Anxiety: It's All About Attention, Baby! (Episode 160)

SPEAKER_03 0:01

I noticed that when I was desensitizing and getting to a good place, I realized my confidence in my ability to control my attention was what got me out of it.

SPEAKER_02 0:11

Which one of those big five personality traits makes you vulnerable to develop an anxiety disorder? Neuroticism. I'm really paying attention to how I feel. What's going on inside me is very important all the time.

SPEAKER_03 0:20

Our attention also goes inwards because when we detect a problem, when we detect something to fix, when we detect something's wrong, and we keep feeding it, that is the sensitization process.

SPEAKER_02 0:29

You're biased toward looking for threats that come from inside of you because it feels unsafe to leave them. It really feels safer to follow this attention cue inside of myself. Then I'm going to take a chance and put my attention over here while it is begging for me to come back to it. It's really brave.

SPEAKER_03 1:01

I hope that I have your attention. My name is Joshua Fletcher, also known as Anxiety Josh, and I'm a psychotherapist who specializes in the world of anxiety and anxiety disorders. Written books on the subject, including same time next week, which is really a good book.

SPEAKER_02 1:16

And I love doing this podcast with my fellow co-host who is uh I am Drew Linsolata, coming to you from New York, where I am also a therapist that treats anxiety and anxiety disorders. We're we're like the same dude, just on different sides of the ocean. Um, also an author, a co-author of the Disordered Guide to Health Anxiety, which is a really good book, by the way. So um yeah, and you know, you know all the deals. If you have listened to the previous 159 episodes, you know who we are. So go listen to them and you'll get all the intros. Today we're gonna talk about attention. Again, we've talked about this a lot, but it's worthy of discussion from a lot of different angles.

SPEAKER_03 1:49

I the more I do this and the more I work with anxiety, and the more I think about it, and I know Professor Adrian Wells was kind of on it as well with metacognitive therapy. All of this, all of it, anxiety stuff, is always linked to our attention. Yep. Where is your focus and attention? Particularly when you sense and when you're not. We did an episode recently on the work when you're calm, but where's your attention? And I noticed that when I was desensitizing and getting to a good place, I realized my confidence in my ability to control my attention was what got me out of it. Now, don't get me wrong, I didn't perfect it like a Jedi Jedi master. But it's all about attention, even using distraction if you have to. But stop staring at how you feel, which is a phrase Drew likes to be saying. And I went down a bit of a research hole recently. Do your own research. No, I went down a research hole recently, and um yeah, I just the more I uh I come to it, the more I realize it's attention when we are anxious where our attention is locked in, but sometimes when we're not anxious, we're still checking with our attention now of habit, yeah, routine. And I think ultimately part, a big part of a massive part of recovery or desensitizing is practicing with your attention in all states, but particularly when triggered.

SPEAKER_02 3:14

Yeah, and MCT. I mean, we had Rihanna on, she talked about you know metacognitive therapy. It is the whole thing, like the cognitive attentional syndrome is what drives it, and you learn attention training and detached mindfulness is an attention thing. We don't have to go like in 2026. We can go back many, many years in mental health. And people who still follow the you know the big five personality traits, which is really old school at this point, but you know, what's which one of those big five personality traits makes you vulnerable to develop an anxiety disorder? Neuroticism, which is just paying close, very close attention to what's going on inside of you. It's not a bad thing, it's not an insult. Some people score high in that trait. It's just I'm really paying attention to how I feel, what's going on inside me is very important all the time. And then we get a little stuck that way. So it's not it's not new, you know.

SPEAKER_03 3:59

There's a really cool word that we that we Drew and I discovered uh as part of the brain called the Do you want to say it, Drew? Can you remember it?

SPEAKER_02 4:08

Locus coroleus, the old Roman Empire.

SPEAKER_03 4:13

Yeah, father to a murdered son, yeah, husband to a murdered wife, and it will have your attention in this life or the next. Absolutely. Uh the locus coroleus is the part of our brain that is associated with sensitization. So the sensitized state where the nervous system feels constantly on edge and easily triggered, is closely linked to the locus coroleus.

SPEAKER_02 4:37

We we that has to be uh a hundred percent dust, Maximus.

SPEAKER_03 4:41

The locus coroleus is the main brain the brain's primary source of neureporephrine, which is a neurotransmitter critical for arousal and the stress response, which we're all very familiar with. Interestingly, repeated or chronic stress can lead to heightened locus coroleus activation and hyper-arousal, which is basically us, and anyone listens to this podcast. Yeah, a process akin to kindling and epilepsy, where repeated low-level stimulation eventually leads to a full-blown response. This is why a lot of sensitized people takes very little for the you know them to be triggered to go from zero to ten. Um, that sensitization means that the locus coroleus and a reporephrine system, sorry, there's lots of syllables here, becomes hyper-responsive. Um, and I thought that's really interesting because a lot of people, when that basically is it's a way to describe um sensitization, with that our attention also goes inwards because when we detect a problem, when we detect something to fix, when we detect something's wrong, we keep going round and round and we keep feeding it. And that's like the that is the sensitization process. The attention keeps us in that little loop. And I I thought it was really interesting in relation, you know, very similar to the kindling in epilepsy, where the more you kind of do it, the more easier it triggers. Sure. Uh, and I just thought that was uh I thought it was very interesting. Um, I'll read a bit more from that paper later, if you're interested, or you know.

SPEAKER_02 6:10

No, I think it's great uh because it really does kind of lay things out. We can always put a link to the paper in the show notes too, if you want. But you know, it's interesting because it talks about like anxious individuals tend to exhibit a a high sense of high bias toward threat. Yeah, we're looking for something to be wrong, and then sure enough, we find it. So I I think it's, you know, the attention, when the attention gets hijacked, and it gets hijacked because it feels like the safest place to put your attention. An anxiety disorder, like when you're afraid of your own body and mind, you pay close attention to what's going on inside of you and you're constantly looking, you're biased or looking for threats that come from inside of you because it feels unsafe to leave them, to not look around, to not manage them. I have to feel safer. And the desire to feel safer drives your attention into the threat. And I the thing that's interesting about this is nobody would argue if if you knew somebody who was living in like a horribly abusive environment where they were being physically harmed, and they spent all day long just on the lookout and on guard, like trying to not get get physically beaten, you wouldn't question that. Of course they're looking for that. They're trying to stay safe, they're trying to stay safe. Well, the same exact mechanism happens, except our attention goes inward to thoughts and bodily functions that we interpret as danger. And that's it. And that's all I care about all day long is that. That's what I cared about all day long was I need to watch my body work and I need to watch my brain work, and that's it. Uh, nothing else seems to matter. This is the this is the most important thing in the room.

SPEAKER_03 7:41

It's the main difference as well. Like the main difference between me being anxious to sensitizer now is that my attention is not on how I feel, really. Right.

SPEAKER_02 7:49

Which I think is the default. You know, that that article also mentioned default mode network. Like, yeah, we have self-referencing thoughts, but left to its own devices, your brain will think about yourself in in various different ways. But they're not threat scanning thoughts, they're self-referencing, but it's not we're blissfully unaware of how we feel most of the time in a non-sensitized state. We just don't care.

SPEAKER_03 8:09

That's the and that's why I love distraction. Not distracting, as in like not distracting as uh pushing away feeling, but from this particular point. I like it. Each time you distract yourself, you're training a neuropathway to to go on anything but obsessed with how you feel.

SPEAKER_02 8:25

Yeah.

SPEAKER_03 8:25

I'd rather people distract themselves with Lego than sit there going, How do I feel? How do I feel? How do I feel? How do I feel? How do I feel? How do I feel? That's the problem. Yeah. Well, if you break that cycle a little bit, also in that paper, they talk about default mode network, which you love, but also the task positive network, yeah, which is activated during goal-directed externally focused tasks that require cognitive effort. And why I love this particular one when you're anxious and panicking is that human short-term memory only has a certain amount of of capacity. Yeah, RAM. So when we're panicking, all our short-term memory is I'm panicking, I'm panicking, I'm panicking, and I'm panicking, and your memory goes out the window. But when when you even panicking or high or intrusive thoughts, when your doubt response is high, and you focus on something that requires more cognitive load, it fills up that short-term memory kind of slot. So then you stop slowly, stop forgetting like how you feel and the importance of that of how you feel in that moment. That's why I always do. Like, I sometimes I've had a panic attack for like, well, I could sit here and try and resist and forgive all my attention, all that. Or I could literally give my brain something else to work out because I know this is safe. Yeah. Uh, and that's the difference, you know, and that's how it starts sometimes. So when people say, Oh, I've distracted myself, I'm like, Well, good, good, it's better than compulsively scanning and giving it 100% of your attention. That's in my opinion, which I heard was fact by some guy down the boat.

SPEAKER_02 9:56

No, I agree with you. District, we've talked about this. We did a whole episode on distraction. We'll keep talking about it. Like, distraction isn't automatically evil. Intent matters. I need to get away from this feeling, so distraction is an escape or safety thing. No, that's not so good. Like, the only role of distraction is to save me from myself. No, no, no. The role of distraction is can I teach myself what it looks like to put my attention over here, even though it feels safer to put it over here? And I think in MCT, Adrian Wells really said it like people don't even understand what attentional control feels like because we often don't. Like we go through life, generally speaking, our attention just gets hooked automatically. You know, sometimes we pay attention, but there's an entire cottage industry based on study with me, deep focus, deep work. Who Cal Newport wrote wrote books about this that people idolize how to focus because we suck at it so much because our attention naturally just drifts into whatever comes into our field of view. So in MCT, we teach distract, we teach attentional control because people don't know what it looks like. Mindfulness is just attentional control because we have no idea what it looks like and we suck at it at first. Like, oh crap, I can do that. Yeah. I can, you know, who knows?

SPEAKER_03 11:04

Absolutely. Attentional control is so important. Absolutely. Um, let's stop listening to us bang on about stuff. The world is full of guys with microphones talking. Have we got anything from the community? Yeah, we do. Let's listen to this one first. Good one.

SPEAKER_00 11:19

Hi guys, I have a massive did it anyway, and I'm so happy because I really hadn't had anything to share as I've been listening to this podcast over some time. But um this past weekend, I um was able to drive my son from Columbus, Ohio to Baltimore, Maryland for a lacrosse tournament. Originally, it was supposed to be me and my husband taking him, but my husband actually got a uh blood clot in his leg after he was hit by a foul ball, which is super random. Um, and we didn't want to take the chance of him sitting for that long. So it was just me and my son. I have never done a solo trip like that before, even though I'm in my 40s. Um, and it was a lot of driving windy mountains, and I still got there. We got there safely. Um, we got to all of his tournament games on time, and um we made it back, obviously. Otherwise, I wouldn't be sending this message. Um, it was stressful, but uh I did it, and I was extremely proud because not three months ago, I could barely leave the house without having a panic attack. So it was a huge, huge thing for me. Uh, we even spent some time in Inner Harbor and we went to the National Aquarium, which was pretty cool because my moody teenager usually doesn't want to do things with me. Um, but anyway, thank you for the show. And I just had to share because it is something I'm massively proud of right now. So thank you.

SPEAKER_03 13:08

Should be super, super. That was a massive one. Well done. Uh, and I'm really happy you're proud of yourself as well. Uh well done. That's uh that's a lot of uh it's a lot of uh Billy Mays uh in there as well, wasn't there?

SPEAKER_02 13:21

And we hung out in the inner harbor. I haven't been in the inner harbor in a long time with a moody teenager that normally doesn't want to do stuff. Love it.

SPEAKER_03 13:27

Is is Baltimore where the um the wire was filmed?

SPEAKER_02 13:31

Yeah, I believe so. I I wasn't really a fan of the wire, but I think that's the yeah, that's the city. It's one of my favorite shows. I loved it. Baltimore, yeah. I love it. So thank you for sharing that. Sender innerer, who did not use her name. So that's fine. So we will not, but yeah, they're really great.

SPEAKER_03 13:46

Um, super, super, but love that. Uh Walriad, shall I read out a written one? Yeah, let's do it. Might as well. Yeah, no, no, let's have a look. Uh, this person has requested we do not use their name. Uh Sonia Shortwoman. Yesterday I had a meeting with a superior at work that I had been feeling very anxious about due to a similar approach made made made to me last year that caused an anxiety attack and started the cycle of avoidance. I took time off work and ultimately returned from some time off and worked through my avoidance issues, but there was always a red zone, which was the scenario of dealing with superiors in a recruitment context. Last week I was approached again, and despite feeling anxious and afraid in the lead up to the meeting, with my brain screaming at me not to do it, I did it anyway, and the meeting went really well.

SPEAKER_02 14:37

Love it.

SPEAKER_03 14:40

Love those ones. Well done, well done for doing the meeting. Despite the amygdala screaming, you took your attention and took it into the meeting. Well done.

SPEAKER_02 14:49

Yeah. I think it's always important to play things like that. Remember that you know, sometimes the attention is going to be grabbed by like, oh, there's a current disaster, but it's also grabbed by prediction of disaster. This is gonna be bad, this is gonna be bad, this and there's nothing going on right now, but I have a meeting in two hours, and that's gonna be really bad. And then all of your attention gets hijacked and brought into somehow trying to solve that future disaster that it is sure is gonna happen. And often doesn't, but okay, you know it's all right, rolling the pentamillion gone.

SPEAKER_03 15:18

Yes, exactly.

SPEAKER_02 15:19

I I think it's so interesting too when we look at this, and people will often so are the objections to like attention. Yeah, you guys are always you know talking about attention, it's all about attention. So am I supposed to just ignore how I feel? I get that all the time. I have fatal attraction. I will not be ignored, Dan, or whatever the character was in fatal attraction. Like well, that's an old movie, by the way. Um half the people don't get that, but fatal attraction. Yeah, it's a great movie, and that's Dyke Glenclaw. I will not be ignored. And like, so I I think people get tripped up by that. Yeah, but but I know I hear you talk about distraction, but then it all goes out the window because like I can't. What am I supposed to just ignore that scary thought? But but that's real. But but people do get cancer, my health anxiety, like this is right, I should pay attention to that. It's not that you can't you can't ignore it. I could you couldn't ignore it if we paid you.

SPEAKER_03 16:07

No, you can't ignore it.

SPEAKER_02 16:08

Yeah, so there's always an element of what feels like risk and requires some sort of brave leap of faith where like, well, I it really feels safer to follow this attention cue inside of myself, but I'm gonna take a chance and put my attention over here while it is begging for me to come back to it. That's really brave. Yeah, that's really brave.

SPEAKER_03 16:27

I do it like um it's an old analogy I've used on the podcast from a long time ago, but I'll bring up for here like you go to a restaurant with your friend or your partner or whatever, and it's a busy restaurant, it's very loud, and you know, you go in and you're quite sensitive to noise. Maybe you've got you're going in with an anxiety disorder, and you sit opposite your partner, your friend, and things are loud, there's music playing, there's people chatting and laughing, uh, there's plates clanging, glasses, people walking around, chairs moving, loads of noise in the restaurant, and it's a bit overwhelming. But with the power of your attention, and people just naturally do this anyway, um, you start to concentrate and listen to what your partner or friend is saying over the table. And within five, ten minutes, you haven't dialed down the restaurant, but it your brain has started to make it less important, and you've zoned in and habituated to the situation, and suddenly all that matters and all that your brain thinks that matters is the conversation with your friend. You didn't physically go around telling everyone to shut up and turn off the music and and and taping the chef's mouth shut and making everyone drink out of rubber receptacles. No, you didn't. But with your brain and the role of your attention, you uh kind of dialed everything out. And I use that analogy a lot for anxiety disorders. Stop trying to quiet the restaurant, focus on what matters, and the brain will follow suit.

SPEAKER_02 18:01

Yeah. But in that initial discomfort, though, your brain will absolutely insist. The the narrative that gets built around that is this is too much, this is too loud, we must quiet the restaurant, or really more practically, we must leave this restaurant, or just never go into a restaurant. But that's not the way that actually works. So people try that's the control strategy. The control strategy is I listen when I when an attentional cue fires up inside of me, the CAS and is activated. I pay attention to it, I follow it, I follow all its directions, and I try to control what I think is causing this problem, which would be trying to quiet down the restaurant. But really, that's not correct. And and I think you hear it in other places too. People who are dealing with chronic pain conditions who learn mindfulness and practice mindfulness will say the pain didn't change. My experience of the pain changed. You and I both have tinnitus or tinnitus. Uh I don't hear it now. It's always there, it's never gonna go away, but I don't hear it.

SPEAKER_03 18:57

I obsessed over it as well. I couldn't sleep, I couldn't eat, and then suddenly the power of attention, my tinnitus has never changed. Right. And yet I don't, in fact, I think the fact that you just brought it up, I just remembered it exists. Right to for it from it going from the most important thing in the room for months, I lost weight, you know, because it's too meh. Right.

SPEAKER_02 19:21

Yeah, meh.

SPEAKER_03 19:22

In fact, when it's loud now, I'm like, oh, I must be stressed or chill out.

SPEAKER_02 19:26

That's exactly right. It means I'm sleep deprived, it means I'm a little too stressed, I'm driving myself too hard, it becomes a cue. It's so interesting, too, because I think I was working with a person actually earlier this week who said, you know, what what's happening is when an anxious triggering thought pops up, I noticed that I I don't even have to coach myself through moving my attention anymore. Like he's just worked on it so much over the last year that it's just an automatic response now. Oh, yeah, that's that's fear trying to get my attention of going back to this meeting that I'm in. And the the impact was shrunk to almost nothing. And he's like, Yeah, I don't even have to, I don't even have to coach myself anymore or remind myself. Oh, go back to the meeting, go back to the meeting. Yeah, because all those reps moving your attention actually mattered, and that muscle got stronger, and now it's almost automatic for him. Like, oh yeah, I noticed uh I just had a scary thought. Um I'm over here though. We're not doing that.

SPEAKER_03 20:17

Yeah, yeah. Just shrugging your shoulders is justn't, you know, you don't have to change everything because of it.

SPEAKER_02 20:23

No, um one of the things that I want to bring up real quick though, if we go back to that article, uh Locus Corelius, the the emperor, you know, it talks about how, like, you know, in an attentional redirect system or a framework, if you're going to use that, which we're talking about all the time, the attentional redirect has to be something that has some reasonable duration to it, because it has to outlast the anxiety and the panic or whatever, the triggered state. And it has to fill up your working memory. It has to it has to have enough cognitive load, which is one of the great reasons why traditional CBT is like bullets off of Superman we discovered in this in this environment. We tried, but or calming or soothing because then you your your task at the moment becomes managing and looking at the thing that has hijacked your attention. So if you think that every time you get triggered, your job is to do some sort of intervention that calms or soothes or puts you in a ventral vagal state or whatever you think that is, you are legitimately like staring at the thing that should not be stared at. I'm trying to manage it. That's the worst possible thing to do. And that's why those things just are never-ending hamster wheel that I just have to tap my cheekbones all day long to try to manage my anxiety. That doesn't work out.

SPEAKER_03 21:37

So no, no, that makes sense. Do you want some nerdy stuff?

SPEAKER_02 21:41

I a hundred percent. I'm here for the nerdy stuff.

SPEAKER_03 21:44

Okay, nerdy stuff number one is obscure quotes from Gladiator. You you knew Marcus Aurelius. I did not say I knew him. I said he touched me on the shoulder once. Rest in peace, Oliver Reed. Second nerdy thing is working memory capacity. And cognitive load, uh, which I'm going to read from from the articles. Working memory is the cognitive system responsible for temporary temporarily holding and processing information. It has a limited capacity. According to attentional control theory, anxiety consumes working memory resources, particularly the central executive by prior prioritizing threat-related stimuli, which we can all relate to. You know, all of our attention, this is why I can't not think about it. I cannot do that. Yeah, this is what happens. Anxiety does consume in that moment your working memory. However, the reverse is also true. Engaging working memory can reduce anxiety. Studies using high-load cognitive tasks, like the NBAC task, have shown that when working memory is fully occupied by a demanding task, state anxiety and their physiological fear response, such as the startle reflex, are significantly reduced. They've done loads of studies on this. And because working memory has limited capacity, filling it with a highly demanding and cognitive task leaves no remaining resources for the brain. Now, that's great to know. The perfect one to do there then is allow the anxiety to be there and commit your attention to what non-anxious you would do. You don't, I'm not, we're not saying wheel around a giant whack-a-mole machine, and every time you get triggered, you have to plug it in and start whacking moles because it consumes your entire working memory. What we're saying is you're allowed to, the permission to give your attention to something else, towards your values, to do whatever non-anxious you would do when triggered, whilst allowing the feeling, is the way out. Yeah. Any polyvagal theorist on that.

SPEAKER_02 23:38

No, you're right. And the the article even goes on to say, and I love this, because it can easily, an article like this will easily be hijacked by wellness, wellness TikTok or whatever. And like, oh, look, yeah, let's let's hack the attentional system, let's hack the locus corellius. No, the article is very clear, and I love it because even though it's all neurobiology based, which is fine, it can go off the rails, it's like, yeah, but you cannot engage in these high cognitive low tasks with the intention of fixing the anxiety because you will actually counter that's counterproductive. It legitimately says that. The goal is not to frantically fix or escape the feeling as urgency breeds more anxiety. So that whole idea we're like, oh, now that we have all this cool neurobiology, we can develop a hack. This is a technique you use to hack this system. No, because then you're going in thinking that you can fix the anxiety or make it go away. I think it's a tapering thing. So the anxiety shows up and it peaks, it's going up, it's going up. At that moment, the brave choice is I'm going to try to engage in another task that's more meaningful to me in my life. And as my attention shifts into that task, the loudness of the anxiety will taper down while the attention on the other task tapers up. But you got to be patient and let that happen naturally.

SPEAKER_03 24:49

Oh, yeah, that one there.

SPEAKER_02 24:51

Take that quote, put that in the uh yeah, whatever we're if we actually used podcast promotion, we would use that quote. Yes, that's exactly right.

SPEAKER_03 24:58

No, but like at the start of the episodes where you like two. Oh, that's it. Oh, you're making the sound better than we are.

SPEAKER_02 25:04

No, it's a taper. You have to let it like a crossfade, you know. Like you can't say, like, oh, I'm gonna go to this crossware puzzle and bam, cut off the anxiety, and I'll instantly be involved in the crossware puzzle. No, you won't. Like, no, Sudoku with it.

SPEAKER_03 25:15

Yeah, do a Sudoku with it. Yeah, let's have uh let's have uh another community one. Thank you for the one from the an audio, or have we got one from uh well. Let's do one from the community.

SPEAKER_02 25:27

Yeah, because I think this is really great, and I want to, you know, I'm gonna say the person's name, but um, this person posted just a day or two ago, and she says so many things this week with a lot of exclamation points of the clear excitement, and there's pictures, by the way, which are lovely. Traveled 16 hours in a car with my husband, ate so much food with all the oh, so much food. And in parentheses, she says, You have no idea how amazing this is when I only ate 10 foods two months ago, danced at a bar with some ladies for hours, had an alcoholic beverage, shopped, spent time at the beach, et cetera, et cetera. Just two months ago, I would have been scared to death to even think about taking a vacation like this. And although I've had anxiety 24 hours a day while here, I have just brought it along with me everywhere I've went. And I feel like this has been a huge rewiring trip for my brain. Hell yeah.

SPEAKER_03 26:21

Get in. I love that. So good, right? And that follows on nicely from what you were talking about. You know, there's that I'm practicing, I'm rewiring for my brain, I'm actually enjoying it. But yes, anxiety is there, and the more the use of the attention, the easier and easier it'll get. And you know it's rewiring because if I said to you now, you know, you have to do that trip again next week, yeah, how would you feel less anxious? Right. Well, there's an evidence of that tapering.

SPEAKER_02 26:47

Right. And but I I think only, you know, the thing that's tricky about that, and we have an audio data in any way that speaks to this that I'm gonna play. Could you do the trip next week? Well, I would suspect that in our community, not just the community app, which is awesome, by the way, should check it out, disorder.fm slash community, but not just that community, but the entire listener base. 50% of the people would say, Yeah, I I think I learned that I could do that again. They might still be doubtful. That's okay. It takes a while to build that confidence. And the other 50% would be like, oh no, it was awful. Because the only thing they are paying attention to in retrospect is how they felt. So it was awful. It was terrible. It was awful. I just I felt like I was gonna pass out. I felt like I was gonna choke. I felt like I was gonna die, I felt like I was having a heart attack. Did you choke? Did you die? You have a heart attack. No, but it felt like, and I can't do that again. So it's so important. Your attention will get hijacked even after the challenge if you're not careful. And it will insist that all you do is tell a story of how awful it was. Oh, I love it. The person who sent that in is in our studio audience right now, watching us record. And she said, Yeah, I could do that trip again. I'm so proud of myself. That's how you take the the W. Take the win, take the lesson. Yeah.

SPEAKER_03 27:56

Excellent. Love it, love it, love it, love it. Uh, so good. I've got one by, you know, let's let's uh let's have a read of this one, shall we? Um let's see. Do they say we can use the name? Uh, I'm not gonna assume. Okay. Dear Drew and Josh, hello from Cambridgeshire in the UK. I'm so glad I found your podcast and want to say a huge thank you. In May 2025, after a faint backwards onto the bathroom floor with concussion and some nerve damage along my spine, I was diagnosed weeks later with PPPD. Very debilitating trampoline walking, fireworks behind my eyes, etc. I immediately accepted this was a neural circuit disorder and made quick progress until a frozen shoulder last October affected my physio homework to move normally. I soldiered on, but seemed to stop making progress by February this year. I was going down rabbit holes of well-meaning advice when I heard Yonit Arthur, steady coach, recommend your disordered podcast. That's really nice. Thank you, Yonit Arthur. Whoever that is. Dr. Yeah. That was a massive turning point. Your explanations really resonated. So thank you. I had not been fell climbing since this happened. We returned yesterday from Somerset, where I took Craig the Critic with us as I struggled up the Quantox. This is only 1,000 feet, not a Monroe or Lake District. What's wrong with you, etc.? I ignored him. Oh, wait, this is only a thousand feet, not a Monroe or Lake District. What's wrong with you? That's your Craig the Critic. He sounds like he went to Eton. I ignored him as my head pressure increased and felt such achievement that evening when my calves ached. I love this. I have a Faye's return to work next month in an acute clinical environment, cardiac cath labs treating 999 heart attacks. At various points last year, I wondered if I was broken and would ever get back to it. As you advise, I take credit for the work I've put in, but you guys were in my ears as I ventured across Cambridge on my own, in bright sunshine, navigating bikes and tourists to reach my favourite cafe. Then on further solo outings, your chat is reassuring, down to Earth, and I'm so grateful I found you. Please keep up everything you do. I recommended your podcast to a friend who has just been diagnosed with vestibular migraine. Isn't the body-brain thing fascinating? All the best. Oh, love this. That was really good. Well, welcome. That's a journey, isn't it? I mean, we don't really like to use the word journey, but yeah. I'm gonna describe that as a journey.

SPEAKER_02 30:30

Yeah, 100%. Love it. You know, that critical voice, like you should be doing this, is an easy climb. What's wrong with you? You shouldn't be struggling with this. Yeah, but you know what? It doesn't matter! I was gonna get it in. I was gonna get it in at some point. So that ability to recognize it.

SPEAKER_03 30:46

Do we still have the eagle sound?

SPEAKER_02 30:47

I have to put it in. I don't have the eagle sound in the soundboard. I'll put it in there though. You know what I have to get rid of though? I'm a little nervous about this, but I might have to get rid of that. I miss our sad fanfare. It's how we when we release books. I'll put it back in for that. Anyway, that was a great did it anyway. That really was very inspiring.

SPEAKER_03 31:09

The climbing using uses of attention as well through all these did it anyways. Love it. Look, where is your attention? Do you find ever find it? A wonder that when you're distracted, you don't feel as anxious. Well, yes, because you're misusing your attention. It's very hard because when your brain literally thinks it's threat and it triggers your doubt response, you're supposed to feel doubtful. This is what I said. You're supposed to feel doubtful, you're anxious. Yeah, but how how do I know to leave this alone? You don't. You're supposed to practice with your attention whilst being doubtful. That's the skill, that's the willful tolerance of uncertainty that we bang on about. And all boils down to the wonders of your attention.

SPEAKER_02 31:49

Yeah. It's interesting because that person brought up Dr. Yo, Yoni, Arthur. She had me on her podcast. She's called the study coach. And it's so interesting because she just deals with vestibular disorders and vestibular issues. And wouldn't you know it? Wouldn't you know it? The way she teaches people to deal with things like PPPD, which is real, the perceptual, you know, it's the dizziness, it's unsteadiness, migraine, oculomigraine, all that stuff, or vestibular migraines. She could literally co-host disordered with us, and you wouldn't be able to tell the difference. So it's exactly for those of you listening who are like, yeah, but I get that dizzy on a boat feeling. So then the rules don't apply. As it turns out, we were you a guest on that podcast. I was a guest on her podcast. She was lovely. And yeah, we we are in quite an you would agree with her on so many different things. We had a few moments where we disagreed, but it was respectful and it was fun and it was informative. But interestingly, the way she teaches people to deal with the vestibular issues is exactly the way we teach people to deal with panic attacks, OCD, health anxiety. The same thing. As it turns out, if you make your dizziness the most important, horrible thing, it must have your attention all day long. Then it doesn't go away. But when you learn to like, yeah, I'm feeling this way, what should I do next? What should I do with this? Your experience changes. Who saw that coming? Everybody.

SPEAKER_03 33:04

Here's a disordered tip. Yeah. Say it to yourself, how good am I when you wake up in the morning? How good can I be today at not giving my anxiety attention? Yeah, sure. I can practice. You're not gonna be perfect, no one is. But that's the aim. Yeah. You know, you know, and that's and look and then see what happens.

SPEAKER_02 33:22

And I think I I love that. It's a good way to challenge yourself when you wake up in the morning, but you gotta do it. We do it incrementally. It's okay if you can only manage a few minutes at a time. There's nothing wrong with that because everybody starts that way. Everybody. Yeah, yeah. We had somebody in the studio audience say, Yeah, but it's so tiring when you have to keep bringing your attention back to something else. And that is true. Sometimes, and this is always sounds weird because I know, well, easy for you to say you're like not anxious anymore. It it's a lot less effort if you can let go. Uh it it really is. It's will feel scarier, but often that the tension of you're still bracing while you try to do the seducco or the crossword puzzle or talk with your friend or pet your dog or whatever you're doing. If you're still hanging on and you're tensed up and like trying to make it go away and gritting your teeth, it's exhausting. It is much lower effort. It's not easier, but it's a lower effort when you actually do something brave and fully let go. You have to fully let go. And as it turns out, you use less energy to do that. Who saw that coming? Everybody.

SPEAKER_03 34:22

And remember, you can't. Here's the thing with the attention thing that I always back up. You can never observe the autonomic state shift. Yep. You can stop staring at ass. We're back to here again. I said in my TED talk. Yeah, the more you try to stare at ass, the autonomic state shift, the longer you'll stay stuck because you cannot observe the moment that shifts. So why are you staring at it? You can't, you might as well focus on something else. Yeah. Because it won't go with you staring at it. It does not work like that. No one, I've never met a single person that has pinpointed the exact moment their anxiety disappears. They can narrow it down to a window. Oh, oh, within the last 10 seconds, I think I know it's someone. But no one ever stares at it and goes, Right. Oh, now I'm calm. Have you ever done managed to do that, Drew? No, never. You only in retrospect can you look back and say, Oh so somewhere within the last hour, I've calmed down. Yeah, I don't know when that happened. The biggest mistake we make is now I'm gonna sit here, lock in, and focus on how I feel to see if it goes away. Absolutely no point. Yeah.

SPEAKER_02 35:25

You know, it's I might, and that is true. There was never a time, although I wanted desperately, I was just looking at it to watch to see if it was going down, and it never worked. It would keep me elevated. Now, in a desensitized or recovered state, I can't say that I can see the autonomic stature because you can't, we can't observe it. But I can notice when I stop escalating that I've learned to notice over time. So if I have an anxious thought, which I can still have, remember the pathways don't go away, they're still there, there's no delete button. Like if I have a particularly anxious day or I get a triggering thought of some kind or a sensation that I don't like, and it can happen to us, we talk about it openly. I am I can observe when I start to resist it and when I let go. But uh, but I'm not like trying to see when a panic attack turns off because that just never works, just doesn't happen. No, that's the trap I used to feel before. How about we do another audio did it anyway? What do you say? Yeah, let's do it.

SPEAKER_01 36:23

Hey Josh and Drew, my name is Chase. Um from Florida, United States. You can use my name. I've had anxiety for about five years, U.S. Army event. So it was all new to me. You guys kind of taught me what anxiety really was, and I am terrified of bridges. I did it anyways. I had to drive over a bridge. Well, they drove me over a bridge for the army. And I was freaking out in the car. The guy in the passenger seat knew I was freaking out as he was driving. And he was like, Are you okay? I'm like, Yeah, you know, I'm just a little nervous about bridges. And he's like, Why? It's a bridge. That kind of made me feel a little bit better. Still was freaking out, a little bit better. And I just sat with it, all the symptoms, the heart not beating thought, the you know, dizziness, the backflips with your eyes, you know, where you think you're doing backflips, everything like that. Went there, came back over the bridge the second time, which equally sucked as much. And yeah, I'm still here. Kind of showed myself that I can do it, and if I have to do it, I can do it again. And uh just want to say you guys are amazing. You guys are great, you guys are hilarious, and uh, I do like the laughs. But just wanted to show I did it anyways. You guys are great, everyone else, you're doing great. Keep it up, you can do it. Believe in yourself, if not anyone else, and have a great day and a blessed day.

SPEAKER_02 37:43

Go get that bridge, man.

SPEAKER_03 37:46

Oh, man. That made me smile. Also reminded me of the movie A Bridge Too Far, which is my grandfather's favorite movie. Ah, that's a great movie. Uh that was uh well done. That's so good. Thank you, Chase. And also as well, the guys, the guys are vet, you know, like it goes to show that anxiety disorders do not discriminate. 100%.

SPEAKER_02 38:06

There was uh, I forget, I mean, professional athletes. There was a guy in the National Hockey League, uh, he had left the team for a while. I'm reasonably certain he started talking about it a little bit. It was an anxiety problem. He had a huge anxiety problem. These are the toughest mofos on the planet. Like I'll lose four teeth and be back on the ice in 45 seconds. And this guy felt victim to an anxiety disorder because oh, yeah. It can happen too.

SPEAKER_03 38:27

You get it, it affects everything. Yeah, you know, that's all good. Yeah, thank you. That was really lovely, Chase, and made me smile. And uh yeah, you did it, buddy. And thanks for sharing the compassion for others as well.

SPEAKER_02 38:36

Hey, for the engineers listening who design bridges, we're sorry. I know just people hate bridges. It's the dentist, it's the bridges, trapped, because I will be trapped, and I will only be able to, I can't get away from the thing that has my attention. A bridge is too much.

SPEAKER_03 38:51

So yeah, well that yeah, I won't be able to get away from the thing that has my attention. Right. Yes, which is the fear, isn't it?

SPEAKER_02 38:58

Isn't that wait-was there a paradox there? Like everybody tries to get away from it, but the way they try to get away from it is by staring at it. How the hell could that be? You're trying to get away from it, but you're looking at it to watch to see if it's going away. That's why we can't do uh control things. Make it this is how you calm down and activate your nervous you know, regulate your nervous system, because then you're looking at the thing that you're trying to get away from and evaluating what it's doing, and the checking state kills you every time.

SPEAKER_03 39:29

So Josh has you know what the busy little bee said next? She told him everything. And on that note, I think we should uh wind down this up.

SPEAKER_02 39:41

You're probably right.

SPEAKER_03 39:42

Locus correctly.

SPEAKER_02 39:44

I think we're gonna need a bigger boat. Yeah, I'll just throw a random quote out for you there. Uh doll's eyes, dead eyes.

SPEAKER_03 39:51

That's I'm gonna mine are all from Gladiators, too.

SPEAKER_02 39:54

Yeah, I mean Dragon Old Dragon.

SPEAKER_03 39:55

I'm actually if anyone's ever watched Gladiator 2, there's some things worse than OCD and Panic Discord. It's like that movie. It sucks so badly. I was like, this yeah, this is awful, this is painful. I'd rather go back to having intrusive thoughts and an A and E or panic attacks than re-watch that.

SPEAKER_02 40:12

Okay, go Gladiator 2 or Kickboxer 2. If you gotta watch one, which what it's which one's kickboxer 2 is all right, it's fine.

SPEAKER_03 40:17

Homage the first one. Kickboxer 1 is an amazing movie, and I will fight anyone uh who says otherwise.

SPEAKER_02 40:24

Oh, kickbox anyone who with me. That really is you I cannot tell you guys how long Josh tried to get me to watch Kickboxer, and I did, and it really was life-changing. I thought I was recovered. I truly wasn't until I watched the movie. It was only about a year ago I fully recovered watching kickboxer, no doubt.

SPEAKER_03 40:42

I might put that on the on the distorted app later like name a movie better than this. I'll wait. I'll wait.

SPEAKER_02 40:47

Fight me. Anyway, guys, attention, attention. We're gonna keep talking about attention and distraction, all these things because I think they're they're really built in. I do a lot of mindfulness work on the app, blah, blah, blah. And yeah, because we that matters. Attention.

SPEAKER_03 41:01

Shock, attention, resistance, shock, little attention, no resistance.

SPEAKER_02 41:06

Yeah, the shock is still there. That's the Claire We's first fear.

SPEAKER_03 41:09

Can't change the shock.

SPEAKER_02 41:10

Right, right, but that's okay.

SPEAKER_03 41:12

Um anyway, cool. Nice, guys. Um, catch us every Friday. We're here. Thank you for the lovely reviews of the podcast and stuff. Thank you for the disordered community uh who support each other, share their anyways, and chat about stuff. And thank you to listeners, and yeah, we'll be here each time. Uh, if you've got uh the disordered guide to health anxiety is available on Kindle and Paperback on Amazon if you want to go check that out. And uh yeah, we'll be here every Friday.

SPEAKER_02 41:40

Yeah, see you guys next week.