Anxiety Questions and Answers (Episode 166)

SPEAKER_02 0:01

How much of your day is consumed by staring at how you feel, monitoring symptoms, threat monitoring, judging your anxiety, is it up, is it down?

SPEAKER_04 0:11

The fear comes before the threat. It's out of order. The only thing that tells you that something is wrong is that you feel like something is wrong. The theme is, I I'm just obsessed with how I feel and what I think, and that's it.

SPEAKER_02 0:21

Your exposure would then be, I need boundaries around how much time I'm giving this. If it's urgent, I'm fueling an anxiety problem. If I'm doing it like non-anxious me would do, then that's the way to do it. And the exposure would be doing the opposite of what your urgent mind wants you to do.

SPEAKER_04 0:38

That's what you gotta ask the therapist, though. Like, uh, you know, this whole thing where we're trying to regulate and ground me forcibly. I've been trying for years and years and years, and I just have to keep doing it over and over and over. So maybe can we try a different approach here?

SPEAKER_02 0:53

Welcome to Disordered. Uh, this is episode 166, where it's a QA with the community, questions sent in. Um, we're gonna answer, go through as many of your questions um as we can. I'm Joshua Fletcher, a psychotherapist and previous sufferer of an anxiety disorder, specialized in the subject. And it's my passion to bring evidence-based, proper advice for overcoming what is can be an annoying, nuanced, and complex condition. Uh, I don't get to do it alone though.

SPEAKER_04 1:22

I get I'm joined by my wonderful partner in crime, yeah, who is uh Drew Linzalata, a therapist that specializes in anxiety and anxiety disorders in New York, so the other side of the Atlantic Ocean. You know, we had that whole transatlantic vibe thing going on. I don't know. Do we still have it? I think we do. Can't tell. Yeah, yeah. I think so, yeah. Anyway, I have pretty much the same bio as Josh. I used to have these problems that we talk about on this podcast, an author, a guy with a lot of microphones, podcast host. And yeah, this is my thing, man. Anxiety and anxiety disorders. It is it is my jam. Love talking about it.

SPEAKER_02 1:52

So excellent. Straight in. Hey, Drew. I've only recently discovered your podcasts and I'm finding them helpful. Excellent. However, I don't have panic attacks, phobias, health anxiety, OCD, or gad. I have anxiety symptoms all day. Turmoil in my stomach, chest pain, derealization, tension band across the forehead. I also have depression. So I'm trying to accept or allow the anxiety symptoms all day long. Have you covered this sort of constant anxiety that has no particular focus other than being anxious about doing anything?

SPEAKER_04 2:30

Yeah, every episode? I mean, at the risk of sounding flippant. I'm gonna sound flippant because you want me to in this situation. You don't want to be unique, and you're definitely not, question sender, interrupt.

SPEAKER_02 2:39

Yeah. Yeah, it's a good question. I hear this a lot. Anxiety in OCD will convince you that yours is special and you must give it your focus, attention, energy, and resources. So there it's helped construct a narrative, hasn't it? No, this is different from what everyone else has. No, look, your symptoms and the anxiety being there all the day long is the problem. But I'd always argue, and I can't diagnose someone I've never, you know, kind of had a had a session with and stuff, but what you're describing is so akin to you know, fear of fear and OCD. It's literally that. If how often, and and answer this honestly to question sender in a brilliant question, how much of your day is consumed by staring at how you feel, monitoring symptoms, threat monitoring, judging your anxiety, is it up, is it down? You know, OCD is obsessive compulsive. I measure how much of your day is obsessing and compulsive, how much of your day is consumed on how you feel. And when you say, Well, I don't have those things, I don't know. Look, if you zoom out a little bit, I was the same by the way. If you zoom out a bit, well, I certainly have an obsession, that's how I feel, and and anxiety itself. Yeah, and my compulsions are monitoring, threat monitoring, scanning, reassurance seeking, ruminating, and there we are, you start to feel like you're in the you're in the rumination town, compulsion town.

SPEAKER_04 4:04

Yeah, I it is it is the common thread across all presentations. In our context, you know, and we we've talked about this before. Some people don't like the word disorder. I love it because it's literal. In this situation, the fear comes before the thread, it's out of order. The only thing that tells you, question sender, and everybody listening to this podcast, the only thing that tells you that something is wrong is that you feel like something is wrong. Now that may vary, whatever the story is that your brain cooks up to explain the internal experience is going to vary from person to person, but the only thing that tells you that something is wrong is that you feel like something is wrong. And that's it. You can end there, it's all good. So you're the same as everybody else, because that is the common thread across all of these different diagnoses or presentations. So yeah, absolutely. Um, so yeah, super common. We have people in our studio audience saying that when I was in the peak, I had symptoms all day, all every day too, and I had no reason. Now I have clarity that I was obsessing about it and keeping it alive.

SPEAKER_02 5:01

Yeah. Yeah. And someone else said I also sit and stare inward at how I feel and wanted to control things I can't control. Sure. All very common. Yeah. You know? So practice, I would say, you know, gently and compassionately, be like, Oh, I've noticed, I'm doing it again.

SPEAKER_03 5:15

Yeah.

SPEAKER_02 5:15

And you're if you're like me, I used to do this all the time. I'd wake up and the first thing I think is, How do I feel?

SPEAKER_01 5:22

Now I wake up and go, Ooh, I've got any bread in a fancier sausage and egg sandwich.

SPEAKER_02 5:28

Yeah.

SPEAKER_04 5:29

That's the difference. There are times when I wake up and I literally will start with, Oh god, I feel like crap this morning, but that's okay. I get out of bed anyway. Like back in the day, that was a reason to stop because feeling like crap must mean something, and I have to figure it out. But so yeah, it's it's it's super normal, it's really okay.

SPEAKER_02 5:44

Um thank thank you for sending that in. It's a really good question. Now no questions too silly or anything on here. And what's really nice about these episodes is that when you send in a question, there'll be hundreds of other people going, Oh, yeah, that applies to me. So well done.

SPEAKER_04 5:59

Yeah. Keep in mind, I think, uh again, just and then we'll move on to the next question. Like, this is why people like Josh and I never, never address the content of the anxiety. Very, very, very rare. If something comes up, yes, maybe. But with there's no root cause in anxiety disorders. We're not looking for the thing that that well, we just have to fix your relationship issue. We just have to fix your health issue. No, no, no, no. We never do that because the theme is I I'm just obsessed with how I feel and what I think, and that's it. So keep that in mind. Yeah. Um have you well have you got Drew? I got one. So here's a question that was sent in uh by somebody who said we could use their name. Hi, Drew and Josh, or Josh and Drew. I'm very diplomatic. This is JT, you can use my name. Hello, JT. I'm a GAD sufferer, and I found that a lot of my rumination involves the older home that I live in. It requires lots of expensive upkeep, like most homes do. And even though I've done quite a bit of stuff, there's always one more thing that needs to be done. So I guess my question is since that is a source of anxiety and worry for me, and I live there, you know, I sleep there every night. Is there a reason why that constant exposure hasn't improved the anxiety and rumination and so forth? Thanks a lot. I think that's a great question, too.

SPEAKER_02 7:09

Oh, that's a really good question. That's a really good question, right? Thanks, JAT. Yeah. Uh that this is when, as like therapists, we'd have to sit and really kind of look at what is happening here. A lot of people in our community, we talk about exposures a lot, and people think, well, exposures are the thing that if I do a thing, my anxiety goes away. But with anxiety disorders, it's two things. An exposure is either doing the scary thing or it's a not doing. That's the exposure. For some people, take the gym, for example. I'm afraid to go to the gym and get my heart rate up. So it would be a doing exposure. I'm gonna go to the gym and get my heart rate up, and that's an exposure to my internal sensations and feelings. But then there's other people that go to the gym and use it compulsively. Oh, I'm feeling anxious and I need to go to the gym and run off all this adrenaline because I hate that feeling. Well, then their exposure would be not going to the gym. It would be sitting and being with the feelings of not doing that. So my initial reaction to this question is yes, I'm doing things that I need to maintain my house, but this seems quite obsessional just from the I'm I'm making a jump and an assumption here, JT. So if I'm wrong, I'm sorry. Um but it for me, my instinct is saying maybe this is a not doing thing or an urgent thing. Because OCD and that type of thing will say, no, you need to do this, this is where you live. Your house is aging, that you live here. But the difference between having to do something pragmatically lies in the urgency. If you feel like you have to do it urgently in your rest time, don't get me wrong, if there's a hole in the roof and you can't go to bed, get it fixed. But you know, if you're doing those things, look at the urgency and the obsessional side of things. Your exposure would then be, hmm, I need boundaries around how much time I'm giving this. If it's urgent, I'm fueling an anxiety problem. And if I'm doing it like non-anxious me would do, which is something we re constantly repeat on this podcast, uh, then that's the way to do it. I don't know. What would you add to that, Drew?

SPEAKER_04 9:10

Uh I I would agree with everything you said. I I think the urgency is always a clue. JT says that he has GAD, so maybe he has an official diagnosis. Maybe that helps us because GAD is generally defined by excessive and difficult to control worry about one or more things. And that usually the definition, the difference between GAD and OCD is OCD tends to be a little bit more, you know, like fantastical or fanciful or or strange fears that we all know can't come true. Whereas the GAD people will say, no, but it's my house. I live there. Like, so this is this is a real thing. So therefore, my strategy, and last week we talked about the strategy of anxiety, is correct. I'm sorry, I can't turn those off because I'm in the app recording. So I don't know if you hear. I can't hear them. Can't hear them? Okay, good. Um, so I uh it the issue here is what is the exposure? So yeah, like Josh is saying, your exposure in the house is I'm going to let myself be worried about my roof, my plumbing, my whatever, the concrete wall, because it's old, but I'm gonna do nothing about that. I'm gonna go play a video game now. I'm gonna watch a movie, I'm gonna eat my meal. I'm gonna just let the worry be there because I have to learn that the strategy of constantly problem solving my own home or old home is not the right strategy, even though the home is in fact old and needs up upkeep.

SPEAKER_02 10:22

Yeah, right. So it's able to hijack something that's important and make it hyper important. That's right. Um, definitely. Also, you can have just OCD of medial things. Yeah. I've had people could happen. Um just just because a lot of OCD sometimes it can present as a sate satiation, but I can't say the word satiation, sating, so satiation. Uh uh a lot of OCD just wants you to feel sated. So it's like, you know, a lot of people sometimes they'll wash their hands because they contamination, but sometimes OCD can be like, it just doesn't feel right. Yeah, that's right. And I'd watch out for that too. So whether it's GAD or whether it's OCD, whatever, there's obviously an obsession there. And the exposure would be doing the opposite of what your urgent mind wants you to do.

SPEAKER_04 11:09

Yeah, when you're thinking about the fact that the windows may need to be replaced because the house is old and it makes you uncomfortable, there's that strong urge to address that discomfort. And then you use a strategy that doesn't help you at all. If you're actually calling the window guy and making plans and picking windows, then you're doing something. If you're just thinking about it, not at 3 a.m. Not at 3 a.m., right, exactly. That's exactly am I doing anything about the windows right now? No, I'm just thinking, so I have to divert to something else to teach my brain that this urgent feeling will pass. So, like, just be careful about how you're doing air quotes exposures for that. Good question, though, JT. Really good.

SPEAKER_02 11:43

Really good question. Uh, I've got a question from Jack. Yep. Uh hello, Josh and Drew. I have a big question for you. Found your podcast through Josh's TED Talk coming across my algorithm. Wow, I got into an algorithm. God, I beat Mel Robbins or something. Ever since then, uh I have been implementing the things you talk about, and it has helped me tremendously with GAD and panic disorder, although I'm still sensitized. I've been working with an anxiety therapist for years, and I'm wondering what you would do when some of the things my therapist says directly contradicts what you guys preach about, such as distraction, breathing to lower the anxiety, etc. What do you think, Drew? How would you what would you say to Jack?

SPEAKER_04 12:30

Ooh, this is a tough one. Good question, Jack. And I think there's a question we do see a lot in public in social media and in public channels. It's hard because as a therapist myself, if you were my my client and you walked in the next session and said, the two guys with the microphones said, I would be like, All right, hang on. Are they in the room with us? So I I I can't speak for you, Josh, but I will always almost personally say, I have to default to the person who actually knows you, Jack, right? So they are a better source of advice than we probably are. I would say to ask them that question. It's okay. If that if that therapist is worth their salt, they want to hear that objection. Like, I don't know. I I I feel like I'm not making progress, and you are contradicting some of the stuff that I see widely discussed in addressing anxiety disorders. So ask them the question, right? But uh it's also okay if you are sure this is my presentation, I panic disorder, I have agoraphobia, whatever you have. I I kind of need somebody who specializes in this, who understands it. It's okay to ask. You could ask the therapist, you know, what do you you treat this, right? You know, what do you think?

SPEAKER_02 13:37

Also, as well, I would I would be a bit more I get a bit more strict with this. You know, all you overcome panic disorder because it is a fear of fear. If you're being taught breathing techniques in response to panic, right, you are teaching the brain that panicking is bad and you've got to get rid of it. So I'm but I I like to just cut through that nonsense. Just be like, no. And I've been through it myself, deep breathing. And then the more you do the breathing and the techniques, and then when it doesn't work, you're often made to feel like, or you're not doing it properly, or you're even more ill than you think. Well, if it's not working for you, then there's something wrong with you. Well, no, actually, it's really common, Jack. We teach we we're overcoming the phobia and the fear of fear. If we're spending all day trying to find techniques and trying to techniquify our way out of a feeling, yeah, then we're just reinforcing to the brain that that's there. And you can say that to your therapist. Say, listen, I kind of feel like I need to kind of be with the feeling more, yeah, as opposed to try to get rid of it. Therapist's not a bad person, it depends what modality they're in as well. But sometimes you need an anxiety disorder-informed person, particularly if my TED talk resonated with you. It's the reason why I said the TED talk's got half a million views now. Yeah, because actually, yeah, that sometimes there's a different approach. I love deep breathing stuff like that. When I'm stressed, I'll go and do a mindfulness, deep breathing. I will de-stress, but I won't do it to throw it at a phobia of how I feel.

SPEAKER_04 15:06

Well, because your stress is in an emergency, it's discomfort that could be addressed. Yeah, I'm working really hard, or there's a deadline or something, and I'm gonna take a break to chill out. Are you right? So, what I think what Josh said is perfect. That's what you gotta ask the therapist, though. Like, uh, you know, this whole thing where we're trying to regulate and ground me forcibly, I've been trying for years and years and years, and I just have to keep doing it over and over and over. So maybe can we try a different approach here? I need to learn to get through this instead of instantly clamp down on it. Admittedly, though, that is a hard sell because many therapists, and I'm not picking on them, I think everybody is well-meaning. They the default is I have to help you feel better. You're my therapy client. I I have to help you feel better. So we are weird in that, like, no, we actually don't. I gotta I gotta help you learn how to get better at feeling crappy.

SPEAKER_02 15:52

Drew and I are like, what can we do whilst feeling like trash?

SPEAKER_04 15:55

100%. That's exactly right. So, like when I'm working with an emetophobe and we spend half the session having her tell me a very detailed story about what happens when she drinks spoiled milk. Like most therapists are like, You're traumatizing. That's we can we have to regulate. No, actually, this is getting her better now, believe it or not. So, anyway, yeah, yeah, yeah.

SPEAKER_02 16:16

That's cool.

SPEAKER_04 16:16

Yeah, should we uh should we have a did it anyway break? We can have a did it anyway. We have some written ones, we have an audio. How about we play the audio one because it's pretty good?

SPEAKER_00 16:25

Hi, Josh and Drew. My name is Madeline. You can totally use my name. I'm sending this in from California. Just wanted to share my did it anyways. A little bit of backstory. I'm a graduate student studying architecture. And a couple months ago, after a really, really stressful semester, I started having panic attacks and just a flare-up of my OCD and anxiety. And last time I went to a movie theater, which I usually love to see movies, I ended up leaving within the first 10 minutes of the film. I just felt really uncomfortable. I was just completely wound up and overstimulated. And so this past week, my friends and I bought tickets to see a highly anticipated movie. Um, and I was so anxious about it. I had so much anticipatory anxiety, just the whole week was completely like terrified. And then I ended up just sucking it up and going. Throughout, I definitely had you know symptoms. I had chest tightness, I had shortness of breath. I felt like I wanted to leave. There were times when it was really loud, there was times when I was overstimulated, but I sat through the whole thing. And for reference, it is a three-hour movie, and so I'm really proud of myself for that, anyways. And I ended up really enjoying it. And then afterwards, we sat in a really long line out of the parking garage, and that usually makes me nervous too. And I just kind of, you know, popped on some jobs and just talked with my friend, and I'm really proud of myself for that, and I'm proud of myself for you know sitting through it and doing it anyways. Also, thank you so much for your podcast. Genuinely has helped so much. You guys can't even understand. It's been a great compliment to therapy, and these do-it anyways are just so empowering. And so thank you so much.

SPEAKER_04 18:22

Amazing how I'm sitting through the movie. Lovely. It's such a common experience for people in our community, and it's a big win.

SPEAKER_02 18:28

I love yeah. Also, you went to see Odyssey. You could you went you went to see Odyssey.

SPEAKER_04 18:33

It's the only three-hour movie out at the moment that I'm aware of, right? Uh so yeah, yeah.

SPEAKER_02 18:37

Well done. Well done. That was so so well done. Um I hope you're really proud of yourself. Thanks for sending that in.

SPEAKER_03 18:44

Yeah.

SPEAKER_02 18:44

Also, my brain, this is where my brain goes. I went, I went to the movie theater a few years ago and I had to leave after the first 10 minutes. Yeah, you probably were watching Gladiator 2. I did the same.

SPEAKER_04 18:56

I love the grudges you hold against certain films like Gladiator 2. I love it.

SPEAKER_02 19:01

I I'm never no.

SPEAKER_04 19:04

No, I'm never gonna forgive those people for that.

SPEAKER_02 19:08

Ridley Scott is one of the greatest directors ever.

SPEAKER_04 19:10

True.

SPEAKER_02 19:11

But he's not made a good movie in 20 years. Yeah, you know, stop it. Stop it.

SPEAKER_04 19:17

Come on, dude. Enough already, right? So I get it. Yeah, uh, no, it was really, really well done.

SPEAKER_02 19:23

Someone in the community said I went to see minions this week.

SPEAKER_04 19:25

Is that three hours? Not three hours of minions, is it? Three hours of minions. Oh my god, how traumatic would that be? I mean, cute, but like really. Um I kind of get it. Uh, somebody asked a question in the studio audience that kind of piggybacks on that, did it anyway. What is the best intervention for anticipatory anxiety, like Madeline described? What would you what would you say, dude? Because she was talking about how she was a mess the whole week before the movie.

SPEAKER_02 19:46

What do you do? Um acknowledge that it's okay to be nervous towards something, you're not trying to get rid of anticipatory anxiety. Um just kind of being aware of it, noticing that it the rumination is not a tool to stop the outcome. But you will sometimes keep checking in on it because that's what fear does. Um, to not you're not trying to get rid of anticipatory anxiety, but you're also not trying to fuel it and see its importance. Um, Stirly Winston and Marty Seif's book on anticipatory anxiety is really good as well. I re that's a good one.

SPEAKER_03 20:18

Yeah.

SPEAKER_02 20:19

You know, um, that's also one specifically if you want to read about anticipatory anxiety.

SPEAKER_04 20:24

Yeah, I'd agree with that. I my clients do pretty well when we work on the anticipatory anxiety by not working on it. Like, okay, you know you're gonna do an exposure tomorrow and you're really nervous about it, then just be nervous. Do your life while you're nervous about tomorrow. And that's a way to practice willful tolerance in a lower stakes way. And then, well, what happens when I get to the exposure? We'll just keep bringing that in. I know, make it sound easy, but anyway. Um a Hungarian art house film, it's seven and a half hours long, says somebody in our studio audience. Youch.

SPEAKER_02 20:52

I'd rather watch that than the first 10 minutes of Gladiator 2.

SPEAKER_04 20:56

He's described it as a bit slow, the seven and a half hours. Uh very good, very good.

SPEAKER_02 21:04

Whose turn is it? Yours, I think. What have you got?

SPEAKER_04 21:06

You were the last question, right? Okay, here we go. Um, hi Josh and Drew, Kara from Germany here. Hello, Kara. I hope it's okay that I sent another question. Oh, okay, the last one for 2024. It's been two years, so fine. Um, I've actually written my question down. Uh this was an audio recording, so I'll cut to the chase. How can I work on real tasks and problems without my OCD making me feel like I have to fix them 24-7? I end up constantly thinking about it all day, every day, even though I know it's not productive and it's not doing me any good. For example, relationship issues are all just all day, everyday issues that just can't be resolved, like within five minutes, or maybe just an issue with a loved one, things like that. I'm really struggling with it because I want to do this in a non anxious, non compulsive way, but I keep stepping into OCD territory and it sucks. Sure does. Any tip, any tips? What's the old any tips? Ooh.

SPEAKER_02 21:53

It reminds me a lot about the house question, actually, as well. Like yeah, a little bit like kind of how do you know what No um I don't know. What do you think?

SPEAKER_04 22:01

What's your initial So sometimes and and it's funny, I posted an article in the community app about this um earlier in the week where we always talk about do what non-anxious you would do, anything but rumination, redirect your attention, outward focus. Yeah, those are all episodes those are all examples of response prevention, right? So we're always working in the ERP model, which is exposure and response prevention. When you do what would non-anxious me do, or redirect my attention or focus outward or whatever, you're doing the RP part. If the RP part isn't enough, which often it isn't, kind of have to add some E in there, I think. So I can only suggest, right, because Kara, we don't know you, we we actually don't know what the specific situation is, but sometimes when all you're doing is just constantly redirecting, redirecting, some people make great progress that way, and that can actually get them where they want to go. But if you're dealing, say with a relationship issue or whatever, you know, we might actually want to start to trigger that intentionally so that you can practice intentionally and in a more consistent way, like telling that imaginal story about how your relationship falls apart, even though you want this to be the love of your life, and just sitting with that discomfort. Like sometimes I think adding E can can be the magic thing that people are missing. I don't know if that makes any sense. Or maybe not. I could have this wrong because I don't know you, Cara, but that's one thing I might look at.

SPEAKER_02 23:16

Yeah, often I what I do as well, like if it's like relationship OCD, it could be, I'm not sure. You know, I don't know enough, but like but the relationship OCD is like, oh, what if this is wrong? What if they're gonna leave me? What if they're not the right person? What if I don't truly love them? What if I find uh other genders more attractive than my partner? Uh yada yada, etc., etc. Just says the same, plays the same tune. I'll often encourage people to like, well, do the opposite. What would non-anxious you do? Well, actually, probably give them a hug and a cuddle, then do it then.

SPEAKER_03 23:46

Yeah, cool.

SPEAKER_02 23:47

And then if you are giving them a hug and a cuddle, but you're in your head, like, oh, what if, what if, what if, and then just come out of that, talk. Right. Show the uncertainty response. There's no urgency here, you know. That question doesn't need to be there. Also, as well with relationship stuff as well. I always ask that question how do you feel when you're chilled and not triggered? Oh, happy I really get on my partner. Well, there we are then. Right, right. Exactly, right? But I want to feel certain whilst triggered. Oh, yeah, oh, really? Oh, is that all you feel certain about a question whilst triggered? Oh, right, okay. Oh, okay. Well, if if I find someone that works that hard up to do that, I'll let you know. Because I don't know how to do that either.

SPEAKER_04 24:26

That's a good point. Like, I'm not really in a way, the the equivalent is I, you know, well, what what kind of food do you want right now? Oh, no, I'm not really hungry right now. Yeah, but I want to know what to eat when I'm hungry. Yeah, I know. So does everybody. So, like, I want to I want to be certain when I'm uncertain. Uh yeah, I know. That's a good analogy. Yeah, yeah. Yeah, exactly. Right. So um, I kind of get it, but it's tough because sometimes you don't even know what the E would be, you know, like uh, but and that would have to be very, very individual. You don't know, but uh and as an example, somebody in our studio aren't just talking about being kind of fixated on the fact that the the pet situation in their house has changed so that introduce new animals into the house, and so this person's brain is constantly looping back through what is going on? What if this what if something bad happens? Well, sometimes it can be helpful to practice that. Go ahead and write the story about some horrible animal apocalypse if you need to, and if that's super triggering, sit with that, let it dissipate over a few minutes. You know, that your brain gets the message that way.

SPEAKER_02 25:21

Yeah, I often use the radio analogy as well. Like, oh, there's radio, what if again?

SPEAKER_04 25:25

Yeah.

SPEAKER_02 25:26

Do I tune into it or do I just let it play in the background? You know, and that's that's a that's a practice. I I can't turn off the radio, but I can decide to tune in to it or not.

SPEAKER_04 25:37

And if I'm if I'm running from that constantly, then I might have to actually lit turn up the volume and listen to radio what if that's the E. We should start that. That's our second side project, Radio What If. It's just 24 hours a day of us reading horrible nightmare scenarios of just anything that comes in our heads.

SPEAKER_02 25:56

That would still be more helpful than the Anxiety Guy podcast.

SPEAKER_04 25:59

Right and more entertaining than Gladiator 2.

SPEAKER_02 26:02

And more entertaining, yeah. Um here's a question. Uh they've not given permission to use their name. Uh hey, sometimes my anxiety feels so intense that I struggle to eat. This could could be my emetophobia speaking, but I'm worried that if I eat when anxious, it will increase my chances of throwing up. But another thought that I know sounds completely irrational is that if I eat, I will give myself the energy to panic or feel more anxious. I'm not really sure how to get around this, but it really scares me because even though I want to, and I know I need to eat, I feel as though I physically can't. And we pitched this question to our emetophobia um expert on the panel, Mr. Drill Insulata. How would you respond to that?

SPEAKER_04 26:48

Well, you know, we talk about this stuff all the time. You know, do it anyway is a good example. Do it anyway. Well, I want to eat, I know I have to eat, but I'm really the eating makes me very uncomfortable. It triggers a fear in me. Okay. Well, the trick is I'm gonna have to eat and then be really uncomfortable about what's going to happen. There's really no that that's a very simplified explanation, but uh most of the time the person's gonna try to find a way to not I don't but I don't wanna what do I do about that fear? How do I get rid of that fear so I could eat again? Well, you kind of if it's if you haven't been able to do that, then you're gonna have to start to and it's okay to do little nibbles, it's all right. You could do that in a graduated way. You don't have to go and eat a steak dinner, force it down your throat. But I feel like I can't eat usually in my practice means no, I can, just that when I go to eat, I get really uncomfortable and really afraid, and I feel like I'm making a mistake, so I put down the food. Uh you're gonna have to keep keep chewing, keep chewing, you go ahead. You could do it, you could swallow. Yeah, but then what if I gag or what if I start to get panicky? Like, oh well, let's see what happens. Let's experiment, see what happens.

SPEAKER_02 27:50

Yeah, you say you're safe and you're okay. Um, I remember what before the TED talk that I did, like when when you're anxious about something, yeah, you don't feel hungry. I was terrified and I felt sick. And I literally say in the TED talk, I'm afraid I I'm having intrusive thoughts of throwing up over Olympian Chris Boardman. You didn't see him in my video though, and um, yeah, a gold gold medal, multiple gold medals winning Olympian Chris Boardman.

SPEAKER_04 28:18

I'm gonna throw up on a gold medal winner, yeah, exactly.

SPEAKER_02 28:22

That'll be that's that's the real highlight of your career. Absolutely. And um, yeah, I remember doing that, and but I remember making soup and just you can still eat. I remember I was like, I don't want to have this soup, but I'm sipping it, I'm getting nutrients in, it's all good, and actually it's good for your stomach because it settles it down a bit better, you know. Yes, you've got the go and lean into the uncertainty, but then you've also got just basic stuff like you're gonna feel better if you eat. Yep, no one feels better from not eating.

SPEAKER_04 28:49

That is true. We have to there are certain truths that I think in this process we always have to land on, like that. No one feels better not eating, simply not true. Because in the long run, that's gonna bite you in the butt, right?

SPEAKER_02 29:00

And it's yeah, and then you've got more stomach acid, and then then it's gonna it's it's not good. Just get some of it in there, you're all good. It doesn't have to be, you know, a wagyu steak. You know, you can just I I can make a nice tasty soup and I put it in a flask and I sip that all day and I'm getting all my nutrients and I feel better.

SPEAKER_04 29:17

Yeah, I think the other thing you gotta arrive at as truth or or be willing to call out is it's interesting because I'm watching the comments in our audience here. This person said, if I eat, then I'm providing energy for panic. And another person said, Yeah, but with rest, if I rest, then I'm fueling the panic engine. So I will deprive myself of rest. Like, yes, you're right. If you rest, you would have probably more energy after the rest. So you have to be willing to call out that is patently absurd. That reasoning makes zero sense. I will deprive myself of rest and and food.

SPEAKER_02 29:49

Yeah, because like usually in my experience, you panicking regardless, whether you or if you're overtired, yeah, you know, always nurture your body and rest. Yeah, there is no you are not saving yourself, no matter how your anxiety or avoidance manifests. Eating and resting is always the best thing to do. Yeah, and if your anxiety convinces you otherwise, yeah, but if you rest or if you eat, it's fuel for panic. No, a stern no from here at disordered.

SPEAKER_04 30:19

Yeah, and then so you know, somebody had to chime, of course, yeah, but anxiety doesn't yield to logic. That's right. But if you if you insist that its logic is is must be followed, but it's so scary and it's so hard to disobey, okay, then then you're done. Then follow it and don't eat and don't sleep. But you have to go to call it book.

SPEAKER_02 30:38

Right. It's not anxiety, it doesn't yield to logic. You must yield to logic. Yeah, anxiety's not going to do it. It's you.

SPEAKER_04 30:46

So you will yield to it all day long. You will listen and follow it all day long and then say, yeah, but I can't use logic. No, you are. You're using its logic and calling that correct. That is not right. You have to land at that is patently absurd. Do I hear myself say that out loud? I I can't eat because it might fuel a panic attack. Forget my bodily organs and my brain and everything that needs fuel. I will deny that so that I don't fuel the panic. Does that sound right if you say it out loud? No, you gotta be able to call the shit out, right?

SPEAKER_02 31:14

So I also relate to it as well. I can see my brain's done a lot of that as well. Oh, yeah, like I um yeah, I I used to not. Everyone knows exercise is good for you, regardless. Everything it's a fact. Exercise is healthy and good for you, but I would not exercise because yeah, it would evoke panic and feelings, you know. And then and then you're like, hold on, let's question that a bit. But really, really good question. I really, I really like that. Thanks for sending that in. Yeah. Um and the honesty around that.

SPEAKER_04 31:42

Yeah, yeah. No, I get that. And and anxiety won't listen. You're right, we're calling out the irrationality. So you're gonna have to do something brave. That's just the way it's gonna have to be. You're gonna have to do something brave, disobey its strategy and its logic, and then then it will yield to rationality. But you're right, just the rational thing by itself won't do it. Um, I have a I have a question. Um Yeah, this I think this is a pretty good question. So the question came from our from our community, but I won't say the person's name. How do I know if I'm planning a compulsive exposure? This is really good. I've been doing various values-driven exposures for the last few months to prepare myself for an upcoming flight overseas, but usually top of the exposure ladder, right? I struggle with OCD and panic disorder, so I have the whole I'm afraid of being trapped on the plane thing. So I've been doing things that non-anxious me would do while feeling anxious as prep. Well done. Trains driving far away, no cell phone service. Excellent, really. But now I feel like I need to plan a practice flight ahead of my actual flight. I think I probably want to do this to expose myself to the fear, but largely I want to do it so that I can rip the band-aid off, feeling af getting get feeling afraid out of the way and stop worrying about how I might feel on the actual flight. I can sense that I it might be genuinely helpful for me to do a practice flight, but it also may be a bizarre new form of avoidance. Non-anxious me would never take an aimless hour-long flight. Anxiety aside, I just don't want to do this because it sounds exhausting and like a waste of money, but I worry that not doing it will leave me unprepared for my overseas flight. What do you think? See how they see what's happening here?

SPEAKER_02 33:08

Press the button. Yep. Craig.

SPEAKER_04 33:11

Oh, 100%. It's Craig the Critic. Yeah, I'm you're gonna do it wrong. You're doing it wrong.

SPEAKER_02 33:15

Craig the critic, one like no, literally, go and take an hour flight to do something wonderful and compassionate for yourself and do an exposure. Yeah, and the only thing that's intervened there is Craig the Critic, who's saying, This is silly. Why would you do that? Non-anxious you, it's oh, it's been brought to this. It's Craig the critic. Tell him to do one silly. It's so good. Ignore that critic side. That's all I have to say about that.

SPEAKER_04 33:41

Yeah, it's interesting because you can see the cycle turning, like, well, it would be good, but but then it would also be a waste of money, and I wouldn't normally do that. Yeah, I know. Every statement was correct. That is right. Like, there is no perfect correct answer to this. If you do the practice flight, cool. If you don't do the practice flight, cool. Guess what? In the end, it seems like you're making progress, you're doing a good job already. So either way is okay, and maybe the trick is no matter what I pick here, I can be okay. So let me make my decision and end it. And then that's it. I made the decision.

SPEAKER_02 34:11

Yeah, yeah, absolutely. That'll be the first thing to do there. Just notice uh, label, that's Craig the critic. Yep. You know, you your logic is brilliant, but you're listening to a very loud critic. Oh, that's silly. Why are you doing that? Right. Other people don't do that. Yeah, they do. We set homeworks to do that every week. There is people around the world doing third wave CBT, doing the most ridiculous, interoceptive exposures, plight uh plans, stuff like that. That flight is yours, go and do it. Yeah, and and and enjoy it and give yourself a pat on the back.

SPEAKER_01 34:42

And when the Craig, the critics like, Oh, you never used to have to do this. Uh oh my god, the non-anxious, you wouldn't have to do that. Just tell it to shut up.

SPEAKER_02 34:53

Yeah. When you get off that plane, pat on the back, get yourself a gelato, and skip on.

SPEAKER_04 34:58

Yeah, that that practice flight was compulsive. It was you were compulsing, you're not doing it right. You're never gonna get better that way. Like, get get bent. No, really, seriously.

SPEAKER_02 35:06

You're doing a scary thing, yeah, and you're rewiring your brain, and well done. That's it. That's all I say about that.

SPEAKER_04 35:13

Wow, the comments. Everybody in the studio audience hates Craig. I'm looking at one right now that I won't read.

SPEAKER_02 35:21

Honestly, it's the most frustrating thing as a therapist.

SPEAKER_04 35:24

Yeah.

SPEAKER_02 35:24

Hearing people's inner critics, you know, not them, but they're inner critics. Yeah. No, it's a block to seeing how capable they actually are.

SPEAKER_04 35:31

Yes, you're 100% right. Yeah, yeah.

SPEAKER_02 35:34

They'll sit there and have a panic attack and think that they're burdening me. And I'm like, no, I can watch this all day.

SPEAKER_04 35:38

Yeah.

SPEAKER_02 35:39

But that critic, oh, that's the biggest block.

SPEAKER_04 35:42

100%. What else we got? Anything in particular?

SPEAKER_02 35:45

What have I got here? Yeah. Oh, I've got one from the community. I like this one. Uh this is uh this is a did it anyway from the community. Bring it. Uh I like this one, only a short one. Uh, I'm not gonna read the name, but um, my anxiety is primarily health and sleep issue based. But traveling always but traveling always makes me anxious, but now I'm afraid that I'll panic, be anxious, etc. Unable and unable to travel back or make a fool of myself. This last week I went to a church camp three hours away and stayed the entire time three nights. I was anxious, I had a lot of DPDR, which is my main symptom currently, as well as some pretty strong dread down feelings since I returned. But I did it anyway.

SPEAKER_04 36:32

Oh I did the wrong one again. I gotta get rid of that. That's the sad way to I gotta play it again. So good. I mean, it's a fanfare, right? Well done though. Very good job. Very good job.

SPEAKER_02 36:46

Yeah, excellent, well done. Uh, and you've proven to yourself in the anticipatory anxiety, it's like, oh, you're gonna go there, freak out, make a fool of yourself. You didn't make a fool of yourself. You went, you're anxious, you had all the symptoms with it. Didn't make a fool of yourself, did you? Well done.

SPEAKER_04 37:01

Yeah, absolutely. You always you always gotta take the lesson out of that, too. Always remember when you do something hard, yeah, you did it anyway, celebrate for sure. What did I learn about that? I there was a voice in me that was absolutely certain this was gonna be a disaster. I would not be able to tolerate it, unhandleable, meltdown, horrible nightmare. And as it turns out, I was able to handle being uncomfortable three hours away at a thing I wanted to go to. Who knew?

SPEAKER_02 37:23

Very good, very, very good. Very, very good. Uh, what time are we on?

SPEAKER_04 37:28

Got time for another question? Or well, we got I have a uh written did it anyway, which I think is always nice to hear. Actually, we do it.

SPEAKER_03 37:34

Okay, written did it anyway.

SPEAKER_04 37:36

I don't know if we're allowed to use this name, but so I'll just read it. Uh just over a year ago, I became sensitized after a successful long struggle with secondary infertility and battled through my daughter's third birthday, feeling guilty that I couldn't be more present. Oh boy, I hear that all the time. Uh fast forward to a year now, and I am 23 weeks pregnant and just threw a massive party for my daughter's fourth birthday. Although I did have a bad cold. Being pregnant with health anxiety has not been a walk in the park, but I'm doing it anyway. So proud of myself for not being able uh for being able to give my daughter a great day, despite feeling overwhelmed and not physically great. Thank you so much for your amazing work. Charlotte, yes, you can use my name. Thank you, Charlotte, and very well done.

SPEAKER_02 38:19

Love that. Well done, Charlotte. That's brilliant. My favorite word, I think, one of my favorite words um when we do this podcast or work with this type of anxiety is despite. Yeah. Love it. Yeah. She she gave her favorite word. Despite. Yeah, yeah.

SPEAKER_04 38:35

She clearly is uh probably a British person because she said whilst I had a bad cold. Which is great, despite. Whilst I had a bad cold. Whilst?

SPEAKER_02 38:44

How would you say?

SPEAKER_04 38:45

Even though I had a bad like we never I don't think we really use whilst here in the US. That's a very good thing.

SPEAKER_02 38:49

You take her language and you change the letters and things and you say all sorts of silly things.

SPEAKER_04 38:54

What are you gonna do? Should have won the war 250 years ago. What can I tell you? Oh, too soon.

SPEAKER_01 39:00

There's my ego account. I don't have it.

SPEAKER_04 39:02

Oh, I have it. I can't remember what button I put it on. It doesn't matter. Uh oh wait, that I have.

SPEAKER_02 39:11

So good.

SPEAKER_04 39:12

Uh we're we entertain ourselves so well. Aren't you glad you guys tune in for this? Just Josh and Drew cracking each other.

SPEAKER_02 39:18

Yeah, yeah. Anyway, very well. Better help. That would be great.

SPEAKER_04 39:28

Oh, could you imagine we're sponsored by Talkspace or BetterHelp? That would be the best. Don't call us, call those guys.

SPEAKER_02 39:37

Yeah. Oh my god, I love it. Um, yeah. If you've got your own questions, did it anyways. Um, audio did it anyways. You want to record yourself? Yeah. And go over to disorder.fm, drop us that. If you want to be part of the studio audience of the community, you can uh go to disorder.fm and join the community um if you would like. Uh there's loads of resources in there, workshops, articles, people writing their own did it anyways, general chat discussions, and it's a really lovely community as well. Um, um, if you if you want to, it's not compulsory, we don't hide or gatekeep anything. Um, if you want to read a book about health anxiety, you can do called The Disordered Guide to Health Anxiety, which is available on Amazon and it's by Disordered Press. Um, and if you want to follow us on socials, not that I've been posting not recently, it's uh anxiety josh and the dot anxious dot truth. Anything else? No, I think you covered all the bases. We'll do it again next Friday, right? Sounds good. And thank you. Yeah, thanks for tuning in, and we'll see you next Friday. And thanks to the studio audience for all the fun.

SPEAKER_04 40:38

See you next week.