In today’s episode of Your Anxiety Toolkit podcast, you will learn how to meditate to reduce anxiety. You’ll also learn which meditation is best for anxiety and how to find a meditation practice that suits your lifestyle and your recovery needs.
With the pressure of today’s society and the news being so scary, people are rapidly turning to meditation as a powerful tool to calm their minds and ease their anxiety. My name is Kimberley Quinlan. I am a licensed therapist and anxiety specialist, and my hope today is to teach you how you can use meditation to help manage and reduce your anxiety.
Now, what is meditation? Meditation is a training in awareness, and the goal is to help you get a healthy awareness and understanding of what is going on in your mind. So often, our minds are like a puppy. They are just going all over the place, jumping, skipping, yelling, screaming, and going in all different directions. If we aren’t skilled, and if we aren’t intentional with that, we can be off with that, off down the track in negative thinking, scary thinking, and depressive thinking.
There are many benefits of meditation for anxiety relief. Meditation helps train your brain. Now, there are so many benefits to meditation for anxiety relief, and I want to share with you some of those benefits.
The first one is, it rewires your brain. It reduces the activity in the amygdala, which is the part of the brain that is responsible for the fear response. Meditation can also lower stress hormones such as cortisol. It can increase the production of those feel-good neurotransmitters like serotonin and dopamine. This is really important, particularly if you struggle with depression.
It can also shift the brain chemistry and lead to improved mood, reduced anxiety, and an overall sense of well-being. We could also argue that this would be helpful for anybody, even if they don’t have anxiety.
We also know that meditation cultivates mindfulness, which we talk a lot about here on Your Anxiety Toolkit, which is the practice of being fully present and nonjudgmental in the moment.
Meditation increases self-compassion and acceptance, which I think we all agree can help us with our mental health, and it helps reduce negative thinking patterns and also reduces self-criticism.
Now, there are a couple of problems here, though, with meditation. Often, when people come to me, they'll say, “I don’t know about this whole meditation thing. It sounds a bit like a cult or a bit like a scam or a fad, a psychology fad.” Often, that’s because people have a misled idea about what meditation is and how it works.
One of the main problems that I hear is that people expect that meditation will, poof, make their anxiety go right away. As they’re practicing meditation—and it is a meditation practice—as they’re starting to practice this meditation, they’re getting frustrated because they’re thinking, “This isn’t working. It’s not making my anxiety go away.”
We want to first challenge the idea that meditation is not a quick fix. It’s not something that’s going to, poof, make your anxiety go away, but there are so many benefits that I will talk to you about here in just a second.
Another problem that people have with meditation is they get frustrated with the practice. They have these expectations that they should be able to do it. Well, simply because it’s often sitting or very stationary, they assume, “I must be really good at this. It’s such a basic task.” But the truth is, it’s not. We have to remove those expectations that we will be excellent at it, that it should be easy, or that discomfort won’t arise.
Another problem people have is that they do experience anxiety while they’re meditating, and they’ll say, “I’m here to get away from my anxiety, but when I’m meditating, everything is still, and I actually feel more anxious.” We’ll talk about that here in just a second.
People also don’t like meditation because they have been told that the solution to anxiety is to make it go away. And so, what would this mindfulness meditation practice really do if we’re actually just sitting there thinking? What a waste of time, actually putting more focus on the actual problem of anxiety. Again, not true, but these are the common problems people have.
The last one is, people say, “I don’t have time for meditation.” I always laugh because I do know that the Dalai Lama said, “For those who don’t have time to meditate, they’re the ones who need to meditate twice as long.” That always made me laugh because there’s been many times where I’ve said, “Oh, I don’t have time today,” and I laughed thinking, okay, even more important that these are the days that I focus on meditation.
Let’s talk about which meditation is best for anxiety, because I know you’re here to talk about how meditation can help with your anxiety. Now, there are many types of meditation. No one really agrees what the best one is, and no one really even agrees on the specific types because there are so many and so many modifications. But here are some options—we will also talk about later how to apply these to your anxiety disorder—that you may want to consider.
The first one is mindfulness, or what we call Vipassana meditation. Now, this is a meditation that really helps you become skillful in how you respond to your intrusive thoughts, your feelings, and your sensations.
Another type of meditation is body scan meditation. This is very body- and somatic-centered in that we’re focusing on different parts of the body, often with some kind of relaxation technique to slowly move down the body and move us into a place of relaxation.
Now, there are pros and cons to this meditation. Some people find it very relaxing, especially when we’re looking at getting sleep. Others find that, again, their expectations are very high, and then they get quite frustrated when they’re unable to get relaxed, because the truth is, when we’re anxious, when that amygdala is firing in our brain, it is really hard to relax. Sometimes meditation in and of itself is not going to fix that. But a body scan meditation is a really effective one, particularly if you’re trying to slow down the nervous system. Maybe look at trying to get some sleep, a nap, or some rest.
Another type of meditation is visualization meditation. This is where you actually visualize something happening to you. Maybe you’re walking along a path or along a beach. You’re in a relaxed setting. Let’s say you’re an athlete. It might be visualizing you doing the activity, the exercise, or the skill that you’re practicing—a layup for basketball, running a marathon, or so forth. The visualization can help with empowerment. It can help promote creativity. It can help create a sense of mastery over something that you haven’t yet mastered.
Another type of meditation is walking meditation. This is a great one, particularly if you’re someone who is very sedentary during your work. I am one of those people. I sit a lot during my day. Walking meditation is similar to mindfulness meditation in that you’re very aware of the present moment, what it feels like for your feet to touch the ground, for the balls of your feet to touch the ground compared to the heel of your feet, what it feels like for the wind to blow on your face, or what it feels like for the weight balance, going from left foot to right foot, and so forth.
Another type of meditation practice is self-inquiry meditation. This often involves inquiry or curiosity to who I am in this moment. It might be, who am I as I hear these sounds? Who am I when I have these thoughts? There are some pros and cons to this for those with anxiety. Sometimes, when we have anxiety, we already spend a lot of time doing a lot of self-inquiry or self-rumination about who we are. What’s our identity? Are we good? Are we bad? This type of meditation can be beneficial for some, but for many people with anxiety, they may find it not helpful at all unless they’re with someone who can very much direct them and keep them on track with the active inquiry instead of going into rumination.
Another type of meditation is mantra meditation. This is where you repeat a mantra, a phrase, or a sound over and over again. It’s about the training of the mind and the training of discipline for one specific sound, tone, or word. It can be very helpful, again, if there’s a particular intention you’re trying to go towards. But again, for those folks with anxiety, this can be very frustrating because, again, there’s sort of this attachment and expectation and clinging to a certain outcome. For those of us who have anxiety, that can actually create a lot of distress in our bodies. Not to say that any of these are bad or good; it’s just dependent on your specific set of situations.
One that I always love and talk about all the time is loving-kindness meditation. This is an act of compassion where you send yourself others and all sentient beings loving kindness and care. It is a way of generating, practicing, and nurturing self-compassion. It is a beautiful way to be in connection with people out in the world that maybe we don’t have a connection with, particularly if we’re lonely or feeling isolated and alone. Loving-kindness meditation can be so beneficial to people with anxiety or depression, OCD, health anxiety, and so forth if they’re feeling so alone and they’re really very hard on themselves. Loving kindness is absolutely a beautiful meditation for people with anxiety.
Another type of meditation is zazen meditation, which is a specific zen meditation where the goal is to be focused on a direct experience of this present moment. The main goal is non-attachment. The goal is to allow everything to be just as it is. It’s a very disciplined practice, but can be very beneficial to people who have anxiety.
The last two: number one, breath meditation where you focus on the breath and you have that as your focal point. This is very beneficial for people with anxiety. The only thing I would say is, for those who have somatic obsessions of a specific type of OCD, if your somatic obsession is already focused on the breath, we actually then wouldn’t practice this because it would actually add to their hyper-awareness. But overall, breath meditation is a very beneficial practice for people with anxiety.
And the last one is a sound meditation. This is where your focal point is on sound. Very beneficial for those with somatic obsession and very beneficial for people who really like the vibration of sound and really love music, and music is something that grounds them, lifts them up, motivates them, and so forth.
There are different types of meditations and some pros and cons, but there are some specific things I want you to know and remember as you start a meditation practice and while meditating, because so many people have come to me to say, “I don’t like meditating. It doesn’t help me. Therefore, I’m not going to do it.” I feel that that is such a shame because meditation can be such a powerful mental health practice. It can be such powerful training for the brain.
I often say to my clients, when you start to notice some tightness in your knee or some shoulder pain, you don’t just ignore it. You think, okay, I have an opportunity to strengthen that muscle around the knee or stretch out that shoulder. We usually move in and do some work, exercises, and practices to create an environment where that pain can go away. I think of meditation as being exactly that. It’s like physical therapy for the brain, and it can help. Like I talked about, there are so many benefits to meditation, but it does require that we do it specifically in a way that doesn’t make more anxiety.
Now I have a really exciting thing I want to mention to you before I get into all the things I want you to remember as you move into your meditation practice. Because so many people have come to me and said that they’ve listened to meditations online, they’ve gone to meditation trainings, and they actually found it to be not helpful for their anxiety, for their intrusive thoughts, or for their depression.
I have created an online meditation vault specifically for those who have anxiety and repetitive intrusive thoughts. My goal with this meditation vault is to make it very informative for the person who struggles with high expectations and rapid, repetitive intrusive thoughts, and I try to bring that concept into the meditations so they’re specific for people with anxiety.
There are over 28 meditations. There are specific meditations for people with OCD, health anxiety, social anxiety, panic, generalized anxiety, and depression. There are meditations on sleep, meditations on compassion, meditations on mindfulness, and meditations on strong emotions like guilt and shame. I did my best to pack them all into one specific place so that you have a wide range of guided meditations specifically for whatever it is that you need. There’s even a meditation for people who don’t want to meditate. I felt that that was really, really important.
You can click the link in the show notes below if you’re interested. You can also go to CBTSchool.com to get information about the vault. It is very low-cost. I want it to be low-cost so everyone can access it, and I’m so excited for you guys to check that out.
If you are wondering how to meditate to reduce anxiety, there are things you need to remember as you practice meditation.
Do not expect anxiety to magically disappear. Number one, if that were to happen, it probably wouldn’t be for very long anyway.
I want you to imagine this practice as the slow and steady growth of a muscle. If you were going to train at the gym, you wouldn’t go straight in and pick up a hundred pounds right away. You would start low; 10, 15, maybe 10 to 12 and a half, then to 15, and you would slowly work your way up. You wouldn’t have these expectations that your body would be able to pick up a hundred pounds at a time without pain afterwards. You would go in knowing that the cost of this is going to be that I may get pain if I overdo it, and I want you to think about that with your meditation practice as well. Not that you’ll have pain, but that it’s healthy to take baby steps and do it slowly and steadily.
Another thing I want you to think about is, again, to think of this as an opportunity to change the way your brain responds to anxiety. Think of this as an opportunity to change how you respond to discomfort, how you act in your daily life, and how you can change your habits to benefit your mental health.
Often, people will ask: how long does it take for meditation to reduce anxiety and stress? The answer here is very simple, which is, let’s not put pressure on that to be the outcome. I know you came here to learn that exact answer, but the thing to remember here is, the more we resist anxiety, the more we want it to go away, the more we try and avoid it, the more we’re feeding to our brain that it’s dangerous and scary, and it will make our brain send out more stress hormones.
We want to use meditation as an opportunity to train our brains that we are no longer going to run away from anxiety and stress. Instead, we’re going to open up a space for anxiety and stress and have it be a safe place. Have our bodies and our minds be a safe place for anxiety to rise and fall. It’s important that we understand that this, again, is an opportunity for you to change your specific emotional reaction to having anxiety and stress.
Now that being said, I will still answer the question, which is, I think within time, you will probably see a very significant improvement. Most research shows that a short meditation practice of four to six weeks will significantly reduce people’s stress and significantly improve people’s relationship with their anxiety.
I often say to my patients, give it 30 days. Go in with a solid commitment to practicing as often as you can for 30 days. Track your anxiety; maybe even put it on a scale from 1 to 10. If you’re able to do it in this way, where you’re not trying to get rid of anxiety but instead trying to make it a place where you can have anxiety and not respond with judgment, criticism, and resistance, you’ll probably find that you’ll have significantly reduced levels of anxiety and stress after 30 days.
Now, again, I want to emphasize that there is significant research to show that meditation for stress is very beneficial. In fact, we’ve found that practicing meditation again downregulates your stress response. It reduces your nervous system’s activity and reactivity to stressful events in your life and can greatly benefit your overall well-being. Definitely, if you’re someone who’s struggling with a very stressful time, and I think we all are given that the news is so, so painful right now, I think it’s a beautiful opportunity for us to start a meditation practice.
Another thing I want you to remember here is that by practicing meditation, you widen your window of tolerance. Now, what does this mean? I’ve talked about it on the podcast before. If your window of tolerance is very narrow, it means, as soon as you have any kind of strong emotion, strong experience, sensation, or pain in your body because you haven’t practiced being able to tolerate that, you are very much more likely to rely on unhelpful safety behaviors to cope with that distress.
In discomfort, as I mentioned, we actually widen our window of tolerance. The wider we can have this window of tolerance, the more likely we are to be regulated when we have a lot of emotions. We can be steady and really intentional in how we respond. We are more likely to act according to our values than according to our fears. So we want to practice widening that window of tolerance. There is so much benefit to doing that.
Another thing to remember, and I’ve mentioned this already, but I think it’s really important as we finish up, is to not put pressure on yourself to get this right. I will often say to clients, and I say it all the time in the meditation vault over and over again, expect anxiety to show up over and over again. Expect your mind to go off track and go off and think about the grocery list. Your job is to bring it back to the present moment.
Don’t be upset with your brain for going off track. That’s its job. Its job is to be highly functioning and thinking about all the things. But the training and the benefit is that discipline to bring you back to the focal point that you’re on right now, depending on the type of meditation that you’re doing.
I hope that you can practice letting meditation be messy, because it is. Even very, very skilled monks who practice meditation for hours a day still report that there are days when meditation is messy. There are days when your brain will be all over the place like that puppy dog, but with practice, you will start to see an improvement in your ability to be disciplined and intentional with where you put your attention, which again, as I mentioned, reduces the chances of you engaging in safety behaviors that aren’t helpful, reduces the chances of you engaging in compulsions, and reduces your chances of going back down into those negative thought processes. There are so many benefits.
The last thing I want you to remember is, as you begin this practice, be curious. Be open. Instead of being judgmental and rigid about what you think will happen, be curious about what might come from inquiring and moving into this practice.
Meditation has changed my life. It has calmed me in the darkest hour. It has been there for me when I needed support, and I hadn’t had anybody else to lean on. Meditation, as I mentioned, is a practice where you teach yourself to be a safe place for you to experience any emotion at all, and you know that it’s there; you can take it with you wherever you’re at. It costs nothing to practice meditation in the moment, and I hope that it’s something that will bring you as much joy and as much wellness as it has for me.
Have a wonderful day, everybody. As always, it is a beautiful day to do hard things. Again, if you’re interested in the mindfulness meditation vault, you can click the link in the show notes.
Have a wonderful day.
If you are scared to take medication, you are in the right place. Today, we are going to take a deep dive into a very common fear that impacts many people and their recovery, and that is the fear of taking medication. If you’re someone who needs help with this, I think this is going to be really helpful for you.
Hello, my name is Kimberley Quinlan. I am an anxiety specialist, and I help people with anxiety. My hope is to make it an easy and a kind recovery for you.
Now, today we’re talking about the fear of taking medication, and a lot of what I do with my patients in my private practice, which is in California, is really helping them work through that fear. In addition, on my online platform called CBT School, I often get a lot of questions about this, such as whether or not people can take meds, should they take meds, and so forth. But before we get into all that, what I want to share with you first are a few housekeeping points that will keep us on point and in the right direction today.
If you’re someone who is scared to take meds, we first have to acknowledge that this episode is not going to cover whether you should take meds or not. I am not a medical doctor. I am not a medical professional. I am a mental health professional, and I do not prescribe medication. I am not licensed to do that. But I am here to help you manage the fear around it. If you are someone who wants to take medication but is afraid of it because of the side effects, or maybe because of the shame, the guilt, and the stigma around it, my hope today is that we can work on managing that fear and getting you the information and skills you need so that you can speak with your medical professionals and make a decision based on what is best for you.
It is important to remember that every person is different, and it’s important that you make these decisions with your medical doctor so that we’re making a decision based on your medical history, where you’re at in your mental health recovery, your genetics—all of the things that you need to discuss with your medical doctor. But today, let’s get going. We’re talking about managing medication anxiety.
Where did this episode come from? I actually made a post about this on Instagram not long ago, and the response was overwhelming, with people saying, number one, “I’m too afraid to do it. Help me,” and number two, a lot of people said, “I had a lot of anxiety around taking medication. I got the help I needed and I managed it, and now I’m so relieved that I did.” I wanted to spend some time today talking about the reasons people are scared to take an antidepressant or other psychiatric medications or even medications in general.
There are multiple reasons patients do not take their medications, due to fear. In this episode, we are coming the core reasons fears stops people from taking their antidepressants or other medicines.
The number one reason that people reported being scared to take medication is the fear that medication will cause side effects. This is a very common fear around taking medication, and it is true. We will talk about the side effects here later in this episode, but that is a valid concern. But often, people are afraid of the side effects, even though they are not afraid of it being a catastrophic side effect. They’re often afraid of just change, or they’re afraid of what is uncertain and unknown, and that is a big thing for them.
Another reason that people are afraid to take any kind of medication is an OCD fear of taking medication. The reason I say it like that is, it’s beyond just a generalized fear of the side effects. It’s often around a belief of what this medication will do to you.
One example I’ve had in my private practice has been the subtype of OCD called emotional contamination. They’re afraid that by taking the medication, it will dramatically change their personality or that they’ll turn into a different person. There’s a lot of compulsions around that, rumination around that, and avoidance around that. They’re also doing this kind of avoidant compulsions in other areas of their lives as well.
Another OCD fear of taking medication is under the umbrella of health anxiety. A lot of people are afraid that the side effects will be catastrophic, that it will give them some catastrophic medical condition if they were to take this psychiatric drug or any medication in general.
Now, in addition to that, there is actually a specific medication phobia called pharmacophobia, which is a phobia of drugs and alcohol. This is a specific phobia where people are afraid of any and all drugs. Often, in this case, they’re afraid to take headache medication or allergy medication. They’re even afraid to look at pills for reasons that could be plentiful. It could be a learned behavior around medication, particularly if they’ve heard stories of people who have misused drugs and bad things that have happened. That is another reason why people are often scared to take meds.
Another common fear, as we’ve already discussed, is fear of medication’s sexual side effects. Now, for those of you who have a specific fear around the side effects, you have a valid concern. There are some medications that do cause sexual side effects, and we did an entire episode on Your Anxiety Toolkit talking specifically about the sexual side effects of anxiety medications. We had a psychiatrist come on and speak about this. It’s episode 332, and I will link to it in the show notes if your interest is specifically more in-depth information about that. But I will also give some tips and tools to use around that later on here in this episode.
Another fear around taking medication includes the fear of being ashamed or the fear that you’re weak or that you’re stigmatized for taking medication. This is a really, really big one. A lot of people feel that they are weak, faulty, or wrong for needing medication. Now, this is where I slow down and get very transparent. I am very comfortable sharing that I take medication for anxiety. I have, through different stages of my life, needed to take medication for this, and I’m an anxiety specialist, guys. I want to tell you that, not because I want to make this about me, but because I want to share with you that you can have all the tools and skills, and they really do work.
Research does show that if you were to compare medication and CBT, especially for anxiety disorders, Cognitive Behavioral Therapy is actually the number one way to get recovery from these anxiety disorders. But even better than that, the research shows that combining medication and cognitive behavioral therapy is the gold standard. And so, if you’re really struggling, by combining these, this is where you can get massive help with your mental health struggle.
Again, I want to really share with you that even though I have the skills and the tools, I take medication. There’s no shame in that. A lot of times, we often will compare that you wouldn’t feel ashamed for taking diabetic medication. You wouldn’t feel ashamed if you needed medication for another medical condition. There is no shame, no guilt, and no stigma that I want you to take away from this episode from taking medication.
Now, I want to also validate, yes, there is still a stigma. There will be some people out there who may even respond to this episode by saying, “You shouldn’t take meds, and you should try this other treatment,” and so forth. That’s still going to be there. But I want to offer you a degree of compassion and a degree of education that there is absolutely nothing wrong with you if you want to take medication or need to take medication.
Last, the fear about taking drugs is the concern that the medication will be addictive or that the person will become reliant on the medication. We’ll talk about that here in just a little bit, but the one thing I want to mention here is, if you are in contact with your doctor—you’re being constantly followed by your doctor and checked in by your doctor—you can bring up these concerns with them, and they can help determine that. Again, each of the questions you have, you should go to your doctor and bring it up because if you do have a history or if, in generations above you, you have a history of addiction, then absolutely bring that up to your doctor and they can help make decisions around different medications that can help prevent that for you.
MANAGING MEDICATION ANXIETY (SKILLS & STRATEGIES)
Now let’s go into managing medication anxiety. This is where the good stuff comes in. Number one is, I want you to prioritize finding a skilled and trustworthy psychiatrist or medical professional. It doesn’t have to be a psychiatrist. In fact, there are other people who can help prescribe your medication, whether it be your pediatrician, your medical doctor, or your intern. It could be a nurse. There are psychiatric nurses who can prescribe medication. You want to find somebody who’s going to slow down, take their time with you, not just push you through really fast, and answer your specific questions.
Now, when it comes to managing anxiety, OCD, or health anxiety, we usually discourage asking compulsive questions, repetitive questions, or going overboard with the questions. But I do think that it’s important that you give yourself permission and honor your need to ask the questions that you have about the medications you want to go on. That will help you understand the medication, understand the side effects, and understand the pros and cons so you can make an informed decision.
As we’ve said before, we want to understand questions about side effects, sexual side effects, addiction, how long you should be on medications, and what specific side effects you should be looking out for. We want to understand this. We want to know what the norm is for these medications on what it would look like, how fast you can see results, and what this process is going to look like. Don’t be afraid to ask lots of questions.
Now, if you have OCD fear of taking medication or pharmacophobia, a thing you might want to consider is finding an ERP therapist. I’ve had a lot of clients come to me who have consulted with their doctor, and they’ve agreed that medication would be helpful for their recovery and that they required some mental health advice in moving in that direction. What we did is either start by just looking at pictures of medication or we might fill the prescription of the med that they need to take and just have it with them, hold the medication, put it in their hand, smell the medication, and take one with the care and following of a medical professional. Start that process by slowly exposing them and practicing being around that medication to start with.
If you are someone who’s struggling in that area, absolutely consider seeking out an ERP therapist (exposure and response prevention) who can help manage all of that as we go and help with the response prevention piece. Because remember, exposure is not the main work; it’s also catching any compulsions that you’re doing around the medication. Maybe you’re doing a lot of compulsive checking with the medication and so forth.
Another thing I want you to think about is being able to challenge your faulty thoughts and beliefs about the medication. As we talked about before, with those reasons that people are afraid, there is often a lot of faulty, catastrophic thinking around medication. Ones that are common that I see with my patients are, “I won’t be able to handle the side effects.” Let’s say a common side effect for a medication might be some nausea. Then we will say, “Okay, let’s talk about your ability to handle nausea. Have you handled nausea in the past?” Let’s say it’s headaches. “Okay, what could you do if those headaches were to appear? How might you speak with your doctor about those? How might you be able to plan for that?” Maybe it’s like, “What if I have a panic attack if I take the medication?” “Okay, let’s talk about some skills and talk about challenging your ability to manage the anxiety that you feel.”
A lot of people say, “I already have a lot of anxiety. I don’t want to do things that create more anxiety.” Again, we’ll say, “Are you willing to tolerate that anxiety? What are you telling yourself about your own mastery of riding waves of discomfort and so forth?” If you have, let’s say, emetophobia, the fear of nausea and vomiting, “What do we believe about vomit? Do you believe that you can’t handle that?” And again, you may need to defer to an ERP therapist to help you if you have emetophobia, the fear of vomiting and nausea, to help you manage that so that you can take the medications if that’s something you’re wanting to do. We do want to challenge faulty thoughts, and we want to challenge faulty beliefs about medication.
Again, here is where I get really, really passionate about saying: There is absolutely no shame in taking medication. Taking medication does not mean you’re weak, does not mean you’re lazy. It doesn’t mean you’re doing anything wrong. It doesn’t mean that you’re never going to get better, and it doesn’t mean you need to be on it forever. Again, we’re here to encourage you to consult with your medical doctor and be flexible with your recovery.
Now, being flexible is so important here. So often, patients of mine will say, “But what if I don’t like the medication? What if I get on it and I really don’t like it, or it makes me feel terrible and I can’t function?” Well, okay, we’ll cross that bridge when we get there. We’re going to be flexible with this. We don’t have to stay on it forever. Once you get on it, if then there is an issue, we will address that issue. Then we’re not going to spend time before taking the medication trying to troubleshoot all the possible catastrophes and scenarios. We’re only going to take one day at a time, and with each day, we’re going to make measured, skillful, and wise decisions based on the actual events of that day, not on the possible scenarios that may happen, that may be catastrophic that haven’t happened yet.
So often, people who have a fear of medication are responding to things that haven’t even happened yet. I know when I got POTS (postural orthostatic tachycardia syndrome), I was not functioning, my anxiety was through the roof, I was depressed, and the doctors strongly advised me to take medication. A big part of me was absolutely like, “What if this makes it worse?” and all these things. I had to just say, “Kimberley, be present. Stay with what’s happening today, and we will address that as it goes. We’ll cross that bridge when that happens. If that does happen, we will speak with a medical professional. We will take one step at a time and we will do what we need to do.” We want to catch that anticipatory anxiety about medications and the anticipatory anxiety about the side effects. It’s very, very important that we catch and manage that as we go.
Another thing to remember here is, you have to be willing to have side effects. As you go on medication, you have to be willing to feel some feelings that may be uncomfortable. As I mentioned, common side effects: headaches, nausea, tiredness, maybe a little jittery, and so forth. Again, I want to keep prefacing: please speak to your medical professional about the side effects because each medication is different. But be willing to have side effects. Again, being flexible, knowing that if this medication doesn’t work for me, we can try something else. I know for me personally, I had to try five medications before I found one that fit me. Five. It took a long time. I had to taper up and then I had to taper down, and I had to try another one, which brings me to the next skill I want you to practice, which is patience.
I just kept honoring my own needs and said, “I’m going to be patient with this process.” A lot of my patients have found one medication that was prescribed by their medical professional and found that it was great. It’s worked for them straight away. But we want to be patient, and we want to be willing to have a lot of different sensations. I’m not saying you will, but we want to be willing. I actually have a whole other episode on Your Anxiety Toolkit called How to Have Uncomfortable Sensations. If you’re struggling with that, that may be a good resource for you to use as you go through this process as well.
Now, if you have, or if you’re afraid of sexual side effects, again, I talked about listening to that episode, but I will also say one thing that they did say in that episode: It is okay to seek out a sex therapist or try other skills, such as a skill called sensate focus, or speak to your medical professional about that.
Now, there are a lot of meds that do not have sexual side effects. If that’s something that is a concern for you, please mention that when you’re seeing your psychiatrist or your medical professionals so that they can pick a medication that will reduce the likelihood of that. Again, we don’t want to catastrophize about potential problems that haven’t happened, but it is okay to bring that up if that’s important to you.
Now, of all the things and skills I’m going to give you today, the one thing I really want to emphasize is, please give yourself lots of space and lots of permission to rest during this process as you begin medication. I remember when I first went on medications, my mom actually said to me, “Hun, why don’t you just use this time? Thin out your schedule and give yourself lots of time to rest. If you do have side effects, then you won’t be overwhelmed with trying to work and push through.”
Any way you can during this process, take as much help as you can, whether that be neighbors helping you pick up the kids, grocery delivery, whether it be you don’t clean the house this week and you just let things sort of slide a little. You let your colleagues, your teacher, or your coworkers know that you’ve started a medication and that you might be feeling well.
Take as much space and take as much care as you can as you start this process. It is scary. It is anxiety-provoking. I’m not here to tell you that it won’t be, but what I am here to say is we can do hard things. How can we support you as you make this value-based decision? How can you find help, support, and care as you lead forward with your values? You’re not letting fear stop you anymore. You’re doing the hard thing. You’re taking the step for your long-term recovery, even though it’s the hard one. How can we be very kind, compassionate, and effective moving forward as you move through this process?
The next tool I want you to think about is being mindful around the side effects. What I mean by that is, when we do have side effects, we can be non-judgmental, we can stay present, and we can stay in non-resistance to that side effect if you have any. What we know here is, research does show that mindfulness practice does reduce people’s experience of suffering. What we mean by that is, if you’re suffering, your experience of it could be, “This is very, very bad,” or your experience could be, “This is tolerable and doable, and I can handle it.”
How can you take the judgment out of the side effects? When you’re having them, are you catastrophizing, saying, “This is terrible, this is bad, I can’t handle this,” or are you saying, “This is neutral and tolerable, and I can manage this”? If you’re having a side effect, are you resisting it, pushing it, and fighting it, or are you giving yourself permission to be uncomfortable, and are you willing to allow those sensations to rise and fall?
As I’ve already discussed, one of the points I had here in my notes is to remind you to always put your values first. If you believe that medication is the right choice for you, lead with that value. Do not let fear interfere with your decision here. That was a lot of rhyming words, but we’re going to go with it.
The next thing I want you to think about is to talk with your doctor about whether it would be helpful for you to log any changes. I find that it’s very beneficial to log your symptoms. The day you start taking your meds and how many days you take that meds, you probably will need to taper up maybe, depending on what your doctor has told you to do. Take note of when you change any medications. Are there any changes in your anxiety? Is there any change in your mood? What side effects are you experiencing? And that will be there to help when you talk with your doctor next about how it’s going and whether it’s actually the medication.
I know a lot from my patients, they’ll say, “The medication is definitely causing this problem for me. I’m tired all the time.” But actually, if they’ve logged, we can see, “Actually, around that same time, you started getting less sleep for reasons like around school, or maybe you had a lot of travel, or it was the holidays. Could that be what’s actually causing your symptoms?” Take that log to your medical professional and let them help you decipher whether it is in fact the medication or if this is actually a lifestyle change that has happened in your life.
Again, let’s challenge the stigma here. My main hope here with this whole episode is to take the stigma out of it. There is absolutely no reason for you to feel ashamed for taking medication. There is no reason to believe that you are weak for needing medication. I personally am proud of myself for saying and honoring that I matter. My wellness matters. I will do nothing but put my wellness, my mental health, and my medical health as number one, and I will do that proudly. If that means taking medication, so be it. If other people want to judge me, that’s fine. I don’t really mind if they judge me. Yes, it hurts my feelings sometimes, but they can have their opinion. I’m still going to do what’s best for me.
I hope that that empowers you to, again, learn from your medical professional what’s best for you. Decide for yourself whether this is a value-based decision. Decide whether you’re going to let fear stop you, and take baby steps. I cannot emphasize how important it is to take baby steps and to stay present. Only deal with problems as they arise. Do not make decisions based on potential problems that may show up in the future. Because if that’s the case, you’ll never move forward with your values. You’ll always move forward with fear. We recently did a whole episode about how to act according to your values, not fear. This is another very important step for your recovery.
The last thing I’m going to say is, it’s a beautiful day to do hard things, and you can do hard things too. If you have a fear of taking medication, if you’re scared to take medication and it’s impacting your recovery, I hope that this has helped you to manage medication anxiety, to give you a little bit of empowerment, a lot of hope, and hopefully help you to manage your anxiety as you move forward.
Have a wonderful day, everybody. It has been a pleasure being with you again. I know your time is incredibly valuable, and I’m so honored that you chose to spend your time with me today. I’ll see you next week.
If you are wondering if you have (Generalized Anxiety Disorder) GAD vs. OCD (Obsessive Compulsive Disorder) and how to tell the difference, this episode is going to be exactly what you need.
My name is Kimberley Quinlan. I’m a cognitive behavioral therapist. I specialize in all anxiety disorders, and I help people overcome their anxiety in the kindest way possible. Now, I have treated generalized anxiety disorder and OCD for over 15 years, and I want to share with you that it is true—there is a massive overlap between OCD and GAD. They do look very similar. So I’m going to break it down and address the GAD and OCD overlap. Let’s go.
GAD versus OCD. You might know this, but in the world of anxiety disorders, this is actually a very controversial topic right now. I’ve been to conferences and master classes where clinicians will very much disagree on how we differentiate between the two. In fact, some people believe that they are so similar that they should be labeled as the same thing. We don’t all agree, and the reason for that, as I said, is that they do look similar. They do follow a very similar cycle.
My hope is that in order to understand what GAD is and what OCD is, we need to actually go through the diagnostic criteria. And that’s what we’re going to do for you today so that you too can understand the difference between GAD and OCD and determine for yourself what you think will help move you in the right direction. Let’s talk about it.
As I mentioned, in order to get a GAD diagnosis, you do have to have a specific set of symptoms, and we’re going to go through them.
Number one, if you have GAD, the first symptom you need to have is anxiety and worry, and that’s usually focused on everyday events like work, school, relationships, money, and so on. Now, the frequency of GAD needs to occur more days than not for at least six months. The person needs to find it difficult to control this worry and anxiety, and it focuses on areas that are not consistent with other mental health struggles.
What we mean by that is, let’s say the focus was on being judged by other people. Well, that’s better understood as social anxiety. Or if the focus of your worry was on your health, then we would actually be better diagnosing you or understanding your symptoms as health anxiety. If it was focused on a specific thing, like planes, needles, or vomit, we would better understand that as a specific phobia. In order to have the diagnosis of GAD, it needs to not be under the umbrella of a different diagnosis. Other things that we would rule out when we’re thinking about GAD are things like panic disorder, body image, or even a previous trauma.
Now, the fifth symptom is it needs to cause distress and impairment. That’s very, very important here because, again, we’re talking about a disorder. What that means is a lack of order, no order. So what we want to see here is that it’s highly impacting their daily lives, highly impacting their ability to function.
And then the sixth criteria is it has to be ruled out that these symptoms could be from a medical condition or substance abuse. An example of that might be even me with POTS. I have postural orthostatic tachycardia syndrome. A lot of the symptoms of POTS can actually look a little bit like generalized anxiety.
The seventh criteria are the specific symptoms, and this is important to recognize because this might be true of a lot of different situations, symptoms, diagnoses, medical and mental. You need to have symptoms such as restlessness or being on edge. You need to be either easily fatigued, have difficulty concentrating, or have what we call a blank mind. You might have irritability, you might have muscle tension, and you could also have sleep disturbances.
That is the breakdown for GAD. As I said, it’s very easy to mix it up with other mental health disorders, such as OCD, because they can look very, very similar.
Let’s talk about OCD now. What is OCD? Now, in order to understand what OCD is, we need to again address the specific criteria to get a diagnosis of OCD. The symptoms of OCD include the presence of obsessions and compulsions or one. Sometimes, again, you might have obsessions without the compulsions, but usually, at the onset of the disorder, you will have both. You’ll also have intrusive, unwanted, repetitive thoughts, feelings, sensations, urges, or images, and these cause a very high degree of distress and anxiety, as we mentioned with GAD. The individual with OCD will often attempt to avoid or suppress these thoughts, feelings, sensations, or urges, and they will try to neutralize them using what we call compulsions.
Now there are five different types of compulsionS. A lot of you who have followed Your Anxiety Toolkit will know about these compulsions. We’ve talked about them. We actually go over them extensively in our online course for OCD called ERP School. If you’re interested to learn more about that, you can go to CBTSchool.com. We have a whole array of courses there to help you work through this and get help if you don’t have access to treatment of your own.
We do have five different types of compulsions. The first one is avoidance. The second one is mental compulsions. The third one is reassurance-seeking, whether it be from Google or a loved one. The fourth one is physical compulsions, like checking or jumping over cracks or washing your hands, just to give a few examples. The last one is self-punishment. So there are five types of compulsions.
Now, these compulsions are not connected in a realistic way and the way that they’re designed to neutralize or prevent. They’re usually clearly excessive behaviors done repetitively and done usually from a place of not wanting to do them, but more that the person with OCD feels like they have to do them to reduce or remove their obsessions.
Now, obsessions or compulsions are time-consuming. The frequency here is that they need to take up more than one hour per day or cause a significant degree of distress and impairment in their social, occupational, or other areas of functioning in their lives.
The next criteria is that the obsessive-compulsive symptoms are not attributable to physiological symptoms, substance abuse, or a medical condition. Similar to GAD, again, we want to always check for medical and substance abuse issues before we go ahead and get a diagnosis of either GAD or OCD.
And then, last of all, the disturbance is not better explained by another mental health condition. Again, if the worry or the obsession is around needles, like we talked about before, or being judged by somebody else or health conditions—if that were the case, we would give them a different diagnosis. Now, this is also true for trauma. Again, I want to make sure we understand that. Often, this same cycle will play out in different anxiety disorders—PTSD, BFRBs, phobias, health anxiety, BDD (body dysmorphic disorder). Once we have ruled those out, we can then move forward and acknowledge that this might be OCD or it might be GAD.
Now that we’ve gone through all that, we can actually slow down a little and really take a look and talk about OCD versus GAD and how to tell the difference. Let’s break it down.
Both GAD and OCD have intrusive thoughts or what we call obsessions. A repetitive thought. Now, both have the presence of rumination compulsions and reassurance-seeking compulsions. That is true for both conditions.
OCD tends to be more on irrational topics and subjects, whereas GAD tends to be more focused on daily stresses and rational actual events in the person’s life, but not always. Again, sometimes the person with GAD may engage in a lot of catastrophic thinking or irrational thinking that can actually make this disproportionate to their daily life stresses.
Questions that you might want to ask yourself when you’re considering how to tell the difference between GAD and OCD are questions like, are your worries related to a daily stressor, or are your fears intrusive and repetitive?
People with OCD tend to identify that their thoughts are very intrusive, that they can’t stop them, they’re relentless, they’re repeating themselves over and over, whereas people with GAD tend to find that these are more preoccupations with problems in their lives, and they’re trying to solve them.
Another question to ask is, are my fears realistic or are they irrational and distorted? That question too can help us differentiate whether your symptoms are more related to OCD or GAD.
Another question to ask is, does anyone in your family have GAD or OCD? We know that these conditions are very, very genetic. If you’ve got someone with OCD in your family, it might actually help us to determine, is this something that’s going on for you? Are you better understood as having symptoms of OCD than you are GAD?
Another question or thing you might want to do is, you can take a GAD test or an OCD test. We have specific diagnostic tests that can help determine these. I strongly encourage, if you’re still having a hard time differentiating after you’ve listened to this episode, please do go and speak to a mental health professional who can help you determine and do those tests so that you can really be clear on what you’ve got and help you get the correct treatment.
Let’s answer some questions about this topic that commonly come up, which hopefully will help you get even more clarity on this topic. One of the most common questions we get asked in this area is, can you have OCD and GAD? Often, some of you are looking at these criteria going like, “Yes, yes, yes, yes, yes, yes, yes.” And the truth here is, yes, commonly, people do have OCD and GAD. There is a very strong GAD-OCD overlap here. So it could be that you have both.
The good news here, if that is the case, is that the treatment for GAD and the treatment for OCD are very, very similar. In fact, again, like I said, it’s very controversial. Some clinicians say it doesn’t even matter. We don’t have to differentiate between OCD and GAD because the treatment is going to be so, so similar.
We’re going to use a combination of cognitive behavioral therapy and exposure and response prevention. We call cognitive behavioral therapy CBT, and we call exposure and response prevention ERP for short. Those treatments are focused on reducing those safety behaviors or compulsions, such as rumination, avoidance, reassurance-seeking, physical compulsions, and self-punishment, and also encourage you to identify your fears and learn to face them as much as you can. Learn to navigate those fears by experiencing them, tolerating them, being kind to yourself as you ride the wave of distress, and practice mastering your ability to be uncomfortable. That’s a huge piece of this. Also, master your ability to be uncertain, because in both conditions, they often require you to spend a lot of time trying to seek certainty, to get clarity, to solve the fear, and to prevent the fear. And we actually instead work at reducing that by increasing our willingness to be uncertain.
We also have an online course called Overcoming Anxiety and Panic, and we go through the same steps with that. They’re two separate courses because we want to make sure the person feels very understood and feels like they have a really good plan. Again, if you’re interested in that, you can go to CBTSchool.com. We have two courses for specific diagnoses, and that will help you make a plan for yourself. They are there specifically for people who do not have access to or do not have the means to access mental health services. These are self-led, on-demand courses. You can take them as many times as you want to put a plan together for you.
Let’s get back to the questions. What about other anxiety disorders vs OCD? Well, what we’ve talked about already—hopefully, we’ll clear that up—is the real way to determine what your specific problem or struggle is, what is the focus of your intrusive, repetitive thoughts? Again, if it’s on your body and your body image, we would look at an anxiety disorder, an eating disorder, or maybe even BDD. If the focus is on your health, we’re going to look towards health anxiety or hypochondria. If your fear is around being judged, we’re going to look towards social anxiety. If your fear is in response to an actual trauma you’ve been through, we’re going to look at PTSD and other trauma symptoms that you might be having. It’s important to identify the core fear, and that can actually help determine what specific struggle and diagnosis you have.
Another important question that people ask is, can GAD lead to OCD? We don’t actually have a lot of research on this, so it’s important that we recognize that yes, they can overlap, that yes, you can have GAD, and then you can proceed into having OCD. But I wouldn’t actually say that GAD leads to it or causes it. Usually, again, we don’t really have a lot of clarity on what causes OCD, but we do know that there is a genetic component and an environmental component that are contributing to having OCD.
Lastly, what’s the difference between having OCD and general anxiety or just anxiety in and of itself? Often, again, we’re going to look at that core fear.
Now the thing to remember here is, everybody has anxiety. Everybody experiences anxiety. It is a normal part of being a human. But if that anxiety is starting to impact the functioning and quality of your life, if it’s starting to take up a lot of time, if it’s starting to stop you from being able to do the things you want to do, that’s usually when anxiety becomes what we call an anxiety disorder. When that happens, I’m going to urge you to seek help. There are treatments, there are solutions, and there are practices that can help you overcome this anxiety and get you back to living the life you want to live. You don’t have to live a life where we just accept anxiety at this rapid rate without getting help, skills, and tools to help you move forward.
The whole reason I created Your Anxiety Toolkit is because there are tools that can help you navigate anxiety in the most effective, wise, and kind way. So my hope here is that today, as we’ve learned to differentiate the difference between GAD and OCD and even other anxiety disorders, you can then go to get resources to help you overcome those specific struggles and challenges.
Again, if you’re interested, please go to CBTSchool.com. We are also here on Your Anxiety Toolkit, where we have over 350 free episodes to help you navigate these conditions. It is an honor and pleasure to help you with these struggles in your life, and I’m so grateful to be able to do that. I hope that’s been helpful. Have a wonderful, wonderful day, and I’ll talk to you soon.
If you want to live a life according to your values, not fear, you’re in the right place. I am going to give you a detailed look at how you can do this for yourself, but I will also show you how not to do this.
Lots of people are talking about this idea of living life according to their values, not fear. I want to really inspire you, highlight the way that you can do this, and also show you how it cannot be done so well. I’ll actually give you some personal experiences. Hopefully, my goal here is to inspire you to live a life where your values lead the way and fear no longer makes your decisions. Your fear is no longer in the driver’s seat; you are. If that’s good for you, let’s go.
Hello, my name is Kimberley Quinlan. I’m a marriage and family therapist. I, myself, have struggled for many years with anxiety. In little ways, anxiety just took away the things I wanted, took me away from doing the things I wanted, showing up the way I wanted, and learning how to live a life according to my values, not fear, has literally changed my life.
Now, my hope here is that I can explain this to you. There have been times where my clients have said, “I’m hearing about this idea of values, but it literally doesn’t make any sense to me. Like, how would I navigate that?” So my hope here is to make it nice and clear, give you some clarity and some directions so that you too can live your life according to your values and not fear.
Now, the thing to remember here is that this idea of values has probably been spoken about in many different modalities, but the one that’s really popular right now that people are talking about is a type of therapy modality called Acceptance and Commitment Therapy. What they do is they talk about values as this idea of principles that govern how you want to act. Again, it’s not being perfect. It’s principles that are going to guide you.
Now, unlike just setting goals, values are never fully accomplished. They’re something that involves continuous behaviors. They’re small baby decisions and little pivots that you are going to make throughout your entire life, and they guide your choices and your decisions according to the person that you want to be, the kind of person you want to see yourself as, or that you identify with.
Now, often when we’re talking about values, the biggest question I get asked is, “How do I determine these values?” Let’s just stop for a minute and just talk about how we’re going to apply this.
As you probably already know, fear is a very, very good motivator, and it’s a driver of behaviors. Let’s say you’re just walking along or you’re at home enjoying your day, and then you have a thought or a feeling of danger, like what if something really bad happens? For you, it will be a specific thought or feeling, but for the sake of just making this really broad, basically, your brain has interpreted, “There might be something wrong. There could be danger. Bad things could happen. I feel uncertain about the future.”
When that happens, our natural human instinct is to fight that fear, run away from that fear, freeze in that fear, or go into people-pleasing mode. We call it the fight, flight, freeze, and fawn response. This is a normal human reaction. We all do it. It’s nothing to be ashamed of. It doesn’t mean that you’re wrong or bad.
If there was actual danger, if there was somebody who was intruding on you or making you uncomfortable and that you were in danger, this 5Fs, the FFFFF approach, is a very appropriate response to being in danger. But when our brain tricks us or sets off the alarm, the danger alarm too fast or inappropriately, we often perceive there to be danger, and we go into a response where we respond to that fear as if it is a real danger, and before we know it, we’ve completely gone in the wrong direction from the way we wanted our day to be.
Again, I might be dropping off my children at school, and I might have the thought, “What if something happens to them today?” I have to make a decision in that moment whether I’m going to respond to that fear, that thought, that feeling as if it’s fact, or if it is just a thought, a feeling, or an experience or sensation.
The first step here is being able to stop and identify when fear is showing up and identify then, “How do I want to respond?” And that’s where your values come in.
What I’m going to encourage you to do once you’ve finished listening to this is go onto Google or whatever search engine you use and Google ‘Values List PDF.’ There are hundreds of them, and they’re going to give you a list of all of the different values that you then may want to think about as things that can guide you in the direction that lines up with the way you want to show up in your life.
Again, think of it like a crossroads. You’re going up to this crossroad; there’s a stop sign. The stop sign says, “There could be danger here.” You have to make a decision. Am I going to take a right or a left, which doesn’t matter, towards fear and trying to resolve that fear, or am I going to make a left where I act according to my values? On these lists that you’ve Googled, you will see an extensive list of ways in which you can respond right now.
Some examples of values would be patience, kindness, strength, integrity, and honesty. That’s just a few. Like I said, there’s hundreds of these. And then you can start to decide for yourself which value you want to lead with your step forward. What do they say? Put your best foot forward. That’s what we’re talking about here—the value that you pick is going to be the one that helps you in the long term, is the most skilled response, and is the one that lines up with who you want to be and how you want to be.
Again, think of it through the lens of the one-year-old or the three-month-old you. What would you want that person to do? And that’s how we can then start to choose values over fear. So, so important now.
A lot of people get overwhelmed with the list. Let me help you get clear on how to determine the values that you’re going to choose.
Number one, pick values that have always led you in the right direction. Do a little inventory on when was the time that I really showed up for myself, or I showed up in a way I wanted to in an uncomfortable situation. What was one of the values that led me in the right direction? Often, with patients, I’ll ask them, “What was a time where you really had to muster through a really difficult time?” And they’ll think about, “Oh, there was this one time where there was this one sort of emergency, or I was running a marathon.” I’ll say, “Okay, great. You were able to achieve that. What were the values that got you through that uncomfortable time?” And there it falls very quickly without even looking at the list. It could be some values that matter to you or that have been effective for you.
Another option is, pick values that give you a sense of purpose that helps you look in the long term, not just with short-term relief, but long-term accomplishment, long-term mastery, and long-term relief. In addition to that, pick a value that feels like it serves you in the ‘you-est you’ you can be. I know that’s a funny way. I say that with my patients all the time, like, “What’s the ‘you-est you’ that you can be? What value would lead you towards the ‘you-est you’ that you can be?” Because we’re all different and we all show up in different ways. We have different strengths and different challenges. So we want this to be very specific to you.
But there is an important thing to remember here. There are no “right values.” You are going to look at this list. And as I did when I first started doing this work, I was like, “Oh my gosh, which ones should I pick?” Often, and this is one of the problems that I found, when I looked at them, I ended up with this long list of all the things I wanted to be. I was like, “Check, check. Yes, I want to be that. Yes, I want to be that. Yes, that’s a value of mine. Yes, that’s a value.” It was kind of like a want-to-be list. I had basically highlighted the majority of the values on the list. They were all important to me.
But what we’re talking about here is, yes, they might be all important to you, but the goal is just pick two or three to start with. What we want to do here is pick two or three that will help you with this specific struggle or problem that you’re working through. If it’s fear and it’s anxiety, well, let’s work on that. But if you’re going through a medical condition, a family issue, a relationship issue, or an academic issue, you can then make a decision on, “What are the two or three values that will help me get through that particular problem?”
Another issue that often people ask me about is that theyre getting overwhelmed with this idea of “I want all these things in my life.” What we end up doing is using this idea of values as a way to fix their humanness, that these values work can become a breeding ground for perfectionism. This was the case for me. I was like, “Yes, a good person would check off that one,” and “I wish I was more generous. Yes, I’ll check that off.” It really just ended up making me feel guilty about who I was. I was really picking values based on what I thought a “good person” would pick.
We want to move away from that because, yes, you’re going to look at this list of values as I did and be like, “I want to be all those things. I want to show up in those ways all the time, every day.” But the truth is, you’re a human being. You’re a messy human being, as am I, and we don’t want to overload ourselves with values and these ideas in a way that just is a way of being perfectionistic, hyper-responsible, and overly moral.
We want these values to guide us towards being the person we want to be, but we don’t want to pick them with this idea that we have to fix our humanness. We’re still going to be human. We’re still going to make mistakes. We’re still going to hurt people and say things that we wish we didn’t, and we can still go and repair that and show up as best as we can and be the best that we can. But please don’t use values as a way of raising the level so high and the expectation so high that you are destined to fail and destined to feel bad about yourself. We want to be as compassionate and realistic as we can as we do this valued work.
The solution is to be gentle and kind as you peruse these values. Maybe you need to put your pen down and your highlighter down and just take a second to acknowledge that you might not be in a season where you can choose the “good Samaritan” values. You mightn’t be in a season where you can choose some of the values on the list.
I know when I was really sick from a chronic illness, and I looked at this values list, generosity was a big value that showed up where I was like highlighting, “Yes, I want to be more generous.” But I wasn’t in a season where I had the capacity to give back. I was in a season where I needed help from other people. And so I had to stop in that moment and look at the list and say, “Given the season I’m in, which of these values will help me recover?” I had to work through a little bit of self-judgment and a little disappointment and sadness that I wasn’t in a season where being generous was the priority, at the top of the list.
You can still be a respectful, compassionate person while you work on whatever struggle you’re working on. Absolutely. It doesn’t mean we’re giving you permission to not be a good person. But we have to be able to prioritize and bring things up to the top, but without discounting or thinking black and white that because they’re not at the top, that makes us a bad person. Just because I couldn’t put generosity at the tippy top of my list and priorities for values didn’t make me a bad person. It just meant that because I was in this season, I had to reprioritize values to get me through this season so I could move on to being in the next season, which might have generosity at the top.
Here is a pro tip with this, and I talked about this before. Find one area that you want to improve, and pick one to two values that might help you course-correct. Just do a small pivot. We don’t want to overcorrect. We want to do just a very slight course correction to start.
Today, we’re talking about choosing values over fear. In this case, it might be a small value. Something that’s there for you that will help you face that fear. That being said, let me also say, if your fear is really loud and really aggressive and it’s hitting you from every angle, you might need to pick a value that’s actually very, very, very important to you, the most important to you, and have just that one thing.
Often, and here’s an example—but please, I don’t want you guys to feel you have to use this or feel like you’re a bad person if you don’t use this—a lot of my patients put family at the top of their values when they’re talking about managing their anxiety. If they have an anxiety disorder that’s taken so much from their life, they might say, “My kid is my highest value. And so when fear shows up, I’m going to imagine a picture of my kid, and I’m going to move towards that fear because that allows me to be with that kid,” or that partner or that parent.
Other people might say, “My career matters to me so much that when fear shows up, because I want that career so much, I’m willing to be uncomfortable. I’m willing to ride some big, big waves of discomfort. I’m not going to choose fear anymore when I get to that crossroads; I’m going to choose that one really important fear.” Underneath, there might be a smaller one like compassion, hopefully. But again, you get to choose. You get to choose what’s right for you. This is your journey. Please do not let anybody tell you what your values should and should not be.
Now, one of the reasons that I was so committed to doing this episode today was that I recently have come upon a realization about values that I didn’t know were there, which is that sometimes your values can compete.
Now, I talk to my patients about this all the time. That wasn’t the part that shocked me. Let’s talk about what that might look like. Often, people get confused. “Well, if I have these values, what if they compete with each other?” Let me give you a personal example.
For me personally—but please don’t use this as your values unless they line up with your values—I highly value, number one, work ethic and discipline. It is a huge part of how I was raised. I love the fact that I have a very strong work ethic, and I’m very, very disciplined. It is something I hold as a very high priority, has gotten me through some very difficult times, and has allowed me to have the life that I am trying to create.
My second value is compassion, and I’m still working on that. It doesn’t mean I’m perfect at it, but it’s still a high value. The third is family—my family. My husband and my children are probably the most important things to me above all. The fourth is my mental health.
Now they’re in order, but depending on the day, they will switch, as I’ve talked to you about before. But then patients will often ask me if I share that: “But that doesn’t make sense. If work ethic is a value, but family is a value, how do I make both of those happen? Does that mean I have to choose to be a stay-at-home mom and be with my family? But if I go to work, obviously, I’m not valuing my family. They’re competing with each other.” Some people will say, “I really value rest, but I really value exercise or being strong. How do I make room for both of those? They’re competing.”
The thing to remember here with values is, it’s not always, as I said, in the same order. Throughout our day, because we have to be flexible, we can make room for multiple values at a time, and we can find balance within these values. I can show up to work or right here today and give everything I have, and then still show up for my kids later on. It doesn’t mean I have to give my whole attention to that one value all day, every day, consistently at a hundred percent. Because I value compassion, some days that will mean I take a break, or I value mental health means I don’t have a strong work ethic or be with my kids. I take a drive, I go to the beach, or I take a walk and have some time to myself.
It’s important to recognize that while it might feel like these values are competing, it’s not. It’s about us finding a balance of using them to guide us, but not, again, making them perfect.
Any time, when we’re using these values, when we’re going overboard with them, we want to catch our rigidity in making them the only thing that we do, the only way we think, and the only way we act. We want this to be a flexible, moving target. As we said, values are never finished. They’re never completed. They’re something that we are constantly checking in with ourselves. What do I need? The most beautiful, compassionate question—what do I need? And using values to guide us, not fear—values. Allowing those values to decide what’s important to us, decide how we want to show up, and decide what the future me would want me to do.
Now, this is where I have gotten stuck, and here is where I’ve found a-- how would I say it? A problem. Maybe it’s just me. Maybe it’s just me. But I want to bring it up in case this is true for you too.
Now, I’ve already shared with you my core values. There’s work ethic and discipline, compassion, my family, and my mental health. These are all incredibly important to me, depending on the season, the day, the hour, and the minute. But I realized recently that work ethic, while it’s one of my biggest values, is actually partially fueled by fear. I’m holding it as a value, but it’s actually a partial fear response. Let me explain.
Often, and this is something I want you to look out for, fear will dress up as values and pretend to be values when really it’s just fear. Think of it as a Halloween costume. Fear is like, “Oh, I know how to trump this system. I’m going to dress up as a value and show up in Kimberley’s life (or in your life), and I’m going to pretend I’m a value, but I’m actually really fear. I hope she doesn’t catch that I’m actually in a costume and I’m actually really fear. And so I’m going to see if this works.”
I do genuinely value work ethic and discipline. Like I said to you before, it has really given me so many beautiful things in my life and has allowed me to show up and serve you guys, and it’s been wonderful. But when I was with a client, we were talking about this exact problem, and I asked them a question, which was, if that value—when we’re talking about values—if that showed up, what would the non-anxious, trusting version of you do in this moment? And they realized that it was not the values they’d been working on. And then I thought, “Oh my goodness. I’m going to actually check in with myself on this, because if I asked myself, what would the non-anxious, trusting version of myself do in this moment, a lot of the time it wouldn’t be work ethic and discipline.” I realized that a small part of my work ethic and discipline is coming from a place of fear that if I don’t stay disciplined, that if I don’t hold my work ethic, everything will fall apart and bad things will happen.
This stopped me in my tracks because—again, I want to reinforce this—my values were being tricked by fear. Fear was actually leading a part of that important value, or maybe I could say it was coming in and taking advantage of that value, and it might do that for you as well.
And so what I want you to think about when you’re looking at values—and again, please don’t put pressure on yourself that you have to get this perfect. It’s a work in progress. I’ve been doing this work for a decade, and only now I’m realizing this—is slow down and just check in on “What would the non-anxious, trusting version of myself do in this moment?” I think that is where we can actually really get to the crux of “What are your values?”
Again, they will be ever-changing. Again, we will be forgiving and kind to the fact that we’re still messy human beings. We don’t have to get it perfect. But it did open me up to realizing a value that I didn’t know was so important to me.
When I asked myself this question, I actually realized that the answer is playfulness and stillness—these two values that I’ve never really relied on. As I look back at my PDF of values, I’ve never highlighted them. When I asked myself this question of what would the trusting version and the non-anxious part of me do, playfulness and stillness was the value that rose up to the surface. It was a beautiful moment. I actually cried.
Now, from that, and I’m actually going to tell you a little bit of my news, I thought to myself, how could I implement playfulness and stillness into my life where I still value work ethic, compassion, family, and mental health? Into my mind came the image of a Volkswagen bus. Do you remember the old hippie buses? We call them Kombis in Australia. That was what showed up for me. Like, if I could show up in my business from a place of playfulness and stillness, I wouldn’t be working from this office. I would be working from a 45-year-old Volkswagen bus. And so I did. I did exactly that. I went and bought a Volkswagen van. It’s a 1985 Volkswagen Westfalia. I love, love vintage cars. I am actually a car person. I don’t know if you know that about me, but I love vintage cars, and I never allowed myself to really think about doing this. I’ve loved them forever. I’ve looked at them forever. I’ve wanted one forever, but I’ve always thought, “That’s not high on my priority list right now.” Until I realized that if I’m going to move towards trusting myself and honoring this bigger piece of me, playfulness and stillness have to come up on that list as well.
So if you live in Los Angeles and you see a gold Volkswagen Westfalia—it has, like I said, 195,000 miles on it—if you see one of those driving around Los Angeles and you see me, please beep your horn. That will be me driving around and parking my van at a beautiful place and working from there from now on, and that is my hope. That is my hope for myself, and I hope that you can use values to discover who you are so that you can be the ‘you-est you’ you can be.
I love the idea of implementing values into recovery. That is why I think act is so important as a complementary treatment to anxiety. I think that with some care, compassion, and some thoughtfulness, you too can identify the values that are important to you and learn to live and act from those values, not fear.
I hope that has been helpful for you today. I have had so much fun chatting with you about values. I am sending you so much love. Do not forget, it is a beautiful day to do hard things. I will see you next week. Have a wonderful day.