of, I'm very well in recovery of this right now, but one of the things was me without using this terminology, which you've beautifully put out.

And I actually learned this terminology from you is it was about passing out, passing, like not, not, not passing out, like, uh, differentiating, sorry, my accent got it, differentiating. Um, is this dizziness from my anxiety? Is this dizziness evidence that I'm going to pass out, like faint? Um,

Michael: hmm.

Kimberley: because a lot of [00:13:00] having this condition is tolerating dizziness 24 seven of the day.

Like it's a symptom of the condition. Um, so in that case, just as that as an example, how would you, which bucket would you put this in?

Michael: For sure. Good. Great question. And this is where, like, health anxiety, I think that's why it's really important to, to really notice the stickiness of

Kimberley: Mm.

Michael: Because, you know, as an, also as an OCD specialist, a lot of times when we deal with OCD themes, not often having people, like, deal with, uh, you know, harm obsession. And also undergoing evaluations to see if they're a

Kimberley: Yes. Yes.

Michael: Uh, that doesn't really make sense. health anxiety starts to become this kind of interesting dynamic of, well, what happens if we have anxiety around medical

Kimberley: Yeah.

Michael: And also we have to like, go get evaluations and other things that are actually

Kimberley: Yep.[00:14:00]

Michael: that's a great point. And it's like, okay, so what if the, um, Um, you know, the symptoms that I'm feeling could be an explanation of a medical condition that's happening, or it also could be, you know, from the place of, um, you know, from my anxiety. Um, think the answer comes down to, um, is going to this, what I usually like try to call a pretty, a best guess. Which is, now, when we're thinking about passing out, the one thing I think is always important. as a person that works on a lot of needle phobias and blood phobias is that if you feel like you're going to pass out, get yourself in a safe place, right? Like sit down, make sure you don't hit your head.

You know,

Kimberley: Yep. Yep. Yep.

Michael: But also there's this kind of conclusion that we can come through with our experience that says, know, um, if I, if I think about the symptoms that I'm having right now, where would I put my best guess on those, right? And if we're putting this, that medical side, then we could say, okay, well, [00:15:00] Um, I need to do whatever the doctor has recommended that I do in those situations because that's just what's most helpful. If I'm feeling like it's more on the anxiety side, that's maybe where I could use some of my tools that we learned in therapy to be able to manage that. Now is it a perfect system? No it's not, right? Because there's always this little piece of uncertainty and the unknown there

Kimberley: hmm. Mm hmm. Mm hmm. Mm hmm. Mm hmm. Mm hmm.

Michael: that's, I think that's what's also really important about being able to kind of discuss those things either with your doctor or a therapist to be able to really walk those muddy lines. Um, I have quite a few clients that we try to walk that line all the time where, I've had clients where thought that maybe this was or maybe it was assessed as like, Oh, this is just something anxiety related.

That's why you're having symptoms. And then it's like, months later, surprise, I'm allergic to this, right? And so, that's why we don't always know the answers to all of [00:16:00] those things. Um, but as we kind of go, we can kind of walk that line to say, could I make my best guess about what this is at this current period of time? And if that was the case, what would I do in that

Kimberley: Yeah.

Michael: You know, and so do I need to go a medical route? Do I need to go to a psychological

Kimberley: Yeah. Which I think takes us to next step number three so beautifully. So go ahead and share what is the third thing we need to know.

Michael: Absolutely. So number three talks about. Um, a lot of times our brain can bring us to a lot of different conclusions and we just talked about the conclusions that a lot of times our brain

Kimberley: Yeah.

Michael: into in terms of medical, physical, psychological. And a lot of times we just take those conclusions as the truth. go with them because they're terrifying, they're scary, right? And they feel really threatening. And so one of the things that I think is important for people to recognize is I like to use the example of a spam email. is I'm sure we've all gotten spam emails. And if you haven't gotten a spam email, please let me know your trick because that would be I could clear out like [00:17:00] 75 percent of my email box.

So but a spam email to me is kind of walking this line between is a spam email real? Oh, of course, we all get them in our email box, right? Like they actually come through to us. They have a time stamp, et cetera, et cetera, right? But the one question that we have to start to kind of wrestle with with health anxiety is. is the conclusion or email that I'm getting a reliable source of information. so if you get an email from tomjones1973 at AOL. com that claims to be from the FBI, why would the FBI be sending you from AOL? That doesn't make

Kimberley: No.

Michael: Now, is that email real? You betcha. However, if we can question its reliability to say, can, you know, do I trust this email to be what I think it is?

Kimberley: Mm hmm.

Michael: Then that can really start to dictate some of the actions that we take. So when we think about health anxiety, right, is your brain can give you a lot of really scary a lot of really unknown possibilities that could be going on with you. And [00:18:00] so, you know, one of the things that I think we have to really kind of start to become curious about is, do I just go with them? You know, am I there just responding to all of my spam emails in my email box? And if you do, we probably need to help like. Credit monitoring and all those

Kimberley: Yeah.

Michael: besides, from that point, do we get ourselves into a lot of actions that could be very unhelpful when we take these emails as as reliable?

So, like, for instance, if you, you know, you have the dizziness, right? And you're, you're, you know, the initial evaluation or conclusion that your brain comes up with, aka what we could also call an obsession, right? Is like this could be an aneurysm, right? Or maybe you have a stroke or all these different types of really scary things. If we take that as a reliable piece of information, it starts to make

Kimberley: Mm hmm.

Michael: that we would be like, well, I need to figure that out. I need to be like, look up some symptoms of online or I need to go to the urgent care, whatever those things are, right? but if we get a, oh, by the way, I should have included this earlier, but [00:19:00] that's okay. We'll include it

Michael: This is all on the premise that we have a relatively good answer. if you don't. If you're getting dizzy for no reason, and you have no idea why, I don't want you practicing anxiety

Kimberley: Yes.

Michael: Go to the doctor, right? Like, explore those things, figure those things out, try to get a pretty good answer. However, if we get a pretty good answer about something, and we are going to say it's like, I think this is because of my anxiety, but my brain wants to really convince me of all these other conclusions. can we use some of those tools in terms of, you know, Becoming curious about, can I really trust my brain sending me right

Kimberley: Mm hmm. Mm

Michael:  if this is like the 937th time that I'm convinced that I've had a stroke, what's the chances the 938th time is going to be it? Probably not. so, I could go look on things online, or probably got a lot of other things to do, too, that I could go and get involved with as well. So, that's it. One of those tools is, is really being [00:20:00] curious about, yeah, your brain's going to give you a lot of really scary medical possibilities. If we can ask that question of not if it's real or not, because those things are totally real, but can I trust the message that I'm being sent? It can start that process.

Now, the other tool that I really like to use with people is diffusion. Um, and, and to kind of give it a quick breakdown of cognitive fusion, even though some people may be like some of the listeners may know, is just being able to like what kind of relationship that we have with some of our scary thoughts. so sometimes I kind of describe as like, well, it's not really necessarily getting away from them. It's just about changing our perspective towards them. So like, I kind of think about this example. It's like if you go out into like a really busy highway, you set up a lawn chair right in the middle of a busy highway and you have cars whizzing by you, you can see the traffic, but man, oh man, is it overwhelming. And so if we can use some diffusion skills and those would all be the great things, like, you know. Uh, just repeating or thanking our mind or my favorite is always just [00:21:00] singing, like, you know, the tune to happy birthday,

Kimberley: Yep,

Michael:  be right is sometimes those start to kind of be able to take us from this position of, could you just take your chair and put it on the side of the highway? And if we can do that, we can still see the traffic that's out in front of us, but it's much less overwhelming at that point because you don't have cars whizzing by

Kimberley: all right

Michael:  these cognitive interventions, I think, can be really helpful. Um, because a lot of times our brain is leading us to all of these conclusions, giving us these really scary ideas, and it might really start to go against the information that we have at that time, at least medically.

Kimberley: Amazing. And I, the reason I love this is that was a big piece of it for me, just to sort of give a real example of me having health anxiety and a chronic illness when you are you're dizzy. My brain was like, this is it. You're going down, you're going down. And I had to get used to just having the thought like, yeah, you're dizzy. It could be it. But we know the symptoms of when you are, and you're just, you know, again, like you [00:22:00] often say, like, it's about being uncertain and being able to just to have the thoughts whenever they show up.

So would you add anything to that or,

Michael:  Know it. And I think what's important with that is, there's a piece of uncertainty

Kimberley: um,

Michael:  but we can also act within a reasonable

Kimberley: yes,

Michael:  right? It is like, you know, we can, we can always make those, you know, I always love delay in these situations

Kimberley: um,

Michael:  is if I start to become dizzy and I'm concerned that like this is going to be, this is me passing out, right? And if you just like, if you're dizzy and you remain dizzy and you remain dizzy, you know, those types of things and it, you know, you're just kind of like working through it and it's like, okay, maybe that's one thing if you're dizzy and then the wall start closing in, right? And you start to get tunnel

Kimberley: yeah,

Michael:  Well, that's what you can always make a different,

Kimberley: yes, yes, um,

Michael: I think the lay, but. nothing about health anxiety that likes delay, right? Because whenever these [00:23:00] symptoms come up, it's always going to be about you need to do this

Kimberley urgent,

Michael:  to the E. R. Currently, like right

Kimberley: yeah,

Michael:  wait,

Kimberley: yeah, yeah,

Michael:  if even if we're able to kind of like practice some type of delay, right? We'll be like, okay, this is what this feels like now. I understand the concerns my brain has, like not quite sure if I can trust it. I don't know.

It's giving me some bad advice before. I But could I just wait that out and kind of see how that

Kimberley yeah,

Michael:  And, you know, if it continues to get worse or you start to get tunnel vision, go take care of it. There's probably something going on. But if those experiences, you know, I think what happens a lot of times for people is they, they try to move themselves on to something else, right?

They get back to dinner or whatever it might be. And then they kind of have that reflection point or like later of being like, Oh yeah, I was like dizzy

Kimberley: um,

Michael:  earlier. And it's like, Oh,

Kimberley: um.

Michael:  to that? Right? So I think delay can be a really helpful

Kimberley: Fantastic. Quickly, just because I have a couple of people in mind, and I know what their questions would be here, is in regards to [00:24:00] the, the point number two, where we were talking about the difference between medical, physical, and psychological. Let's say somebody. Um, has just intrusive thoughts about like, what if, actually maybe no, let's say they have a headache, a physical symptom and their brain is just constantly telling them like, this is a brain aneurysm, or this is a brain tumor, like this is cancer and it doesn't quit, um, Um, and the person also experiences this sort of intuition that this is what it is.

What, how would you, what, what bucket would you put that in and would you use the same skills?

Michael:  So, yeah, so the, the questions that I would have for that situation, which is number one, have you been to the doctor? You know, have you gotten it checked out? Have you like evaluated some of these, you know, headaches that you've been

Kimberley: Mm.

Michael:  Now if they say, uh, no, I've never been to the doctor about that. I'm, I'm not a doctor. I'm going to say would be [00:25:00] kind of silly of me at that point to be like, you're

Kimberley: Yeah.

Michael:  You know, that's

Kimberley:  Just tolerate the uncertainty.

Michael:  Yeah, that'd be good, right? We're like, that's probably not great. So because nobody would do

Kimberley: No.

Michael:  Like we, well, hopefully most people would not do that because if there is, so that's the first question I would always

Kimberley: Mm.

Michael:  is if you're having a physical symptom that's different, that's changed, that's more significant, whatever it might be, question needs to always be, have you gotten this

Kimberley: Mm. Mm.

Michael:  part that it's, I really wish there was a better answer to this. but there's not the least that I found, which is like how much is too much, you know? So if you're like, okay, so let's say the answer is yes, I have gotten it looked at and they can't find anything. Um, sometimes the conversation starts to become, well, how much, like, should I go for a second opinion or third or fourth or fifth or sixth? Um, and what's really difficult about that [00:26:00] is no one really knows that answer. Okay. And, um, what I try to really do to level with people, too, is that, you know, if you were having that headache and you're like, I don't know, Mike, like, this is like, I've seen like four doctors, still feel like there's something, like the intuition

Kimberley: Mm hmm.

Michael:  feel like there's something wrong. There's something going on. I can't, I can't fight you on that and being like, no, you shouldn't, right? Because I, the fifth time might actually be the time where it's like something comes back and you're like, oh my goodness, like, I'm so glad they found that.

So. always this kind of difficult time that I get these questions where people would say like, what, what, what is too much now getting like a fourth or fifth or sixth opinion, whatever that might be, could just be reassurance

Kimberley: Mm hmm. Mm hmm.

Michael:  you know, getting another clear scan or whatever that might be.

And it just kind of gives us that temporary relief of like, okay, goodness, like nothing's going on. But I think it's reasonable for us to know it's like it's not a very clear cut

kimberley-_1_06-04-2024_101032: Mm hmm.

Michael:  Of saying, like, [00:27:00] everybody's in their right to go get another opinion. you know, to, you know, however much you want to pursue that. We have to be on board and somewhat of being like, okay, like, go do that. But the other thing that I would always throw in there, too, that I like to try to work with people is, there's going to be productive ways that we can pursue that, there's going to be unproductive

Kimberley: Mm.

Michael:  you're having those headaches, and you're, and you're like, I've seen three people, I kind of want to go see four, I would say, I can't fight you on that.

You should go see that fourth person, see what they say, but that's a productive method of trying to figure something out, right? Like, cause you could possibly, they could give you some scan, right? And be like, Oh my goodness, like right here, we found something, right? also other unproductive behaviors that sometimes people get into, um, that like your brain at 3 a.

1. in the morning while you're ruminating about if there could be something going on in your brain or not, right? have no access to scans, like you're not gonna figure anything [00:28:00] out. You're not gonna come to some revelation of like, Oh, now that I can see inside my brain, I can see what the problem is, right?

So, there's, there's kind of an encouragement that I try to give to people, too, is if you really feel like there's something wrong, and even though you've gotten a lot of things that have said maybe nothing is wrong, if you want, if you feel like it's necessary to continue to pursue those productive ways, set an appointment with a doctor. Go to that appointment when it's the time, right? Great, go do those. But some of these other things when we're thinking about like, but are we like ruminating about this for hours on end during the day? never going to become anything

Kimberley: Mm.

Michael:  not going to come to some insight of like, ah, I see everything clearly now, I see what's wrong.

And so we try to practice those tools in those situations of saying, you know, if that's kind of an unhelpful thing to do, could I find something better to do? Uh, to do with my time than just endlessly going over this in my

Kimberley: Yeah. Amazing. Which [00:29:00] ties us right into the thing number four. Um, tell us.

Michael:  four, the four, I almost held up five, so that's good. Number four is, now, when we think of like, like, you know, for some of the viewers who might be a little bit more familiar with OCD, a lot of times I just use the terminology of TOs

Kimberley: Mm.

Michael:  triggers, obsessions, and

Kimberley: Mm.

Michael:  you might be saying, it's like, well, I didn't think health anxiety was really OCD.

It's not. But. The functionality of these things kind of operate in the exact same way. So number four is talking about compulsions, or if you just wanted to view it as safety behaviors, that's cool, too. They kind of do the same thing, which is there's going to be physical or behavioral compulsions that we could do or mental. and one of the things that we really have to account for is just their ability to not really be able to give us an answer that we really want. and how sometimes it actually, especially with health anxiety, one of the things that I'll point with health anxiety. Usually makes things [00:30:00] worse. So there's always like pretty classic different mental or behavioral compulsions, you know, googling or, you know, going on Web and D and clicking on the little body right and being like, you know, we get the huge list, you know, you put in fatigue and it's like, gives you all these terrible things, right? It's like, Oh, maybe I don't

Kimberley: There's like cancer at the bottom of every single Urban D article.

Michael:  Yeah. Yeah, it's just like this. Just put it on the

Kimberley: Yeah.

Michael: you know, it'll be there. Um, the one thing I think is really important to consider specifically with health anxiety is the tendency for us to become really inwardly focused. And I think this makes it really difficult people to be able to have any chance of being able to move on from any of their health worries. a lot of times what we all want to do is the one thing that we want to monitor is the thing that's wrong. And so for instance, if you go back to your dizziness, right, we might continue to check in on that being like, well, my dizzy now or my dizzy now. How about now? [00:31:00] But the problem is, is that now you're like now you're swapping buckets, Because we have the medical that we have the physical and we have the psychological bucket. But what's a, um, I don't know. You feel dizzy because you drank a little bit too much coffee this morning. You're kind of feeling a little whoa, right? That's a physical symptom. not medical. You don't need to go to the doctor and be like, I've drank too much coffee and be like, great, just go run around for a little bit.

Work it off. Right. Um, but the hard part about that is like, so that's a physical symptom. However, then we could start to get that conclusion that we talked about of like, Oh, my goodness, like, what does this mean? And maybe the conclusion is medical. You know, it's like, Oh, maybe I'm gonna pass out. but then the result of that is psychological. We start to get anxious about it. We're like, Oh my goodness, like this could be really bad and like, I don't want this to happen. However, now the byproduct of anxiety a lot of times is lightheadedness, right? And so we work into this catch 22. The [00:32:00] hard part about it is we keep checking in on those and there's a lot of body monitoring with health anxiety that really gets people stuck, um, paying attention to feelings and sensations and symptoms.

And the hard part is it keeps going back and forth between these two things of we get really concerned about a symptom. It makes us feel anxious, which increases symptoms, which we notice more. And when we notice more, it makes us feel more anxious. And when we get more anxious, and so we just keep getting into the step ladder. So one of the things that I think is important when we think about this Catch 22 that starts to happen, is I try to really encourage people to think about, If often you get, start to get stuck within your body, your, your focus is inward thinking about how do I feel, what do I notice all of these different things? biggest goal that we can do with any of these things is how do we become more outwardly focused? That doesn't mean that you have to like [00:33:00] pretend that you're not feeling some of these things. Um, I'm a huge fan of dialectics in terms of using and

Kimberley: Yes.

Michael:  which is noticing like I'm feeling dizzy right now. And also I could try to be as best of my ability really involved in whatever is going on around me. Um, and so think it is, like there's a lot of different compulsions and things that we could talk about, but the biggest one I would want to bring up, at least for people to be aware of. it's becoming more inwardly focused, gets us stuck

Kimberley: Yeah.

Michael:  And, and it's, and understandably it's scary. to direct ourselves away from those, right? Because then it starts to feel terrifying of like, oh my goodness, if there's something that's really going wrong with me and I'm not paying attention to it? And that's where we start to get to the feared consequence,

Kimberley: Yeah. Tell

Michael:  some of the work starts to become, which is if I can recognize I have a pretty good answer about [00:34:00] this, maybe my brain isn't being all that reliable. I think this is just a psychological symptom.

Um, maybe I'm willing to take the risk that maybe it could be something bigger, better. Um, but in service of being able to get back to my life do the things that I would like to be able to do, maybe that's a risk I'd be willing to take.

Kimberley: me about number five.

Michael:  That leads into number five. realize whenever I wrote these out, these were going to blend so well, but

Kimberley: It's like we're flowing. We're in, we're jiving today.

Michael: I know, right? The number five just goes back to this piece of The hardest thing about health anxiety is that one of the things it's not always about death because that sometimes that's what people always think is like, Oh, you're just afraid to die. Um,

Kimberley: Mmm.

Michael: people's faces whenever I always had the pre face, know, we always like to ask that question of like, what would be the worst thing about that? And health anxiety is always the really like, [00:35:00] uh, interesting one where it's like, well, I'd probably die and be like, what would be the worst thing about that?

And people look at me and they're like,

Kimberley: I'd be dead.

Michael:  that'd be dead. And I'd be like, yeah, I know, but what would be the worst? And so for some people it is,

Kimberley: Yeah.

Michael:  death. But there's a variety of different, um, feared consequences that I think it's important for people to wrestle with too, which is some people it's around

Kimberley: Mmm.

Michael:  Some people it's about just the struggle. It's about treatment. It's about just how miserable it'd

Kimberley: Mm.

squadcaster-48hd_1_06-04-2024_121032: You know, uh, it would be about, you know, the whole process around, you know, getting treated and. You know, saying goodbye to people. For some people, it's not just about death, but it's also about, um, like, the impact that they would see a huge increase in health anxiety when people usually have, like, big life events. Uh, not just in terms of stress, but like, they get married, and now it's kind of like, it's up the ante of their health anxiety. It's like, well, now it would be kind of bad if you

Kimberley: Yeah.

Michael:  But it would be even [00:36:00] worse because now you'd leave like your spouse behind or even worse like

Kimberley:  Yeah.

Michael:  kids search into the picture, right?

And it's like, Oh my goodness. And so I think it's really important to kind of start to look at is a lot of things that we could really fear to lose. The dirty trick that health anxiety plays it kind of makes us lose those things before we've even lost

Kimberley: Yeah.

Michael:  And what I mean by that is that sometimes we become so preoccupied with our health. Going to the ER, you know, running to the doctor again or, uh, just ruminating her mind or, you know, the family's around or you're having dinner and you're on your phone, right? Like looking up symptoms, right? things that we're afraid to lose might already be

Kimberley: Yeah.

Michael:  they're there in front of you to be able to engage in. the really hard thing is, is we're afraid that those would go away, but they've already gone

Kimberley: Yeah. Umm.

Michael: other process. So. think the one thing we have to kind of really wrestle with is [00:37:00] it's not just about trying to get rid of anxiety. I mean, that's part of the picture.

Um, I'm sure for anybody that's ever in the helping profession, they'll always have somebody come in and saying, I really want, you know, this to go away, to be less pain, to feel less anxious, to feel less sad, whatever that might be. And those are cool goals. Like I'm on board with those, right? Like, I don't want people to feel more anxious. Um, I want people to feel less anxious. But if that's the extent of our goals for ourselves is just to, like, worry about my health less, I mean, that's kind of good, but we're missing a big part of the picture here, which is really, what can we add? You know, because health anxiety wants to steal all these things away from you in your life, The things that we're so scared to lose in the first place. And so a big part of number five, I think, is important for people to really recognize, is that Health anxiety is going to want to take those things away from you. And I wouldn't want people to work just like feel less anxious about their

Kimberley: Yeah.

Michael:  I would want them [00:38:00] to work in what are the things that you're really afraid to lose. I want you doing more of

Kimberley: Yeah.

Michael:  Right. And that is going to get to the point of having to work to give up some of the things that often would make us feel like we need to do to be able to keep ourselves safe. And that's hard. That is, that's the

Kimberley: Yeah.

Michael:  Is being able to lean into those things. But, the work also becomes, also gets with the reward, which is, we're actually being able to live life and be able to do those really meaningful and valuable things that we really are afraid to lose in the first

Kimberley: Yeah. And when you start living your life, you tend to be focused less inward on all the symptoms as well. So it's sort of like a reverse snowball effect.

Michael:  That one of the, absolutely. Good, I'm glad you bring up that point, right? Because that's what happens,

Kimberley: Yeah.

Michael: we get involved in something else, we start having fun, and then it's that tendency for our mind to want to go back to be like, well, how does this[00:39:00]

Kimberley: Yes.

Michael:  How does this feel? And so my encouragement for anybody is that about trying to get away from those. I try to draw a quick, line between distraction and redirection, which is a distraction is like an escape, right? Be like, I can't think about this. I got to get away from it. You know, like, let me focus on this movie,

Kimberley: Mm hmm.

Michael:  Where a redirection is really just trying to make a place for that of just noting of like, yeah, I am feeling this way.

I noticed my brain is like yelling at me to be like, look this up on Google right

Kimberley:  Yes.

Michael: I could notice that. And also, I know it's going to be more helpful for me to make a place for that. Get back to the movie. Really try to get into that. Pay attention to it. that gives us a chance to do, just like what you said, is now we're focusing outside

Kimberley:  Yeah.

Michael: Instead of all the things that could be going on in our body, which some of them could possibly be serious, but most of them are probably just our bodies being

Kimberley: and I think that's cool too is like our bodies will be bodies there, especially as we [00:40:00] age. I see a lot of people's health anxiety go up as aging. You said aches and pains, sleep issues, like it's so common. Yes. Yes. Okay. Yeah.

Michael: and it's like sleeping on like something like really uncomfortable floor and And then like, I'm like, oh, I slept really good. And then like me, as I got older and there was like a sock in your bed that you slept on and you're like, oh my goodness.

Like, and, and age is gonna

Kimberley: Yeah.

squadcaster-48hd_1_06-04-2024_121032: had to remember as, as age goes up, health

kimberley-_1_06-04-2024_101032: Yes. Yeah. Yeah.

Michael: you know, the question real quick, I'd just like to add with this is a lot of times I do get the question of like, well, what if you've had cancer in the past? Right? Like, is that still health anxiety? And it's like, well, you know, if you're in remission you're doing all the things that you need to do, you know, you're probably getting more frequent scans, all those different types of things. We can still become preoccupied with the [00:41:00] possibility of like, what if this new thing, whatever we're feeling is cancer again, right?

And that's, I think we have to walk that, that piece of like, that's an incredibly understandable place. And also we go back to number three. which is, is like, are we getting information from our brain that's reliable? And if all the other information that we have in the current period of time, working with an oncologist, whatever it might be, is saying, Hey, your markers look good.

Blood work looks good. Your scans look great. Then that's maybe what we challenge ourselves to say, maybe I need to get back the things that are most important.

Kimberley:  I love this so much. Thank you so much for sharing these points and bringing so many applicable skills and tools as well. Tell us where people can hear about you. Tell us about your book. All the things.

Michael: Yeah, absolutely. So, um, A couple different things with that. One is we did release a book in the mid December. Um, [00:42:00] it's right here. The Complete Guide to Overcoming Health Anxiety. Uh, How to Live Life to the Fullest Because You're Not Dead Yet.

Kimberley:  Punchy little yes.

Michael: Still here. So, um, there is a book out on Amazon. You can get it, uh, soft cover or you can get a Kindle version. It's written, wanted to write it. Uh, so the, my coauthor. Uh, Josh

Kimberley:  Yes.

Michael: and I wrote it, um, and we really wanted to write a book that didn't feel too clinical, didn't feel too like, um, you know, that, you know, like you're reading like a, an academic book or something like that.

So I think if you appreciate maybe a little bit of a lighter approach, at sometimes funny, some points, uh, cringy, maybe not cringy, I'll just blame it on Josh. Maybe that was all his cringy points. I, I did all the good jokes. Uh, just kidding, Josh. I love you. Um, uh, it is, it's just written in a little bit of a different way that I hope that, you know, some of the feedback [00:43:00] is for people have said that like it's written differently, but it's just written and they feel like they can connect

Kimberley: Yeah.

Kimberley:  make sense. Um, but that's also very back to, you know, number three that we talked about in terms of cognitive interventions is that you know, it's really important to start to change our relationship with those. So the book is out there, but also we, we also started a website, um, overcoming health anxiety. com. Um, and it has a ton of different resources.

We just redid it and try to add a bunch of different other stuff. So we have a health anxiety one on one section. We have treatment resources. have videos, you know, different podcasts. Um, we have a link to our free virtual support group that meets every Thursday of the month.

Michael: So, um, uh, so, uh, we have a link to there. Because we really just want to be able to try to reach out. And like I said when we first started [00:44:00] is, a lot of people know that this is a thing, right? Because they, they know and there's even the term cyberchondria out there, right? Like people know about health anxiety. But very people do know that you can actually like get

Michael: this not necessarily just through a doctor in terms of like, Oh, here's your medical treatment, but there's psychological tools that you can use that with that. So, yeah, those are our resources. We got that website. We got the book. Um, and, um, we're just trying to connect with health anxiety sufferers to show them that there's some hope to feel better.

Kimberley: So good. Thank you. So many wonderful resources and amazing book. Thank you so much for coming on. Um, those folks are the five things you need to know about health anxiety. Thank you so much, Mike, for being here with us today.

Michael: Thanks for having me. I appreciate it.

Today, we’re going to go through the six reasons you procrastinate so that you can make a plan and hopefully end that procrastination so you can get back to doing the things you want to do. 

Recognizing the reasons why you procrastinate is so important. I want to make sure I cover one key point before we get into the six reasons, and that is: you’re not lazy, and you’re not faulty. It’s not a bad personality trait that you procrastinate. I want to dispel that myth right out of the gate so that we can beat the self-criticism, the self-judgment, and the self-punishment that you may be doing or have done in the past. The fact that you procrastinate does not mean that there’s anything wrong with you. You’re not broken. 

We engage in these patterns and safety behaviors to manage distress in our bodies. Procrastination is an avoidant behavior to avoid having to be uncomfortable and to work through the deep stuff that’s going on in our brain, mind, and body. First, I wanted to review that this is not your fault. You’re not bad because you do this. I’m even going to reframe a couple of those things here.

A PERSPECTIVE SHIFT ON PROCRASTINATION

As we talk about why you procrastinate, I want to tell you a story that changed my thoughts about procrastination. As an intern, I had a supervisor when I first became a therapist who supervised us and all our cases. A lot of the interns were talking about how we were so behind on all of our research and our study. We had all these tests, we had all these assignments, and we had to see clients. She questioned us by saying, “Procrastination isn’t necessarily a problem. First, you’ve got to look at the function of procrastination.” She said that if procrastination is working for you and it means you get the work done, you complete it in time, and you’re happy with the product you’ve created, procrastination isn’t a problem. In our society, we tell ourselves that we should be organized and calm when handing in the assignment instead of pressing the button right at the very last minute or sliding into work right as we should start. 

Now, she said, if it’s working for you, go ahead and keep doing it. But so many of you, particularly those with anxiety, say, “No, Kimberley, that’s not the case. It is not working for me.” If that’s the case for you, let’s first look at the effects of procrastination. Suppose you are somebody who has an extreme amount of anxiety when you procrastinate, and it’s coming from a place of anxiety. In that case, it increases your panic and stress at the last minute, and you melt down. Then, this is why we want to explore the causes and why you procrastinate so that we can come up with a solution and a strategy that does help you. 

The Six Reasons We Procrastinate

1. Fear of Failure

This is true for many people because we fear making mistakes. Our society has become allergic to making mistakes and failures. So we create such a story in our heads about how it’s going to be so bad if we fail, and it’s going to be so bad if it doesn’t go right, and how we are going to look stupid and how we are going to feel terrible. But much of that comes from this entrenched belief that we are not supposed to fail. I took a whole year and practiced failing for an entire year. I tried to fail a hundred times, which completely changed my thinking about failure in everything I do. I got good at things because I failed repeatedly and changed how I looked at failure. 

Now, I understand that we are expected to perform at such a high level in today's society. But what I want to have you do is act from the place of a B-. What I mean by that is, instead of going for an A+ all the time, try a B-. You will find that if you just drop the bar and let it be imperfect, you’ll have so much less anxiety. It is much easier to practice being gentle and kind to yourself when you mess up or fail. I’ve had so many patients and students tell me, “Failing is not the problem; it’s the beat-up I give myself when I fail that I do not want to do and do not want to experience. That’s why I avoid it. I don’t want to beat myself up if I fail.” We want to make sure we change the way we look at failure.

2. Not Wanting to Be Uncomfortable

This could cover all of these categories because all of the reasons we procrastinate are ultimately just trying to avoid discomfort. So often, I procrastinate while recording this episode of Your Anxiety Toolkit, or I avoid and procrastinate while working out. It’s not because I don’t want to do those things. I love making these videos and exercising, but what I do is avoid the uncomfortable feeling that I have. Ultimately, I’m avoiding the hard work stage of any product or anything we do. 

So many positive things in our lives that fulfill us require hard work. Nobody likes hard work. It’s not that fun. It’s uncomfortable. As a human species, or any species, we love to avoid discomfort. We do what we can to cut corners, and procrastination is one of those things. Often, we’re scrolling on Instagram or checking our email to avoid having to propel ourselves into doing the hard thing. 

The tip is to break things down into small, manageable, tiny, doable steps and open up our willingness to allow for some discomfort. Willingness is a mindfulness skill that will help you so much in your anxiety recovery. I talk about it a lot here on Your Anxiety Toolkit because it is crucial for the management of anxiety. The more we’re willing to lean in, be open, and release the tension we hold from feeling discomfort, the more we get to embrace that discomfort, overcome that discomfort, and, in many cases, recover from anxiety. Willingness will be necessary regarding the discomfort we feel from doing the hard, scary thing.

3. Perfectionism

Perfectionism is so similar to the fear of failure. Perfectionism is all through our society. We are told that we have to be perfect, that we have to do it perfectly, and that we can’t make those mistakes. I want to offer you here that if you struggle with perfectionism, we want to adopt the B- mentality. We want to adopt kindness. We also want to pause and acknowledge how our society has created this because the truth is human beings are inherently imperfect. It is impossible to be perfect, yet we’re striving for it. We’re so committed to it as if it’s a reality, and it’s not. We won’t be perfect. Even if you achieve a perfect score on a test, you’ll still have to look in the eye for imperfections three minutes later. We will have to see the other things we’re not perfect at. It’s essential to see that. If your goal is perfection, you’re chaining yourself to having consistent anxiety. 

When I was suffering from an eating disorder, I was constantly going for perfection with my body, with my diet, and with my exercise. That kept me stuck, and even when I did get to this “perfect goal,” I had anxiety about maintaining the perfect goal. Even once I achieved it, anxiety was still there. Anxiety was still running the show, and I was in panic mode all the time, either trying to be perfect or fearing that I’d lose this idea of perfection, which I never had anyway. But again, it’s all something like a construct in our brain that keeps us stuck and anxious. It’s essential to understand how that impacts us and the fact that we will never be perfect. 

Thank God, I love imperfect people. I find it hard to befriend these “close to perfect” people. I don’t relate to them, and I don’t feel safe with them. I actually sometimes feel uncomfortable around them. You probably think the same way, but I feel so much better when I’m with real people who are comfortable or willing to admit their imperfections, share their imperfections, and connect with our humanness together when we settle into that imperfection. 

4. Feelings of Overwhelm

If you have anxiety, yes, overwhelm is a thing. I think of being overwhelmed like there are papers, things, and phones swirling around in my head. All I want in that moment is just a moment of inner peace and outer peace, where I want everything to slow down and stop so I can catch up in my mind. However, that’s probably not going to happen. 

There often needs to be a physical way to get everything clear when we have a deadline or something we must do. The only thing I have found helpful with this is to simply write down the steps I need to take and how I will do them. That is the only thing. But at the end of the day, similar to the discomforts, a lot of the work we have to do with overwhelm is to be willing to feel it, slow down, and identify catastrophization. When we catastrophize, we increase our feelings of overwhelm, and that’s a cognitive error we engage in. If you catastrophize a lot, you’ll probably feel overwhelmed frequently. That’s just the way that it goes, unfortunately.

We want to create a system where you have something to do that you can break down into small steps. I’m visual, so I like to draw, write circles around it, and put numbers one and two. If you’ve been following me here on Your Anxiety Toolkit, I want a step-by-step process. I like the five reasons for this so that I can comprehend it in my mind. If you need that, lean into it and use it to help you create small baby steps. 

Another thing to do here is to breathe. When we’re overwhelmed, we often stop breathing. When overwhelmed, we often clench and hold all this tension in our brain and body. Our main goal here is to slow it down. You’re still going to be uncomfortable. You’re still going to be anxious. You will still be overwhelmed. But can you reduce the problematic response to that? Remember, we can’t control our experience and how it shows up, but we can control how we respond to it. We can control how we react to it. We don’t want to clench as much as we can. Again, we’re going to move slowly into the activity over time. Set some time limits. Maybe you do it for 10 minutes. There are so many Pomodoro apps that you can set a timer for three minutes and say, “I’m just going to do this for three minutes, then I’m going to take a break.” Do some breathing. But you’re moving in small, baby steps.

5. Lack of Motivation

If you’re someone who suffers from depression or you’re just not very motivated today, that’s another reason it’s difficult to launch yourself into something. An essential tool to remember when it comes to motivation is that we often rely on motivation to get us started, and that’s fine. That’s actually helpful if we have it. However, we want to flip the script on motivation. If you lack motivation, the only thing that’s going to generate motivation is to get moving. I know what you’re thinking. You’re probably thinking, ‘Yeah, but if I had motivation, I could get going. So I just need motivation to get going.” But I’m here to say no. Sometimes, you just need to go back to creating small baby steps. Once you start, you start having positive feelings about yourself. You begin to have positive feelings about what you’ve generated. And that is what creates motivation. Again, tiny baby steps. That is a very encouraging mindset. 

Try to be your inner bestie. Encourage yourself. “You’ve got this. You can do it.” “I believe in you. Just a little more.” “Just get started. I know you can.” You’ll feel so much better when you do. Just keep talking to yourself, coaching yourself, and embracing yourself with that motivational best friend voice that encourages you. That can be very beneficial, as you’re doing this daunting thing that you really don’t want to do. 

6. Poor Time Management

This is one of the most important, especially if you have something that has a deadline. If you don’t have time management skills and aren’t good at really understanding how long the activity will take, you’re probably going to procrastinate and miss the deadline. We talk all about this in our online course called Time Management for Optimum Mental Health. We actually sit down and, step by step, plan your day. Not compulsively, but what we do is actually plan pleasure first. That’s the first thing we put on the schedule. 

One of the main reasons people procrastinate is that they want pleasure. We want to feel good. We want to have great, fun things in our lives. So we spend a lot of time going back and forth, “I have to do this assignment, but I want to relax. But I have to do this assignment.” Because we haven’t planned our time and scheduled pleasure, we end up negotiating and spending a lot of our time going back and forth. 

You plan and schedule your pleasure first so that you know you’ve given yourself what you need. And then you’re so much more likely to do the hard thing because you’ve already promised yourself and followed through that you would do the pleasurable thing so that you can get that more challenging thing done. In addition, you might want to be someone who schedules pleasure, hard, pleasure, hard, pleasure, hard, and gives yourself lots of breaks where you have lots of pleasure and things that bring you fulfillment and joy as you do this hard thing. I often do this with household chores. As I’m doing the hard thing, I’m listening to a podcast that I like. I’ve planned that. For example, I know that there’s a podcast that comes out on Friday, Your Anxiety Toolkit. On Saturday morning, when I know I have to do the laundry and fold the laundry, which I hate doing and often procrastinate with, I go, “Okay, Saturday morning when I want to listen to that podcast, I’m going to marry the positive and that difficult together.”

Time management is so important. If you’re interested in taking the Time Management course, it is a deal. It is reasonably priced for something that will help you run your week and your day much more easily. You can go to CBT School or click the link in the show notes to get access to that course. 

Those are the six reasons we procrastinate. I hope that this has helped you identify where you’re getting into trouble so that you can make changes and get your life going so that you don’t have to panic and be stuck in that absolute last-minute frantic panic. You can just schedule your time, break it into small steps, be as gentle and kind and motivating and encouraging as you can, and get the things you want done so that you can go and live your life. 

Don’t forget, as I always say, today is a beautiful day to do hard things. I want you to remember that none of this is easy breezy. I never want to make it sound like it’s easy breezy. It’s hard work, but we must remind ourselves that hard work is a part of being human. It is a beautiful day to do hard things. I don’t want you to buy into society’s idea that life should be easy. “This should be easy for you. What’s wrong with you?” Nothing’s wrong with you. It’s hard. No one wants to do hard things, but you can do those hard things. 

I hope you have a wonderful day. I’ll see you in the next episode.