Anxiety Recovery: Worse Before Better? (Episode 46)

SPEAKER_02 0:02

But it seems that as soon as I started to acknowledge and accept, the dizzy symptoms got a lot worse. My question is: is it normal for a symptom to get worse once you acknowledge the fear, even though you have been terrified of that symptom for years already?

SPEAKER_04 0:16

A lot of anxious people want to feel neutral. They're so sick and tired of feeling anxious, despondent, alone. So they they strive towards a feeling of neutrality.

SPEAKER_02 0:27

It feels more. Not worse, you feel more. You don't feel worse, you feel more. So you wouldn't say it's raining worse. It's always been raining, just that now you've decided to go and stand in it. And of course, then you feel it. So it's not that the rain is new, the rain has always been there. You've just been hiding from it.

SPEAKER_04 0:42

Part of anxious recovery, a big part of it is allowing yourself to feel more. Welcome to Disordered. This is episode 46 entitled Anxiety Recovery: Worse Before Better. My name is Joshua Fletcher, also known as Anxiety Josh, and I'm a psychotherapist, an author, previous sufferer of anxiety, content creator creator, and happy to be the co-host of this podcast.

SPEAKER_02 1:15

I am Drew Linsolata. I am a therapist in training in the US, state of New York, specializing in anxiety and anxiety disorders. Also an author, a podcaster, content creator in this lovely community of ours and a past sufferer of anxiety and depression for many, many years. And uh the other co-host of Disordered. What are we talking about today?

SPEAKER_04 1:33

Like any spicy curry, does it get worse before it gets better? Yes, absolutely. That's a great analogy. You tolerate the initial heat and the sweat and the and the discomfort, but if you persevere, have your glass of milk with you. Yeah. You know, you get halfway through, you're like, you know what, I think I could finish that right now. Uh and that's what we're going to talk about today with in anxiety recovery. Should we talk about our own stories first?

SPEAKER_02 2:00

Yeah, we could do that for sure. Or, you know, should we start by celebrating the community a bit? We'll do some did it anyways.

SPEAKER_04 2:05

Yeah, let's not rab it on about ourselves and actually give attention to the people who are way more important.

SPEAKER_02 2:12

Well, what we got today? We have a couple. Here's a good one. We'll do an audio one and we'll uh let's see what this person has to say. We don't want to say her name because she didn't want us to do, so here we go.

SPEAKER_00 2:21

Hi Josh and Drew, I just wanted to share and I did it anyway. Um, I've been afraid of making commitments for a really long time now because it's just like how oh, how am I gonna feel? Or I might not feel I might feel be anxious that day. Like I just don't want to commit to anything, um, especially something on a reoccurring basis. So um I ended up committing to coaching my daughter's soccer team, which is something that I always wanted to do. And so we've had two practices in our first game, and I'm just committed that I am just gonna do it because it's something I want to do, regardless of what my mind is telling me. Um she's a little kid, but um they played at the big stadium, uh high school stadium, and so the whole time I'm like, okay, like I'm gonna have a heart attack in the middle of this field, but it just really didn't matter because I'm do I'm living life the way that I want to live, regardless of what my mind is telling me. So I just wanted to share that with all of you, and I'm very grateful for your standing.

SPEAKER_04 3:30

That's brilliant. Value-driven exposures. It's what non-anxious you would do. I want to do this. Yes, anxiety screaming, or you shouldn't hold up. No, I want to do this. I know deep down I want to do this, and well done. That's fantastic. You've got to play in the big stadium as well. I think that's brilliant. And what a good experience for your daughter.

SPEAKER_02 3:50

For sure. Yeah, I I'm not gonna let it dictate what I do because this is what I want. This is important to me. Best exposures there are.

SPEAKER_04 3:56

Yeah, I would agree with that. Uh, if you want me to arrange a friendly match with Manchester United in order to boost the self-esteem of your young football team, um, they will play their best, but you will beat them quite quite happily.

SPEAKER_02 4:11

It seems like they would, right? Manchester United versus like a bunch of eight-year-olds.

SPEAKER_04 4:15

Yeah, um I money is the eight-year-olds. Yeah, yeah, don't worry. Well done. That's what a way to open the episode.

SPEAKER_02 4:21

Very good.

SPEAKER_04 4:21

Um, actually, I want to add to that. Um uh I have a written Did It Anyway here. Uh I love this one. Uh we love them all. Uh, any Did It Anyway is fantastic, but uh I just like the imagery of this one. Um uh they've not said we can use the name. Hey guys, I'd like to share my Did It Anyway. My wife recently planned a double date with our neighbours that I have been dreading. The plan was to go to a dinner and to a bar that hosts axe throwing. On the way to the restaurant, my anxiety set in, but I focused on what non-anxious me would do. We got to the restaurant, had a great meal, followed by a fun time throwing axes in a noisy bar. By the time the night was over, I had forgotten about my anxiety, despite being in a place with axes flying at wooden targets. My wife appreciated the night out, and I was proud of myself for doing something non-anxious me never thought twice about. Thanks for all you do and keep up the good work. Love it. I love that that's how disordered anxiety gets you. You can't imagine stood in the bar and his axes flying around, but you're completely chilled and having fun because the anticipatory anxiety will tell you, oh, you won't cope there. And actually, you weren't even anxious by the time you got there.

SPEAKER_02 5:42

Well done. Yeah, I found an axe throwing bar about 10 minutes from me. I'm doing that. I'm dying to go do that. I've never done that. Oh, come on over. Is it fun? Everybody that does, I mean, this is an anxious person who wound up having a good time throwing axes. So, like, everybody seems to like it. I'll try it. I'm gonna try it. Sounds good. Very good. Well done. So we this week we're talking about like recovery, anxiety recovery. Does it worse before better? And this was prompted by a question that we had somebody emailed in, and you can send in your questions at disordered.fm if you want to do that. And the question was uh it's a longer question, I will distill it. I knew I needed to start dealing with fears in a constructive way instead of just pretending they didn't exist. True. But it seems that as soon as I started to acknowledge and accept the dizzy symptoms got a lot worse. My question is, is it normal for a symptom to get worse once you acknowledge the fear, even though you have been terrified of that symptom for years already? Good question.

SPEAKER_04 6:37

It is a good question. We'll talk about that today. I mean, you could apply it to symptoms, you could apply it to kind of disordered anxiety, really. Does it does it get does it get worse or it gets better? What do you think?

SPEAKER_02 6:50

Well, I mean, you know, uh those of you who've followed followed along with me for any amount of time on my old podcast and social media probably came through Claire Weeks somehow. That seems to be how most of the folks in my community arrive here. And uh Dr. Weeks wrote about that. She even said in her books, like it's gonna feel like things get worse before it gets better. So, yes, I do believe that the experience will make you say that it's worse, getting worse. I think it just feels more. Not worse, you feel more. You don't feel worse, you feel more. I like that.

SPEAKER_04 7:24

Yeah, yeah, it's not worse because when you say worse, that could tie itself to an unhelpful metric of what recovery is. Yeah, it you feel it more. A lot of anxious people want to feel neutral, they're so sick and tired of feeling anxious, despondent, alone, self-critical. So they they strive towards a feeling of neutrality. Uh but yeah, a part of anxious recovery, a big part of it is allowing yourself to feel more.

SPEAKER_02 7:56

I like to use the rain analogy. That's my the one I go to over the years, which is if it's pouring outside, it's raining. If you decide to duck in under the covers right away, as soon as it you won't get wet, but it's still raining. And then if you decide, you know what, I I need to get out anyway, and you go out, you'll get wet. So you wouldn't say it's raining worse, it's always been raining, just that now you've decided to go and stand in it. And of course, then you feel it and you got wet. So it's not that the rain is new, the rain has always been there. You've just been hiding from it. Wow and through varying degrees of success. A lot of people get really good at air quotes analogy, hiding from the rain. Like anxious people can get super creative in their soothing and their safety behaviors and their avoidance, and so they keep it at bay, and then when they decide to not do that, of course, it's there. So, you know, it's like, oh no, it got worse. It's a great analogy.

SPEAKER_04 8:43

Yeah, brain analogy. Uh how would you apply this to like the question Askara said? Um, maybe there's a symptom that they become more aware of.

SPEAKER_02 8:54

Or how how does this apply? Um, well, I'll I'll give you a little bit of my own experience, and I think the way I would apply that would be for me, it there were so many heart symptoms, you know, racing heart, and I was just fixated on those skipped heartbeats. I would have these benign PVCs, which I had many more of when I was an anxious person. I have hardly any of them now. You go figure. But uh when I would have them, I had a whole ritual around it. As soon as I would feel a skipp heartbeat, I would sit down, I would start to poke at my chest, I would take my pulse, I would drink orange juice or eat a banana because there's a lot of potassium, you need potassium to regulate your heartbeat, like this was in my head. And then I would start to feel better and I would assume, oh, okay, see, I'm I'm fixing my fixed my heartbeats. And when I stopped doing those things and just let them be there, it was they were so loud, and it was like, oh my goodness, there's so many of them. But I had to learn that, like, oh, they've always been there. I just deluded myself into thinking that a banana was fixing me. It wasn't. Well, going back to the getting the credit episode.

SPEAKER_04 9:53

Yeah, yeah, or for all that time you didn't get the credit. Yep. Really good episode, one of the first in the first 10 that we did. Um, you know, every time your anxiety will will always pass, but and sometimes it passes quicker when we unhelpfully try to make it pass quicker by almost like diluting ourselves into eating the oh, thank god I've had my banana. Now I won't have a heart attack. Well, actually, no, that wasn't gonna happen. Uh, and being aware of anxious symptoms, yeah, it's a thing, it's a it's a phenomena, it's uh like almost like a somatic sensitization. I know during the IBS episode with Dr. Sula, she was saying like the more you kind of focus and obsess about symptoms, yeah, they they sometimes do present stronger. This definitely happens with me. Um, I remember like my brain will fixate, and often I've struggled with health anxiety in the past. Um, I remember like misinterpreting kind of like chest pains or stomach pains, uh, and thought I had a hernia and stuff. So I do all these like stretches and I poke around like Drew did, and I just maul with it and I focus on it. And while I'm doing that, I'm teaching the threat response and thanking the threat response, yeah, yeah, maybe there's something wrong here. So the threat response is being helpful, and then so it releases adrenaline cortisol, which keeps us tense because we tense up as an outlet for all that adrenaline and cortisol. And lo and behold, I'm still getting aches and pains because all these muscles are tense. Now they're sore because I've been mauling around and overstretching with them. Um, yeah, it just it's a phenomenon that happens the more you fixate and immerse yourself into a symptom, whether it's a feeling or whether it's uh uh like a physical symptom, yeah, expect it to kind of stick around and and feel more intense.

SPEAKER_02 11:42

It's weird because I think that those safety behaviors not only do they focus us in on it, so we feel it like very intently, but there's a strange duality there, dude, because they also provide a bit of distraction or like what we think is a shield. And so we focus in, but the act of focusing in is to try to save ourselves from it. And there's a certain to me, there was a certain amount of distraction in the poking and the prodding and the checking my pulse. So when I just act still, which this person is saying, well, I knew I have to confront my my dizzy feelings in a more productive way. So when I do that, which for me was just I'm gonna have to just sit still and let these skipped heartbeats uh go, because uh my doctor, my cardiologist, everybody told me they're fine, they're benign, they every heart because it's a safe, uh I have to just sit and feel them, no more distraction. And it was oh loud and pronounced and uh the safety behavior was also a distraction. I'm like, oh my goodness, it's just me and this symptom. I remember once in my my Facebook book Facebook group back in the day when it was incredibly active, I had somebody say, Yeah, but if I do this, if I do what you say, I'm it's just me and the symptoms. I'm just left with the symptoms.

SPEAKER_04 12:50

Correct. And uh introducing our friend the amygdala. Oh boy. Amygdala. What are you showing and demonstrating to the amygdala when you do just sit with the feelings and symptoms?

SPEAKER_02 13:03

Yeah, that I call it sending a green light signal back down the chain. I'm giving it an experience that says, I know you're in freak out mode. We're cool. It's okay. Look, I don't I don't mind.

SPEAKER_04 13:14

I'll show you. You can scream and shout as much as you want. Yep. Give me the scary, intrusive thoughts, the videos of my heart exploding, the doubt of oh, what if you've missed it this time? No, I'm just gonna sit here and roll the dice. Except, you know, it's a five million sided dice, and only one of those faces. Well, I mean, what an enormous object that would be. But only one of those faces would uh would be the disaster.

SPEAKER_03 13:44

Yeah.

SPEAKER_04 13:44

And you know, I've I think I'm willing to sit and let that dice roll and not hit, you know, the very unlikely scenario that this could be something bad. And it's and if it is something bad, it's gonna be nothing to do with how I feel.

SPEAKER_02 14:04

Yeah, and I I think you know, to the worst before better thing is that that conversation, if you will, even though it's not really a conversation, it's a demonstration. You're not having a conversation with your amygdala, you're demonstrating to it. That is the process by which, and we've talked about this and who gets credit, the attitude shift was a big one where we talked about this. It is I'm going to allow myself to have the full experience of this symptom and not do anything about it so that the only conclusion my brain can draw was that I didn't have to do anything about it, and I don't have to be as afraid of it. But I'm going to allow myself to have the full experience and be willing to do that means it will be loudest and it will feel strong, and there'll be nothing between me and that symptom or that experience. So of course it will feel like it's getting worse. These guys are telling me to face my fear and it's getting worse. No, you're just you're just starting to starting to adopt that attitude of willingness.

SPEAKER_04 14:59

Yeah. Interestingly, the name of a five million sided 3D shape is a pentamillion gone. So if you struggle with health anxiety or any sense of urgency, something awful is about to happen, just roll the pentamillion gone. Yeah, bad things do happen, and anxiety will let you know. But it's only going to be one side of the pentamillion gone. And you don't even when you roll a dice with that's that improbable that something bad's gonna happen, you can sit there, and this shape is so enormous, you have to wait for it to finally land on its side. But the odds are so in your favor. Why bother? Why even wait for the dice? You could just roll it and walk away because you know you're pretty comfortable. Yeah, there's a chance something bad could happen. Yeah, but it's so infinitimely small. Just roll the dice, walk off, turn your back on it, and uh and just let it be there.

SPEAKER_02 15:54

Just like an eagle would do. Eagles do that every day. Yeah, I don't know why I did that, but it just felt it just felt right. No, it did seem like it felt right. I think it's interesting too, because it's not just symptoms that feel worse. It'll be the thought that come along with that. And I think this doesn't apply just to physical symptoms, it will apply to you know, intrusive thoughts or scary thoughts, or the thoughts that follow the symptoms. So when you do that and you say, you know what, yeah, the odds are infinitesimally in my, you know, against the disaster. They're overwhelmingly in my favor. But allowing that one in five million feels worse. Because the thought, that doubt thought this could be the one. Somebody dies of this, says your abygular.

SPEAKER_04 16:35

It happens, that's why, but that's what the doubt response wants. Yep. Do you know? Can you remember the name of a five million sided 3D shape? Penta million gone. Oh, yeah. Yeah, it does highbrow stuff on disordered everyone. We need that sound effect, pentamillion gone. Like to get it. Yeah, roll the pentamillion gone. It's all good. Uh uh, you'll find, yeah. I mean, you could be really unlucky, and anxiety will persuade you that you're gonna be the unlucky one. Yeah, but but no, you you know, go with probability. What about the folks that have OCD?

SPEAKER_02 17:03

Do their thoughts get worse if they are a pure O type of person? I have self-harm OCD and I start to do ERP work, it's getting worse, does it?

SPEAKER_04 17:11

The thoughts don't get worse, they may increase in frequency. I never say the thoughts get worse, I always say the feeling gets worse. It's never the thought, a thought doesn't get worse. A thought is a thought. Yeah, but when you have thought kind of action fusion, uh and when you allow a thought and turn your back on a thought and the amygdala hates that, it will start to scream.

SPEAKER_02 17:37

It will start the volume down.

SPEAKER_04 17:41

There we go. It will start to scream. Yeah. So if you're someone with OCD intrusive thoughts and your compulsion is to go inwards, ruminate, play out the catastrophe, do things just in case that thing happens. You are kind of actually taming the amygdala. But we don't want to tame the amygdala. I hate this phrase, taming anxiety. You don't want to tame the amygdala. I think you're placating it. Yeah, you're placating it, but you are taming it because you're not allowing it to fire off loud enough. Oh, right, I see what you're saying. Okay. Because you're you're taming it, you're keeping it, you know, I've tamed you, but you're still quite unruly. What I've said, you know, just when you turn your back on it and allow yourself to not act or respond by ruminating or compulsing to an intrusive thought, you are letting the amygdala out of the cage like a big lion. Except this lion's not interested in attack in attacking you, it's just been trying to warn you and just let it run off. Anyway, it'll get tired.

SPEAKER_02 18:44

Yeah, and but it'll feel worse. I love that. That's really a good way to frame that. Oh, so thought didn't get worse. Thoughts feel got strong, right?

SPEAKER_04 18:52

Yeah, thoughts are just thoughts. And I know that's a horrible phrase here. Thoughts are just thoughts, but what people don't add to that cliche is that some thoughts feel feel more real or feel more urgent because of that threat response activation. Yeah, yeah. Yeah. So suddenly this feels more important. And you know this. So if you're someone who's had intrusive thoughts in the past that no longer apply now. I've had themes of OCD in the past that would keep me up all night and fill me with terror. Now I can think of those thoughts, and I'm like, nothing's bothering. Has that thought changed? Is it worse? No, right. It's that the threat response has decided. I don't find that important anymore. So thoughts don't get worse, the feeling does.

SPEAKER_02 19:38

I think you could say the same for symptoms too. I mean, yeah, clearly there's a range of physiology. That's true. Your heartbeat can beat at 110 or could beat at 130. That's true. But it's the way you feel about it, the amount you're scared, the amount you're disturbed. I'm not hiding from the thoughts or the sensations anymore. So I feel worse. And that's where that, you know, the awareness of like, well, now I'm emotionally reasoning. So because I feel more afraid, then I will say that must mean that this is getting worse. No, it just means you feel more afraid.

SPEAKER_04 20:07

Yes. Absolutely. Absolutely. And yeah, so when we say feeling worse before better, yeah, it's good. You've got to evoke the scariness, you know, and it always ends in a in a it looks like a parabola. So it starts, you maybe anticipate your anxiety, three or four out of the ten. You do the exposure, or stop your compulsions, allow that feeling to be there, like Drew did with his heartbeat, or you may have derealization and you have to sit there and just feel spaced out for a little bit, or you may be having intrusive thoughts about harming your loved one, you know, and you got to sit there and not compulse for a bit, you know. Yeah, suddenly the anxiety creeps up. So it was a three or a four, and then it will hit an eight or a nine. Uh, and then it will stay there for a little bit, and then the body just goes, and the amygdala goes, Oh, I've thrown every warning signal at you. You've not really done anything, but also nothing bad's happened.

SPEAKER_02 21:03

I guess we're okay here.

SPEAKER_04 21:04

So the amygdala goes, Oh, okay. Well, I'll make a note of that, rewire that there. Ah, okay. Yeah.

SPEAKER_02 21:12

All right. Well, I've obviously got that wrong. My bad. And in the beginning, it'll be like, oh, my bad. But I'll be back in three minutes to do it again. Uh, you know, I'll be back in three minutes to do it again. Yeah.

SPEAKER_04 21:22

But if it's the same topic or the same thought and you've not responded, you won't go to a nine, ten, you'll go to an eight and you do it again. I love it. And you go to a six.

SPEAKER_02 21:31

I love your, you know, we're gonna bring geometry into this or math. I love your power uh the parabola, like the parabolic trajectory of your fear, which is true. And I think what anxious people want though is if you think of a curve, it goes way up and then it goes back down again. What they want instantly, and I wanted, you probably wanted, was I want the top of that curve to come way down as close to zero, so there is no curve. But that isn't how it worked. First, the curve gets steeper and lasts shorter. So it's a peak and it's back down. But you still get the peak. You need to go to the peak. You need to go to the nine, the ten, and shorten the experience. And then the curve begins to flatten. So if you if you're a visual person, think about that. It must be getting worse. Well, no, you used to do a ton of avoidance and safety behaviors that kept that curve at down like a six or a seven. Now you've dropped them so it goes all the way to 10, but you get back down to zero faster.

SPEAKER_04 22:26

Yeah, I'd rather climb up the hill, a steep hill, so then I can look forward to jogging back down it again than walk 10 miles up a gradient. That's exhausting. That's rough. You know, yeah, yeah. It's like, oh, this is never ending. It's horrible. Whereas like, okay, this is gonna be super uncomfortable. I'm gonna climb the hill, be really tired. But when I'm on top of the hill, I'm like, oh, it's all downhill from here.

SPEAKER_03 22:48

Yeah.

SPEAKER_04 22:49

Whereas sometimes when we simmer in anticipatory anxiety and avoidance, stuff like that, it's just like walking uphill. Yeah, it's manageable, it's more comfortable than climbing the hill. But it's just like, oh, but it also never ends like all day long uphill. Well, it I I think it does end physiologically, but it you you've been climbing that hill all day. Yeah. Whereas with a good exposure, you can just be like, let's get over and done with it.

SPEAKER_02 23:12

This is where we need a bigger budget for disorder. We can have motion graphics and like the curve and all kinds of cool. We don't have that now. All we have is eagles now. Silly project. We'll get there. Keep leaving us good reviews and maybe one day we'll have motion graphics on Disorder. Who knows? This podcast is sponsored by Powdered Green. Oh boy. Can't wait to do that one. Um that's a disordered after dark episode that we've been hanging on to. Um anyway, so that's worse before before it gets better. To me, I I I get it. But we can go all the way back to Dr. Weeks. I mean, there are words for it in you know, behavioral theory, uh the extinction burst. The extinction burst is like, oh, just before that behavior goes away, it we see an increase. Almost through entire animal species, not just humans, like before this behavior is extinguished. That's old school behaviorism, but it's still there and still observable. There's an extinction burst. The frequency of the behavior increases before it goes to zero. So like this is like a common thing. You know, you're you don't just get rid of it. It will feel you'll feel all the things.

SPEAKER_04 24:25

Yeah, I I know in OCD they have they talk of this phenomenon called the backdoor spike.

SPEAKER_02 24:30

Oh, the backdoor spike.

SPEAKER_04 24:32

Yeah, it's just like ah, you're comfortable with this topic, and then it sneaks its way in through the back door. Yeah bang, captures you. I just call these like uh just adrenaline dumps. You know, just expect the adrenaline dumps. Sometimes they'll just hit you from nowhere, uh, but immediately you just practice what you preach there. This is where I practice my willful tolerance of uncertainty. But expecting the adrenaline dumps, that was a big one for me. I think the first time I got to grips with anxiety, it did feel a lot better and it felt great. And then sometimes I just have an adrenaline dump in the middle of the night or walking around like wow, hit with derealization, panic, racing thoughts, something bad's gonna happen. I need to be rescued. And I'm not gonna sit there and question why. It's like, okay, well, for a long time I've been anxious, so it doesn't really surprise me that sometimes I'll get these adrenaline dumps because that's been my default mode of of being. Yeah, so I I don't blame my brain and body for suddenly stepping into that now and then, but the same applies. But yeah, that can feel suddenly worse. You know, try not to fall back into the oh my god, it's back. This is what no, no, it's like it's all part of it. An extinction burst.

SPEAKER_02 25:44

The extinction burst. I love that it's just a cool word. That's a just a cool movie title to Nicolas Cage movie.

SPEAKER_04 25:50

It sounds like one of those posh paints you get from those high-end uh paint shops, you know. Extinction burst. I'm done with Mole's breath. Can I please have a sample of the extinction?

SPEAKER_02 26:00

Extinction burst, please. Yes. Yeah. That's a total action movie. I would make that movie for sure. I think uh, you know, worse before better, people also, if you want to judge something, you can't help it. Like people in our community, they're going to judge, do I feel worse if I feel better? You can't help it. It's gonna sneak in. But if you really want to measure something as worse and better, don't measure how you feel. Measure the change in the response to how you feel. Like, oh, couldn't it? What's worse? What's worse is okay, worse would be I'm going backwards into I need to go and lay under my covers and need to like stay inside for four days after a panic attack. Maybe that you call that worse. Better is, well, I had all the scary thoughts, but I still coached the soccer team, like, you know, and and I did it anyway that we started with. I still did that. That's getting better. It isn't it's you know, what's getting better and worse is your response to how to how you how you feel. And before you go and Google backdoor spike, that's when you used to be scared of a thought and now you're not so much anymore, but now you're scared that you're not scared of the thought. So it's it's not that the thought comes back, it's like, oh no, if it doesn't bother me as much, it must mean that I like that thought now.

SPEAKER_04 27:04

Oh, yeah, people with intrusive thoughts about yeah, come on, I've done so well. And it's a backdoor spike.

SPEAKER_02 27:11

Yeah, it finds a new way to get you, you know.

SPEAKER_04 27:13

Like yeah, yeah, I've had an intrusive thought that's horrible.

SPEAKER_02 27:16

Yep.

SPEAKER_04 27:16

And I'm and I'm anxious about it. Now I'm no longer anxious about it. Oh my god, what if that means something more? Now I'm not anxious about no like come on, yeah.

SPEAKER_02 27:27

Really, like it makes you shaking my head for sure. Not at at you if you're listening. You know, come on, anxiety, come on, brain. Like we can do better than that.

SPEAKER_04 27:35

So so sorted out, brain. Well, what are you doing there? Um, yeah, it's interesting. Worse for better. So I think I mentioned one of one of uh very early episodes. You know, if I have a client who comes in and says, Oh, Josh, I've had an amazing week. I've not been anxious. I'm like, okay, well, I'm good, I'm happy, I'm happy that you you've not been anxious, and you know, you've been anxious for a long time, so I'm glad you've had some contentment. But a really good week for me is Josh. I've been anxious a lot this week, but I chose to be anxious, and I went and did stuff anyway. Look at all these scenarios that I did and challenges that I did where I purposely made myself feel in inverted commas worse.

SPEAKER_02 28:22

Yeah.

SPEAKER_04 28:23

Now that is not worse, it's getting better. But but I can see why people feel like, oh, you've got to feel worse. No, you're gonna feel more, and that's good, and that's a really good week.

SPEAKER_02 28:36

That's the attitude shift, episode 10. Uh, the thoughts are just thoughts was episode 11. Who gets the credit was episode nine? You guys go back and listen to these old episodes.

SPEAKER_04 28:44

The golden trifecta.

SPEAKER_02 28:45

They're good, those are good episodes. But I think also, like, yeah, I had a week where I chose to feel air quotes worse. So it's not like, oh no, what if it gets worse before better? Better is I choose the worst to get to the better. That's another way to frame this, if you will.

SPEAKER_04 29:00

And no matter how that presents, so it could be not responding to the anxiety, which is really good, or it could be walking towards the anxiety. Right. So if you've got agrophobia, you know, I chose to feel more anxious today because I decided that I wanted to catch the bus into the city. Yeah, okay, compared to last Monday, 10 times more anxious. But actually, I found in the evenings I was a bit more proud and relaxed and had a bit more hope, and I did some good brain rewiring. Or people with health anxiety, you know, like actually, yeah, I chose not to Google or ruminate or ask for reassurance or body check or body scan or measure that patch on my skin for the thousandth time, you know, and I and I chose not to do that, and I felt worse for it, but I know why I'm doing it.

SPEAKER_02 29:51

Anyway, so should we uh are we good with like worse before better? Do we want to go to anything to end the episode with? Another day.

SPEAKER_04 29:58

Let's conclude. Yeah, things can feel worse before better, but if you're judging that uh as yourself, as as uh are you stepping towards recovery, then that isn't worse. That is better. There's a nice paradox for you to to dwell upon, but don't dwell on it too much.

SPEAKER_02 30:15

No, the par that's I love that you end the conversation on paradox. All of this is a paradox. Isn't recovery about feeling better? Not necessarily. So you will feel better, that's what we will say to you. Yeah, but yeah, but that's not the target. It's crazy. It's a happy side effect. Recovery is the long-term target.

SPEAKER_04 30:33

Your short-term target is to not feel better, your long-term target is to feel better.

SPEAKER_02 30:36

Which makes no common sense. And the last episode we talked about different types of therapy for inside it plays into that where a lot of people will be like, Are you insane? How do you tell people to feel worse? It's it doesn't make sense. It's counterintuitive here. Yeah. And confusing. Anyway, uh, should we go to we have an audio did it anyway, but we can certainly do that one.

SPEAKER_04 30:58

We've got an audio did it anyway. We can listen to that, or I've got a question if you're to fire at you. Yeah, through the question. Here's a question submitted on disordered.fm. Um, here we go. Uh hey guys, I can't thank you enough for coming together and making these podcasts. Have they been has as they have been extremely comforting and helpful. Well, thank you very much. I'm currently midway through an anxiety episode that I felt was brewing for a while. I'm constantly feeling uncomfortable and I'm so tense, which I think is triggered by unwanted intrusive thoughts. I feel I cannot speak to anyone about my thoughts as I feel I'll be put in a strait jacket. I feel so alone sometimes. My question is, is it normal to feel like I'm going crazy while having these thoughts? They are so intense and make me feel so uncomfortable. I have recently, in the last eight months, gone through a traumatic event which maybe is the trigger. Please don't use my name. Thank you so much for your work.

SPEAKER_02 31:59

Uh, what would you say to that, Drew? Uh the common thing that we hear a lot is like, I I don't even want to tell anybody what I'm thinking because they're gonna lock me away or put me. It's so wrong to even have this thought. And that's one that I you got to challenge almost right away. That's where psychoeducation comes into play. Like, no, no, no, no. Human brains create all kinds of thoughts, none of them are inherently evil or wrong. So we start from that respect. Like, no, no, just having a thought doesn't mean that you're broken or it's true, or it's you know, yeah, and you can have nasty intrusive thoughts.

SPEAKER_04 32:30

Yeah, it might have been but when we're super stressed or gone through something traumatic, yes, the threat response fires off when we don't need it in a disordered way.

SPEAKER_03 32:39

Yeah.

SPEAKER_04 32:39

When there is no threat in your environment and there is no threat around or anything that's perceivable, it will go to your mind and so you will have weird intrusive thoughts. We all do. Every single person has intrusive thoughts, but suddenly it's kind of latched onto this one because it's gone, well, we're super stressed, we've might have gone through a bit of trauma. Uh maybe that's the threat. That thought about you killing a loved one, maybe it's drowning your kids, maybe it's having sex with someone you shouldn't do, maybe it's putting feces in your mouth, maybe it's driving off a bridge, maybe it's just existential thoughts where you think you're crazy and it doesn't matter, they're all the common intrusive thoughts. And if I've caught you in that net, just know that that's okay. It's common. Um, you're not going crazy, no. My advice to you is to seek um an ERP therapist specializing in OCD. I'm not giving you that diagnosis, but those therapists, I've heard them all.

SPEAKER_02 33:33

Yeah, and it's interesting. Note how Josh just reeled casually through a list of what would seem like horrific thoughts. You cannot bring a thought to us that we haven't heard already.

SPEAKER_04 33:43

No, you can't. The thoughts, um, yeah, they're just just I used to have nasty ones, man, like like killing my pet and eating it. So stuff like that. Like, why am I having this thought? Like, I love my I love my butt that attacks your values and what's personal to you. So you if you have OCD and intrusive thoughts, yeah, you ain't gonna get an intrusive thought about uh you know, um Charlie Steron knocking on your door, being like, Yeah, do you want to play Halo all evening and eat pizza? No, never get intrusive thoughts about that. It's always something that attacks what's personal to you. Uh and just know this thrives because it's the opposite of who I am. Your doubt response will say, but what if it isn't? Right. We already knew it was gonna say that. Shut up, doubt response. Shut up, amygdala. Boring.

SPEAKER_02 34:28

It's true. Uh it is true. You call it intrusive for a reason. If it was a thought that was really in line with who you are, you would not see it as an intrusive thought at all. It would just be a thought. So yeah, that tells you everything. Your reaction to it tells you everything about it. You're not crazy. You're alright. Should we do our audio did it anyway? It's a combination, it's a question and a did it anyway, all roll into one.

SPEAKER_04 34:49

Yeah, this is this is um pretty moving.

SPEAKER_02 34:52

It is. Let's bring it. Here we go.

SPEAKER_01 34:55

Hi Josh, hi Drew. Um massive fan of what you guys do and really enjoy every episode that you've done so far. Um, kind of a quick question. Um so my mum's recently just passed away. Um, it was kind of expected, and I was just wondering about how the best ways of dealing with grief. I've had a look on the internet and just trying to find a bit of words of advice to, you know, about how to cope with it. Um obviously it's made my anxiety feel a lot higher, and it, you know, it's quite scary going through it and full of emotions and just, you know, don't really know what to think or what to do. Um just wondering if there's any advice that you guys can have. Uh it also falls under hashtag IDITAnyway. I have a massive favour of hospitals and health and all that. Um but I managed to sit through and comfort my mum right until the end, um, which was really emotional. Um, and it really, you know, took a lot to stay there, but I did it knowing that I was gonna be there and be strong for my mum and for my sister who was with. So it was quite emotional and quite proud that I did it, um, you know, considering the circumstance. But yeah, well, if there's any advice that you can give, it'd be much appreciated. Thank you. Oof, that's a rough one.

SPEAKER_04 36:10

That's uh brilliant, well done. Yeah, uh what I did it anyway as well. Uh, I think that's absolutely outstanding, and that's current courage and bravery um that we find really moving. And we're really sorry to hear about the passing of your mum, but I know that she would have appreciated your bravery to do that. That's a horrible situation to be in, and you don't like hospitals, and you did that, you did all that because you love your mum, and that is a wonderful thing to do. Um, your question is about grief. Well, um I I'm no model in uh processing grief. It's a bit different for everyone. Uh what I would say to you is uh don't push your feelings away if you're grieving or if anyone else is grieving, don't push them away. Uh don't do what I did. Trying to drank too much and did things I shouldn't have done. Um, no, because you're trying to push it away. Allow it. You're gonna feel rubbish, you're gonna feel irritated sometimes. Try not to take out on loved ones, but just let them know. Um, you know, you're gonna feel angry, you're gonna feel tearful. If you feel the tears coming, great, let them flow. Sometimes you're gonna feel nothing, and that's okay too. It doesn't mean you don't care. You know, sometimes you just might be walking through the park and feeling happy, and then you might feel guilty. That's okay. Your brain is like with grief, it's like one of those balancing um punch bags, you know, those freestanding punch bags, and you punch it and it goes down and then it comes back and down, down. That's what that's like. It's like, and eventually over time, the the it self-writes itself, you know, you pit it, bit it, it comes back at you, it goes back and forward and so forth. Grief's a bit like that. Um it's good that you're seeing a therapist and CBT for your anxiety disorders. In the last episode, we spoke about certain modalities. Um, I think sometimes grief is great to be spoken to with a nice person-centered counsellor or even a grief counsellor. Yeah uh definitely. Um we love CBT here and we bang on about it, but actually, I don't think CBT is that appropriate for grief. Oh, I don't think it is at all. Grief isn't a CBT problem. No, no, it's not a CBT problem. That's a place where you can look sit through, talk about things, celebrate your mum. There may be other emotions that come up that come to do with your mum, like anger, um sadness, uh the deep grief, things like that. Just know that you're doing all right, you're not as broken or as you know um incapable as you think. And if you're capable of doing it, did it anyway like that, you're more than capable of getting through this very tricky time. And we really appreciate you for sharing that with us.

SPEAKER_02 38:53

Yeah, it was a big deal. I can't really add much to that. I mean, you had personal experience there, which I always appreciate, my friend. And I think uh the only thing I would add is recognizing that big emotions and all of the physiology and everything that comes with that is just gonna be part of this process that's normal. Like feeling big now is normal in that situation. So the CBT part would be my anxiety wants to dissect why I'm feeling big and make it into something else. But it's not, you're just gonna have big feelings now, and you're supposed to.

SPEAKER_04 39:22

Yeah, and anyone who's grieving, uh don't be surprised if you suddenly get panic attacks or intrusive thoughts. Yeah, you know, it just trying it's because you know, everything you're going through shock, yeah, and there's different components in your brain that's trying to work out why you're going through shock, and it'll suggest madness to you sometimes. Just expect it. Like, whatever. You know, this came. I'm not gonna add secondary fear here. You struggled enough with it with anxiety disorder, you know, don't let things do that. But also, and I and I say this with the utmost sensitivity and respect, do acknowledge that in that did it anyway. I bet you you probably thought that you couldn't do that, and you did, and you're still here. Well done, mate.

SPEAKER_02 40:08

Which means you're gonna handle the grief too. So that was good. Yeah, that was good, yeah. Some of a way to end, but also hopefully I hope. And uh, if you guys have wanna send in did it anyways or ask us questions, you can go to disorder.fm, send us voicemail or email, and uh we will do our best. We listen to just about all of them. We can't always get them on the air, but we do go through most of them.

SPEAKER_04 40:29

So yeah, yeah, also uh this also isn't a shameless plug as well. I talk about grief a lot in the book, my own personal grief. Uh I talk about what not to do. So just you know, if you want to know what not to do, um, you know, check that out when it's out. Um, but also, you know, someone uh fellow guy, fellow Brit, probably a lot a lot of cultural things in common. Yeah, um, I think it's uh good to uh to kind of process that grief in in a patient, compassionate, and considered way.

SPEAKER_02 40:57

By the way, that book is called And How Does That Make You Feel? Because Josh never says the title of his book. And if you want to know more about it, go to disorder.fm slash four six. I appreciate that, my friend. You're welcome. All right, guys, we'll see you next week. Thanks for coming by. See you later, guys.