Anxiety Recovery: How Important Is Attention? (Episode 89)

SPEAKER_03 0:01

So I think attention is possibly or near enough the entire problem with an anxiety disorder. You're the person with an anxiety disorder at a party, and your attention is on how you feel or on your thoughts.

SPEAKER_02 0:13

If you can engage in the event, your attention goes to the event, and that becomes at least as interesting as how you feel inside. Isn't that ignoring the problem? No, it's not engaging with the problem. Because there's no problem. The attention part, that's the part where you see the impact operationally, functionally on people's lives. My partner's running out of patience with me because while they are enjoying Thanksgiving dinner with the family, you are much more attentive to what's happening inside of you. Sometimes we do get in conversations with ourselves, that's normal, but we don't spend all day long that way. Welcome to Disordered. This is episode 89 of the podcast entitled How Important is Paying Attention? I am Drew Linsolata, one of the co-hosts of this fine podcast. I am a therapist practicing under supervision 2024, specializing in anxiety and anxiety disorders in New York. I am a three-time author on the topic of anxiety and anxiety disorders, a social media dude, an advocate, a former sufferer for many years, but better now. And uh yeah, it's Thanksgiving morning in the U.S. And I'm I'm joined from with my uh by my friend from the UK sitting next to me. What up, Josh? Who are you?

SPEAKER_03 1:28

Hello, uh yeah, good afternoon, Drew. Happy Thanksgiving. Uh I'm Joshua Fletcher, also known as Anxiety Josh, therapist, author, podcaster. Um a guy?

SPEAKER_02 1:43

Just some guy, just some guy from the UK. Yeah. Found him on the street.

SPEAKER_03 1:46

Thanksgiving over in the US, and it's um Thursday in the UK.

SPEAKER_02 1:51

Or as we call it in Manchester, Thursday. So let me answer a quick question before we even get started, because people have been asking me this, because I always say practicing under supervision, that means that in New York State, I cannot have my own practice until I do 3,000 hours under the supervision of an experienced clinician. So for those of you who have been asking that question again and again, that's why I say that, because I have to I have to disclose that. But uh yeah. Anyway, thanks for asking. Well done for doing your due diligence. Thank you much. I appreciate it. What are we talking about today? How important is it to pay attention? And pay attention to what I'm saying. Sorry, what? Uh you aren't you weren't paying attention, were you?

SPEAKER_03 2:27

See? I wasn't paying attention. I see what you did there. Attention, attention and anxiety disorder. I think attention is possibly or near enough the entire problem with an anxiety disorder. You're you're the person with an anxiety disorder at a party, and your attention is on how you feel or on your thoughts. You're the person waiting for an exam and you're just ruminating about failing. You're the person lying in bed, you know, maybe with your partner, and they're thinking about the book they're reading, and you're thinking about how you feel, or scary what your thoughts, or scanning your body. Uh you go you're on a park run, you know, and all your all your bodies are running along and taking in the sights, and you're thinking about, is my heart rate going too high? You know, maybe you're starting a work meeting and people are thinking about the the content of the meeting, uh, maybe they're daydreaming or whatever, and you're thinking about the DPDR and the room looking scary. Your attention is what fuels probably all anxiety disorders. I know we spoke about it in the shock attention resistance episode, but we're gonna really focus on attention, and and it was actually kind of inspired by a really good did it anyway that we received where the question sender inner um highlighted how important it is where where your attention lies. I agree. Maybe we should play them on right now. What do you say?

SPEAKER_02 3:55

Yeah, let's do it.

SPEAKER_05 3:58

Hey, Drew and Josh, my name's Kevin. You can use my um just wanted to share when about three weeks ago. I was asked to go on a work trip to DC. Not very familiar with DC. I was going with a bunch of people that I didn't know to go do a job that I didn't really know anything about. I've been struggling with some anxiety and obsessive thoughts since about May of this year, and it's interfered with my career, and I was worried that I might go crazy in DC or have a panic attack or something of that nature. And I ended up having a really good time, but it really highlighted how important attention is uh when it comes to this condition. So I ended up having an excellent time, had a lot of fun, laughed harder than I have laughed uh this year, and yeah, really just had a good time with it. Went to my best friend's wedding afterwards down in Richmond and had an even better time down there. And overall, it just highlighted that you know the experiences, upcoming experiences aren't you need not anticipate over those, and that likely when you get into the experience that you're anticipating, you'll be so saturated and sucked into that experience that you won't be uh you won't be as anxious as maybe you were anticipating. But anyway, it was a win, had a great time, and uh, I thought you guys deserve to know all the work that you do has been super helpful. And you know, I've been I tried to remember that when I was on my trip and still working through this disorder and this condition, but uh grateful for you guys nonetheless. Thank you so much.

SPEAKER_02 5:50

Good job, Kevin. Well done, Kevin. Yep, thanks for sending that in. Nailed it. He did nail. There was two, he he specifically mentioned attention, and then I love when he's like, but when you get into the actual event, you'll get so sucked into it. Yes, that's the attention. Like if you can engage in the event, your attention goes to the event, and that becomes at least as interesting as how you feel inside.

SPEAKER_03 6:14

Absolutely, and when we talk about, you know, I got you got sucked in, or when other people talk about distraction, sure. No, you're choosing to move your attention, you know. But you know, but isn't isn't that ignoring the problem? No, it's not engaging with the problem, you know, and because there's no problem, you know, you're engaging with something, and then the brain gets confused and thinks it's a problem, but anxiety is actually not a problem. How could you say that, Josh? I've been living with anxiety and anxiety disorders for years, my life's been a misery. Yeah, I know, I've been there. But what happens is the discomfort becomes a problem because of the attention that we give it. Happened with me. My first ever panic attack, de derealization, depersonalization. Freaked me out so much. Went home, gave it all my attention.

SPEAKER_04 7:02

Yeah.

SPEAKER_03 7:02

By working it out, ruminating, trying to fix it, etc. When I stopped doing that, the threat response turned off. Same with intrusive thoughts. You know, oh, but this intrusive thoughts, high stakes, it feels real. Threat response is kicked off. Maybe if I just think a bit and give myself some mental reassurance, then it will go away. I'm giving it all of my attention. And part of ERP, exposure, response prevention is we expose ourselves to the emotions, not just the trigger, the fear. We expose ourselves to the emotions, and part of the response prevention, and I still think it's the biggest part, is you you prevent your response by not giving it all attention or lowering it significantly.

SPEAKER_02 7:44

Yep. And that attention could be like Kevin did. Yeah, that's exactly right. So, and that attention could be physical, like what you're doing physically, or it could be mental. It could just be checking and scanning and going inwards, you know, that inward inwards compulsion we've talked about in different episodes. So, and I think the attention part, that's the part where you see the impact operationally, functionally on people's lives. In other words, it's ruining my relationship. My anxiety is ruining my relationship. My partner's running out of patience with me. Yeah. Because while they are enjoying Thanksgiving dinner with the family, you are much more attentive to what's happening inside of you, and you start to disengage. I did it. You know, I I was that was a big problem for me. I disengaged from everything, from my business, my friends, my family, the whole world. I spent all day long really in a conversation between Drew and Drew, which was not a good place to be. Sometimes we do get in conversations with ourselves, that's normal, but we don't spend all day long that way. And the attention is where you see the impact in people's lives. I I can't go to work, I have to pay attention to what's going on inside of me. I can't go to school, I have to pay attention to what's going on inside of me. I can't go to the gym, I can't go and meet my buddies for a beer. I have to pay close attention to what's happening inside of me. Do you?

SPEAKER_03 9:00

Yeah. Yeah. And we're persuaded to by scary what ifs. Oh, yeah. So, like the gym example, you know, I can't go to the gym, I have to pay attention to what's inside of me because the what if has persuaded me to give it attention.

SPEAKER_04 9:12

Yeah.

SPEAKER_03 9:12

What if you have a heart attack at the gym? Oh, yeah, I better give this attention now. Yep.

SPEAKER_02 9:17

And I think some people will uh some and I know you might be listening right now and thinking, are you insane, Josh and Drew? Right? Like, what do you mean don't pay attention to it? How can you not pay attention to this? Like, do you ever you hear that? People are like, I don't understand how this is the worst thing that ever happened to me. How am I supposed to not pay? Of course I'm gonna pay attention to it. What how would you respond to that? Because I hear it every day.

SPEAKER_03 9:41

Well, I you I used it in a in a recent episode, didn't I? And I use this analogy often in my practices. This it's the restaurant analogy. Drew and I go to a fancy Italian restaurant, and it's a loud one, loud music playing, plates smashing, loads of people talking, you know, people at the bar laughing, whatever. It's really loud. Drew and I sit at our own table across to each other, and we start talking about I don't know, the amygdala or something, because we're boring, and uh, and we'll sit there and we're chatting that within 30 seconds. I've not lowered the volume of the restaurant. My brain has decided to focus on what was important to me at that time, uh, and that was talking to Drew. Yeah, and now and actually the the noises in the restaurant are still frantic, they're still chaotic, but I chose to zone my attention on something, and then the brain kind of naturally just allows everything to be in the background, yeah. And I and I love that analogy with anxiety. You're not trying to, you know. What if I stood up in that restaurant and was like, well, everyone shut up. I can't hear my friend, you know, turn the music down. You guys over there, shut up. This and that. No, because that's resistance, and then I'm gonna be met with resistance. So everyone will get up and start picking up plates and assaulting me violently in the middle of the restaurant. I'll be banned from the restaurant for life. Resistance doesn't work. But if I'm like, okay, it's a busy restaurant, talk to Drew, suddenly everything, nothing actually changes, it just feels less important because I'm not giving it attention, and the brain habituates to that.

SPEAKER_02 11:19

Yeah, the same applies with anxiety, but that's the way our brains work in everyday life. Like, we we don't pay attention to everything that's going on around us all the time. Like we we are focused on one thing or another. So if you had to pay attention to every input that your your body and brain were getting all day long, you wouldn't we wouldn't be able to find it. We'd be frozen. So we pay attention and the other stuff falls by the wayside. We are naturally designed to do that. That is the way we work, just that it seems incredulous. And I do understand the tipping point for a lot of people listening would be like, yes, but this feels so bad that I must uh how would I I'm supposed to pay attention to this? That's that's the mistake. But is paying such close attention to it doing anything? Like I understand you want to because it seems it's so impactful and it's so unpleasant that I I should pay attention to that, right? Well, I know that makes common sense, but where is that getting us? That's one of the things I think that anybody who's gone through the recovery process, I I sort of had to come to that realization. This is actually not helping me. I do want to pay attention to it, but it's it's I'm not getting anything if I spend all my time engaged in a conversation with myself about how I feel. I had to face that reality at some point. This is not helping me at all. I'm not nothing is changing. I'm just getting from hour to hour and feeling lucky that I got there. So yeah, it is a tough concept, I think, for people, but because it feels like, but I have to pay attention. Part of this is the risk taking, right? Well, what if I don't? What will happen?

SPEAKER_03 12:51

Well, you've been doing a lot of reading, studying uh about this, haven't you, uh Drew? Why don't you uh I have give us a TED talk?

SPEAKER_02 12:59

I really need other hobbies. Uh welcome to my TED Talk. No, we were talking about before we hit the record button, like one of the things I gotten really interested in lately is uh something called a predictive processing model of subjective reality. And that's there's if you can go Google it if you want, but there's a lot of a predicting processing model.

SPEAKER_03 13:15

Predictive processing model, right?

SPEAKER_02 13:17

Of subjective reality, right? So like our subjective experiences, we would argue, were like, well, yeah, I don't really know what your what your reality is because they can't be inside your head. You don't know what mine is. We seem to share one, we agree on certain things, but in the end, our perception of reality is a bit subjective. Where does that come from? People used to think that it was a bottom-up thing. You got sense data, and then it processed from the bottom of your brain up, and then you came to some conclusion about what reality is. But functional MRIs are amazing. And what we actually discover is there's more signaling from the top down, literally, than there is the bottom up. So what that seems to indicate in the research is we predict what we're gonna get, and this all happens in milliseconds. Then we take our sense data, and then our brain compares well, this is what I thought I was gonna get. This is what I actually got. Hmm, they don't match. Let me change my prediction to match what I got. So reality chimes in and changes our expectation millisecond by millisecond. It's incredibly fast. In our case, we can apply that because there's another variable called precision weighting that says depending on what I find most important and I am paying attention to, precision waiting is just attention. I may decide to not update the model. So, in other words, in the most egregious example would be my brain insists that it's raining out. And I go to the window and I look, and it's blazing sun, blue sky is not a cloud, and there's kids are playing on the lawn. There's no rain. But I am so heavily invested in my belief in rain that my predictive processing model does not change. And I'm still expecting rain. And then I have a problem because what I'm expecting and what I'm getting is different. So attention in our context today is I am paying such close attention to everything going on inside me and my what-if thoughts and my fears that I ignore the fact that nothing is happening other than my heart is beating, other than I'm having thoughts. I ignore all the reality that shows me that nothing bad is happening to me, and I hang on to that model that says, I got a problem and I got to solve it. So that is where attention falls. When I'm reading on the, I'm like, oh my goodness, I'm literally like standing up and like fist pumping, like, yes, this is a really good model that explains this problem that we have in our community, and I had and you had. It's the attention that decides, no, no, no. Reality, the fact that I made it or I did the exposure doesn't matter. So, how many people are listening right now? They're like, well, I do the things, but I'm not making any any change. Nothing's happening. I just see it as torture. Yeah, because I'm so heavily invested in paying close attention to what's happening inside of me that I throw away the experience, the actual reality that says, I did it. I I moved through the panic, I moved through the nothing happened to me. I I handled it. Throw it away. Start again with the old model.

SPEAKER_03 16:12

Spending all your time scanning each and every bit of the blue sky, yeah, trying to find the rain.

SPEAKER_02 16:20

The rain has that's exactly right. It must be there somewhere, it has to be there somewhere. And everybody around me is like, Will you come out of the house and join the picnic? And I'm like, No, no, it's raining. And they can't see the rain.

SPEAKER_03 16:33

I was also as as you were talking there, I was thinking about um that show. Um, what was it uh Real or Cake? You know, and they just there's these like items, everyday items. I don't know, it might be like a grapefruit or something, or or a block of wood or whatever, and you've got to guess whether it's real or it's actually a cake. So your brain's like, no, I'm convinced that that football is a football, and then they take a knife and they put it through it, and bang, it turns out to be a delicious Victoria sponge that looks like a football. And I was that's what I was thinking about then. I was like, your brain is convinced, and you're watching and you're watching, and then bang, actually, the data was wrong, you know. That was that was that was interesting. I don't know why I was thinking about that. Yeah, I was also thinking that you're a massive nerd.

SPEAKER_02 17:24

I am such a nerd. I I'll take it though. I do enjoy that stuff, but it also explains like there's those little like uh do you see an old woman or a young woman? That's so famous, that optical illusion. You know, well, oh, I see an old woman, but as soon as somebody points out the young woman, you can't unsee the new thing.

SPEAKER_04 17:40

Oh, yeah.

SPEAKER_02 17:41

Right now, because now my brain is saying, oh, well, I see it. I'm gonna see a young woman when I look back, and it has changed the model. And now you can see both of them. I might see this or that. At first, it's like, no, it's clearly an old woman. I'm gonna I'm gonna look and I'm gonna predict an old woman. And maybe it says, Oh no, but I see a young woman and boom, you instantly flip, or you can't see the young woman until the person points it out.

SPEAKER_03 18:04

So the power of attention and how the brain can shift its association with things. Now, if you're taking it within the context of an anxiety disorder, maybe you're afraid of panic attacks, or you've got an intrusive thought that has all your attention, where would you say the role of this plays a part? So let's say I don't know, I'm I'm really scared of anxiety and it doesn't feel safe to not give it my attention.

SPEAKER_02 18:32

Yeah.

SPEAKER_03 18:32

Where where does that apply?

SPEAKER_02 18:34

Well, I think in that situation, it's like again, you're gonna hear people, and if you go from the beginning, like Claire Weeks, so many of our listeners, you know, read her books and whatnot, Dr. Weeks, and it's like, well, you're fine. It's okay. Accept float, accept let time class. Your legs are perfectly fine, even though they are shaking. She would say those sort of things. And then you may hear people like us say, it's okay to have scary thoughts. It's okay to go ahead, let your heart rate so race. It's totally fine. Because we know that there's no danger, but you are still predicting danger, right? So your model is still based on no, no, no, this is an actual threat you don't understand. It could, and that threat could be interpreted, I think, a lot of different ways. It's physically threatening to me, it's psychologically, it's gonna break me. I'm gonna have a psychotic break, or just that general, it's too much. You know, we talked about that before. It's just too much. I can't handle it. And that's my model. But no matter how many times we say, but you can handle it and you do handle it until you open up to the the possibility that you might be wrong and allow yourself to pay attention to the reality data that comes into the model, you're stuck. That's why we need to what that's that thing where you activate, you cannot change anxiety until you activate it. You gotta wake your amygdala up to give it new messages. That's part of that too. So I think in this situation, it's the whole like I have to at least open up my model or which would be my expectations, and at least consider that these two bozos might be onto something. Is that making sense that I answered the what you the question that you answered?

SPEAKER_03 20:05

Oh, yeah, definitely. I'm just trying to apply it to everyday stuff. So for example, you get people who feel dizzy or if they have a fear of fainting, and like, oh, see, I I feel a bit lightheaded or I feel a bit unstable. Uh oh my god, I need this, I need to give this my attention now because you know the worst case scenario could happen here. I'm making a prediction, all my anxious brain's making it a prediction that you know, I'm gonna faint and pass out, humiliate myself. But I also think that why don't you try not giving it your attention and continuing walking or doing what you're doing? So, and actually that also helps the brain go, oh yeah, I was wrong about that. Yeah, so I don't need to do it, and the metacognitive belief that if I give something attention, I prevent the bad thing from happening. No, no, no, unless you're like a night watchman or a dormant, then yes, you should keep attention, sure, you know, or maybe attention on driving, you know, but in general, when it's your thoughts and feelings, no, they don't need your attention, and particularly for those regulates a lot, you know, you don't need you cannot regulate yourself by observing yourself, and I still mind blowing for me. Uh, you can never observe. I love this. You can never observe the exact moment anxiety disappears. You can never ever do it. So there is literally no point in staring at how you feel because there is not one moment where the brain goes, yep, oh, anxiety's gone. Have you noticed that? It always passes when your attention is engaged with something else, whether it is distraction, forced or willing, whether it's just someone's taking your attention away, you know, it always goes. So there is literally no point in observing. Observing because you will not catch the magical moment that anxiety disappears. Because you cannot induce neurosception through observation. Oh, there we are. You cannot induce neurosception through observation. There's my nerd throwback at you.

SPEAKER_02 22:16

This may officially be the nerdiest episode we've done now. Now that you threw that in. You know what's interesting.

SPEAKER_03 22:21

And neurosception is just your nerve system changing from sympathetic to parasympathetic, which is sympathetic is stressed and anxious. Parasympathetic is lying down, digesting food.

SPEAKER_02 22:31

Yeah, chilled out. Yeah. And I think you can even apply that to the use of like coping skills. We don't really talk about coping skills because and there's reasons for that. We'll get into that one day. But if you are trying to use coping skills, in the situation where people will say, Well, I do I'll when I panic, I try to do my deep breathing. Okay, well, let's break that down for a second. Let's say you are a deep breather, you you think you want to deep breathe to stop the panic attack. If your attention, if you're breathing, well breathe deeply, which your body can do on demand, you just tell it and it does it. You don't have to pay attention to that. But your attention is on the state that you're in. That deep breathing doesn't work, does it? But if you're drawing from the actual breath itself, you now have a better chance that it calmed me down. I'm using air quotes because we don't use video, I gotta tell you that. But because now I actually paid attention to the sensation of the breath and the mechanics of the breathing. There's a lot of people in our community can't do that, but that's how the if you're gonna breathe and just watch the state while you breathe, the state doesn't go down. So that that's exactly I can't watch the anxiety while I deep breathe and hope that the anxiety goes away. It's just not gonna happen. I have to actually watch the breathing. And that's that's why distraction techniques like ice cubes and stuff like that. Yeah, I get so carried away with the ice cube in my hand because it's really painful to hold an ice cube for more than about 10 seconds.

SPEAKER_03 23:52

Now my attention is somewhere else. It's it's all attention, isn't it? Even like with your calming techniques, coping techniques, because people with anxiety disorders are doing it and then observing to see you fall into did it work? Is it work has it worked yet, Territory? Because that's your attention. Uh with anything like um I know people take anti-anxiety medication or antidepressants, and they're initially more anxious because their attention is increased tenfold because they're like, is there side effects? Am I less anxious? Am I more anxious? Is it making me worse? Because their attention is fixated on any variable change and change in their mood, etc. Um, it's all an attention thing. When I was became re-sensitized, don't use the word relapse. When I became resensitized, all that meant looking back was that I felt scared, so I gave it all my attention. That is literally all that happened. It felt horrible, really scary, intrusive thoughts, felt like it was a failure. Craig the critic was there. Don't get me wrong, there's all that, but in a nutshell, I all re-sensitization is is I didn't like it, so I gave my attention. Uh, we also get a lot of messages and stuff from people like, hey guys, I'm 85% recovered or 90% recovered, which we'll do an episode on this as well. But it's like 85-9 recovered. So that tells me probably 85%, 90% of the time, you're happy to not give how you feel or your thoughts attention. Right. But you're still here and you're doing that because there's that last 10% where you're like, yeah, I've still got 10% kind of doubt that keeps persuading me to give all of this attention and effort.

SPEAKER_02 25:30

One day I think uh maybe we'll stand in front of like one of those giant blackboards, like at a university lecture hall with full of equations and where we'll have a model that describes all this. Because I think you know, we've no one will be at that lecture. No, they won't. No one will care. We'll be the only ones like high-fiving each other and like being proud of ourselves.

SPEAKER_03 25:47

There'll be a 100%.

SPEAKER_02 25:49

But I think in that situation, but the way Jay Shetty's lecture in the room next door. Why they're so having fun next door, and it's us and two people in the audience. I the but the model we talk all the time about it's the delta T between OMG and OL, between the oh my god moment and the OL moment. So as you progress in recovery, that gets shorter and shorter. You do get triggered. That's normal. That's the Dr. Weeks first fear, and then you wind up in the oh well. Like I, this is okay. I can relax into this and put my attention somewhere else, and then sure enough, it passes pretty quickly. But there what happens is I think there's a there's another variable here, which I think is maybe the tolerance threshold. First, I can go short OMG to OL in low trigger situations, but then I get triggered for whatever reason, it's a bigger response where I see it as more scary. Nope, I'm not gonna go OL. So my delta T there is longer. So like you're shrinking it up the ladder, you know, in a way, like that time. So, okay, you get 85% recovery, which means most of the time when I get triggered, I can, oh well, within a minute, I'm back to OL and I go on with my life and it doesn't impact. Look at me, I'm getting better. But this felt too scary. So it went over the acceptable threshold or the tolerance threshold, and I don't go to OL, I stay in OMG, and that's because my attention stays here. And that's the part, like, no, you just got scared enough again to forget to go to O well, which is moving my attention. Yeah, look at us with that. Well, this could be like a 3D modeling Legos. I don't know how we're gonna do this, but we're gonna do it.

SPEAKER_04 27:17

No, uh no, absolutely.

SPEAKER_03 27:21

And it is, and I'm just looking through through my own experiences and people working with people in the practice and stuff like that. It is that, you know, like I've had a bad week this week. Why? Oh, just I've been down, I've been in bed, I've not I've avoided, I've given it all my attention, it just feels too scary to not give it attention. And I I I empathize with that, I've been there myself. But then it's interesting because there's a correlation between the people that have had good weeks where they've probably had two or three panic attacks, but when they realize, oh, I tolerated that, or they've had they've done gone to places with that intrusive thought on repeat, but they're engaging with everything else, they seem to come in with like a bounce and be like, Yeah, I I feel empowered because actually I always have control of my attention, it's just very tricky. You know, it's easier to concentrate on my friend in a quiet restaurant, but I realized I can still concentrate on my friend in a very loud restaurant too. And you see the bounce and the confidence increase in people that you can use that attention. You can also train your attention, can't you, Drew? Oh, 100%.

SPEAKER_02 28:32

Yeah. I mean, like MCT uses specifically uses attention training, like metacognitive therapy. We have Rihanna, she talked about that. Attention training is a formal part of metacognitive therapy, but also we use attention training like in mindfulness-based stress reduction. I'm going through that training, which is the whole thing, and we'll talk about one day because that's an interesting experience. It's about learning how to pay attention and being aware. Like, what am I going to be aware of? I don't know. The feeling in my foot, which is my toes are a little bit more interesting than the scary thought that I have, or I can try to make it at least as interesting. And so it's just it's attention training. It all is. One of my favorite moments that I have in therapy with clients is the person who comes in and wants to tell me that they got re triggered. And in telling me the story, they recognize the win. Like, oh, wait a minute. That's okay. So, what did you do? Oh, well, I went to work anyway, and whatever. Like, how'd you feel by the end of the night? Oh, I forgot about it. And then be like, wait a minute, this isn't even a story. Yeah, like they realize in the middle of the story that, like, I don't even have to tell you the story, and then they're so excited because, like, oh my god, I'm doing it. It's so great. I love those moments.

SPEAKER_03 29:35

That's the win. And it's so like the the the success criteria is so important, yes, with anxiety. People do miss that. This it's not about being triggered, it's not about being anxious, it's what you do in response to it. And in this episode, in particular, is okay, I feel scared. How much attention am I giving it? And how much am I willing to feel scared and practice with my attention external? Now, Craig the Critic loves this because it'll say, see, you if you're someone who's really taking um the principles of this podcast on, but you've got a very loud internal critic, you might be inclined like to get frustrated at yourself because you've noticed you're compulsively checking or giving it attention. That's okay. Not interested in that. We're interested in you noticing your checking and on and um giving anxiety attention, going, no, thank you. I'm gonna take my attention away now. Because each time you do that, you rewire new neuropathways and weaken the old, unhelpful one. Yeah, so it's not about oh I can't do this. I I was thinking about my anxiety all last night. Well, when was the moment you noticed you were doing that? Okay, and did you try to take it your attention away? I did, it was tricky. I had to do it several times, but I did it. That's brilliant, yeah. Because it's all it's nigh impossible to just completely ignore anxiety, but noticing when you're giving it attention compulsively and bringing your attention away and doing what Kevin did. So actually, in Kevin with anticipatory anxiety, he was probably dreading his trip to DC. But have you noticed when he was there, his attention was external. He chose to commit his attention, and then actually, when you are engaged with stuff, it becomes easier and the threat response turns off. So thank you for that, Kevin.

SPEAKER_02 31:26

Here's a pro tip. Let's let's do a little pro tip. I think that whole like I'm gonna move my attention to something else. There's a little bit of a twist to that that I try and teach people. Like, no, no, no. If you get triggered and there's a scary thought or a sensation or something, whatever it is for you, the first attention did automatically go to that. That's you cannot stop that. It automatically did that. Before you can really put your attention somewhere else and to stay out of the I'll try to ignore it or pretend it's not there, it's there. You feel it, you can't ignore it. I would first acknowledge what you're feeling. Oh, I noticed I notice my heart is racing, or I notice my stomach is churning, or I notice I feel a little nauseous, or oh, I notice I'm having that thought again. But it's okay, I can go somewhere else. Starting with the acknowledgement of what's happening, I am finding is more productive because otherwise people try to instantly like, oh no, and I they run away from it by trying to. I must go with another focus. I have to focus somewhere else. Well, first just notice what's happening. Oh, notice I'm having those thoughts again. What else can I do? Now I'm gonna go over here. I don't know if that makes any sense, but it lets you off the hook because you can still hear the thoughts, it's okay. You're in the loud restaurant, yeah, right.

SPEAKER_03 32:34

Okay, the aim is to not quieten the restaurant, it's just where's your attention? And it will be it will feel less and less. In fact, we had a really good question sent in actually, which is about attention. Uh to it. Yeah, yeah, yeah. Um it was it was both a did it anyway and a question, wasn't it? Should we uh should we give that a whirl?

SPEAKER_02 32:55

Yeah, let's this one comes all the way from Bangkok, which is awesome. We're like super internationally undisordered. They're both questions worldwide. Absolutely. Oh never mind. Um, they are both questions that aren't about attention, but they really are. So let's hear the first one.

SPEAKER_00 33:13

Hi Josh, hi Drew, it's Kay from Bangkok, Thailand. For my journey, it's been one year, so it's my anniversary actually, with my anxiety, and I'm getting better. Uh, I you you guys just helped me a lot, and also I have a therapist, but uh I still have some setbacks uh when I have something happen big in my life, or I broke out with my girlfriend. Uh, if I will flight back my home country, so symptoms are back, but this time I can control, like I say, my amygdala, hey, stay there, you know, not this time, because uh I'm learning with experience, so every time I understand better, but still same when symptoms are comeback, I feel weak, I feel uh not strong enough, I feel uh I feel like I'm missing something, and then I back to you know, uh the try to read something, try to listen something, so it's focus my focus go to all about anxiety again. So this is the issue like how can I change this? Thank you so much. Love you guys.

SPEAKER_02 34:23

That's a great question. That is just a sound effects, but he had everything in there. Amygdala. It's Craig the Greg. Everything was in there. Thank you, Kay. That's an excellent, excellent question. Should we play the other one too and then take them both at the same time? Because I think they're kind of the same question if you really think about it. So yeah, all right, let's do it. Let's listen to this next question. Whoops, hang on, what is going on here? All right, let's do it. Here we go.

SPEAKER_01 34:48

Hello, Josh, Andrew. And I'm early into my recovery. Uh, four weeks ago, I had a panic attack that has led me to a mental health illness, including general anxiety and some health slash cardio anxiety. So, my question, and I know this is going to be very individual to the person, but how much rest do you need against exposures you schedule into your week? Uh, for example, my exposure yesterday was to get on a train for 40 minutes and then went at my destination station, get off, leave the station, and buy a hot drink from the local Costa Coffee. Then I got back on the train and came home. Uh, I was very proud of the exposure, but then in the evening I had an intrusive thought while watching TV about breathing shallow and spent most of the night not sleeping and completing breathing exercises. Could it have been because I had pushed too much that day with my exposure? Uh sleeping can be an issue at the moment, so my energy levels must be low. Where do you both think that the balance lies? And for the first few weeks, months, should I just be resting? So that's my question. Can I leave this message by saying thank you for such an informative podcast? As well as the panicking about panic and practical about panic books. That I've read one of them, I've got uh one of them to read. Uh and Josh, I've just completed your online course and we'll be going going over it again. So thank you, gents, and I look forward to your thoughts and your feedback.

SPEAKER_02 36:26

Oh, well, thank you, Neil. We we cut out an A.

SPEAKER_03 36:30

Okay, uh we we play both those uh next to each other because yeah, for me, what's coming through there is an attention thing, isn't it? It's like well, first of all, well done for to both of you. Sounds like you're doing some really good work, some great metacognitive awareness there from Kay and uh great exposure as well. Well done, Neil, for getting on the on the train and then going to the coffee, and that's brilliant. But I'd invite you to kind of look at where's my attention when I'm not doing those things, you know. Is it done it? Has my exposure got rid of my anxiety yet? I'll tell you what, I'll give it attention to see, you know. So you applied willful tolerance and acceptance, etc., to the exposure within that. However, that kind of the attention got sucked back in later when you had a bit of air hunger later on, and then we tried to fix the air hunger by giving it all of our attention and forcing, trying to force away the discomfort by doing breathing exercise. I I know I used to do this as well. Like, I don't like it, I don't like it. But what I've noticed is that now I've spent three, four hours just focusing on how I feel and symptoms because my attention went. That's okay, but that's also the exposure too. In terms of the rest question, yeah. For me, I think it's more exhausting to be sedentary and only and and paying attention to your anxiety than it is going for a walk and not. Yeah. So people think that, like, oh, if I'm doing lots of physical things that you know that that I'm I'm using up my energy. No, I'd I I'd argue it's more energizing to do a light workout at the gym listening to a podcast or a book than it is to sit at home ruminating, scanning, and giving all your anxiety attention. I think that's more exhausting.

SPEAKER_02 38:14

Yeah, I agree. On the rest, especially on the rest question, one of the things I used to talk about I haven't talked about in a long time, but there is no immune response to anxiety. So if you get a head cold, you might call out of work for a couple of days because you have a fever, whatever, just feeling miserable, you lay in bed, and your body does something to get rid of that infection, and then you feel better. That doesn't exist like in our world. And I think it's one of the common misconceptions. Oh, I need to go and rest to heal. Rest is retreat. I mean, it's fine. You're allowed to rest when you're tired. That's okay. We're we're not trying to like just push through being tired, but the idea that rest is recovery, I think, is way overrated. We should probably do a whole episode on that. So it's okay to be tired, rest when you're tired, but but tired is not an indicator of whether you're getting better or not. And the thing that I find about both of these questions from both Neil and Kay, there was a but moment. But where, like, oh, I got something that disturbed me enough where I threw away the rest of my experience. So for Kay, it's like, hey, I'm getting much better at this. I'm I'm better at talking to my amygdala and relating to my anxiety. Like, but I had something come up that went beyond my tolerance threshold, and I reverted back to putting my attention on like I better listen to podcasts and read books. And for yeah, for Neil, it was like I did my exposure. I planned it and I did it the way I planned it, and I had a win, but then I felt that a breathing thing, and that ink that went past my tolerance zone. So I threw away the exposure and I went back to trying to fix my anxiety. I'm gonna throw away the win and just let me just my attention went straight up.

SPEAKER_03 39:48

And I bet Neil after that probably didn't give it a lot of attention because probably felt good after his exposure. Yep, but the exposure happens again, and sometimes exposures are not in our control, you can just be triggered. Yeah, that's when the exposure begins.

SPEAKER_02 40:01

Exactly right.

SPEAKER_03 40:02

Um, but some really good stuff there, and um yeah, really good. Yeah, uh it also rings the bell with the you know, the I'm the 85%, 90% recovered crowd. It's like I can do it here, but there is outliers that when they trigger me, I find it very difficult to not give it my attention.

SPEAKER_02 40:23

And if you put it in the, I mean, we didn't really necessarily answer K's question, but it's specifically what how do we say, how do I stop doing that? It's the recognition that, like, oh, this is make I want to put attention back into the act of the act of recovering and monitoring myself and seeing how I'm doing. In reality, it's if you think about it in attention terms, it's like, oh, wait a minute, I don't have to go back and listen to more podcasts and read new books. That's the problem. The problem is like it wants my attention. This seems so worthy of my attention. Can I go back to what I've been doing that that gets me through those that has improved my life? That is, wait a minute, and with which was given it less attention, probably leading reading less books and listening to less podcasts. So it's the opposite. You don't need a podcast to overcome that.

SPEAKER_03 41:09

Yeah, it always comes back to the golden rules as well. Rule one, what would non-anxious you be doing? Yep, would non-anxious you be sitting there reading anxiety book after anxiety book after trying to constantly fix yourself and give it give everything attention. Yep. And goal rule number two is is what I'm doing right now teaching the brain that this uncertainty is okay? Well, no, I'm responding to it by trying to find out more, forcing breathing exercises, trying to resist everything. No, follow those golden rules, K. Yeah, and Neil, and anyone listening, yeah, and you do some good brain rewiring.

SPEAKER_02 41:43

Final word on attention. We do have we'll save the the other did it anyway for next session, next uh episode. But uh another last word I think maybe on attention would be, and I have this come up sometimes too. It's like, well, I'm better, I'm so much better, but I'm still afraid to unfollow all my anxiety people and leave my anxiety groups, and like sometimes attention is there too in the moment, yes, when you're really, but also how much of a role is your internal state paying in in your overall lifestyle day by day? If you're feeling like you're doing so much better, is it really helping you? Whether, like again, I'm the worst podcaster ever. I tell people to not listen to me when I talk into a microphone. But is it really helping you to have disordered or the anxious truth or your Facebook anxiety groups as your default every morning? Maybe it's not. What if but what if you start to put your attention on things you used to do? Reading books, taking a walk, going to the gym, interacting with your friends, playing with your dog. Try putting your attention somewhere else.

SPEAKER_03 42:42

We'll still be here if you need it, but and ultimately it's you that's got to get the credit for it. Don't get me wrong, we love the kind words and stuff, and I'm sure there's other people there. Um and we'll we'll take some credit to show you the way to do it, but ultimately the end goal is you getting the credit. It's not, oh, I'm only here because I'm surrounded by all these these things. It's you, yeah, you do it, you couldn't do it. That's completely okay. So it enrages me when you see these OCD coaches putting a load of people with OCD and WhatsApp groups. I'm like, why would you do like terrible idea? Terrible, terrible idea.

SPEAKER_02 43:19

Yeah, you know, yeah, and that's a you know, well, forget it. We're not getting into a rant, but that's the whole like community thing, too. Why don't you why don't you guys have a disordered community? Because that's attention. Like you do not need to be in the disordered community every day checking to see what people have said and checking the messages and seeing what Josh and I had to say. Then all of your attention is on how you feel all the time. It's not a good pub. You can dip in whenever you want. Yeah. Yeah. So anyway, that's exactly right. And we close at night and go to bed for a while. So it's totally fine. Um, yeah. Anyway, that's uh that's our episode on attention. It's a good one.

SPEAKER_03 43:52

Yeah, thank you. Thank you very much for tuning in. Submit your questions and did it anyways at disordered.fm. Subscribe to the mailing list for more disordered roundtable discussions. We're really enjoying them. And give us a follow on social media and a rating on Spotify or Apple if if you want to.

SPEAKER_02 44:09

We really appreciate it. Thanks for tuning in, guys. You're the best. We'll be back next week when it's not Thanksgiving. And uh, I don't know what we're gonna talk about, but we'll be here. We're out.