Exposure Is Learning To Be Uncomfortable (Episode 174)

SPEAKER_01 0:01

Hello, Drew and Josh. I just wanted to submit and I did it anyway. Panic disorder, agoraphobia, you know, tracking a bit of OCD, a little bit of all the things. Anyway, today I planned an exposure. It was to travel to a certain spot with my puppy and then walk the puppy near near a nice, it's near a nice beach about sort of 25 minutes away. Anyway, I got here and the bloody road works. I don't know, anyone with panic disorder agrophobia will, you know, they know that they are an arch nemesis of mine. And not only were they roadworks, but it was a small bridge, and you have to wait at a red light um for at least a minute and half two minutes, right? Before you can go, and then you have to wait on the way back. And so immediately, of course, I turned around. And I went almost all the way back to town, and then went, oh, oh hang on. Hang on, hang on. Maybe, and normally if I do that and I don't do the thing, I'll just go, oh, I failed. Alright, I'll try again tomorrow. But I was like, I still have like five hours left in the day. I do have time. Why don't I try that again? Revelation. Um, anyway, I did do it. I did wait. I didn't explode, which was surprising. I didn't actually, you know, melt into some kind of liquid on the bridge, trying to get across the bridge like my brain told me to. Not only that, I went for a really nice walk, and now I'm gonna go further to another beach because I've got the confidence from what I just did. So, all that to say, I did it anyway. Absolutely stoked. Thanks for all you do. It's amazing. Okay, bye.

Josh Fletcher 1:49

Welcome to Disorder. This is episode 174. Uh, Drew, what's it called again?

Drew Linsalata 1:56

We're talking about learning to be uncomfortable.

Josh Fletcher 2:00

Learning to be uncomfortable. Uh, there's some professional podcast insight for you. What a way to start off the episode as well, which uh encapsulates the message of not only today's episode, but the podcast perfectly. Um, going back to the situation and learning to be uncomfortable. Well done. That was fantastic. Yeah, we've got to get a round of applause.

Drew Linsalata 2:24

And and the Billy Mays, please. Uh, she does deserve a Billy Mays, 100%. Am I gonna get it right?

SPEAKER_04 2:29

But I'm not done yet.

Drew Linsalata 2:30

Billy Mays is gonna be big this week.

Josh Fletcher 2:32

So yeah, very good. Just not done yet. Carry on doing stuff. Uh, why why today's topic, Drew?

Drew Linsalata 2:39

Um, I think one of the biggest things, you know what we didn't do, but I think it's okay. Let's leave it. We didn't do the usual who we are, but I think that's okay. It's so good. Go back and listen to the 173 episodes, you know who we are. Today, this was sort of my oh sorry, we're gonna have notifications, what can I tell you? Um I I think it's a thing that I see often, whether it's in our social media comment section or the online community, even in my therapy practice, no matter how many times people listen to the podcast or read the books or watch the videos or whatever it is, I think it's human nature to still hang on to the idea that when I when I decide to do it anyway, or I do willful tolerance, or I do floating or acceptance, Claire Week style, I'm still trying to not get triggered too bad. Either not get triggered or I'm trying to keep it under wraps. I think people really have a hard time, and I get this, it's nobody's fault, coming to grips with the fact that you do the thing to be uncomfortable. That is the point of doing it anyway. Not to prove that you can sit in traffic like our sender enterer or go to the supermarket or have dinner with a friend. You're not trying to prove that you could do that. Yeah, you find out that anyway, you're practicing being uncomfortable.

Josh Fletcher 3:46

Yeah, that's the reframe. It's the most powerful reframe. You can't blame people for you're surrounded by it. So if you're on social media, um, you know, you scroll any TikTok or Instagram feed, it's full of people telling you, here's how to get rid of a feeling. Get rid of a feeling. If you're anxious, you're doing something wrong. You have to do this, you have to do that, you have to do that. But ultimately, the end goal is to get rid of a feeling. Now, don't get me wrong, this is what we're trying to do here on this podcast, but it's from the belief that when all feelings are welcome and you are comfortable with all feelings, that you are going to have the ones you like more often. But what you resist persists. So if you resist anxiety, if you resist discomfort, it it sticks around long enough. And anyone listening to this can relate to that. I've tried everything to get rid of stuff, tried everything to get rid of stuff. And the Did It Anyway sender in a perfectly encapsulates that. She gets to the traffic lights, she sees the bridge. No, there's a feeling I don't like, I have to get rid of it. So I turned around. But what we love about this is that no, actually, I'm willing to be uncomfortable. She turned around to be at the traffic lights, to be on the bridge, to get good at being uncomfortable, and then she went on a walk and did all those things with the feelings that she wanted in the first, she was willing and to practice being uncomfortable, and that's the end goal. Yeah, you know, it for a lot of people, the goal is if I want to be uh to go from A to B as quick as possible. I don't like this feeling, I want to get rid of it. So I'll turn or go home, or I'll rely on safety behaviors or magic people or objects or techniques or Reddit feeds or AI or all these things. I want to get rid of this feeling. No, that was the win there. She's practicing being uncomfortable. And wonderful, wonderful way to set up today's episode.

Drew Linsalata 5:42

I think it's perfectly applicable, right? Especially, you know, now near the end, she's like, Well, I didn't, you know, turn into a pile of liquid goo. I love it all, the humor and all. But yeah, that's the lesson. But many people would be like, Yeah, but I was afraid and I was uncomfortable. That's the problem. No, I know I knew I wasn't gonna die. I'm not afraid, I don't, I don't think I'm gonna die. Uh, but I just I'm just so afraid and uncomfortable that no, I can't do it until I'm not afraid. No, no, no. You gotta do it when you're afraid. Like, that's the point of do it anyway, is I did it while I was uncomfortable and afraid and thought I shouldn't, and all of that stuff. So she did it perfectly, really well done. And the lesson turns out to be if I allow myself to be uncomfortable without running from that or fixing that, it appears that the situation improves over time, but that's the happy secondary outcome instead of trying to not be triggered. Like I gotta go and be triggered and work through that, and then as it turns out, I end in a better place. Who saw that kind of thing? Yeah, and it's okay, it's good to say I'll calm down eventually.

Josh Fletcher 6:36

Right. You know, it's fine. I'll be uncomfortable, I'll calm down eventually. Yeah, if I try to rush that and be like, oh no, no, I need to calm down now, which is the initial driver that made a turn car around. No, I'll calm down eventually. I'll go, I'll go and sit in traffic.

Drew Linsalata 6:54

Right.

Josh Fletcher 6:55

And she did. Yeah, she did, and at triple prizes. A nice beach walk, doing all that, living values, way better than the initial, all right, I'm home, I'm safe. But now I've got Craig the critic really loud, and I need to go back to the drawing board. Yeah.

Drew Linsalata 7:10

Uh super duper. She would fail if I would just go home and say, Oh, I failed. Yeah, that's not right.

Josh Fletcher 7:17

So you might as well feel anxious there and and and have that, and it outweighs the feeling. Yep. Um, definitely being anxious means you're not doing anything wrong. You're rewiring the brain. You're teaching the amygdala that being uncomfortable is not dangerous, it's just its title. It's just uncomfortable.

Drew Linsalata 7:36

Yeah, and it's just slow to learn, unfortunately. We need to repeat the process, and that's the way it goes. But you know, that's what we get with the amygdala. Can you say that's the way that's the way it works?

Josh Fletcher 7:45

One of my favorite episodes I've ever done uh is the attitude shift, it's one of the most important ones. And it's for me, it was what encapsulated my own desensitization. When you wake up with the attitude of what can I do anxious today? How can I prove myself and my anxiety wrong? Yeah. Well, how far can I really go? And when you stick your head above the parapet and start to see things like, ooh, ooh, ooh, I I wasn't expecting I didn't think I could do that. And that can become infectious. And I try to encourage people to do that.

Drew Linsalata 8:19

What can I learn about anxiety? What can I learn about myself? That the curiosity. We did another good episode on the death of curiosity. Anxiety takes away your curiosity, but you really want to be curious about this. So, like, okay, like, you know, what in the end of an exposure, when I do exposures with my clients, at first we do them together. There's always that debrief. And one of the questions I was going to ask is, what did you learn about yourself in this? And invariably the lesson starts to become wow, I learned that I was I actually am brave. I learned that I actually am capable. I'm a little bit more flexible and strong than I thought I was. Like the anxiety isn't as powerful as I thought it was. So, like, you're always looking for like, what did I learn from in choosing to be uncomfortable? I didn't learn that I can sit in traffic. Yeah, I could if I need to, but I really learned that I can, in fact, handle this thing. I can do that.

Josh Fletcher 9:02

Yeah. Yeah. Oh, well, someone in the studio audience, and if you want to be part of the studio audience, you can go to disorder.fm and be in the studio audience uh as we record live. Uh someone said, the problem I have with this is that annoyingly, you have to take the leap of faith to believe it could be anxiety first, before you can try and teach the amygdala that anxiety itself can't actually hurt you. Well, that's a really good comment. Why don't you reframe it to no, I'm practicing with uncertainty? Because what you're saying there is no, I need to feel certain before I do something. Right. That's the problem. No, no, no. You're practicing with uncertainty. Yeah, but I have a problem with that. Well, no, that's what we've got to practice with. That's the uncertainty. Your rational brain has mountains of evidence to know that you are okay and you are safe. Anxiety can't hurt you. Panic attacks have never killed anyone, blah blah. All you've got is a what if what if it's not anxiety this time? Literally one if. One what if against mountains of evidence. And this is why we talk about rolling the pentamillion gun. Can you get certainty before you do something? No. Do we know that uncertainty is inflated, magnified, and exacerbated by anxiety and a threat response? Yes. It's not a leap of faith. It's a I'll go and find out.

Drew Linsalata 10:25

This speaks directly to how willful tolerance, exposure, floating, accepting, all the words, how it works, and like why it works. So uh first of all, I would say to that everybody fears that. Nobody just hears us say, like, oh, exposure is in the facing willful tolerance is totally safe. And everybody just runs. Okay, cool, let me just jump into the abyss. Nobody does that. Everybody hits that point where it's like, yeah, I hear you, but it feels so real. Like that thought, yeah, but what if this time? Feels so powerful and makes me so afraid. Ultimately, there's a couple of things. You have to find some courage to act even though you're sure you shouldn't. That part of your brain is gonna say, nope, this time it's a real deal and you're gonna kill yourself. It's not cool. This is put you in the grave, this is the thing. So you have to be courageous, but also you have to come to grips with the idea that the staying on the sofa and all the stuff that you have done in the past, that your brain will be like, see, that's what kept you alive. No, that's theater. Like tomorrow's episode of The Anxious Truth that's coming out is literally about this. I almost died. I almost no, you never almost anything. And all the things you did was 100% like a lot of motion and energy for nothing. So we gotta learn that if I do none of those things, then I still wind up okay.

Josh Fletcher 11:37

Go with the evidence as well. Yeah, you know, uh there's another thing like if your brain is locked into the idea that it's not anxiety, it's actually something dangerous. Well, it's not locked into the idea. Yeah, you've listened to that idea. Right. Your brain has multiple voices, has rational brain, as likely brain, it has compassion brain, has all this. If you're listening to the loud, anxious brain screaming, but what if I used to have this all the time. If I leave my uh apartment, I will have a heart attack. If I climb up the stairs, I'll have a heart attack. If I stand in a crowd of people, I will go crazy. And that felt real. Yeah, because that's what everyone was saying. My intrusive thought. If I do that, my intrusive thoughts are real, that might come true. It's the very same mechanism, it's not special, and it does require a bit of courage to do that. It is, I suppose, a leap of faith.

Drew Linsalata 12:27

100%.

Josh Fletcher 12:28

But what it is is that for me, the reframing was I am practicing with that uncertainty. There is no, if you wait around and and for the day that's like, okay, find out. Also, just again, look at the evidence. I am alive, I am here, my heart's beating, I'm breathing just fine. My brain works fine, it's got a very loud, anxious brain. I can walk, I can put one foot in front of the other. What's that got to do with a what if thought? None. Can I do I have 100% certainty with that? No. But that's what I'm practicing with, and that's what this episode is about. I'm practicing with that uncertainty, and it takes time. A little bit of a time if you need to, or just go for it. You know, it's the very same mechanism as the sender inner. She said, Oh, I turned back, that's too much. I will. She thought very convincingly that she would turn to liquid on the bridge. So much so that she turned her car around and drove home. That's how convinced she was that she would that would happen. But then she weighed it up and thought, no, the reframe here is I'm practicing with uncertainty. So I will go and find out. She wasn't just three out of ten, or I'm a bit unsure, or no, my anxiety is worse. She was like, No, I turned my car around, I didn't like it, but then went to see. And yes, it does require you to go face to face with uncertainty, and that does require courage and bravery. But remember, use your rational brain and use your probability. Lean into probability. Yeah, you know. What's the probability of a lion eating me if I base myself in barbecue sauce and roll around in its den high? So, and that would give me anxiety. But guess what? I'm not gonna do that because the probability suggests that, yeah, yeah. But the probability of me going for a walk, even though you know, even though I my brain's telling me I'm gonna have a heart attack, even though the doctors tell me I'm fine and this and that, the probability of me having a heart attack on that walk is very little. Is it certain? No. Right. Is it highly unlikely? Yes. Then I'm gonna go with that. Sorry for ranting.

Drew Linsalata 14:40

No, it's okay. I mean, and that was a lovely two minutes. And then when triggered, I'll shut up for the next 20. No, no, it's no, that was really great and very encouraging and very accurately, uh very accurate. And then the next time a person listening gets triggered, they will but I can't believe what Josh said. Right now it sounds very rational, very encouraging. It's true, it's accurate, 100%. Nothing, nothing inaccurate there. Then when I get triggered, that all goes out the window because it feels like this time is it. And then I just I I don't want to take that kind of chance. I can't take that kind of chance. But I think ultimately, forget everything Josh, don't forget it, because it's really good stuff. But the reason I would suggest the reason why our sender Interer at the beginning of the episode was able to turn that car around is when she started heading back home, she said, wait a minute. When I go home, I'm just gonna tell myself that I failed. So now the scale tipped, the pain of not doing the brave thing outweighed the pain of doing the brave thing. And everybody listening to us and everybody in the studio audience has to find their way to that moment. Because if you want to keep saying, yeah, but it sure feels like this time it's definitely not anxiety, and I can't be sure, and therefore I can't apply these lessons, no problem, you get to pick that. But then you have to decide is that choice is the cost of that choice okay? If you're listening every week because the cost of the choice isn't okay. Like my avoidance and my retreat, and no, it just feels too bad. How are you supposed to do that? It's so hard, it's dreadful, it's dreadful, it's too hard, I can't face it. No problem, we support you there too. But then there's a price on the back end. So I failed, I can never get better, I hate my life this way, what's the point? So the only thing you can do before you can practice, and I'll push because now I'm on a rant. But the way you get to practicing being uncomfortable is you have to say, Am I willing to pay the price of avoidance in my life anymore? If I'm not and I'm tired of that, that's what I had to hit. I don't want to live like this anymore. So I'll take the risk, I'll roll the pentamillion gun. Then you can say, Well, I'll I'll trust that crazy dude in Manchester that said the probability is on my side. I'm I will bravely trust him blindly, even though it feels no, I can't do it. I'll I'll take a shot because I can't keep doing it this way.

Josh Fletcher 16:55

Yeah. The the fallacy is as well, like you people, even people with anxiety disorders, do stuff risky things every day, but don't think it twice, but then we'll say no, it's not anxiety. Right. You know, you'll you'll get into a car, you'll take public transport, you'll do stuff. I don't know. It it that doesn't bother you because your threat response hasn't latched on to it. That's right. It's latched on to the unknown.

Drew Linsalata 17:18

How about people in our community that will are scared of like you know, specific things, like cardiophobia or specific thoughts, but have no problem like, oh, my arm hurts a little bit. They'll just go into the medicine cabinet and find any random pill that a family member has left behind from four years ago and take it to try to get rid of the pain in the elbow. Like they they don't worry about that at all. So what is that?

Josh Fletcher 17:38

And another member will be like, I can't take alien things. Nope. I won't, even though I've taken a paracetamol. Even though I've taken it in the past, I've now developed some kind of thing that where I won't tolerate it anymore. Um, but yeah, it just depends on where you're at. Uh let's break up our rants with a written did it anyway. Yeah, let's do it. Uh okay, here's one from Rebecca. Uh, I love these ones. Hi, Josh and Drew. Feel free to use my name. I wanted to write in and share a did it anyway. Back in June, I decided to do the adult thing and go to the dentist. It has been far too long due to prior dislike of the dentist, a lack of benefits, and growing fear from avoiding it for so long. I didn't even make it through the full appointment before having to leave because I was quickly hurtling towards having uh what would be my first panic attack. I found out at the appointment that I would need to have some work done, which I did expect. I feel as though it wouldn't have been that bad of an appointment, but the dentist didn't listen to me when I asked her to stop showing me x-rays triggering my health anxiety. Here's where your mouth used to be. Uh they recommended to get everything fixed, as well as cleanings whilst under general anesthesia, to get all it it done in one go. It's a big procedure. This was another hurdle as I've never had to go under in my 33 years. I spent most of the summer extremely anxious about this appointment, but today I did it. I went into the office, took my little nice little nap. Oh yeah, nice little nap, and now my mouth is just about good to go. The repairs weren't even as bad as the initial dentist said they would be. I was able to speak up for myself and voice my concerns regarding the first visit. Going forward, I plan on slowly re-exposing myself to the dentist and have made it my goal to be able to not fear going. Never liked it, but I don't need to be, I don't want to be afraid. Thank you both for the amazing podcast. Uh, some niceties about this. Um, the did it anyways with you guys is part of what motivates me to get through.

Drew Linsalata 19:49

Well done. Well done. Very well done.

Josh Fletcher 19:51

Dentist is always a big deal. I love my the best part of that is that you literally went in and got knocked out. Like, you don't need to keep doing exposures to the dentist. That is the exposure to the dentist. Yeah.

Drew Linsalata 20:05

And and I think it it in a way it speaks to today's topic. Like the dentist is not the exposure. I mean, the exposure is the thing that the dentist triggers your discomfort. The discomfort is the exposure. So you didn't learn to go to the dentist. You learned that it's okay to be uncomfortable.

Josh Fletcher 20:20

Yeah, and I like the reflection on that too. I don't like going to the dentist. I don't really like people fiddling around with metal inside my mouth. That doesn't mean I have an anxiety disorder. It just means I don't like it. You know, that's okay. Um, but oh well done. And and considering you had the first panic attack there, and you went back and you had such a big thing. Well done. I'm really uh, you know, that's a good gold star.

Drew Linsalata 20:42

Oh, very good. And I appreciate you sharing. Everybody hates the dentist. Well, a lot of people just hate the dentist. In our community, public entity number one for sure. So uh I kind of get it. I I want to talk a little bit about the the idea that and especially it's interesting when I saw saw it when I started practicing, those first exposures that you do with a client, and this is where this comes out, right? I remember doing the drive with a client, and she keeps saying she'll come on the podcast, which I love that she wants to volunteer. So I feel safe in sharing this, of course, anonymously. But and if you're listening, thanks for letting me share. It was the driving was full of roll down the window, put up the window, roll down the window, put up the window, turn up the radio, look for a new song, take a drink of water, take another drink of water, go for the mint, like put your hands all over your face, run your hands through your hair, let make sure your shirt isn't too tight because you're feeling so hot. And legitimately the first five minutes of the exposure were uh pull the car over right now, stop, what are you doing? And she had been trying to do exposure like that. Now, in her case, driving was the trigger, but she was experiencing extreme discomfort and anxiety while driving, right? She had been trying for 15 years to to knock down that discomfort so she could keep driving. And so it was there was a fundamental shift where it's like, no, no, no, we're on the road so that you could be uncomfortable and she had to learn to not do all those things. Now nobody could just turn them all off at one time. But we worked on one thing at a time. No, no, keep your hands on the wheel. No, no, you're not the wrong. But I but I'm getting really hot. I know. And does that make you uncomfortable? Leave the window up. Don't have to turn up the ACP, you crank the window.

Josh Fletcher 22:10

So you're constantly reminding her of what the goal. Constantly.

Drew Linsalata 22:13

I had to keep taking away the feel better thing. And and you know, and finally there was that click that said, like, oh, I get this. I'm like, if you drive through the peak of this discomfort, and then the moment it's heat, you feel like you're just overheating. Oh, I can't get too hot, then I get anxious. I know we're here to be anxious. Wow, everything started to change. So it is so important. I don't care what your trigger is, whether it's driving the dentist, somebody in the studio audience is my trigger is that my daughter might get a stomach virus. Okay, but it's the same principle. Stop doing the things you do to respond to feel better.

Josh Fletcher 22:47

Exactly. It's the attitude reframe. Honestly, it helps. I remember two specific examples. One being on the back of a bus, it was hot. Uh, one of those boiling days, full of people, there was a smelly bus. It was disgusting. I don't know what was going on. It was sensory overload, and I started to panic. My heart rate went. I dissociated, DPDR. Whoa, what's going on? And then I remember because I've been practicing, okay, this is horrible. My instinct now has said, run off the bus. Yeah. This discomfort is not allowed. But then I just remember very specifically going, no, this is a chance for me to practice with discomfort.

SPEAKER_04 23:29

Yeah.

Josh Fletcher 23:30

And you then reshape the narrative to you, just like the original question sender inner. Sorry, that's my computer. Really sorry. Uh yeah, yeah. And um just like the original uh sender inner. And like the other one there, too. Like, I'm going practicing with the dentist. But even then, the reframe at the end, it's not the dentist. Right. You practice with the one goal. The one goal is with the discomfort. If you can deal with that discomfort, the dentist, you can deal with that anywhere else, which leads to a very boring quiz show where Drew is only allowed to answer you're practicing with the feeling. Okay. So, Drew, uh, question one, but what about when I'm on holiday?

Drew Linsalata 24:10

Yeah, you're it the holiday doesn't matter, just be uncomfortable on holiday.

Josh Fletcher 24:13

But what about when I'm at the restaurant?

Drew Linsalata 24:15

Yeah, restaurant is irrelevant. It's just a trigger for the feeling that you're practicing.

Josh Fletcher 24:18

But what about when I'm with my kids?

Drew Linsalata 24:20

Yeah, kids are just a trigger for the feeling you're practicing being with.

Josh Fletcher 24:23

But what about when it's DPDR?

Drew Linsalata 24:25

Yeah, that's just one symptom that makes you very scared and you're learning to be better at being scared. Yeah, but mind getting real symptoms. I know. That's what scared bodies do, and you're learning to be okay with that fear.

Josh Fletcher 24:36

But what about driving? Isn't that dangerous?

Drew Linsalata 24:38

No, but you just think that you're supposed to pull over when you drive because you don't like the feeling when you're driving.

Josh Fletcher 24:43

But what about when I'm doing a work presentation?

Drew Linsalata 24:45

Yeah, that presentation is only a trigger for the uncomfortable feeling that you're learning you can handle. You get boring fast, right?

Josh Fletcher 24:54

Yeah. And the one of the most common phrases we hear, and trust me, I've said it myself, Drew said it himself many times. Yeah. When you're in that sensitized state, but what about if you're someone who keeps asking, but what about insert? Yeah, then just just shift a bit a little bit. Like, no, I'm practicing with the discomfort. Yeah, but what about this special occasion? Yeah, but what about the dentist? But what about this? But what about that? No, I'm still practicing. Now, you know what? I'm not saying jump out of a out of a plane, right? You know, shooting caffeine into your eyeballs and do no, why would you do that? But the aim is, and that's where you can start to do the graded exposure. There is no point framing exposure as, oh, I need to get better with the supermarket. Right. Because then what have you done? Because when you all you've taught yourself is that I can cope in the supermarket. No, I can cope. Now let's use that curiosity to do it in the park or with friends or with family. I am practicing with the uncertainty that these sensations, these intrusive thoughts and these feelings cause me.

Drew Linsalata 26:04

And I think when you make that shift, I think that was episode 10, by the way, the attitude, the attitude shift. It is a big one. When you make that shift and you start to recognize, no, no, I need to practice being uncomfortable. And sometimes that means we do exposures to intentionally trigger the discomfort. The only reason why we do an exposure is to make the discomfort. I I don't care about being on the highway or going to the movies. It doesn't matter. I just want you to be uncomfortable, right? So if we learn to focus on I'm practicing handling the discomfort, that's what the exposure is for. That's what the challenge is for. Then those experiences begin to generalize. That's when we see progress and a more durable and lasting recovery because it's a flexible recovery. So people will often ask us, well, I'm up to the point now where I can do two-hour exposures away from my home, but next week I'm going on a family vacation and that requires I be four hours away from home. That I haven't done that yet. No, that that tells me that you're probably trying to learn how to do two hours without panicking or without being too anxious. And you're doing the hard work. If you've been two hours away from your home, you've done the hard work. Just remember what you're learning. That's right. I think like you you learned the lesson, you just missed it and tried and applied it the wrong lesson. You've done all the hard work. That's exactly right.

Josh Fletcher 27:16

It's like doing an exam and getting 100%, getting A's, and then putting someone else's name on the front. God damn it.

Drew Linsalata 27:22

That's a great. That is a great. I'm stealing that. That's really good. Like no, you did it. Like you're doing it.

Josh Fletcher 27:28

You just think I've written a Nobel Booker Prize winning essay and signed it, Mel Robbins. No!

Drew Linsalata 27:36

Why? It's so funny because somebody in our audience just said these conversations in any other context would be bananas. I want you to be uncomfortable. 100% right. It's why many, many therapists look like people look at people like Josh and I as like we are the odd men out. Like, wait, you what? You know, like let's come up with a crazy story, like about how the worst possible thing, no, no, and when when we do imaginal exposures and you prompt your client to, like, no, no, be more detailed. What did it smell like? What did it sound like? What were you wearing? I want it to be as absolutely detailed and triggering as possible. Like, this is therapy. Yeah, this is therapy. But I think the trick would be don't forget the part where sometimes we do a thing to trigger the discomfort. But if the discomfort is triggered organically throughout the day by random thoughts or just life events, now you do now you're in the other part, which is the RP part. This that when you get triggered by, again, somebody was talking about, well, what if my daughter gets a stomach bug? Well, you can't make your daughter have a stomach bug. You're right. We could tell imaginal stories about it. But as soon as that thought appears, uh-oh, what if she gets a stomach bug? You got to really look and say, well, what do I do whenever that happens? I get really anxious. What do I do to try to fix it? I have to stop doing that. Just let myself be anxious.

Josh Fletcher 28:43

Have you also noticed, like, and I've noticed it in myself and over the years, every time you get a client who does get poorly or unwell, they're actually not anxious because the body just can't be bothered. They're just wiped out by the flu, wiped out by food poisoning, whatever. And they're like, you know what? I wasn't even that anxious because I was just so exhausted. I was too sick to be afraid. Yeah, lit it literally a thing, isn't it? But too sick to be afraid. I remember when I was hit by COVID first time, I was like, I it was something I was really scared about getting. And then I got it, I was like, oh my god, I'm just I couldn't even be bothered. My brain was telling me I wouldn't cope, and when that actually happened, I was like, oh, I just yeah, horrible, right? I used it as an opportunity to start playing Elden Ring on the computer. Yeah, trying to play Elden Ring with COVID was extra hard.

Drew Linsalata 29:32

Sure, sure. Interestingly, that the same person, and I'm sorry, thank you for speaking up in the chat because we could use it as a example. Can you do a new episode of ruminating? But like I would ask, well, what else do you want us to say about ruminating? We talk about ruminating all the time. The rumination is the response that you need to prevent. Like I start to loop through. My brain tells me that thinking about a stomach bug in my family is a good strategy for protecting me against something I fail, I fear. But it's a terrible strategy. It doesn't protect against anything. Just like turning rolling the window down or turning up the air conditioning in your car doesn't save you from having a stroke while you drive. It's it's theater. It doesn't matter. So like I know that the the ultimate answer is I have to not do the response. The rumination is the response, which means I'm gonna have to do something completely irresponsible, like bake a cake while I'm shaking because I'm afraid somebody in my family might have a stomach bug. I know. That's the only way your brain learns that this is a this is a bad plan. This this doesn't do anything for us.

Josh Fletcher 30:28

If I knew you were coming out of bake to cake, bake to cake. It's a good song. Bake to cake. Uh, someone um in the audience says, I'm doing so many exposures, well done, but can't bring myself to go further than 30 minutes from home. Well, first of all, well done. Yeah, but you've you've you're doing the exposures, remember, because you can tolerate the discomfort. Don't let the illusion be, and this is classic agrophobia, you know, I've had it myself, end of the street and then end of the road, and there comes to a point where you're like, oh I'm I'm assessing and measuring my recovery on distance. So if you keep feeding that back to your brain, oh now I can do an hour, now I can do two hours away, that's fine, and that's okay. But you've got to do a subtle shift of right, it has to change now. It isn't the distance, it's silly. Yeah, it's I can tolerate that discomfort. That discomfort will pass. So, you know, have a go, go somewhere an hour away, but that'll make me anxious. Yeah, and that's the exposure, and it will pass, just like the person who opened the episode. You know, if I go on that bridge, if I wait at that thing, it's gonna be horrendous. And they ended up having a lovely time. They couldn't envisage it. Yep, they found out.

Drew Linsalata 31:45

I think that's part of the process too. Exposure is an experiment. In fact, many clinicians will say these are experiments or behavioral experiments. And I love that because it is an experiment. What would happen if I is a great you spend your whole life, those of you listening today, thinking what would happen if? But that the disaster part, like, well, what would happen if I didn't save myself from that? What would happen if I just went back to that bridge and sat in the traffic and then took the puppy for a walk? Well, as it turns out, good stuff happened. Who knew, right? But the experiment is really part of it. And I think part of it is like, oh, I can't get past 30 minutes from home. Well, it's because I'm trying to learn how to not be anxious, so I go a little bit further. And yeah, that's the old way, like habituation, and it works, but it's also kind of fragile and very slow and it doesn't generalize.

Josh Fletcher 32:28

Yeah, it's a momentum thing as well. And the same person in the audience said, I'm sticking to the same exposures, it's a very common thing. I'm sticking to the same exposures, walk-in parks, certain shops. Yeah, so actually, what you've shared there is you've successfully taught yourself that you can tolerate anxiety. Well done. Yeah, but the credit has gone to those shops and parks. It's okay. And if it's evoking anxiety, remember I'm doing this to show myself that I can tolerate anxiety, but mix it up a bit. Go to a news shop, yeah, go a bit further away, do your stuff. But that will make me more anxious. Yeah. I know it was you can tolerate all you can tolerate all of it.

Drew Linsalata 33:08

It was all of it. In my personal experience, if this helps at all, and of course, my experience isn't a model for anybody else, it's just what I discovered. Driving past my house while everything in me said, pull into that driveway and get out of this car. Like, this is enough. This is too much. You're panicking. Like driving through that sort of stop signal in my brain, just driving past the house. I I didn't go more than a couple of blocks around the house still, but I didn't go home. I didn't get out of the car. That got me 50 miles away. Because ultimately my brain was able to say, Oh, I I can handle it when I'm really panicking. So, what's the difference? I'll I'll go the other two miles now.

Josh Fletcher 33:47

It's the same with compulsions as well. That if you're OCD of the intrusive thought, the compulsion if I just do it once to make myself feel better, just to feel certainty, yeah. And then that's the stop sign saying, you know, get get on your drive. It's like, no, I'm practicing with the uncertainty now.

SPEAKER_04 34:04

Yeah.

Josh Fletcher 34:05

I don't like this, but I'm practicing with that uncertainty. And it feels like my mind's been hijacked, my mood's been hijacked. I mean, my uh no, no, that will pass if you do if you practice the response prevention.

Drew Linsalata 34:18

Yeah. How about an audio did it anyway? This is a pretty good one, too. This is a values-based thing. I just had to get to it. Usually I have a cute up pretty ready. All right, ready, Rock? Here we go. Yeah.

SPEAKER_00 34:29

Hey Drew and Josh. Ben from New England here. Feel free to use my name. I've suffered from OCD and anxiety for as long as I can remember, especially around my health. And I was resensitized over the summer, so I've really had to put my skills to use. Last week I was actually one of the chaperones on a school field trip where we took nearly 76th graders, that's senior seven's for you, Josh, for three days of camping. And you can imagine that my brain was screaming at me in the days leading up to the trip. As it turned out, yes, we had kids who got sick. Yes, being in charge of a bunkhouse of nearly 30, 11-year-old boys with questionable hygiene was actually a terrific way to practice my response prevention. But I've got to tell you guys that on the last night, one of the boys came to me to let me know that the toilet in our bunkhouse was clogged. So there I was standing in a cabin bathroom with like a wet, gritty floor, plunging a toilet and thinking to myself, I guess I'm not done yet. But I'm not done yet. But I also realized I would have plunged 50 toilets. No, not 50, but you know what I mean. If it meant that my students could have the amazing experience that they deserved. So to everybody in the community, you can do it even if you're resensitized, because you have the tools and you want to live your life. Thanks for everything, guys.

Drew Linsalata 35:57

Wow. How good was that? That's so good. Plunging to like, wow, that was really vivid. I can really appreciate it.

Josh Fletcher 36:04

I can see his little epiphany, Ben's epiphany, like as he's plunging, he's like, this is the reality.

Drew Linsalata 36:12

This is the glamour of recovery here, folks, right? We're plunging a camp toilet.

Josh Fletcher 36:19

Yeah. HBO would be like sat in a lovely office to a therapist and looking out, and the sun hits the window through the trees, and the wonderful epiphany, and like all the foods go out. No, it's on a camping trip with a load of one-year-old.

Drew Linsalata 36:33

Questionable crap out of a toilet. 11-year-olds with questionable hygiene. You know what was great that Ben re mentioned though, specifically was oh, I guess I this is a great opportunity to practice my response prevention. Like his health anxiety was like, germs awful. Oh my God, like poop. But like instead of doing the thing that he would normally do to protect himself from that, he plunged the toilet. So really, really great story.

Josh Fletcher 36:55

Someone in the audience as well said, Hey, I just chaperoneed a bunch of 10-year-olds camping a couple of weeks ago. I was so nervous about it, especially having to drive them four hours away. And even though I didn't sleep, it was fine. Yeah. And that's to you all the sleep people. If I don't get eight hours, my brain will explode.

Drew Linsalata 37:13

Uh no, no, it's all good. Well done. I'll be too too anxious. I won't be able to function because I'd be too anxious. Yeah, that's because you start to do all the things to try to protect yourself from your own feelings.

Josh Fletcher 37:23

Yeah, exactly. No, it's very good. Uh and don't get me wrong, I say that tongue in cheek. You know, if you it's horrible when you struggle with sleep and stuff like that. I don't want you to think it's compassionless. Uh, but it's just saying like it's more of an I'm attesting to the fact that you're more capable of coping than you think, and you've never not coped, whether it's two hours sleep or eight hours sleep. So just remind yourself of that.

Drew Linsalata 37:46

One of the questions that just came up, by the way, was we'd love, and this is really useful too. I think we're learning to be uncomfortable. So we would love a list, like a list. Can you give us a list of things that we should remember so that we can practice? No. Well, you write your you write your own list now. Right. And your voice. Yeah, yeah. And the list is almost nothing. I think part of what we're trying to combat here today is the idea that when I do a scary thing, I have to I have to manage it. No, no, no.

Josh Fletcher 38:13

I don't mind the list. I'll I'll I'll protest that one. I don't mind it because you know what anxiety is like when it's screaming at you, yeah, and you just sometimes it's okay to have a couple things jotted down to remind you. So for me, when I did some late scary exposures and this and that, I would just remind myself why I was doing it. So it'd be like, right, what am I doing? All right, I'm practicing being anxious. Step one. Yep. Step two, my common compulsions. Oh, yeah, just just be wary of them because it's you can't recall stuff when you're really anxious. Uh and number three is when it passes, give myself a pat on the back. I had though that was my little list. I don't use it now because I've practiced it. But sometimes when you're in the midst of screaming, the brain's screaming at you, just give yourself a little reminder of what it of what it is, you know. And um, if that helps.

Drew Linsalata 39:06

No, I'm with you on that. I do that as I we call that the pre-exposure checklist. It's like a pilot getting ready to take off. Like, why am I doing this? What's the purpose of this? What do I expect to happen? But like, I don't like the list while I'm that person specific. Like, well, when we're panicking, can you give us a list? The list is panic. Like, we don't want that's that whole like, oh, I need to, what do I say to myself? What do I do? What technique do I use? What steps do I take? Kind of none. Put your hands in.

Josh Fletcher 39:30

Yeah, yeah. No, it's okay to remind yourself as a as a therapist. Okay. I mean, if you're still holding that same piece of paper five years later, then no. But in general, when you're doing it, and particularly if you've been anxious for a long time, it's nice to write that down. Particularly nice to write that down when you've calm. So, hey, you know, this is calm. But you will feel this. These are the symptoms you're probably having. This is what you're practicing with.

Drew Linsalata 39:53

Yeah, but how like you know, but but yeah, but it's so hard to remember hard how to manage. We're not managing. So, this is this is great. I love this conversation. Like, mommy and daddy are fighting. Like Josh and I disagree a little bit on this. Like, I tend to give people one instruction put your hands down. Whatever the symbol is that works for you, because you want to put your hands up and guard and fight and do all the things. Put your hands down. Yeah, that's it. That's the instruction.

Josh Fletcher 40:14

Yeah, go loose, float, surrender. Yep, do those things. Absolutely. Uh, it's okay. I don't mind. I do it as part of graded stuff if it applies. You know, that's uh that's okay. Uh what was it? Something that happens too is that we look for advice too much, probably. Like researching, doing the thing feels like we're getting better. Oh, that's a common one, isn't it? That's a compulsion, research compulsion.

SPEAKER_04 40:38

Yeah.

Josh Fletcher 40:38

It feels like the illusion that I'm doing something about it, uh, which is a difficult one to tread, isn't it? Because you know, you want to be informed about stuff, but then there's got to be a point where you're like, right, let's just give this a go.

Drew Linsalata 40:53

My egg scrambling example, what was I think I wrote it down in one of my books? Like you can keep you can research like crazy how to scramble a leg, but sooner or later you have to actually scramble the egg. You have to actually do it.

Josh Fletcher 41:04

I had scrambled eggs for lunch.

Drew Linsalata 41:05

How were they?

Josh Fletcher 41:06

Did they come out all right? It was really, really nice. I've got this new nonstick kind of wok, and I just cook everything in it. It's wonderful.

SPEAKER_04 41:13

Love it.

Josh Fletcher 41:14

Um, yeah, and then I had some baked beans because I'm very British. Um, here's a did it anyway. Um, I don't know if they gave permission to use their name, but here we go. Uh, I don't think they did. Hi, Josh and Drew. Uh, I've been suffering from monophobia for around 30 years, but I only discovered a couple of months ago there was actually a name for what I experienced. And it was such a relief. Uh AI pointed me towards your podcast. Drew, we're getting recommended by AI. I'm not sure if that's a good thing, but there we are. Uh good. And finding it made me feel much less alone. Good. I've done I've gone through different therapies and medications over the years without significant improvements in my compulsions. After listening to the podcast, I just started working with a new therapist who specializes in exposure therapy, phobias, and OCD. Right now, we are still on the assessment phase. So, my did it anyway is starting this new process committed to exposures. I can already notice the way I speak to myself changing. I was so impatient to start exposures that I did one without any guidance from my therapist. I had a panic attack, and immediately afterwards I was devastated and thought I was I had completely failed. A few days later, I'm looking at it differently. It was an exposure. It wasn't perfect. I had a panic attack, but I did it anyway. I love this. One thing that has completely changed my brain and how I speak about myself is hearing in your podcast about other people's phobias. When you hear a fear you don't personally have, it can sound almost funny, incredibly human, or even irrational, simply because your own brain isn't afraid of it. Somehow, that has helped me take some of the gravity away from my own fear, too. It's still terrifying when I have a trigger, but in a non-triggered state, it doesn't feel so serious anymore. Thank you so much for what you do. I'm now recommending the podcast to basically everyone. Thank you very much. Love it. I love a cognitive reframe. I love it. You've reframed how you're seeing what the goal is. Yeah. It's not failure. I'm practicing being uncomfortable and seeing what I achieved with it. I love that did it anyway.

Drew Linsalata 43:34

It's really good. You know, when you think about that, the disorder isn't really defined by the state. The disorder is defined by the functional impact. So if you are doing something that mitigates the functional impact, meaning I don't go home, I go to the beach, I do my therapy instead of canceling the session, you are winning. Yeah, you are uncomfortable, but that's legitimately a therapeutic win right there. I did a thing that I would otherwise refuse to do. Huge win. So like take take the W, no? So that yeah, that reframe is really important.

Josh Fletcher 44:06

Also, you're such a nerd. Mitigating the functional impact.

Drew Linsalata 44:10

True. I am a nerd.

Josh Fletcher 44:11

That's that's why Drew's not via the party.

Drew Linsalata 44:15

I only go to cognitive behavioral parties, third wave parties.

Josh Fletcher 44:20

Third wave, third wave, a third wave pie just sounds like that.

Drew Linsalata 44:23

It's a third wave third wave rave. Hey, we could arrange that. We could probably make a ton of money doing a third wave wave.

Josh Fletcher 44:29

Third wave pie.

Drew Linsalata 44:30

And it's just nothing but house music and the worst triggers we can find to pack into one abandoned warehouse. That's a third wave rave. I like it. I like this plan. Anyway.

Josh Fletcher 44:42

Uh if you have your own data anyway, please send it in to disorder.fm. Um, if we send in enough audio ones, we'll just do an episode where we're playing out all the data anyways. I do love those episodes. Uh, send them in, feel free to. Uh, if you want to just leave a message at disorder.fm, uh, you can do. Um, if you'd like to join the community app and look at other people's did it anyways and share your own wins. And we do round tables and chats and discussions and articles and pop in and do lives now and then, then you can do. There's nothing hidden on the community app or anything like that. You know, like come come join the app where we show you the real stuff. It's not essential. You can just tune in every Friday. Um, but if you do feel like you're a bit, you know, isolated and want to share a space that where people get it, then you can come maybe even join the studio audience here. Oh yeah. Uh being who are very funny, actually. I'm gonna the only downside is that you're trying to record and think, and then there's some very funny comments that are constantly going around. Take the round dentists. Uh huh. Um, but yeah, you can come and join.

Drew Linsalata 45:46

100% true. Studio audience says ain't no party like a third wave party, because a third wave party don't stop, baby. That's right. That's 100% right. Come on down and join the third wave party.

Josh Fletcher 45:55

Scrolling down the side of the screen at some time.

Drew Linsalata 45:57

As we try to speak in some sort of cogent way. Anyway, guys, thanks for hanging out today. We'll do it again next week, yes. Yes, and I'll catch you soon.

Josh Fletcher 46:06

See you every Friday. We are out of the way.