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

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Now displaying: August, 2021
Aug 27, 2021

This is Your Anxiety Toolkit - Episode 199.

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

Welcome back, everybody. Oh my goodness, I am so excited about this episode and so deeply honored. So, for those of you who know me, you know how completely-- oh my gosh, I get so excited about meeting my mentors – people who have taught me so much as a clinician, who have taught me so much as a human being. Today’s one of those days, you guys, I am so excited and so grateful to be able to have, like I said to you, my biggest mentors on the podcast.

Today, we have on the podcast talking about shame, Dr. Christopher Germer. So, if you guys may remember, I did interview Kristin Neff before COVID about self-compassion, and Christopher Germer, who we have today, has co-founded the mindfulness self-compassion concepts and tools. They have workbooks, they have trainings, a website, and the work they’re doing is so important. I strongly encourage you to go over and check out the work that they’re doing, because it is life-changing.

But today, what I’m so excited about is sharing with you a conversation I had with Christopher Germer about shame, and he really breaks down all of the things we need to know about shame. We talk about some things that I myself have still got a lot to learn. Some of the things he said today – I had to do everything in my power, not to be like, wait, stop, I need to be able to think about that for a second. I need you to say that again, because he just drops so many truth bombs, and he is so amazing.

So, I’m going to stop going on about how excited I am because I have a total fangirl experience right now. I literally just got off the phone with Dr. Germer, and I’m going to share this with you. So, I hope you enjoy it.

If you are somebody who has struggled with shame, you are going to love this episode and take a lot away because it is such an important part of all of our recovery and all of our well-being. So, enjoy the episode, everybody, and I will see you all next week.

Christopher Germer Your Anxiety Toolkit Podcast

 

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Kimberley: Welcome. I am so honored, and I have such deep respect for today’s interview guest. We have today Dr. Christopher Germer. Thank you so much for being here.

Christopher: Thanks, Kimberley. Great to be here.

Kimberley: So, I’ve actually been dreaming of having you on for some time. I really wanted to hear your thoughts about shame. I was at a presentation or a training you did in December, right before COVID started, and I loved what you had to say. So, this is the topic of today. Can you share with us, just give us a brief description of what shame is?

Christopher: Well, shame is probably the most difficult human emotion. Shame is probably the most hidden human emotion, which is also why it’s so difficult, because if we can’t see it, we can’t work with it. But shame is primarily-- it has two main aspects. One is it’s a self-conscious emotion, which means we’re kind of seeing ourselves in the minds of others, and there’s also negative self-evaluation. So, what we’re seeing in the minds of others, it’s usually some scorn, something negative. So, those are the two main characteristics of shame.

Shame also has a kind of-- there’s kind of a global negative evaluation involved. In other words, we don’t just think a part of me is kind of needing to be tweaked a bit. It’s like, I am fundamentally bad or unworthy or incompetent or helpless. So, there’s a kind of a global evaluation. So, that’s shame.

But at the end of the day, what shame really is an attack on the sense of self. So, guilt is a criticism of one’s behavior. In other words, I did something wrong. Shame is “I am wrong.” So whenever there is a self-attack, there’s usually an element of shame involved.

Kimberley: Right. And I think that’s so interesting that you say, because it’s such a huge component of someone who’s struggling with a mental illness, or even just emotions, in general, is a lot of us when we’re having a hard time, we move immediately to like, “There’s something wrong with me.”

Christopher: Yeah. So, shame can either be the cause of different forms of mental distress or the consequence. So, when we think badly of ourselves because we’re struggling, say with an anxiety disorder or depression, then that’s an element of shame – thinking badly about ourselves, right? The self-attack. Or if we get negative messages from the culture, like if what we’re struggling with, it’s stigmatized or if it’s a burden on somebody in our lives and they start to criticize us for what we’re going through.

So, in that way, shame is a consequence of some internal distress, but it can also be a cause. If we are beating up on ourselves or something that happened to us in childhood, and inevitably, for example, if we suffer a lot of criticism or neglect or abuse in childhood, we basically blame it on ourselves and we carry shame through our lives.

Shame takes the form of self-criticism. It takes the form of self-isolation. It takes the form of self-absorption. Any of those ways of being have a serious effect on our mental health. If we isolate ourselves, then we get lonely. If we criticize ourselves, we can get anxious or depressed or anything. So, shame can be a cause or a consequence of mental illness, mental distress, and certainly anxiety.

Kimberley: Right. I love that you identify that. So, I think a lot of us understand that you would experience shame and have some self-criticism in relation to that. Can you share a little bit about why you think we would alternatively isolate?

Christopher: Well, it just goes along with the shame.

Kimberley: It just happens.

Christopher: Isolation is a hallmark of shame, but maybe one way of looking at it is evolutionarily. In other words, we have shame because in human evolution, it served the function, and the function it served was it kept the tribe together, and tribes that stayed together survived. So, when somebody sort of broke the rules, it jeopardized the tribe, it jeopardized the individual, and that wasn’t good.

So, what shame is, is a really intense emotion that we feel when we break the rules, and then the tribe excludes us. And that became hardwired in us through evolution because those people who basically felt shame stayed in the tribe and survived. So, therefore we have shame.

The problem nowadays is that we could feel shame for just about anything that has nothing to do with survival. We can feel shame because my body type or my sexual orientation or gender identity, anything we could feel.

The interesting thing, Kimberley, is that actually, we are more likely to feel shame when we are being devalued in a social context than when we do something wrong. It’s quite possible we do something wrong, even something that violates our own standards. And we just feel just a little bit of shame. But when people treat us in a devaluing way, then we have a lot of shame.

So, the question was isolation. Shame has always been associated with isolation. But what’s really interesting is that in the tribe and among our ancestors, the way they got us back into the tribe, fortunately, was by making us feel bad, not by beating us up. If they had to beat us up to get into the tribe, that would be not good for the survival of the tribe. So, we learned the fine art of shame, and it feels like we’re getting beat up and we just want to get back. We want to get back into the good graces of our friends and so forth.

So, bottom line is that it’s just the central part of shame to feel extra – kicked out of the tribe alone, desperately alone.

Kimberley: See, that’s so fascinating that you said. I’m going to have to relisten to this, this term around like, it’s true. We could be physically hurt, but there’s that emotional when someone says something about us and they attack us emotionally. That can be the most painful, heavy load. That can create a cycle of shame and all of those and isolation and criticism. That’s so interesting. I’ve not heard it being explained that way. Can you tell me about self-absorption, though?

Christopher: So, in a moment of shame, two things happen. One is we are stopped dead in our tracks. There’s like a startle. There is a fear response. Sometimes there’s like a moment of panic. So, that goes with shame. And then there’s instinctive turning inward. This also makes good evolutionary sense because then the idea is you would turn inward, and then you would take inventory of what you did wrong and then fix it.

So, that turning inward is a part of shame, but it’s only helpful, Kimberley, when it’s mild shame. In other words, if you, I don’t know, mistreat somebody, and then you stop, you turn inward, you realize what you did wrong. And then you basically stop feeling ashamed, and a little bit, you start moving a little more into guilt, and then you apologize, right? People in the midst of shame, they can’t apologize. They’re too self-absorbed. But when it turns to guilt, then you can step out of yourself. You can apologize. And then the beautiful thing is when you are basically forgiven, or you’re welcomed back into the tribe.

So, that turning toward oneself, turning inward is part of how shame develop. But when we have not state shame or temporary shame or mild shame-- but when we have a trade shame, shame proneness, intense shame, chronic shame – we get stuck in self-absorption. We get stuck in turning in on ourselves. We get stuck in rumination. We get stuck in obsession. This is a direct fruit of the shame experience.

So therefore, when people ruminate in a-- I say, if you’re having obsessive-compulsive disorder or something, and you’re just ruminating all the time, there’s often a shame component because this is just how we’re wired.

Kimberley: Right. It’s so interesting that you say that, and it is. I even know, I can say personally, if I’ve done something wrong, there is sort of a-- I think what you’re saying is the self-absorption isn’t in a critical way. You’re saying it as criticism, it’s more of that you’re just stuck on “Did I, could I, why did I, should have I, why did I do that?” And you’re stuck in that cycle.

Christopher: You get stuck in the cycle. And when we can see the shame in, we can address the shame, then we can get unstuck. And seeing and addressing the shame – so shame is the idea that “I’m bad,” or “I’m incompetent,” or something. We can’t just say, “Oh, no, I’m not bad, I’m good,” because that’s intellectual. That’s in the higher cortical process. It just doesn’t work to try to convince ourselves of something that is so anchored emotionally. So we need to do something really different to address the shame. We need to actually warm up the conversation.

This is what Paul Gilbert figured out back in the year 2000 with compassion-focused therapy, is that you can’t necessarily exchange a critical thought with a positive thought just because you want to, because your attitude has to change, the tone, the way you talk to yourself has to change. you have to warm up the conversation as he says. I think it was just a really profound insight, which is the centerpiece of compassion-focused therapy.

But the bottom line is that when we-- say, if we’re obsessing, and shame is at the root of this, first of all, we need to recognize that it’s the root of it, but then how do we change that loop? We do it by actually learning to be kind to ourselves because we’re obsessing, not as an effort to drive out the obsession or to fix ourselves or to stop this or stop that. We need to just put down our defenses and just say, “Honey, this hurts.” You are suffering and learn to love ourselves as a kind of a wounded or broken person.

I can tell you, in my own personal life, that’s precisely how I got into self-compassion because I had public speaking anxiety, and I was technically an expert in anxiety disorders after I wrote a dissertation on it and so forth. For 20 years, I couldn’t deal with my public speaking anxiety, although I knew everything that one should do about this.

To put it simply, until I learned to love myself as a wounded healer, as a broken person, as somebody who could do nothing about his public speaking anxiety, just to love myself because I had public speaking anxiety, not as a way of driving out the public speaking anxiety. And when that happened, miraculously, I lost my public speaking anxiety. That was like in 2016, after 20 years. I’m sorry, 2006. I, more or less, haven’t had much public speaking anxiety for the last 15 years because self-compassion addressed the shame by warming up my inner experience and embracing myself as a person suffering with anxiety, not trying to do some sort of slick strategy of fixing or overcoming or tricking anxiety out of my system. That didn’t work.

Kimberley: Right. Can you share with us? Because I think that’s such a real-time experience. Can you share with us what that looks like for you? Of course, we can always, in our heads, picture the person who’s presenting and has a lot of anxiety. I think we all know that feeling. What was the shift for you when you were on the stage and then it moved into that? Or did you have to practice it on stage? Can you share a little bit about your experience?

Christopher: Yeah. So I guess, one thing is I’ve been practicing meditation for decades, but I never practice self-compassion meditation. Four months before I had a really important talk, which is that Harvard Medical School, the conference that I had, helped to organize on meditation and psychotherapy. Four months before that, I started to very deliberately practice loving-kindness meditation for myself for the first time in my life. So that meant just saying really nice things to myself over and over again, like, “May you be safe, may you be healthy, may you live with ease,” and things like that. Just over and over, like a mantra. And that became a new voice in my head. It sure was a new voice.

And then when I got on stage at this conference, when I got up the usual terror arose with me, but there was a new voice. So, in these months running up to the conference, I would sit in meditation and I would then think about this conference and I would be horrified, and I would start to panic on my cushion in meditation. But then I would just say really kind things to myself. And as I said, not to drive the fear out, but just because I needed some love because I was such a mess, because I just couldn’t psych out my panic, right?

So, I was just feeling anxiety, loving myself, feeling panicked, loving myself, feeling fear, loving myself. And then when I got on stage, I felt the fear and the love came through. It was like a new voice that said, “Oh, may you be safe. May you be peaceful. May you be happy.” And with that warmth, the anxiety disappears because, I’m sure you’ve heard “Love is the opposite of fear.” It really is because when we can hold ourselves in a loving embrace in the midst of our suffering, it really does downregulate the arousal, the sympathetic stress response. It downregulates the stress response. So, this actually happened all internally without any intention at the time, because I had been building up this habit for a few months. And that was quite amazing.

But I need to say that I don’t want your listeners to think, oh, I just need to do this for four months, and then all my public speaking anxiety has gone or whatever I’m dealing with is gone because I also had what’s called the “gift of desperation.” Now I’m sure a lot of your listeners have that too, which is also known as a “moment of creative hopelessness.”

I was broken. Okay? I was an expert in anxiety disorders. I’ve been meditating for 30 years. I knew everything in the toolbox for anxiety and nothing worked. So basically, I had the gift of desperation. In other words, I couldn’t figure this out. And that’s when compassion is really most effective. Like, what can you do when there’s nothing else you can do?

Kimberley: I resonate with that so much.

Christopher: For example, in medical care, compassion is usually part of palliative care when the doctors have given up on curing you. So then they just try to make you comfortable. But the irony is that in mental health, making yourself comfortable, giving yourself compassion is cure because it downregulates the nervous system. So, if you’re afraid and you find a way to give yourself the kindness and the compassion you need, it creates an entirely different physiology, which is the opposite of fear and anxiety. So, the trick is how to do that.

In my case, what enabled me to do it was that I was desperate. And in my desperation, it finally landed because I was actually simply being kind to myself because there was nothing else to do. Everything else had been tried and failed. I suspect there are a lot of people listening to this talk who know exactly what that means. In other words, you already have the gift of desperation.

My suggestion is, that is a good thing. When you feel desperate like that, that’s when you can really start to warm up your nervous system, warm up your heart. Again, not to fix anything, but simply because you are broken, broken in a good way, broken because you can’t manipulate yourself into a different state of mind. So you have nothing to do, but love yourself, and that will make all the difference.

Kimberley: Right. I resonate with this so much. I have a similar-- not a similar story, but I remember a therapist and I go to therapy. That’s what I do. My clinician, my therapist was saying, “It doesn’t sound like you’re being that kind to yourself.” I’m saying, “No, I am. I am being kind. I’m not saying anything critical.” She’s like, “But it’s how you’re saying it. Like that tone, it’s aggressive. you’re not saying anything so unkind, but it’s so aggressive.” And softening that tone – I had no other choice. I was so frustrated. Like, “What am I doing wrong? I’m not doing anything wrong.” So, that was so powerful for me.

Christopher: One of the sneaky aggressions, Kimberley, is, this is really sneaky aggression, especially for clinicians. And that is most of us have been sort of trained to try to fix things, fix things in ourselves or others. you’re from Australia and there’s a meditation teacher in Australia named Bob Sharples, who talks about the subtle aggression of self-improvement. Actually, in a subtle way, to think I’m anxious and I should no longer be anxious, and therefore I should do this, it seems as if it is compassionate, when actually the most compassionate thing to do is to stop trying to fix ourselves and to be really kind to ourselves because we are broken. That doesn’t mean that you are going to be broken for the rest of your life. What it means is, this is the first opportunity you have to get fixed. That is to say, to get healed by the power of compassion.

So, as Paul Gilbert says, there are three main subsystems in the autonomic nervous system. One is the care system, which we’re trying to activate. The other is the threat system, which is associated with self-criticism. But there’s also a kind of edginess or self-criticism in the drive system. And the drive system is “I’m going to fix this, then my life is going to be awesome.” But if we are hooked by the drive system to try to fix ourselves, we are actually creating obstacles for healing.

Kimberley: And I think that’s so prevalent in this era of social media, and even my clients trying to get into colleges like, “You have to be going and do some much, and I’ll have to be better,” and all these things. I think that’s so true of this era we’re living in. Better, better, more, more.

Christopher: Yeah, that’s right. We’re not very patient. In other words, this is a fast-paced society, particularly with electronics and the internet. But compassion is slow. Compassion is patient. If you think about how do you recognize compassion, there are a number of ways that we recognize compassion. One is with a soft gaze. One is with a soothing or supportive touch. One is with gentle vocalizations. But another way is with patients. When we are around somebody who is not trying to achieve anything, get anywhere, but it’s just with us in an open-hearted way, we know that we’re in the presence of compassion. But how often do we do that with ourselves? Very rarely. When it comes to ourselves, we are usually more impatient than we are with anybody else. And so therefore, we really need to back off. Learn to be with ourselves in a new way. give up the struggle just for a second and see what happens.

Kimberley: Well, that’s so interesting, because if you were to say like, compassion is slow, that is the opposite of anxiety, because anxiety comes with an urgency, right? Like, get away from it. We’ve got to fix it right away and remove it right away. And that is that sort of paradoxical thing of the answer isn’t to run away fast and the answer isn’t to push it away and just to slow down into it, right? Like you were saying, it’s like the give up. It’s like, let’s just stay.

Christopher: When we give up, we’re actually not giving up. We’re just giving up the struggle.

Kimberley: Yeah. Laying down the sword.

Christopher: We’re not giving up. Say it again.

Kimberley: We’re laying down the sword.

Christopher: We’re laying down the sword, right? We’re not giving up that we’re going to have a happier, healthier life. It’s quite the contrary. We’re just doing it in a new way. We’re giving up the struggle and we’re learning to embrace who we are and what we’re feeling in this moment. The great paradox is that then leads to cure. So, it’s a paradoxical cure.

Kimberley: It is. It really, really is. I love this. So, tell me, what are some of the roadblocks you see when it comes to people? I know I’ve done a lot of presentations with you. You do a lot of self-compassion meditations. What are some of the roadblocks you see people go through in trying to access self-compassion? Because for those of you who don’t know, you have created this amazing program called Mindful Self-Compassion. Have you got any kind of reflections on what might be some of the roadblocks?

Christopher: The roadblocks to self-compassion. Yeah. So, there are personal ones, there are more cultural ones. Well, the main roadblock is the term “self-compassion” because when people hear that, they think selfishness, narcissism, not good. Or compassion, they think, oh, soft, fuzzy, I got enough of that, I’m too compassionate already anyway, that sort of thing. So, the term itself is going to be a problem.

And then there are other subproblems such as people associate self-compassion with self-pity, with lack of motivation, with self-indulgence, with, as I said, selfishness, weakness. And all these obstacles to self-compassion are actually myths. There are misconceptions because the research overwhelmingly shows that people who are more self-compassionate are actually more compassionate to others, less self-absorbed, more resilient when things go wrong in their lives, and they are more motivated, not less, more motivated to achieve their goals. They just do it in a different way. They don’t do it with harsh criticism. They achieve their goals through self-encouragement and kindness.

So, those are the obstacles. The research shows the opposite. But people also have individual obstacles, like personal obstacles based on their childhood. So, for example, if we were punished for crying, most males have been told that’s unmanly. So, if I start to practice self-compassion, I might feel vulnerable inside. I might even touch some old wounds that happen. This is called backdraft that love reveals everything, unlike itself.

People recognize that they might have shut down in order to survive. And then when they start to open up with self-compassion, they start to feel vulnerable, maybe some difficulties arise, and then they think, oh shit-- I’m sorry. Something’s going wrong. And that then is an obstacle. But that’s a personal obstacle because it’s related to a person’s personal, let’s say childhood experience.

So, when we practice self-compassion, we need to really understand the territory. We need to know how self-compassion works, what to do when-- so we have a saying: When we give ourselves unconditional love, we discover the conditions under which we were not loved. So, when difficult emotions arise, as they inevitably will, that’s actually an opportunity for healing. But if we don’t know that, that just means, “Oh, I’m not doing this right. Things are not going the way that they’re supposed to go. I should stop.” That’s an obstacle.

So, in this course, this eight-week Self-compassion Training course that Kristin Neff and I developed, now with the help of thousands of teachers around the world, this course actually guides people through the process, such that it is healing. In other words, we learn how to give ourselves compassion. We are open and kind to ourselves when the opposite arises, as it must in order to heal. And then we learn to meet everything that gets stirred up with compassion. We learn to meet that in a new way. In other words, in a compassionate way. And then as a result of that, we actually heal. In other words, we can even reparent ourselves with self-compassion, but we need to understand the territory. Sometimes it’s really good to have a therapist to help you with that.

Kimberley: Yes. I have taken-- just for the listeners, I’ve taken the eight-week course twice, maybe three times, I think. Twice, and then once I think the quick, fast one on the weekend, which I loved all of them. Let me take you back to something you mentioned before, because I want to make sure people are really clear. So, you’d mentioned the shame you experienced because of somebody else’s way they’ve perceived you or that what they’ve told you or how they’ve communicated to you, but then there’s the internal shame. Would you say that the compassion practice is the same for both situations?

Christopher: Well, compassionate, in general, is a powerful resource for regulating our emotions, for coping, for emotional resilience. So, no matter what happens to us, if we know how to be compassionate to ourselves in the midst of that stress, it’s helpful. But I found that there are many things that are helpful when we’re under stress, like getting exercise. But when we’re dealing with shame, then we need self-compassion more than ever because you’re not going to deal with your shame just by, say running a marathon. That’ll calm you down, but it won’t touch your shame.

So, in order to address shame directly, which has these characteristics of self-absorption and isolation, and self-criticism, we actually need to deliver a medicine, which is the opposite. And self-compassion is the opposite. So literally, Kristin Neff’s three-part definition of self-compassion is self-kindness versus self-criticism, a sense of common humanity or connection versus isolation, and mindful awareness versus self-absorption or over-identification.

So, what I experienced, example with my public speaking anxiety, is that I only discovered that I had a shame disorder after I had been giving myself compassion for four months, that in other words, the self-compassion enabled me to finally see what the problem was. It was like a resource or a strength. It was like a platform. It was like a firm foundation that I can actually see what the problem was.

So, when we think about self-compassion as an antidote to shame, we really want to front-load the resource. We want to start getting good at self-compassion, and then we can turn around and touch the shame from a position of strength. And self-compassion targets shame because it’s the opposite of shame. But just let me say that it’s not only the opposite of shame. It has more than non-shame. It is kindness, which is different than non-self-criticism. It has a sense of connection, which is different than non-isolation. It has mindful awareness, loving awareness, which is different than just stopping to ruminate.

So, the cool thing about self-compassion is it has all these positive qualities that actually create positive cycles in our lives. They warm up our experience. They make us happy, which makes other people happy, and it generates a lot of positivity. So, therefore, when we give ourselves self-compassion for shame, we’re not just downregulating shame, but we’re also building a resource, which actually creates – it’s very clear in the research – happiness and life satisfaction.

Kimberley: Yeah. And quality of life, right? Like connection. It is so true. If you talk about shame being about isolating, I think anxiety does that too. It makes you want to hide. But if you can be compassionate, you can stay present with your partner or your child or your best friend or whoever. I think then that is even more healing, right? It’s healing upon healing, upon healing.

Christopher: It’s healing upon healing. That’s a nice way of putting it.

Kimberley: Yeah. So good. Is there something that we haven’t-- I want to be respectful of your time. Is there something that you feel like we haven’t addressed that you want to share on this topic?

Christopher: We covered a lot of ground in this short time. And I guess the main point that we’ve already made, but maybe I can say it again because it’s so critical, and that is, we have what’s called the “central paradox of self-compassion.” And it is that when we suffer, we practice self-compassion not to feel better, but because we feel bad. So, I said this a few different ways already, which I’m pleased about because it is the difference that makes a difference. When we give ourselves compassion for its own sake, it works like a charm. But when we do it as a kind of strategy, some slick strategy for fixing ourselves or how we feel, it really doesn’t work.

So, the metaphor is like, if you have a kid with the flu and your child is crying, “Oh, it hurts mommy. My head hurts. My tummy hurts,” naturally, your heart will go out to the child and you’re not thinking, oh, I’m going to be really nice to my kid so that my kid’s flu will disappear tonight, because it’s a five-day flu. You’re just nice to your kid because you can feel the kid’s pain, right?

Similarly, can we do this for ourselves when we suffer, just like we have the flu? And mind you, we all have the flu. It’s called human suffering and we all do it, and we’re going to suffer until we die. So, this is like a lifetime flu that we all have. And so, what happens when we suffer? Can we be as kind to ourselves in the moment of suffering as we would toward our own child who is suffering? That’s the challenge. When we can do that for its own sake, self-compassion can change your life.

Kimberley: Yeah. Thank you. Oh my gosh, I love it so much. It’s so powerful, and it’s so crucial. I’m so grateful for you sharing all of that wisdom. Actually, we covered double what I was hoping to talk about today. So, I’m thrilled. Share with us where people can find out about you and all your resources. We’ll make sure to have them in the show notes.

Christopher: Yeah. So, we have an organization called the Center for Mindful Self-Compassion that basically is a clearinghouse for everything self-compassion-related training, and you can download audiotapes and videotapes of things. That website is CenterForMSC.org, and my website is ChrisGermer.com.

Also, if people are interested, particularly in the research, you should go to Kristin Neff’s website. She’s really the-- I could say the main pioneer of self-compassion research and she is Self-Compassion.org. Her website is just amazing, and her work is amazing. And she just came out with a book called Fierce Compassion, which tries to correct our misunderstanding that compassion is always soft and tender. Sometimes it’s fierce and it’s tough. Sometimes we need to do really hard things in a kind way. And that book shows people how to do it. So, you can learn more about Kristin at her website as well.

Kimberley: Yeah. She’ll be on the show here in maybe, I’d say six weeks.

Christopher: Okay, great.

Kimberley: Yeah. Again, because she’s been on before. It’s so good. And you said there was a training for clinicians as well.

Christopher: Oh yeah. So, we have a Self-Compassion in Psychotherapy Certificate Program, and this is a 10-- I’m sorry, a 30-week training with a lot of renowned people as faculty. Basically, it teaches how to integrate self-compassion into all aspects of psychotherapy, as well as into our lives personally. It’s a 30-week training, with the first cohorts going to complete the training in the next few months. And there’s a new training that’s starting in October of this year. So, if you’re a clinician and you’re excited about self-compassion and you want to know how do I bring this into my clinical interventions, into therapy relationship, into my own personal life, and into therapeutic presence, that’s the best place to learn it. you can learn about that from that website – CenterForMSC.org.

Kimberley: Wonderful. Well, thank you. I’m so grateful. I have, like I said, such deep respect for you. I’m so grateful for the work. It’s been crucial in the work that I’ve done as a clinician and for myself. So, just major props to you.

Christopher: Thank you so much, Kimberley, and thank you for all the heartfelt and really effective work that you’re doing – getting out insight into new approaches to old problems. Anxiety has been with us since the birth of humanity.

Kimberley: It’s true. It causes a lot of suffering.

Christopher: So, we’ve got a lot to learn, and thank you for being in the center of that conversation.

Kimberley: Thank you.

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

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

Important Links:

https://chrisgermer.com/
https://centerformsc.org/advanced-skills/

 

Mindful Self-Compassion Workbook

https://www.amazon.com/dp/1462526780/ref=cm_sw_em_r_mt_dp_3YD9C23Q1KQ56WDYCN3C

Mindful Path of Self-Compassion

https://www.amazon.com/gp/product/B005CWSC06/ref=dbs_a_def_rwt_bibl_vppi_i1

Aug 20, 2021

This is Your Anxiety Toolkit - Episode 198.

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

Okay, friends, how are you doing really? How are you doing?

It’s summertime, you guys. Oh my goodness. We’re here. How did this happen? Just to let you know, I will be taking a break as I have done for the last several years over the summer. So I will probably take a few weeks off in July so I can have some time with my kids to really rest and repair and play and be human. It’s such a weird year. And so as I’m recording this, it’s not summer yet, but it’s crazy to think that we’ve landed in summer already of 2021. Am I right? Holy smokes.

Okay, before we get started, as I always say, please do go and leave a review. I will be giving away Beats headphones to one lucky winner when we get a thousand reviews. We’re on our way, guys. So please do go and leave a review. I would so be grateful. It just really helps me strengthen the podcast, and it’s one of my big goals for 2021, is just to really help people with this amazing platform.

All right. So here we go. Today, I am talking about how I am protecting my daughter from an eating disorder. But what I’m really going to be talking about is how we, me and my husband, are protecting my daughter and my son from an eating disorder. The reason I preface that is because, number one, yes, while women are more likely to develop an eating disorder, there is an increase of prevalence of young men and young boys getting and experiencing an eating disorder.

There are many different types of eating disorder. It doesn’t have to be anorexia. They can be binge eating. There’s also types of eating disorders, such as bigorexia, which is around developing muscle. There’s orthorexia. There’s so many kinds of, again, bulimia anorexia, of course, we’ve discussed. There’s so many types and it’s so important that we recognize that this is not just a problem for women and girls.

So let’s talk about it. How myself and my husband are protecting my daughter and my son from an eating disorder. So there are two main things I want to discuss today. Number one is how we talk and number two, how we model. And so I’m going to give you much more detail into how we are doing that and how we’re choosing to do that and the struggles that we’re having.

I, myself, had an eating disorder. So I’m really, really protective of this topic with my children. It’s something I really want to try and protect them from while I know that I can’t entirely protect them. I can do a lot of education to give them everything they need to hopefully not have to go through what I have gone through and what so many people have gone through with eating disorders.

So, first of all, let’s talk about what we talk about. Let’s talk about what we talk about, shall we?

All right. So the first thing, and you guys have heard me say this probably before, the first thing we talk about is diet culture. This is where we identify how our society is teaching us to believe that we should be a certain way. Our bodies should be a certain way. Our skin should be a certain way. Our hair should be a certain way. We should look a certain way. And we want to be able to identify this so we can call the BS on it.

So the reason that I call BS on it is, just because society tells us our body should be a certain way doesn’t mean it’s true. In fact, it’s entirely BS. Your body, my body, my daughter’s body, my son’s body, and my husband’s body – doesn’t have to be any particular way.

Society and diet culture is going to tell us that it should be thin. It’s going to give us all of these messages. “We should be thin. We should be strong. We should be tall. We should be short. We should be eating this certain thing. This product will help us with our metabolism. This product is bad. These foods are good. These foods are bad.” And there’s so many messages that are faulty and proven to be wrong. So, so important. So we talk a lot about this with my children.

When my daughter and I go shopping, which we haven’t done in a long time, but when we see advertisements, when we watch TV shows, when we look in magazines or pitches of books in books, when we look at Barbie dolls, we talk about diet culture. I might say, “What about her body? Let’s talk about Bobby.” And we look at Bobby and I’ll say, “What do you think about her body?” And she’ll be like, “It’s kind of weird. It looks kind of strange.” And I’ll say, “Yeah, why do you think that is?” And she says, “Well her waist is really small.” And I’ll have a conversation with her. We talked to her about, “Do you feel like you need that to be beautiful? No, no, you don’t.”

How might we change this? And I might say to her, “You don’t have to look anything like that. You know that your body is genetically set up to be exactly the way your body is and there’s nothing you need to do any differently about that.” So important.

Same with my son. Look at the action figures. We might say, “Your body doesn’t have to look like that.” That’s diet culture. You don’t have to have a six-pack of abs. He’s only six, but we’re still already having these conversations.

Now, what’s interesting is my husband right now is reading the book to our children, and it was a book that he read when he was a young kid with his parents. It’s interesting because there’s all these references to fat, like fat this and fat boy and fat girl, and she was fat and so forth. We talk about the word “fat.” We talk about, is that a good word or a bad word? No, it’s just a word. It’s a descriptive word. But would we use it to describe somebody else? No. We would use many other things to describe somebody than using that kind of word. Not that there’s anything wrong with the word. It’s just that we don’t want to encourage them to define a person by their body.

We try our hardest not to compliment our children’s body. You might think that’s crazy. Some people go, “Oh, no, no. My child won’t have an eating disorder. I tell them how beautiful they are every day.” I often will educate them and say, “That doesn’t actually prevent anything. In fact, it just adds to that kid and that child thinking that the way they look is important. Because what if their body changes? Then they’re going to be like, ‘Oh no, mom’s always complimenting me on my body, and now my body changed. So does that mean I’m bad?’” So we do our best not to compliment their body or anybody’s body.

I have worked really hard since my own recovery to never congratulate someone for losing weight, which is really hard. In fact, I’ve had one really difficult conversation with our friend where she was saying, “I really just want you to compliment me because I have lost a lot of weight.” And I’ve said to her, “That doesn’t line up with my values. I love you, but I never want to engage in something where you believe your worth is caught up in your body. I just can’t do that. I’m sorry. But I love you and I love everything about you, every part of you, whether your body is in a large body, a small body, a tall body, a short body, whatever color skin. I love you.” And we say the same to the kids. Now, of course, we also don’t ridicule their bodies. We don’t comment on their bodies, their ever-changing bodies, as they, my daughter moves into preadolescence.

We’re still in the talk section. We talk about what we do value. That person is very kind. He has kind eyes. She has a beautiful smile. She radiates love. She is a fun person. She’s very intelligent. My five-year-old son says intelligent a lot. “He is very intelligent. I am very intelligent.” Not that we want to overvalue that either. Because we want to really remind them that unconditionally, we will love them and that their worth is consistent. It doesn’t matter what. It doesn’t matter what. That they’re worth and our love for them is consistent.

And to be honest, I will say there is nothing more powerful than hearing that from a father, particularly if you’re a young woman, a young child like my daughter. For my husband to say, “I love you, no matter what. Don’t ever let a man judge you or comment on your body and you believe what they say, because you’re more than a body.” To teach our son that other girls and other boys are more than a body. To teach him that he’s more than a body. So important.

Now another thing we do is we praise all foods. We celebrate all foods. We are grateful for all foods. We do not have good and bad foods in our family. We don’t talk about things being healthy and unhealthy. While we do very much value health, we really try to help the kids understand that they can listen to their body and our body.

This is the kind of funny story, I’ll tell you. My daughter is going to be 10 and she can outeat anybody. It’s really quite phenomenal. She’s always hungry. And my instinct is to go, “You’ve already eaten. Stop eating. You certainly cannot be hungry.” I’m feeling full and she’s eating double what I have. But I really catch how we talk to her about her food and we celebrate, “Good for you, honey. You’re listening to your body.” She’ll often come to me and say, “Mom, I’m starving. What can I eat?” And we laugh. And she smiles. And I say, “Hun, what do you think I’m going to say?” And she rolls her eyes and she says, “You’re going to say, ‘You can eat whatever you want.’”

Now, of course, we have some rules around this. We don’t encourage and we don’t allow the kids to eat a lot of snacks before a meal. We try to really have them understand the importance of waiting for their meal. But that’s probably 45 minutes at the most. Often my daughter will have a full peanut butter and jelly sandwich 45 minutes before a meal and still eat her whole meal, and we praise her for that.

My son is really, really picky around food. There’s certain things he really, really likes. And interestingly, he has no interest in sweets. If he could choose between salty and a birthday cake, he would choose salty all the time. We encourage him to just listen to his body. I talk to them about me listening to my body. They’ll be like, “Mom let’s go have ice cream.” And I’ll usually sometimes not eat ice cream. That’s not because I’m restricting. I might say, “No, I’m listening to my body. I don’t really need ice cream right now.” And then there’s other days where I’m ordering three scoops of ice cream because I’m really hunkering down for some ice cream. So I try to also teach them that it’s okay to listen to your body as does my husband.

So these are all really, really important things we talk a lot about. And this is the last thing we talk about, which is health. What is health? Is health only eating sugar-free foods? Is health being thin? Is health being tall? No, none of those things. Is healthy eating only organic food? No, absolutely not.

Health is having balance and taking away judgment. We have to remember here too, health is not just physical, it’s mental.

I know people who eat the most “clean diet” and they exercise, but they’re not healthy because emotionally they’ve got a really unhealthy relationship with food and their body. They’re hard on themselves. They beat themselves up. Maybe they binge. So this is the thing to remember. Your definition of health might not be what is the real definition of health.

Now this is really true and I’m going to make sure I have some people on coming here once we get back after the summer on talking about health at every size. This is a crucial conversation we need to have. If you haven’t read yet a book called Health at Every Size, I urge you to. It’s so important to really understand the science behind that and understand the issues we have around how we have stigmatized people in bigger bodies as being unhealthy when we’ve actually got lots of science to prove that you can be really healthy in any size body, that health is not indicated by just your size.

Okay. So now we move on to what we model. This is similar, but very important. So my husband and I have two completely different body sizes. Not that that’s super important, but I feel it’s important for our children to have those two examples and to have family members with different body sizes, where we celebrate every single body, and we do a lot of modeling around that. We do a lot of modeling, celebrating bodies – all the body sizes, shapes, skin colors, nationalities, sexualities. We try to model to our children and normalize differences instead of things being like, “This is good and this is bad.”

We also model, like I’ve mentioned to you, how we eat. We try not to judge each other for what we eat in front of each other. We try to really encourage by modeling like there’s no time you should eat food. A lot of my patients will say like, “Oh, I had a bagel for breakfast so I can’t have a bagel for snack.” And we go, “No, you can eat a bagel for breakfast and for lunch if you want.”

My son loves more than anything to put cream cheese and sprinkles on his bagels in the morning. He loves really sprinkled-up bagels and we allow it. We figured it’s no different than him putting jelly or jam on his bagel. And so we allow it, we allow him to enjoy his food. Given that he’s a kid who doesn’t like a lot of sweets, we’re all for it.

We also model by not saying negative things about our own body. My son is a personal story, but my son once came in and I was getting out of the shower and he said, “Mom, your belly’s all jiggly,” which is most moms’ nightmare. You know what I said? I said, “Yeah, it is. Isn’t it beautiful though, that I had two babies in that belly? Isn’t that cool?” He might say, “Daddy’s belly is big,” or whatever he may say. And we’ll go, “Yeah, isn’t that wonderful? We have so much fun eating food and what a wonderful body. Isn’t it so great that we have our bodies, that our bodies do all these things for us, like pump blood and breathe and digest food and run and hold our hearts and hold our brains and filter nutrients and things like that? Isn’t that incredible?” We model body acceptance and body love.

This has been really helpful for us, particularly because I know a lot of women and men who’ve developed eating disorders because their parents were on a diet all the time, that their parents model these strict diet culture rules, and good and bad rules, and all of this stuff that’s so dangerous for young ears to hear.

Now, we also model this or share one more personal story is, so much of eating disorders is around restriction. Over the last two years, my daughter has had some medical issues where she had to restrict several different food groups and this was really uncomfortable for me. I was very strong against it. I had said to her pediatrician, “I’m very uncomfortable with this. I do not like the idea of her restricting.” And he really coached me through. “You have everything you need to help her protect against this becoming something eating disordered. And just because she needs to do this medically doesn’t mean we have to make it about her body,” which was really helpful for me to hear. And so, yes, she has had to restrict several really important food groups because of some stomach issues that she was having.

And so it’s been a really interesting thing for us to have these conversations around what is a diet and what does that mean and why would we go on a diet and what are some reasons that we probably would not encourage her to go on a diet around and so forth. And so, that has been really, really fascinating to watch her navigate that.

There’s been a couple of times where she said like, “Mommy, I know I’m supposed to check on the ingredient list for certain things.” But she said, “That has made me really uncomfortable having to do that.” And I so appreciated her talking to me about that. And so we came up with basically a strategy that she could know basically what is in certain different foods. And from there, she wouldn’t have to look at the nutrient lists anymore, the ingredient lists. I was so happy that she felt comfortable saying, “This feels not right for me. This feels like it could become a problem.” And so, that has been really, really huge.

I think the only thing I would add from there is, for me as a therapist, but mostly a mom, I’ve had to really allow a lot of space for anxiety around this stuff because I never want my child to have to go through that. I have caught myself being hard on myself and feeling a sense of hyper responsibility, like it’s your job, it’s your job to protect her. I’ve had to really pull back on that as per my conversations with the pediatrician in terms of saying, “Kimberley, you can do what you can do, but you don’t have control. It will be what it will be. You can model and you can talk and you can be the best you can be, but we also have to let go of control and just be uncertain.”

Like I’m always telling you guys, it’s an uncertain thing. There’s no promises that we can do the best that we can. If we make a mistake and we mess up, we apologize and we share and we talk about where that mistake in that era came from, where did we learn it, what triggered us in that moment. And so, that has been really, really important for me as well.

So I hope that that’s being helpful. Those are the main pieces that have helped us as a family to protect our daughter and our son from an eating disorder and body image issues. I do hope that even one point has helped you in navigating this.

If you haven’t, if you’re not the parent of somebody, these are also messages and things that you’ll have to do for yourself, to model to yourself, talk to yourself about. And if not, go and find an eating disorder specialist who can help challenge this and work through the beliefs you have around food and diet culture in your body, and that can be really, really, really helpful.

Okay. I love you all. Have a wonderful, wonderful day. It is a beautiful day to do the really, really hard thing and you’re doing it. I know you are. So, I will talk to you very, very soon.

Have a wonderful, wonderful day.

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

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

Aug 13, 2021

This is Your Anxiety Toolkit - Episode 197.

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

Anxiety Toolkit Mindfulness Mental Compulsions OCD Mindful RuminationWelcome back, you guys. So grateful to have this precious time with you. Thank you so much for coming and spending your very, very precious time with me. As we do this together, it’s exciting, we’re almost at 200 episodes. You guys, I cannot believe it. I am pretty, pretty proud of that, I’m not going to lie.

Today’s episode is with the amazing Jon Hershfield. He’s been on the show multiple times and I have been really reflecting and thinking about how important it is for us to practice response prevention and how that is so, so important for everybody who has any type of anxiety, whether that be an anxiety disorder like OCD, social anxiety, specific phobia, generalized anxiety. Even for myself, I’ve been reflecting on any time I’m responding to fear and responding to discomfort. It’s just a topic that I want to continue to address because I think from you guys, I just continue to see how much it’s a struggle for you.

As I thought about continuing education on tools you can use, I thought, who else can I have none other, but Jon Hershfield to talk about using mindfulness to manage compulsions. Now we talk about compulsions like mental compulsions and rumination. We talk about reassurance-seeking, avoidance, any kind of physical compulsion. We also talk about how to practice mindfulness so that it doesn’t become a compulsion. And so I’m just so grateful to have John give us his very valuable time and to talk with you guys about these amazing concepts.

I’m not going to spend too much more time doing the introduction. You guys know how amazing Jon Hershfield is. He has some amazing books. He has The Mindfulness Workbook for OCD, and he has Everyday Mindfulness that he co-authored with Shala Nicely, and The Teen OCD Workbook, and Harm OCD book. He’s just written amazing books. So please do go out and support him. He does share all that information at the end of the show, and I can’t wait for you guys to listen.

In the meantime, please do go and leave a review. It helps us to reach more people. I’m going to be quiet now and let you listen to Jon’s wisdom. Have a wonderful day.

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Kimberley: All right, welcome. I am so happy to have the amazing Jon Hershfield with us again today.

Jon: Thanks for having me. You make me sound like Spiderman of the OCD world.

Kimberley: You are the Spiderman of the OCD world. I love it.

Jon: What does that mean?

Kimberley: Yeah, it’s true. Well, that’s a good thing. I know my son is probably jumping up and down at the idea of me meeting the Spiderman of something. Thank you for coming on. I really wanted to invite you on, of course, because I love the work that you’re doing regarding mindfulness in OCD. I really wanted to talk about how we can use mindfulness, particularly to address compulsion, because a big part of Exposure and Response Prevention is the response prevention piece. I would really love to pick your mind on how you implement mindfulness as a part of that and also address some of the misunderstandings that happen regarding mindfulness.

So, let me first ask you, just for those who don’t know or new to the show, how would you give a definition? How would you explain mindfulness, particularly in the respect of treatment?

Jon: It’s interesting because we all make this same grammatical error. I do it too. We say we use mindfulness as if mindfulness was an act or an action or a thing that you use as opposed to a perspective that you take. So I’m thinking about what mindfulness means. Usually, the definition we hear is “Paying attention to the present moment as it is without judgment and without the desire to change it.” And that’s a great definition. It’s escaping me at the moment who actually coined that exact language, but I think it applies to most mindfulness concepts.

But I don’t like that it starts with the word “paying” because it still implies that you’re doing something. I think mindfulness is actually the perspective that you have when you’re paying attention to the present moment. If you want to play around with the words, it’s really noticing the fullness of the mind – mindfulness, right? It’s a position that you take as opposed to a thing that you do. Right now, I’m sitting here in my desk chair. I’m aware of the sensation of my body in the chair, hearing my voice in the headphones and I have coffee and tasting that coffee. These are all things that I’m noticing and I’m being mindful of.

The other part of mindfulness that I think is important to understand is that, in a state of mindfulness, you’re best able to observe the difference between an experience – I just listed for you a bunch of experiences – and a story. A story is a narrative. It’s the meaning and the webs that we weave around those experiences. So it’s me thinking I’d had too much coffee today, right? That’s a story about the taste of coffee in my mouth right now and its significance, but they’re two separate things.

When we’re treating something like OCD, which is very much about being pulled away by your mind into these narratives, these fear-based narratives – to be able to drop out of the narrative and into the experience would be to take a mindful perspective, or in colloquial terms “to use mindfulness.” But I think a lot of times when we say “using mindfulness,” we associate that with stopping what we’re doing and focusing on the breath, or pulling out an app and doing a meditation, or trying to execute change in our environment by being mindful. When in fact, mindfulness is very much the opposite of that. It’s not about executing change. It’s actually about stepping back and seeing the way things really are.

Kimberley: Right. I love this. So would you say in this perspective that mindfulness is not adding something on, it’s just dropping down into what was already there?

Jon: Yes. I would agree with that.

Kimberley: I like that. So how might we use this, particularly in terms of managing anxiety or uncertainty or any other discomfort? Can you give me a walk-through of what that might sound like or look like for somebody who is practicing mindfulness?

Jon: Well, one of the things you might think about, when somebody feels triggered, something happens. You’ve touched something you think is contaminated or you’ve become aware of an unwanted, intrusive thought, a harming thought, or something like that. Then you have an experience in the brain and in the body that alerts you to the fact that you’re under attack, that you’re distressed, something is wrong and it needs to be fixed.

What most people do is they immediately go into the story of, “This is bad. I’m triggered. I need to get away from this trigger. How do I make this feeling go away? Because it’s unpleasant.” Of course, it’s unpleasant because it’s your brain’s way of trying to help you jump into action to get away from the things that could harm you. So it’s natural that we want to get rid of this feeling.

And then we do these things called compulsions that reliably, in the short term, get rid of these feelings. If you know anything about OCD as you do, it’s like you get stuck in that loop. The more you compulse, the more you really feel the responsibility towards your obsessions as they arise.

In that space, between the trigger and the compulsion, there’s an experience you’re having. A person who has been practicing mindfulness or who is mindfully aware can show up to that experience in the same way they might show up to other experiences, again, without having to make it go away. So you render the compulsion less important because you’re willing to be in the presence of that triggering experience.

If you were to take this to the mat and think about, “Well, what happens when you’re meditating and you get an itch?” what is the instruction? It’s not, “Well, just scratch it so you can be more comfortable.” It’s usually, “Okay, well, notice what itching is like. Notice what it’s like to be sitting, which is what you’re doing, and then have your attention pulled away from the sitting to the sensation of itching, to be able to say, ‘Oh, that’s itching.’”

Now at some point, we all break and we start scratching ourselves all over it because it’s too much, but that’s fine. But that’s not the first instruction. The first instruction is simply notice itching. And then if you’re capable of letting go of that and going back to what you were doing before you got distracted by the itch, you’d go back to your breath or whatever the anchor of your meditation might’ve been.

It’s the same thing in real life. You’re minding your own business. You’re trying to read a book and then you have an intrusive thought that something terrible is going to happen. And then you notice that experience of this mental itching and you’re, “Okay, that’s happening.” And then you have a choice. You can drop down out of that back into your book, or you can dwell on it, ruminate on it, try to figure it out, try to figure out a way to make it go away, and then give yourself permission to go back to your book.

Kimberley: So, we call it in my practice, my staff have called it “itch surfing.”

Jon: Itch surfing. Yeah.

Kimberley: I always laugh when I say “itch surfing.” So, let’s say you have the presence of a thought that’s really concerning, right? It’s triggering. And you’re trying to be mindful, but you’re also not trying to step across the line to where you are ruminating or being compulsive related to that. How might someone differentiate between the two?

Jon: So there’s a couple of things to consider here. One is that a lot of people will say, mindfulness is about watching your thoughts come and go. There’s a good reason why we use that metaphor, that idea of sitting at the bank of the stream and watching the leaves go by. But it’s not really accurate in the sense that it’s more about just noticing thoughts coming and going. Watching thoughts coming and going implies that you’re supposed to sit there and stare at them and give them special attention. You’re supposed to remember, right? It’s a perspective. It’s not an act. You’re supposed to remember like, “Oh yeah, it was a thought coming and going. Okay, that’s cool.” And then let go of it.

Ruminating is when you’re digging up that thought for the purpose of trying to figure it out to digest it. You’re trying to act on the thought and get certainty about it. It’s a very active thing you’re doing when you’re ruminating.

To be mindful would really be the opposite of that. It would be to notice that you’re ruminating and stop. Because the whole point, if you’re being mindful, it’s not that you’re executing change on your environment, but you’re simply noticing what’s coming up. So it was really impossible to be mindful and ruminate at the same time because that would be like being mindful while trying to figure out some problem.

So the instruction would be to notice that urge to ruminate, to notice what’s coming up for you in your body, that experience of, “I really want to figure this out,” and then to allow that experience to be there, and again, drop back down into your anchor. In real life, it’s whatever you were doing before you got distracted. In meditation, it’s whatever your anchor is – the breath, the feeling of your body in the seat.

Kimberley: So it’d be like using the metaphor of, if you’re sitting at the edge of the stream and you’re just watching the leaves come and go, that would be mindfulness. But ruminating or being hyper-aware would be like watching the leaf after it’s way, way, way, way down the river, but you’re still giving that attention and missing what’s right in front of you?

Jon: Yeah. It’s easy to make that mistake because you could feel like you’re being mindful. You could say like, “Well, I’m just watching this leaf and seeing how far it goes.” But in fact, when you’re doing that, you’re missing everything that’s happening in the present moment, all those other leaves that are going by.

A lot of times, people think of themselves as being very negative because they get distracted by negative thoughts, and the thought comes down the stream and they follow it. And while they’re falling, those negative thoughts, all sorts of other nice things are happening – the smell of their breakfast or the warmth of the sun or whatever it might be. But they’re not noticing that stuff because they’re immersed in tracking that negative experience that they had. They think of their lives as being negative instead of thinking of their lives as just being whatever it happens to be in any given moment.

Kimberley: Right. Talk about, if you will, hyper-awareness, because I think sometimes people think they’re being mindful, and I think it’s going to be very similar maybe in your answer, but I just want to be really clear for people who I’ve heard struggle with. They’re trying to be mindful, but it becomes hyper-awareness. Do you have any thoughts on that?

Jon: A lot of this, I think, comes down again to language. Most of us are trained to say things like “Sit with uncertainty,” which sounds like a good idea, but the implication for some is that you’re literally sitting and there’s literally uncertainty in front of you. It’s like sitting on your head and you’re immersed in it and you’re dwelling on it. So it gets translated as “Dwell on uncertainty,” and feel bad as long as you can feel bad.

Actually, I interviewed Jon Abramowitz who some of you may know in a lecture series here at Sheppard Pratt not too long ago. He said he likes to say, “Act with uncertainty instead.” I really like that because to me, that is still mindfulness. You’re doing something, you notice you became distracted, cool. That’s what that’s like. Now I’m going to go back to what I was doing before I got distracted. I’m going to act with the uncertainty instead of sitting, letting the uncertainty sit on my head.

I think it’s such an important distinction because to be mindful of your thought process is to be aware of it. But it’s not the same thing as to be trying to figure it out or be certain about it. That would be the opposite of mindfulness. And so the whole instruction, if you’ve had a lot of experience meditating, it might sound something like you wander away from your anchor and you start trying to figure out what’s wrong with your life. And then you go, “Oh yeah, thinking.” And then you go back to your anchor. No meditation teacher is going to tell you like, “Well, just notice that you’re trying to figure it out and keep trying to figure it out and try to get to some sort of outcome.” That really would go against the larger project.

Kimberley: Yeah. I mean, for me, if I were to explain it, if I were out and about, and let’s say another emotion showed up, like shame or guilt or something, my practice is just to go, “Oh, hi, Shame.” I think actually in the last episode, you were here talking about teens and you were like, “That’s cool, bruh,” or whatever it was, but that’s observing it and allowing it to be there. But then there’s a redirect to the present. Would you agree that’s a method that you use? I mean, again, we’re saying it’s not a doing, but talk to me about whether that’s something that you would apply to.

Jon: I would absolutely apply that. I mean, at the end of the day, we’re coming up with fancier and fancier ways of politely and compassionately saying, “Let it go.” We might have all the different ways of saying “It’s okay to let it go,” where we understand that it’s very painful to have these experiences and that makes it difficult to let it go. We don’t mean let it go, like, “Oh, you’re being silly.” I mean literally, it arrived and you allowed that, and now it’s leaving and you can allow that to let it go.

To become aware that you have an urge to ruminate or an urge to do some other compulsion and to let that urge be a thing, don’t sit there and stare at the urge and wait for it to go away. just be like, “Oh, that’s happening.” Just like shame arises or guilt arises. And then just gently note it and allow it to be, and you don’t have to do anything. It’s really a beautiful thing. The shame and the guilt and the urge to ruminate and the urge to wash, it’ll go away in its own time. You don’t have to be actively involved in it.

Kimberley: Right. It’s like mindfulness underneath there. A major component is non-attachment, to not be attached to it or the story we tell about it or what it means and all the things.

Jon: I mean, if you look at that and the concept of diffusion, they have specific skills for trying to make that happen. I think people can argue over like, “Well, what are the mechanics of building those skills? And could there be some compulsivity involved in that?” I mean, I think there’s some people that certainly could. If you’re going around saying, “It’s just the thought, it’s just the thought, it’s just the thought,” that’s not exactly what we’re getting at when we talk about diffusion. But the end game is diffusion, it’s being able to say, “I’m having a thought that...” What we want is to be able to do that without having to say it, without having to remind ourselves. But instead, simply have the experience that the thought arises much the same way the credits in a movie arise on a screen. Okay, yeah, that is the thought.

And then you get to decide, “Do I want to engage with this or let it go?” If it’s an obsessive thought that you’ve been grappling with, that you’ve decided is your OCD because you keep trying to get certainty about it, well then the instruction is going to be to drop it, not to play with it.

Kimberley: Right. Yeah. I think that this was a lesson for me early in my mindfulness game. Mindfulness is not just that heady, heady meaning like only a cognitive skill. It’s like you talk about dropping down, and it’s a behavioral skill as well. It’s not just sitting still and thinking, thinking, thinking, thinking your way out of discomfort. It’s also a doing. It’s a body thing as well, instead of it just being heady. I think that’s where we get into trouble, right? We start to try to think our way out of problems or our way out of discomfort.

Jon: Look at checking OCD, for example, like OCD where there’s a lot of checking compulsions. What happens is there’s this experience of not being complete, something missing or something being lost. And rather than own that experience and be able to say, “That’s something that just came up for me and I’m willing to allow that,” the instinct is to get rid of that experience by engaging in the checking compulsion. So, mindfulness plays an important role in being able to say, “I’m aware of this urge to check, and that’s fine. I have all kinds of urges throughout the day. I don’t have to give in to this urge.” You don’t have to do anything about it.

Like you were saying, that’s an experience you have in the body, like a sense that the body is craving a change and your willingness to allow that craving. Again, not to sit there and stare at it and wait for it to go away, but just simply just know that it is there and then go onto the next thing.

Kimberley: Right. I think that this is true in so many compulsions. Would you use the same skill? Would you use the same concepts regarding reassurance-seeking compulsions?

Jon: Yeah. Well, reassurance-seeking is really just another form of checking, isn’t it? It’s like you have a sense that you know something, just like you have a sense that your door is locked when you go back to make sure. In the case of reassurance-seeking, you’re going to a person or the internet to try to make sure. But again, it’s that experience of dis-ease, right? Not feeling ease with your experience and wanting to change. Instead of resisting that by doing compulsions, you’re saying, “I’ll allow it.”

I’ve been using this coping skill with the client. I might have mentioned that they prefer “allow” rather than “accept” because accept felt, I don’t know, it felt different to them. We can use whatever language you want, but I liked it. I’ve noticed that as a coping statement. If something comes up, like, “I want to change it,” and they’re like, “Nope, I’ll allow it.” And then now you’re free.

Kimberley: Open the gates to it.

Jon: Yeah.

Kimberley: Right. I like that a lot. The same goes for avoidance, right? Do you want to share how you might drop into mindfulness when it comes to avoiding, whether you’re about to avoid or you’re already in avoidance? What would your thoughts be there?

Jon: Well, it’s like observing your inner magnet, right? Something is pulling you in a direction. It might be pulling you away from something or pulling you towards it. And again, what does that feel like for you? What does that experience in the body? And rather than telling yourself “Accept it, accept it, I got to accept it, and push, push, push, push, push,” can you just notice where the resistance is? Can you let go of that, that part of you that’s resisting? you want to go to this party, but it’s overstimulating and you might say something embarrassing and there’s something there that might be triggering for you or something like that. But you want to go. As you’re approaching it, do you notice that resistance? Do you notice that push-pull in your body? And again, can you allow it? Can you say, “Worth it, investment return, worth it.” Very quickly, not spending a lot of time on it.

Again, I think cognitive therapy gets a bad rap a little bit in the OCD world because it can so easily turn into mental rituals, trying to assess the probabilities and things like that. But just a pinch, like a pinch of salt, a pinch of cognitive therapy where you’re able to say, “Come on now, this is a black and white thinking. I can handle this.” If you’re allowed to do that.

Kimberley: It’s funny that you say that because I was actually just about to ask you, like, go back to your story. Remember at the beginning, you were talking about the stories we tell ourselves. And I think in avoidance, there are so many stories that take us away from mindfulness. So I was actually going to ask you. Do you want to share how you would maybe implement a cognitive skill there?

Jon: So, if you’re being mindful, it means that you’re aware that you’re thinking. And if you can be aware that you’re thinking, you can also be aware of the tone of thinking. This is especially useful if you’re trying to quickly assess. Are you ruminating? Are you engaged in mental rehearsal? Are you thought-neutralizing? What is the mental behavior? If you’re noticing the way that you’re thinking and that tone, you might be able to pick up historically if that tone has been helpful or not, or if it usually ends in you feeling like you have to do compulsions.

Take catastrophizing, for example. You’re saying, “Something in the future is definitely going to go badly and I’m not going to be able to handle it.” Now, if you’re aware and you’re mindful, you know you’re thinking, and then you know that that’s what you’re thinking, and you know that that’s catastrophizing, you can simply say, “Yeah, that’s catastrophizing. I don’t need to do that right now.” Very simple. “I can’t predict the future.” You don’t have to go into “Everything will be fine,” or “The probability is that this is going to go my way.” Again, we want to spend as little time there as possible because we don’t want to get wrapped up in arguing with the OCD, but to just call it out and say like, “I can’t predict the future. I’m going to just go with this and see what happens.” And then when you make that choice, notice what that feels like. Can you allow that or not? And if you can’t, that’s okay. You can go find something else that you can allow.

Kimberley: Right. I will always remember many, many years ago, probably even when we worked together, a client of mine, and they gave me permission to tell this story, but I won’t, of course, disclose any information. But they always said they can feel the shift in their body. And that was them being mindful. They said as if they were holding onto the sides of their chair. So even though they weren’t sitting in a chair, they could feel this shift in their body of clenching. You can’t see me on the video. You can see me on the video, but listeners can’t. But just this wringing of the hands or clinging of the hands, and that her being able to just identify that slight shift in her body was enough to be able to shift out of that avoidance or resistance. I think just being aware and mindful of that, I think, is a big piece of the pie.

Jon: So, it’s knowing the quality and the tone and the texture of your internal experience. That’s essential for being able to pick out and resist mental compulsions. Ruminating is not just thinking about something because you like to think about it. Ruminating is very much like, there’s a puzzle and you’ve put all the pieces together but one, and now you can’t find that one piece that it’s somewhere. Maybe it’s on the floor, it’s under your desk. You know what that feeling is like. It’s so intense. And that mental quality is what’s going on with the person who’s ruminating. And that’s what they have to let go of, or be able to experience to let go of the ruminating.

If you can’t truly appreciate the tone and texture of your mind that “Sometimes when I’m thinking this way, it feels like this, sometimes when I’m thinking this way, it feels like that,” it’s just very difficult to trust yourself enough to call out the mental compulsion as they happen.

Kimberley: Yeah. I love this so much. I think it’s so important that we do address it. So, in all, I know there has-- we have addressed this, but I want to make sure we’re really clear. Do you believe that someone can mindfully ruminate?

Jon: I think it’s an oxymoron because to be mindful is to remember that everything going on inside is an object of attention, and to ruminate is to really engage in a changed behavior. So it’s really the opposite of mindfulness. There are types of meditations like traditional meditation. You have an anchor. You notice when you’re not paying attention to the anchor, you return your attention. Then there’s other types of meditations that might involve free-floating, like free-associating. Notice that this thought then connected to that thought, then connected to that thought. That is a kind of meditation. And you could argue that there’s a kind of mindful awareness of where things are going when you’re doing that. I still wouldn’t call that ruminating though, because ruminating is done with purpose. It’s done with a specific intention. It’s not just watching where your thoughts land.

Now, if you have OCD and you’re learning to meditate, I certainly wouldn’t recommend you do the type of meditation where you just watch your thoughts bounce around each other. But if you’re a more experienced meditator and you want to do that free-associating of watching each thought arise and fall and rise and fall and connect to other thoughts and feelings, that can be fun. But it’s not ruminating. To ruminate would be to intentionally try to figure out or try to get certain about your obsessive content. And I don’t think that there’s any mindful way to do that because it is literally the antithesis of mindfulness, in my opinion.

Kimberley: Right. No, and that’s how I was trained on it as well. I think the thing that I often will say to clients is, anything can become compulsive. Treatment can become compulsive. If you were to technically look at the term, engaging in compulsive treatment isn’t actual treatment because it’s going in the direction of doing compulsions, which is not the technical term for treatment.

Jon: It’s tricky with exposures. For example, I encounter people all the time who are doing checking compulsions but calling them exposures. “I have a fear of something. So I’m going to go over and pretend to do that thing and expose myself to that fear by being in this scary situation. And then it’s going to go away and then I’ll know that I’m not going to do that thing.” Well, that wasn’t an exposure. It might’ve been hard, but it really wasn’t ERP. I usually tell people not to do ERP when they want to. That’s usually suspicious of that. And also to consider what the point of it is. Like, if your OCD is getting between you and some valued behavior, that’s a good reason to go do that ERP. But if it’s not, and it just exists in your head, you don’t have to go ahead and be ready to go find any ERP to do. You’re allowed to just live your life. That’s allowed.

Kimberley: Right.

Jon: Yeah. I think that the other thing that happens with rumination that I think is very confusing and hard for people to appreciate is that, though, I wouldn’t say you can mindfully ruminate. You can certainly be lost in thought and you can certainly ruminate without full awareness of what you’re doing, because a lot of it is habit, right? Rumination, some compulsions, they can become habitual, but most of them are pretty easy to tease apart from habits. But mental behavior is a little bit trickier, I think.

In the same way that a person who’s-- let’s say they have difficulty with biting their nails, and they always bite their nails when in front of the computer. The computer becomes the cue to bite their nails. The hands go up to their face. They start chewing on their nails. They’re not necessarily thinking, “Oh, I’m going to bite my nails now.” It’s just happening. And then they might become aware of it. And if they’re working on it, then they might use a habit blocker or some other strategy that they might remember to be mindful of the urge to bite it and come up with another strategy.

The same thing happens in the mind where if you’re someone who’s used to engaging in compulsive rumination in different contexts of your life, there are going to be things that actually cue you to do it without you paying attention. You might not notice that, but it’s like, “Oh, every time I’m in this chair, I start to ruminate.”

The goal here in terms of improving your mental health situation would be to take ownership of the moment that you become aware of what you’re doing. Not to beat yourself up for ruminating, because again, your mind was like, “Oh, are we sitting in that chair? Okay, sure. Let’s bring up that topic and start reviewing it.” And you can’t take responsibility for something you can’t control.

You might argue, “Okay, well, that’s not really rumination because you’re not the one trying to control it,” but it has all the same words. You’re just lost in this thought of like, “Well, I know this thought must not be true because of this and that, plus my therapist said this and I read in a book, blah, blah, blah, blah.” You don’t know that you’ve left the building. You still think you’re sitting in the chair. But then, boom, you become aware. You suddenly remember, “Wait a minute, I’m a guy sitting in a chair, having a thought, and wait, I’m trying to figure out if my obsessions are true. Nope. Not going to do that. That’s rumination. Okay, good. Where was I?” Let it go.

But I think people can get very self-critical, really hard on themselves, and say, “I can’t stop thinking, I can’t stop ruminating.” In part, some of that is then taking responsibility for something that’s-- it’s just habit. It’s just the brain has been trained to just start revving up the engine. That’s all right. You’ll catch it earlier and earlier and earlier if you practice.

Kimberley: Right. Okay. Is there anything else that you feel we haven’t covered in this area? I mean, of course, we haven’t covered everything, but is there anything that you really want to drive home here in this conversation?

Jon: Well, I guess one thing that’s been on my mind is, we talk a lot about how thoughts aren’t the problem, right? If you’re being mindful, thought as a thought is a thought. And if you have mastery over your OCD, whatever, a thought about what day it is or a thought about hurting your baby, they’re just thoughts. It’s no big deal. And to some extent, that’s true. We don’t treat OCD by treating what thoughts people have. We address how they’re relating to those thoughts and what behaviors they’re choosing in response to that experience.

But in the interest of remembering self-compassion too, I think it’s important to recognize that it may also be the case that people with OCD are more predisposed to the average person to receive certain types of thoughts in a certain way. So even though those thoughts are normal events, it is normal for you to have thoughts about all of the potentials in human existence, all of the different things. We can kill and have sex with all of these things. It’s totally normal to have thoughts about them. But it might also be that when you have that thought, it hits you in a way that immediately generates an urge or a moral responsibility to address it.

And yes, mindfulness can help because it can help. You both recognize the arising of the thought as an object of consciousness and the arising of that desire to do something about it as an object of consciousness. But it’s also worth noting that it’s just hard to have OCD sometimes. And every once in a while, you’re just going to get sucker-punched by it. And that’s not because you’ve done something wrong, it’s because your brain is conditioned or wired to receive some thoughts in that way. And that can be something that you develop mastery over. But I think when we take all of the emphasis on behavior and none of the emphasis on perspective or predisposition, some people feel like they’re not being heard.

Kimberley: Yeah. Thank you for saying that. I think that that’s been largely the feedback I have gotten as well. If people are struggling and they don’t want to struggle, and they’re trying to navigate this thing, that feels like an absolutely crazy puzzle that, like you said, they don’t even have all the pieces. They don’t even have half the pieces yet. So I totally really loved that you said that. I love the idea of compassionate responsibility, which is, we can take responsibility for our experience with the absence of self-criticism. I think we sometimes think that owning this and experiencing this has to mean you have to beat yourself up and that it has to be like “You should’ve done better” kind of thing. But I do not like that.

Jon: Well, you’ve recently written a book on the subject, and I could go on and on about self-compassion. We could do a whole other episode on it. But I do want to end on this note, which is, a lot of what mindfulness means is simply being honest, and we often lie to ourselves about our experiences. We say, “I should have known better,” but when you look at it, there’s no way to have known better, that everything you’ve done is preceded by a thought or an urge or an emotion and we can track this back very, very far. I’m not making the case for no free will or not taking responsibility for anything. I’m just saying self-criticism is inherently dishonest. I say, “I’m a bad person.” That’s a story. That’s not an objective fact. I say, “I feel terrible.” That’s an experience. That’s honest and that’s also mindful.

Kimberley: Right. I love it. Thank you so much. I’m so grateful. I wanted to navigate all this, but I didn’t want to do it on my own. So, thank you for coming on and helping me because you’re just so good at explaining this stuff, and I really appreciate the way that you conceptualize this. So thank you.

Jon: Well, I appreciate you inviting me. I always love hanging out.

Kimberley: Yeah. Are there any projects or things you’ve got going on that you want to share with us?

Jon: Well, right now, we’re working really hard at The Center for OCD and Anxiety at Sheppard Pratt. We have some new team members and so we’re helping a lot of people that way. Not too long ago, we launched the residential program, the OCD program at the retreat here at Sheppard. We’ve had a few people come in and out of that program. It’s really exciting because it’s just a different way of working, working as a team on one or two cases at a time and seeing them every day. That dynamic is new and exciting for us. And then book-wise, the OCD Workbook for Teens is out there. The second edition of Mindfulness Workbook for OCD is out there. I just started working on a new one that I’m co-writing with a friend on how to combine ERP and DBT.

Kimberley: That’s fantastic.

Jon: Yeah. So, dealing with relentless thoughts and painful emotions.

Kimberley: Nice. That would be so important.

Jon: Yeah, I hope so.

Kimberley: Oh, without a doubt, DBT is such an important piece of the work, particularly when those emotions are really strong. So that’s super exciting. We’ll make sure all of those links to that are in the podcast notes so people can check that. Thank you again.

Jon: Thank you.

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

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

Aug 6, 2021

This is Your Anxiety Toolkit - Episode 196.

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

Welcome back, you guys. We have had a break. We are back. I’m actually recording this before I was back, so I don’t even really know how I feel once this episode will be out, but nonetheless, I have been holding off and wanting to do this episode as the welcome back episode for the new season of Your Anxiety Toolkit.

Elle Warren Your Anxiety Toolkit POdcastToday we have with us, my Assistant, my Executive Assistant, one of the most important people behind the scenes at CBT School and in my private practice. She is my intake coordinator. She is the doer of all things. She was originally hired as my Chief Copywriter. She does a lot of work behind the scenes for me. Her name is Elle Warren. Her and I have been working together for some time now. It has been such a pleasure to get to know her.

She today is going to share with you, just so you know, who it is behind the scenes if you’re ever in contact with us or you’re reading out Instagram posts or a newsletter or emails. She’s doing a lot of this stuff for me and we’re working together very closely. I wanted you to feel like you knew her, just like you know me. She also comes with a beautiful recovery story where she shares her experience with mental health and OCD and health anxiety, and grief, and post-traumatic stress disorder and experiencing, and really coming to find a place of peace with her sexual orientation. It is a beautiful, beautiful episode. I’m so, so excited to share it with you.

Again, I want you to feel like you know us. I want you to feel like you trust us and you know who’s behind the scenes, and that’s why this was so important to me. So, I hope you do enjoy the show. Elle really does share her story so vulnerably. If you do notice some background noises, Elle was in a really rural location, a lot of background noise. So, bear with us there. We were doing the best we can. I wanted to make sure we had this episode recorded before we left, so please bear with me. The content is still fabulous. I hope that isn’t too difficult on your listening.

In addition, welcome back. So thrilled to be back. I’ve been trying to do episodes through the school year and then take some time off for the summer. This season, we have some big plans, some amazing guests. I am really dialed in with specifically what I want to address this season. So, get excited about that.

I hope you’re well. I hope you’re being kind to yourself and you had a lovely summer and you had some time to rest and recover. I will share here very soon about our trip and what happened and what I learnt and what I experienced. I always like to refer to a couple of reflections later on, but first, I hope you enjoy this episode with Elle.

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Kimberley: All right. Welcome, everybody. This is a really wonderful start to another season of the podcast because I have here with me one of my core team members, Elle Warren. Thanks so much for coming on, Elle.

Elle: I’m so excited to be here. Thank you for having me.

Kimberley: All right. Let me share. I know everyone’s listened to the intro, but let’s just talk about how important you are as a part of helping me. I’m so grateful for all the work that you do to help me, so thank you.

Elle: Yes. I love it.

Kimberley: Yeah. The reason that you’re so special is because you’re so special. But in addition to being so special, you’re so wonderful as a part of this team because you get it. You get what we’re talking about, and that’s why I’m so grateful to have you on our team. I’d love to spend some time you sharing that story if you’re comfortable and telling us a little bit about your background. Do you want to give us an intro to your story?

Elle: Sure. Yeah. It is a long and winding journey, but I will try my best. I have had OCD for as long as I can remember, but I did not know that it was OCD until about two years ago. I was only actually diagnosed in February of 2020, so right before the pandemic, but I had been learning a lot on my own before that and came to that conclusion. Big themes for me growing up were sexual orientation, health anxiety, safety things. I remember I would always ask my mom for reassurance all the time. And then my mom passed away a little over three years ago now when I was 20, and that was the catalyst for my mental health feeling more unmanageable. I started having panic attacks. I was later much more recently diagnosed with PTSD from her illness and death and all of that as well. At the time, I just thought that my brain was broken, that I was broken. I can see now that it was just the intersections of OCD and PTSD and grief that is a pretty nodded up ball of things. So, that’s an overview.

Kimberley: When did you notice these symptoms first start? Was it in childhood, you said?

Elle: Yeah. I can definitely look back and see it in childhood. I remember one time when I was little, I don’t know, I was probably five or six, and there was a storm going on outside and I was so convinced that a tree was going to fall on our house. I remember I just kept asking my mom, “The tree was going to fall on our house.” That’s one example.

Kimberley: Did your mom suspect anything? I mean, was that something that was in your family, or was that just like Elle being Elle?

Elle: I think no one really talked about mental health in my family. I know now that there is a history of mental illness, at least on one side, maybe on both, but it wasn’t talked about at the time.

Kimberley: Isn’t it crazy when you find out, after the fact that you have this whole long line of genetics? It’s like, “Why didn’t I get told this information?”

Elle: Yeah, exactly. Right. It’s like, okay, there were definitely some signs that could have been. I mean, I don’t blame my parents. They were only doing what they knew and what they were taught, but it would have been nice if those things were acknowledged and then noticed earlier on and if treatment was offered earlier on.

Kimberley: Right. Sometimes it’s that our parents didn’t even know they had stuff. Often not even a parenting blunder. It’s like they had no idea the words to use to describe things either, right?

Elle: Right. Exactly.

Kimberley: Yeah. Do you want to share that about your themes? For those who are listening, we will share at the end that you’ve written some amazing blogs for us and we will make sure we have those in the show notes, but do you want to share about the specific themes that you’ve struggled with?

Elle: Yeah. I think the most significant one, like I said, was the sexual orientation one. That was definitely the one that I can remember taking up the most time and causing me the most distress. One day when I was probably 12 or 13, I was in middle school and I remember I was sitting on the sidelines at cheerleading practice and I had this memory come back to me of this girl in my neighborhood that when we were little, we used to kiss sometimes, which is a very innocent thing. We were four years old. But I agonized over that and wanted to know what it meant and be certain of what it meant. I grew up Catholic and I grew up in a relatively more conservative area, so to me, the idea that I could be anything besides straight was just unthinkable. I think I said this in my blog post about it, but almost equivalent to remembering I had killed someone or something super dramatic like that.

Kimberley: And that was because of what you’d been taught?

Elle: Yes. Really from the ages of 13 to 20, 21, that was a really big thing. It would come in and out, like I’d let it go for a little while, and then it would come back in full force. I would be imagining scenarios in my head all the time and trying to predict how I would feel in them. I would look at people when I was out and ask myself if I was attracted to them and all of that. Now, I identify as bisexual. I think that adds to it as well because bisexuality is often invalidated and there’s the pressure to pick a side and all of that. I didn’t really know. I didn’t know much about my bisexuality. I didn’t know anyone that was openly bisexual. I didn’t see people on TV that were bisexual. I think it was not only hard for me to accept that I could not be straight, but it also didn’t really feel like a possibility that I could be open to more than one gender.

Kimberley: What was that transition like? It sounds like from what you’ve told us, there’s this absolute struggle with this idea at the start and it being a lot of uncertainty. I think you’re mentioning you have a lot of rumination around that. How did you get to the place where you are now?

Elle: After my mom died, about a year after, I ended up moving from Michigan to Denver. Denver is what I would call a fairly liberal city. I knew a lot of people that were open with their sexuality and I wasn’t around the people that have known me my whole life, because it’s a lot harder to go against the expectations of people who have known your whole life. It’s different when you can create the self that you feel like you are when you can start with that.

I think I felt like I had the freedom to explore who I really was. I knew I had people that I could identify with. Also, I think the experience of losing my mother, who was the absolute, closest person in my life, I think it just made me less afraid, in general, because, it sounds cliché, but it was like, you’re hit with the fact that time is limited, and you don’t want to waste it. You don’t want to waste it by being unhappy or hiding parts of yourself. I think in general, it just made me a lot less afraid and less timid because I realized that if there’s so much out of my control, I’m definitely not going to waste time not being who I am.

Kimberley: You move from a place of being uncertain to just fully accepting radically who you were and just waited to land wherever you landed. Is that how the shift was?

Elle: Yeah, pretty much. I don’t know. I remember I was laying in bed one day trying to go to sleep and it just went off like a light bulb in my head. I was like, “Oh, I’m--” other times, pansexual has felt more, right? Truthfully, I don’t get too caught up in a specific label, but at the time I was like, “Yeah, I’m not straight.” It just went off like a light bulb. I think maybe the groundwork for that was laid by the radical acceptance that I had cultivated for my mental health, because like I said, after losing my mom, my brain and my nervous system really went into overdrive and my mental health was really, really, really a struggle. But at that point, I had cultivated a lot of acceptance and self-love for that. And so, I think maybe that foundation was laid there and then paved the way for me to also accept my sexuality.

I think I just realized that it actually doesn’t matter that much. These days, I embrace the uncertainty. Like I said, I don’t care that much about the label. If bisexual feels right now, cool. If lesbian feels right one day, cool. I more so just have the attitude of like, I’m going to date who I want to date and listen to my heart. The certainty doesn’t actually matter.

Kimberley: Yeah. It’s such a cool concept too. I think a lot of the interviews I’ve heard around sexual orientation is like, “Oh, I had all this uncertainty and I did the treatment and none of my fears came true or whatever.” You know what I mean?

Elle: Yeah.

Kimberley: I love that you’re really walking the walk because you had fear and uncertainty and you just continued to be uncertain. It’s not like you have some resolution at the enemy. There was. But I love that you’re just in a place of just being at it. It is what it is. I feel like that’s a story that’s missing when it comes to sexual orientation OCD.

Elle: Right. I think that’s a really good point because it’s true. The uncertainty didn’t go away. My attitude on the uncertainty just changed. I think you’re getting over the hump of shame that comes along with non-heterosexuality is a big part of that too, because I’ve seen on social media, I feel like a lot of people, it really scares them that someone else who had sexual orientation OCD actually turned out to be not straight. I think that that’s scary for a lot of people. That’s a whole other thing. That’s not just OCD, that’s the shame that many of us have grown up associating with non-heterosexuality.

Kimberley: Right. That internalized stigma that is placed on us.

Elle: Right.

Kimberley: I really love when you wrote that article and we will share it again, and you share a lot of this story. I really do love it because I really worry sometimes when I see Instagram posts and things of like, “Everything I’ve ever worried about never came true.” You know what I mean? I see that’s true for a lot of people, but it is a form of reassurance almost of like, “Don’t worry, your fear is just a thought.” I think this is an opportunity to fully embrace these concepts. The thing I love about what you’re talking about the most, and I don’t hear enough people talking about it, is it’s coming from a place of just genuine love. Not from a place of like, “Well, my therapist told I have to radically accept it.” You know what I mean?

Elle: Yeah. Right.

Kimberley: Yeah. Thank you for sharing that. I’ve just loved that story so much, even though I hate that you have gone through a difficult time. You talked about your moms and the grief around that, you talked about how her loss helped you move into radical acceptance, but how else did that impact you and your recovery or your struggles?

Elle: In so many ways. The person that I was before and the person that I am now are two very, very different people. I think the biggest thing is like, my mom and I were very close. I’m the youngest of four kids and I’m the youngest by a lot. So, I definitely got my parents, especially my mom, all to myself a lot. I was very emotionally dependent on her. She was a huge source of love and the most loving mom that I could have asked for. That said, I hadn’t really learned how to mother myself, how to be my own source of love and affirmation, and all of that. That’s terrifying to just be dropped into.

I think the ideal situation, if we all got to have ideal situations, would be that we gradually get to that point. We grow into adulthood while we still have that support, which is the same, my dad is supportive but in a very different way. I felt like there was no one there to hold me up or to witness me. I just felt very alone. She was, I think, the person that I was the most vulnerable with. So, not having that just was really scary. I didn’t know how to cultivate that in myself for a long time. I do now, which is a really good thing.

Kimberley: How did you learn that? I feel like I don’t know how to do that really, really perfectly. You know what I’m saying? I think there should be a course in middle school that teaches you how to do that.

Elle: Yeah. There should be. I think part of it is like, what I learned from her in terms of how she cared for me, I think that I tried to replicate that for myself. There’s a lot of trial and error and it was a lot of not wanting to do it, but I’m making myself do it just in terms of making myself meals, getting out, and going for a walk. Very basic things. Because when you’re in the thick of something like that, the basic things are still hard things. I think it came from this almost outside source of love that I have for myself and the life that I know that I want for myself. It was like, I knew that I deserved that and I knew that I could get there someday again. This is a cliché metaphor, but I felt like I just needed to climb this mountain. I felt like I just needed to keep taking steps. And then maybe eventually, I would be able to see out over the top.

I do have other familial support as well. I have siblings and my father. In terms of some other ways, it’s affected me. It definitely did not help my health anxiety because throughout the time that she was sick, there just were a lot of fluke things that happened, a lot of things where doctors would be like, “Huh, we’ve never seen that before,” things like that. So, that has been an increased challenge.

Kimberley: Are you still working through that? I mean, that has to be really scary because that’s what the voice of OCD says, right? Like, “This one symptom is one of the symptoms that’s going to kill you,” kind of thing. Given that that was your experience, how are you managing that?

Elle: It’s definitely gotten better over the years. Something that I still struggle with, it’s-- I dunno. I’m a lot better at recognizing when I’m in an OCD spiral. I can usually, most of the time, be an observer of it and notice what’s happening. I also did choose to go on medication just earlier this year. For me, that has been really helpful.

Kimberley: And that helps with the health anxiety or for the grief or for a combo of all?

Elle: It’s helped in a lot of different ways. Honestly, it’s helped with the PTSD symptoms a lot and it’s helped with OCD symptoms. It’s helped with depression symptoms. I mean, it can be hard to pick out which is which because they all feed off of each other. I feel like even if it’s really just helping with one of those things, it helps all the other areas too. But just in general, it’s been a game-changer.

Kimberley: What degree did you have to practice exposure and response prevention for all of these symptoms? Was that a part of your work? How did you navigate all of that? Did you do it on your own? Did you have a therapist?

Elle: I have only practiced ERP on my own. I have a therapist that I was working with for quite a while. I think I was seeing her regularly for probably two years. I found out, this was only maybe six months ago, just through us talking, I learned that she didn’t understand OCD really at all. So, I don’t see her anymore. I just try to do ERP on my own every day, and that has worked for me so far, honestly. I would like to work with an ERP-trained therapist at some point, but right now, that still has made a huge difference.

Kimberley: Right. How was it to do it on your own? I mean, a lot of people, this is a common question I get – “Do I need to have an ERP therapist?” Of course, with CBT School, we have the course. We have ERP School. “Is that enough? Or could I do a workbook or could I just go off of what I’ve seen people do on social media?” How did you bring yourself to do that? Is it just by your own education? How did you learn?

Elle: I feel like I started doing it really before I even knew what it was called, before I even knew that it was like a thing because again, I just kept going back to the vision that I had of myself and who I wanted to be, who I knew I could be, my love for myself. But I think that that can sound really romanticized like, “Oh yeah, I just did it on my own, and I’m pulling myself up by my bootstraps.” But it was hard.

In retrospect, I probably should’ve asked for more help than I did. I mean, I don’t fault myself for any of this because you can’t know what you don’t know, right? But I wish I would have been more honest with the people in my life about how poorly I was really feeling. I’m proud of all of those exposures that I did every day. Sometimes it feels and felt literally like you’re walking into the jaws of a shark and you don’t know whether or not you’re going to come out. It really does feel like that. That’s not easy. I think having someone to support you through that and walk you through that is probably really helpful.

Kimberley: Right. It sounds to me like you use naturally a lot of, and I could be wrong here, tell me if I’m wrong, but a lot of what we would call acceptance and commitment therapy tools, like your values really left you, led you down the road you wanted to be at like, “What do I want with my life?” Sometimes that voice and that question, remember, we talked about asking good questions. That’s a really good question like, “What do I want for my life?” I think that can sometimes lead us in that direction. Would you agree with that?

Elle: Yeah, I would. I think that that is what was carrying me through a lot of the time.

Kimberley: Right. I have one more question if you’re willing to share. What was it like for you to have PTSD? A lot of people I know have either been misdiagnosed with PTSD and then find out they have OCD or they find out they have both. What did that look like for you?

Elle: For me, it was a lot of not being able to focus, not being able to be present. I felt really depersonalized and/or derealized much of the time. The panic attacks again, like I said, and the memories always felt very close. They didn’t feel like things that happened a while ago. They felt like things that just happened. Honestly, that’s been a big difference that I’ve noticed with the medication is that I can say they feel they were things that happened a long time ago. It’s still painful, yes, blah, blah, blah. But it happened a long time ago. The way that I would describe it at the time, I remember thinking about this metaphor, it felt like my brain was just this mass of cross wires that were sparking, and again, it felt broken.

Kimberley: Yeah. That’s a really interesting metaphor. I think a lot of people would really resonate with that. Memories, cross wire, everything’s misconnected, and so forth.

Elle: Right. Because it changes the chemistry of your brain.

Kimberley: Right. Yeah. Thank you for sharing that. It’s something we don’t talk about a lot. It's something that I’m actually in the process of being trained on more extensively because I think a lot of people do have PTSD and it has been misdiagnosed or underdiagnosed. I’m so grateful that you’re sharing about that. Thank you. I know it’s not easy to share that stuff.

Elle: No. I’m honestly really grateful to be able to because I think younger me would have appreciated hearing something like this a lot.

Kimberley: Well, before we finish up, I have a couple of questions, not related to your mental health, but just more related to you and I because I love what you’re sharing here. I’m so grateful you shared this information because I think there’s a story here that I think a lot of people may resonate with or be appreciative of to see that you’re on the side where you’re at right now. It’s very cool. What is it like to work for a CBT School? Go ahead. I didn’t tell you I was going to ask you this question. You can be as honest as you want. What is it like for you to work in the work that we do? And again, you don’t have to make it sound good.

Elle: I’ll tell the truth. I appreciate being able to share information that, again, I would have needed or has been helpful for me along this journey. Also, they’re good reminders for me. If I’m writing something about self-care or whatever, then I’m like, “Okay, it’s a good reminder. Okay, I need to practice what I preach.” They’re good check-ins. Also, doing it on social media platforms is just a really powerful reminder that, “Oh yeah, it wasn’t just me. This isn’t just me. Lots of people feel this way, and they also have worried that it was just them.” That’s really connective. Obviously, you relate to this – I need to be fulfilled by my work and I need to feel like it’s purposeful and I need to feel like it’s connective, and it is those things.

Kimberley: Am I just the biggest pain in the butt boss you’ve ever had? You can be totally honest. I am totally a pain in the butt boss. I know I am.

Elle: No. I do tell people how much I like working for you. You have been definitely, I would say, the most understanding and flexible boss that I’ve had.

Kimberley: I think that’s because I was going to say, nearly every staff meeting, we made it almost this time. I think every single time I go, “You’re going to have to bear with me. I’m all over the place today,” I have to apologize for how messed up everything is. I’m like, “You’re going to have to forgive me. I have no idea what I’m doing.”

Elle: Right. It’s like we’ve said in posts before, like being imperfect, it gives other people permission to be imperfect.

Kimberley: Right. I agree. Thank you. When I asked this, I was like, I wouldn’t doubt if she was like, “Oh boy, I feel uncomfortable, I don’t want to tell you the truth.” For those who don’t know, Elle and I meet, and we go through probably 40 things we have to get through. We have this whole list of social media or newsletters and podcasts and SEO and websites and all these things. I think every time I started going, “I really have no idea--” I will add, which I think is hilarious, is that Elle went on a vacation recently and asked me to do some of her jobs. I actually had no idea how to do that. I literally had no idea how to do the jobs that you do for me. Thank you so much for being my friend and helping me in those moments.

Elle: Yes, absolutely.

Kimberley: Right. I’m like, “I have no idea how to call my own clients,” or “I have no idea how to write my own email here, help me.” I’m so grateful for the work that you do. I think that you have a voice. Again, you actually came on to CBT School as the copywriter, as our Chief Copywriter, and your voice is so exactly the voice we need. Your compassion and your experience and your kindness – it’s wonderful.

Elle: That’s awesome. I’m so grateful that we have found each other.

Kimberley: Yeah, me too. I’m so, so grateful. Before we finish up, tell us where people can find out about you or get your information. Besides the work we do here, where can they get your personal stuff?

Elle: Yes. You can find me @griefgurlwithocd on Instagram. I spelled girl G-U-R-L, and everything else is spelled normal. I’m not super active on it, but I do love getting messages from people. Feel free to reach out there.

Kimberley: Thank you. All right. Everyone, I’ll link the blog that you wrote about sexual orientation OCD. They can read that too. Thank you so much for coming on.

Elle: All right. Thank you.

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