The Social Impacts of Anxiety (Episode 75)

SPEAKER_01 0:01

Hi Jimmy Marsh. I'm Emma. I'm from Brazil. My question is related to the social consequences of panic attack or an anxiety attack. You guys said that people tend to evaluate the severity of their panic attacks based on the social consequences of it. And I'm just thinking about how I'm now gonna have to surrender to my anxiety to expose myself to my triggers. The biggest obstacle for me is fearing how people are gonna perceive me if I get anxious in front of them. I tend to have the freezing type of panic attacks, and I feel horrible afterwards, you know, in rooms, social events for me, and I tend to avoid them because of that. I know that I have to accept the possibility of getting anxious. It's hard for me to do because of this fear of how people are gonna perceive me. Is it a type of social anxiety? What's your your take on it? Would love to hear it. Thank you. Bye-bye.

SPEAKER_03 1:09

Welcome to Disordered. This is episode 75 of the podcast entitled The Social Impacts of Anxiety. I am Drew Linsolata. I am one of the co-hosts of Disordered, a therapist practicing under supervision in New York and the USA, specializing in treating anxiety and anxiety disorders. I am a former sufferer of anxiety, anxiety disorders, and depression for many years of my life on and off. Three-time author on the subject, social media dude, educator, advocate. I don't know. I'm just happy to be here.

SPEAKER_04 1:38

I'm happy you're here too. Uh I'm Joshua Fletcher, also known as Anxiety Josh on social media. I'm a psychotherapist who specializes in anxiety based in Manchester in the UK. Um, also the co-host of this podcast and author of the book. And how does that make you feel? And a fine book it is. Welcome, dude.

SPEAKER_03 1:57

It's been a while. It's been a while. It's good to see you again, Drew. Yeah, we had a little mini summer hiatus. So those of you who missed us, thank you.

SPEAKER_04 2:04

Yeah, I enjoyed the uh the the comments, the messages of concern, and the is this a test?

SPEAKER_03 2:12

You're trying to make us anxious, aren't you? Yeah, I did. Those are really funny. I appreciate you guys. Um, anyway, so today we're going to talk about the social impacts of anxiety. And thank you to Anna, the question sender inner, um, for asking a really good question and really kind of giving us a topic to talk about today, because I think it it matters. How do you think anxiety and like chronic and disordered anxiety can impact people from a social standpoint?

SPEAKER_04 2:34

Uh I think if you particularly struggle with shame, it adds an extra layer of fear on to what's an already stressful and high pressure, scary situation. Uh, not only am I struggling internally with anxiety, but there's my threat response is also latching on to the consequences of that. What will happen socially if people see me anxious? What what what impact is is that going to have?

SPEAKER_03 3:04

Yeah, it will definitely add more. I think when you mentioned shame, it's probably a good point. Because I think it's baked in for almost anybody, even people who don't have shame problems, might start to experience some of that when they get a little debilitated or they're running from things they know they don't need to, people don't understand why they're doing it. So there's going to be a shame factor. I I think the social impacts go even beyond just social situations. So Anna's talking about maybe specific social situations like gatherings or parties or whatever. But you know, if we expand the definition of social for anybody that's in sort of your community, your friends, your family, intimate relationships, like those are all social relationships. The impact is big in every one of those areas. So we'll get into maybe some of that too, how it impacts relationships and friendships and all kinds of stuff, community involvement.

SPEAKER_04 3:51

Yeah, definitely. And also looking at what it means, what does an impact mean?

SPEAKER_02 3:57

Yeah.

SPEAKER_04 3:58

Um, I don't have any real shame socially around my anxiety now, genuinely. Um, you don't have any shame about anything.

SPEAKER_03 4:08

That's obvious.

SPEAKER_04 4:10

I know this haircut was a choice.

SPEAKER_03 4:12

Oh, you know, you followed right through. I didn't even have to mention the haircut, you went right to it. Yeah, there's no shame.

SPEAKER_04 4:18

Do I look like someone who carries shame?

SPEAKER_03 4:21

We're only gone for two weeks and we pick right back up. That was easy.

SPEAKER_04 4:26

Shame is learned. Um, and if you're socially anxious, or we did an episode on the fawn response, which might be worth looking back in, is like, why is it so important to you? No, don't get me wrong. No one wants to be anxious around people, and people do care what people think. I do, Drew does, whatever. But it's about the weight of it. Why is it so important for you? And think about that. Shame is learned. Why is my threat response, my fawn response, my social anxiety response, why is it signaling and suggesting that if I'm anxious here, that's a big deal.

SPEAKER_03 5:03

Yeah, it's a big problem. And I think baked into Anna's question here, you can draw parallels. She's talking about social impacts, and well, again, we'll expand that, but it's not really much different than people who are like, well, my fear with anxiety is that it will make me insane, or my fear is that it will kill me, or my fear is that I will not be able to like it's what is most important to you becomes the dreaded outcome, which is I might be embarrassed, or people might judge me, or they might look at me funny, or they might think there's something wrong with me. Like, if that's really important to you for a variety of reasons, then yeah, but it's not I I think almost baked into Anna's question, and and I'm not picking on you, Anna, it's a great question, and it's everybody does this. It's almost like, yeah, yeah, but this fear, yeah, yeah, but what about when it's social? Like, I know I need to face my my anxiety, but but what about when when other people will see me do it? As if that's an exception, you know. But that's everybody carves out an exception for what they fear the most.

SPEAKER_04 6:00

Of course, of course. Yeah, that's really and I'm that's really important, actually. Everyone carves out an exception for what they fear the most, and or everyone, the threat response will try to convince you to carve out an exception because this is different, this is where the doubt has permeated. Yeah, you know, well, yeah, you know, you often hear it, people with OCD like, yeah, I've had that theme, and and their theme doesn't bother me, but this theme, right? This is important. Yeah, I would trade themes with someone else. Well, it's a paradox because the threat response has carved out this. And so when we're eight, nine, ten out of ten anxious, the threat response is going to find the worst case scenario or the catastrophe. And it's really kind of revealing about the person as well. So, as a therapist, when I'm working with clients, when you look at the worst-case scenario, you kind of get a small insight into what the worst case scenario is for that person. So for Anna, the threat response, maybe, just maybe, at some point, has been conditioned to believe that the worst case scenario for me here is okay, I might have a panic attack, or I might be anxious, or I might have an OCD theme, I might go inwards and feel withdrawn, or I might be socially anxious, whatever. Uh, for some people, that's the worst case. If I have a panic attack here, that's the worst case. But for Ryan, it sounds like, yeah, I don't want a panic attack. But the worst case scenario that my threat response is convincing me is that people will see it.

SPEAKER_03 7:32

Yeah.

SPEAKER_04 7:33

And I would invite you, Anna, and anyone who can relate to this question is why is that? Why is the threat response suggesting that people's judgment is important? And that does, I think, tie in with the fawn response.

SPEAKER_03 7:49

Yeah, I would agree with you 100%. And then I there's also that interpretation that says, well, if if your worst case is that people will see you, or they will j or there's a you cause a scene, or you'll be embarrassed. Is it really about what they think about you, or is it because they are then confirming what you already think about you? So I think there's multiple layers that you would look at. I I would have to start to explore that, right? With somebody sitting in in my office with me, would be like, okay, well, they might think that you're unusual or weird or disrupting things, but like, well, what do you think about you in that circumstance? And usually there's a lot more conversation about what they think about themselves than what other people think about them.

SPEAKER_04 8:25

Definitely, yeah. You can even look at it through the lens of complex PTSD, whatever that definition is. But you know, I that's what I use, the closest one, which is again, if you're looking at your conditioned threat response. So if you're someone particularly in early years or growing up, or you've been frightened by someone in your inner circle. So maybe that's your family, mum or dad, maybe they weren't very kind to you, maybe they withdrew affection, uh, maybe you were in a relationship where affection, maybe there was abuse, whatever, where that threat response, our friend the amygdala, is going, I'm remembering all this pain and suffering for later, and I want to stop that happening again. Yeah, I can only imagine that when you're in a scenario where, oh my god, I'm gonna get anxious, and the biggest fear is what people think. That's learned. And I think the uh again, the threat response is going, do you remember all those times in the past? Maybe you know, when you being emotional, you having needs either wasn't met or was an inconvenience to someone, or maybe there was someone that was quite volatile, or maybe it was something and you had to drop that because your feelings couldn't come first. Well, that's gonna come to the surface and even supersede your fear of panic itself. Yeah, and again, it depends what your how your threat response is conditioned. One thing can outweigh the other. For me, it was oh my god, I'm having a panic attack, feel like I'm going crazy and dying and a collapse. Right. That was my worst case scenario. Um, but it will always change, you know, or it can change and it's different for people. And I always think it's very helpful to formulate and conceptualize and just be aware. Oh, my threat response is that. And sometimes that's when it is good to take to therapy. Like, why is my threat response saying that that's the worst case scenario? I couldn't care. If I had a panic attack in front of everyone, I don't really care. Yeah, I mean I I I'm just scared of the sensations, I'm not really scared of the social impact.

SPEAKER_02 10:28

Right.

SPEAKER_04 10:29

Um, but again, I've you know, I've I've worked through stuff and I don't really have that form response.

SPEAKER_03 10:34

And but I think that's telling. I would agree with you 100%. Like, I don't, I mean, I prefer not to panic when I'm out to dinner with friends or whatever. But like if I did, I might even tell them. Like, I don't even I don't care. That's not important to me. But to the person, somebody like Anna, and sorry, Anna, you did send in the question because you keep saying your name, but yeah, we don't mean to single you out, but you you sparked a discussion. But if somebody if you share the problem that maybe Anna is is sharing or we're struggling with, then well, this is important to me for some reason. So that's why I care about that. But it still doesn't mean you know, it still doesn't mean that like, well, yeah, I get it, but like, yeah, but people will in fact see me and then I'll feel bad about myself. But what about that? Well, yeah, you might. And it leads us to the whole like, well, what do you do with that anyway? We're gonna do a whole episode on that. Like, yeah, you know, that that's sort of that questioning acceptance thing. But I think it does. You can't not I've had many people now at this point say, like, I don't even care if I have a panic attack. I just don't want anyone to see it. That's the main thing for me. And then that starts to bleed into social situations, social engagements, gathering. I've heard people say I used to be so active in my community or my church or whatever. I don't do that anymore. I I have a hard time going to work because I people might see me panic at work. It's ruining my intimate relationships because you know, uh the impact I'm always such in such a state and so freaking out. I'm always asking my partner to soothe me or help me, and now they're getting tired of me. So, like, this can bleed into a lot of different situations that would go under the social banner, too.

SPEAKER_04 12:08

Definitely. I always advise like a two-pronged approach, which is identify and understand yourself a bit more about why your threat response does that.

SPEAKER_03 12:18

Yep.

SPEAKER_04 12:19

Um, not to fix, but to understand. Because have you noticed that when you understand how your anxiety works, why it's doing that, in what situation, it's empowering and you and it helps you to lean into exposures. Yeah. Because I know why this is happening, I understand where this comes from. So now it gives me enough to lean into that and trust the principles of um exposure therapy, um, willful tolerance, etc. That's the first prong. Um, and the second prong is well, I suppose they're part of the same prong, is like knowledge and exposure. Um, but I was thinking graded exposure, particularly for social stuff. So with that knowledge, yeah, I'm gonna put you on the spot, Jericho. Sure. How would you do some graded exposure for things like social anxiety where the particular focus is I'm afraid of people judging me when I'm vulnerable?

SPEAKER_03 13:11

Yeah, I think in that situation, you would think that, oh, well, okay, well, well, you just got invited to that big birthday party. Just go. Like your exposure is go to the party. Well, yeah, sure, it could be. But if you're really just getting started with this and you're confronting some real like personal issues of shame or self-worth or whatever, it's it's a big ask to say, well, just go to the birthday party and treat it as an exposure. So I might have somebody start off by going into a public situation where nobody actually knows them and they can be maybe off to the side. Maybe you can go to the shopping mall, you know, in the food court at the mall. Are there still food courts and shopping malls? I guess there are in 2024. No idea. Right? Like, I don't remember the last time I was in a place like that, but like you might go to a public situation where you can be off to the side and maybe you can decide I'm gonna hang in there for you know five minutes and then I'll just go back to my car and leave if I have to. But I'm not forced to interact. I can experience the feelings in a public place, but off to the side where people are less likely to maybe turn around and look at me. So that might be one form of graded exposure. You could probably go even smaller than that, to be completely honest with you. It's you know, it all comes down to like give me a situation that you avoid, and then we can see if that's an exposure. Give me something that you do, a little ritual you maybe perform every day to try and keep you calm. All right, well, let's attack that. Let's see if we tear down that ritual.

SPEAKER_04 14:28

So yeah. And when and if you're taking a more traditional cognitive behavioral therapy route, you would be challenging those core beliefs, wouldn't you? So the core belief that um maybe Anna and similar people have is that if I am vulnerable, and you're identifying the core belief so important, if I am vulnerable, people will push me away and shame me. And that becomes this general universal rule that we ultimately believe, and and our emotional brain believes it, and we all believe it. So the principles of graded exposure is to challenge the core belief when you take a CBT approach. And I this is where I do like the traditional CBT approach when you look looking at core beliefs. Don't get me wrong, I love acceptance, commitment therapy, and stuff like that, and do that, but for stuff like this, which can be convoluted, it's like, well, the core belief is if I am vulnerable or not 100%, I'm unlovable, and people will push me away. Well, I would suggest, well, maybe there's a uh a close friend or a family member where you can practice kind of being vulnerable in front of and seeing what happens, yeah. And then internalizing the result of that. Well, actually, when I did open up to that friend or my sister, she was actually really attentive and didn't push me away. There were no signs of that. And actually, we've planned to do something next week.

SPEAKER_02 15:50

Yep.

SPEAKER_04 15:51

And you really internalize that to challenge that core belief, yeah. And you do little bits of that at a time. I practice it doing like public speaking where I would admit, you know, I'm really anxious, you know, I feel sick. I'm having intrusive thoughts about throwing up on the front row of people come to see me. And challenging that if I'd had the core belief that, you know, uh no one's gonna like me if I'm this, then I would, you know, I uh that would really scare me. But I've challenged that a little bit at a time. You start chipping away at it, and the brain starts to rewire it's go, oh yeah, well, maybe that isn't such a universal rule. So, yeah, that graded exposure, particularly for stuff like social anxiety, is to challenge those core beliefs.

SPEAKER_03 16:33

Sorry, guys. Um, notification. That was a notification to produce this episode, by the way. So I'm a mess this morning, I really am. What you're saying makes perfect sense. And yeah, from a traditional CBT sense, that's what you would look for. If you add in the acceptance part, like maybe some of the third wave act kind of stuff, is well, you might find that if you confide in your sister, she's actually quite supportive and lovely and like, you know, cares and wants to help you and embraces you more than pushes you away. Yeah, then that would be a challenge to your core belief. But there's two things here. One would be you gotta challenge the belief behaviorally. You gotta do the thing. You can't just sit and logic through it, which I think a lot of people try to do. That will that does not work. You have to ultimately call it the street. That's the back. That's exactly right. Like with like telling you it's irrational. Yeah, yeah, we'll just do worksheets and show you it's irrational and you'll be okay because it recognizes irrational. No, you gotta ultimately take it to the streets, but I'll take it a step further. You are challenging the belief that if your sister does react that way, for example, and she's a little colder than you want, or she doesn't care, maybe she doesn't care, which is a good thing, but she's not that attentive and she doesn't embrace you and she doesn't like get all good mushy with you. But even if that happens, you could handle the feelings that you have. So you add, like, oh, I challenge the core belief, it's usually multi-pronged. I would in this situation, I will be shunned and ejected from the group or or whatever, rejected or or turned down. But also I can't handle that feeling. And the second part of that core belief, well, well, you probably could. You really could. So in the end, we're not guaranteed a win, if you will. Like I want the best case to happen, even if the worst case happens, you could get through that. Yeah. These are big deals, right? Because now you're literally telling somebody, yeah, you might panic at that at your grandma's birthday party, and everyone will look at you.

SPEAKER_04 18:34

Maybe you focus, and this is where you challenge the cognitive bias, you focus on the evidence that challenges the core belief. Right. So, like, so your anxiety is saying everyone's gonna shun you, push you away, you're gonna be abandoned, they're gonna march you through the streets of the Red Keep, shouting shame, ringing a bell. That's not gonna happen. Yeah, um, it's it's um okay, it didn't go ideally where the family all held you and put you on a plinth and and worshipped you, right? Uh, and they they might have reacted awkwardly or whatever, but it wasn't what the threat response said it would be. So you take the evidence and a little bit at a time with those exposures. So the behavioral side of things, you know, the Arambeck cognitive side of things and the Albert Ellis behavioral side of things combined together, yeah, um, is is designed to challenge those things. And I think it's really important because we like to simplify anxiety, don't we, Drew? We like to do this, we'll have tolerance, et cetera, et cetera. These are the principles, but sometimes things can become confident, but social anxiety can be very confident because it's a different type of anxiety. Um and also it kind of interacts with the real world a bit because you might be surrounded by people, and let's face this, you might be surrounded by people who are just very judgmental. Could be, yeah. But that happens.

SPEAKER_03 19:54

Like, you know, the the the third wave stuff that I love so much, I I know you're a fan, it's not just me, but you know, acknowledges that. Like, we're not gonna pretend that the world isn't nasty sometimes. Sometimes people are judgmental, sometimes they're insensitive, sometimes they're cold, sometimes they're so self-absorbed that they actually don't like that you are anxious. It's bothering them, it's making it's ruining their day. That can happen. And I there's probably plenty of people listening to right now, like, oh my God, this guy's triggering me to death. But we have to work with the reality of the world as opposed to trying to convince ourselves that that reality doesn't exist and it's only going to be okay. But even if you do experience that, can you tolerate, can you handle that? Do you have the skills to understand what's going on and allow your feelings and not instantly beat the crap out of yourself because you're having those feelings and agree with the people who are judging you harshly? So it's it's really important, I think, to go down that road. Like, yeah, in the end. And I would use, I would ask, you know, somebody, well, can we think of a time when you did have this experience? Because there's a really good chance that if you're asking this question, it's because you've panicked in public and it was a really bad experience for you. So now you don't want to repeat it. That's why you're asking the question. So can you think of a time when this happened to you? Yeah, I'll never forget. I was at blah, blah, blah. I was at an office party, it was Christmas, and everybody was looking at me, and uh, two people came up and asked me if I needed water, if I was okay, and oh my God, I was so embarrassed. Okay, and is that experience still happening right now? Oh no, that was three years ago. And what what happened after that? Oh, I felt so bad. Okay, and then what happened? Well, I was really embarrassed. And then what happened? So, like, well, look, we have evidence that you did survive that. You just felt bad while you did it, and you're not entitled to never feel bad.

SPEAKER_04 21:36

Yeah, I think the only there's two other emotions as well that a lot of people fear fear. They fear the anxious response, particularly you've got panic disorder, gard, etc. But there's two other emotions that I think people fear just as much as anxiety itself. What do you think they are? Well, we've mentioned one.

SPEAKER_03 21:55

Two other emotions that people fear.

SPEAKER_04 21:57

Yeah.

SPEAKER_03 21:57

Well, I I think that people fear anger. And sadness. Those are the two that I hear more than any other.

SPEAKER_04 22:03

Oh, don't yeah, maybe. Maybe. What are your top two? This isn't written in law, just in my experience. Top two are in my experience working with clients for a while, and particularly in the world of anxiety disorders, once you've pulled away the fear of fear and the fear of anxiety, and they worked on that. The two feelings people are afraid of are guilt and shame.

SPEAKER_03 22:28

Oh, those are good.

SPEAKER_04 22:29

Yeah, and people will literally build their lives around feel avoiding guilt and shame, whether they'll self-medicate, they'll avoid, they'll keep busy. And this is again adds to the nuance of social anxiety is that okay, Anna suggested, you know, I don't like anxiety, I don't really want a panic attack around there. But also, have you noticed what was even more powerful there, potentially? I don't without knowing it all, Anna, I'm just speculating here. But like is that I'm afraid not only to sit with anxiety, I'm afraid to sit with shame. And maybe anxiety triggers shame, yeah. And maybe it's seen as weakness. And if you look at the conventional stuff of you know, oh, being anxious is weak, being sad is weak, not smiling is weak, you know, then yeah, people don't like that shame. Yeah, um, and I would invite people to reflect on that. Shame is something that we fear just as much as anxiety.

SPEAKER_03 23:27

Yeah, but in the end, you know, part of the process is I'm gonna have to feel my shame. I'm gonna have to feel my guilt, my regret, my sadness, my anger, whatever. Those are good answers, by the way. Shame and guilt were perfect for this topic. So I'd like to.

SPEAKER_04 23:39

So the names of my biceps.

SPEAKER_03 23:42

As opposed to, what was it, justice and truth? Like no, justice and reason. Justice and reason. Yeah, yeah.

SPEAKER_04 23:47

And then when I've um yeah, when I've not gone to the gym all week and had a few beers at the weekend, they're renamed to Shame and Guilt. Shame and guilt.

SPEAKER_03 23:55

I get it. But yeah, in the end, we have to learn how to feel those things. So I think especially when we're talking about social impacts of anxiety, and you know, well, it's ruining my social life, it's ruining my community involvement, it's ruining my work situation, it's ruining my school situation, it's ruining my family gatherings, and it's even ruining my intimate relationship to a certain it's impacting so much. Well, the way out of that is like, yeah, you might have to feel you're gonna have to feel some stuff. I hate telling people that.

SPEAKER_04 24:20

I don't want to feel stuff.

SPEAKER_03 24:22

Thank you. I don't want to feel stuff, and I get it. Who the hell wants to feel crappy? Nobody does. I don't want to, but we don't get to avoid those things.

SPEAKER_04 24:29

Did you ever um look, and I'm not suggesting doing this, but I will show you that uh Drew and I are not you know the finished article, and I always remind myself of this. Uh, have you ever read the hundred chain attacking exercises? It was uh based on um R E B T and Albert Ellis and stuff. Misused by stoic influencers and some oh god he shall get me started not be named OCD in air quote. Oh that dude, but yeah, he likes this. Yeah, what dude done doesn't even have a name. Um but I love this because they don't own it, and I always always go through to show people how social anxiety, uh, ang and and shame and stuff can still come up in anyone. And to be honest, I call it the cringe list. So I'm gonna put there's a hundred, but I'm gonna pick out a few. And you've got to tell me out of ten. I'm also cringing you would cringe. All right, let's do it. I'm just gonna hand pick a few. Uh okay, number one. Ask someone in a restaurant if you can try what they're eating.

SPEAKER_03 25:30

One to ten, I would put that at at a four for me. That is pretty cringy, though.

SPEAKER_04 25:37

Go into a drugstore and ask out loud for condoms.

SPEAKER_03 25:42

These are really good. Um, I would put that at maybe a three or a four. As you can see, I'm not a really shame-driven guy, but okay, keep going.

SPEAKER_04 25:50

Yeah. Uh one, I'm not using that one because it's misused by the store, the towing the banana down the street thing. I hate that one because you know, it's just so misused. Uh, it's an Albert Ellis one, but I like some more everyday ones. Uh, elect not to applaud when you are not impressed by a performance.

SPEAKER_03 26:07

Oh, oh, that's so cold. That's pretty good. I think if that's a true, I would feel so bad for the person on stage that I would probably put that at cringe level seven.

SPEAKER_04 26:17

Really? Yeah.

SPEAKER_03 26:18

Oh, I would be I don't want to beat on that guy.

SPEAKER_04 26:22

Yeah. Bargaining for a better price, you can always ask, may I have this at a better price? Oh, that's cringe level eight for me. Really? It depends on the context. I wouldn't do it in like a shot, but like if there's a market stall, I'll try and buy something.

SPEAKER_03 26:36

I mean, if I'm buying a car or a house, yeah, there's some negotiation. I'm not going to try and get a better price on a loaf of bread, though. Ooh, that's cringe level eight.

SPEAKER_04 26:43

Here's a so here's a social anxiety one though. Let someone know how you would prefer to be addressed. Because it's important, names are important, it's respect, but I know a lot of people with social anxiety who will just forego. Not correct you. Oh, yeah.

SPEAKER_03 26:56

Yeah, yeah. They'll let yeah, exactly.

SPEAKER_04 26:58

Um that's a good one you can practice with, though.

SPEAKER_03 27:01

Because you're practicing with the shame. Yeah. Uh that would be cringe level six for me. It depends, you know. Depends on how many context, but these are good.

SPEAKER_04 27:10

Yeah, and lovely area, wear clothing you really like, even if it's not normally what someone your age or gender would typically wear. You know, that stuff doesn't bother me. I you know, I live in like live libertarian, you know, you kind of just do whatever you want to do. It's it's you. Um, and there's some other silly ones. I'll just see if there's one uh one that comes out. Oh, yes. Oh, oh, this this one gets me. 34. Give your psychotherapist feedback on whether they are helping you or not.

SPEAKER_03 27:42

Ooh. That's a tough one for you, huh? Would that be high in your cringe cringe rating?

SPEAKER_04 27:48

With that, yeah, because I I think for me, if if I can see someone's trying to help me, I don't want to give them negative feedback because I think it's their intentions are really good. Oh, that's like an eight.

SPEAKER_03 27:58

I think that would be a seven or eight. Like not clapping for the poor dude that just performed, and I'm gonna not clap. Like, oh ouch. How does that mean?

SPEAKER_04 28:06

Ironically, though, if someone if my client said that to me, oh, I'd want to hear it.

SPEAKER_03 28:10

Yeah, yeah, yeah, yeah, yeah. It's so weird, isn't it? But doing it back to the therapy, yeah, that would be really tough. Like, hey, thanks for helping me, but you suck. That's how I interpreted my action, you know.

SPEAKER_04 28:20

Oof. Oof. Uh just a couple more because I'm enjoying this. Yeah. Um, politely ask someone their age.

SPEAKER_03 28:29

Oh, uh, oh, that would be a low cringe level. It just seemed very impolite but or improper, but okay.

SPEAKER_04 28:36

Oh, I'm trying to find one that really gets you. Uh ask for things on the menu that you know aren't on the menu.

SPEAKER_03 28:46

I would probably do that just for the joke. Uh I will tell you, you know what? These are really good. I'll tell you what would be super high in my cringe level. Anything where where I'm asking for acknowledgement or praise or like, no, you know what? I do have a master's degree. I would, oh my god, that's cringe level 11 for me. Like to actually tell somebody my accomplishments or or make sure they're praising. I got better at doing that.

SPEAKER_04 29:13

I hated it, but yeah.

SPEAKER_03 29:14

Oh, that is under-the-table shit for me right there. I can't do it.

SPEAKER_04 29:18

Oof. I didn't I was on a podcast the other week, and they were like awful. I'm not gonna when every time someone says, I'm not gonna introduce him, let him introduce himself. I'm oh no. Tell us why you're a big deal.

SPEAKER_03 29:30

Uh I'm a therapist and uh good point. I'll be honest with you. The intro we do, the little intro we do in every episode of Disordered, it is not easy for me. That is hard for me to do. Yeah, you rushed through it. I keep rapping it. So, see, we all we all have our little triggers that make us feel a certain way socially, I guess. A little shame cringe factor. Yeah, they're out there.

SPEAKER_04 29:55

So uh last one. I'm I got but I actually used this when I was doing my working on my self-esteem, shame many years ago. Uh, and even agrophobia tied it into one. I went to a karaoke bar under karaoke.

SPEAKER_03 30:10

Oh wow. I don't know about that because I know I can't sing. I just it doesn't matter.

SPEAKER_04 30:14

That's the whole point of karaoke. No one can. Would you do it, Drew?

SPEAKER_03 30:19

Well, I'll I'll do it. I've done it. I have sung karaoke.

SPEAKER_04 30:22

Well, I think we need evidence of that. So if you follow the dot anxious.truth on Instagram, I'll be doing nothing but karaoke. Soon you'll find a scene his uh his did it anyway.

SPEAKER_03 30:32

That would I will do nothing but karaoke reels for the next seven days to you know Sinead O'Connor by Drew Linsala. Everything is too high for me to sing, and it's really difficult. And I just, oh, it's not good. There's not enough therapy in the world, you guys. You can't watch that.

SPEAKER_04 30:48

So the reason I brought those up is that like people can relate to that feeling, um, but some people might be able to conceptualize that and like, yeah, I just won't just won't do that anyway, and that's fine. That's okay. You pick you pick your battles, yeah. But sometimes, like I do pick some of these sometimes, like um going in uh cringe or the cringiest one I did. So I have done one on this lesson before was going in politely, not being horrible, but when someone gave someone some money in the game, some change, and I said, Oh, can you just check that change is okay? You know, I knew it was, and he was fine about it. I was like, Oh, and I was like, Oh, sorry, my bad, I must have given this cargate. And I was like, Oh, the cringe, yeah, but it's true.

SPEAKER_03 31:27

Yeah, but you know what's funny. So we spent a few minutes kind of joking about these things, but the point of that is to feel that ooh, yeah, that ick feeling, and you know, we're joking about it because clearly we don't share the problem that maybe Anna and other people share. So we're not trying to minimize the experience, but we all understand that icky, ooh, like that cringy goosebumpy. Ooh. But I think the point is you can feel that. It's okay to feel those really icky feelings because the principle would be like they come and they go. Now, as we have, we're feeling cringy now about some of the remembering things that we've done, but that feeling is over in 10 seconds.

SPEAKER_04 32:11

And being with the cringe because you can rewire your brain. Actually, when the brain realizes that the world doesn't fall apart, right, despite the occurrence of that feeling, yeah, it rewires itself.

SPEAKER_02 32:22

Yeah.

SPEAKER_04 32:22

And actually, it can contribute to your self-confidence, you're not planning around catastrophe. And and in the case of Anna, it's like, well, look what you can do, practice a little bit, you know, might be sitting with a bit of shame, a bit of anxiety. Yeah. Uh but definitely recommend kind of talking about it in therapy, exploring those kind of origins of shame, uh, and being compassionate to yourself as you you know you do things moving forward.

SPEAKER_03 32:46

Yeah. And is there an impact socially? Of course there is, but like in the end, the principles are always gonna wind up being the same. I'm gonna have to risk that people think I'm weird or they're judging me or they don't like me, and I'm gonna have to risk how I feel about it. More than anything else, I think it's how I feel about that.

SPEAKER_04 33:03

Yeah, yeah, yeah. And also if you want to live true to yourself as well for me personally, I I wouldn't really want to hang out and hang around in being here. People who were judgmental about my state and vulnerability anyway. Yeah, you know, it's kind of it'd be a clear out for me. I did there were people that I don't hang around with anymore after my anxiety. People naturally drift apart, but actually, like yeah, I don't really you know, if I'm on this earth once, I don't really want to be spending it with time with people who don't have compassion, understanding, and you know, a grain a grain of selflessness in them.

SPEAKER_03 33:37

You know, I think it's interesting about that observation, that's the stock answer. So if you take this to any group in social media, you post it on your Instagram, you will get your friends, your family, random strangers, sometimes development, personal development gurus, chiming in with that stock answer. If they can't handle you at your worst, leave them, cut them out, get rid of the toxicity. Oh, you know, that's the stock answer. But are you saying I'm a stock answering? No, no, the point is social media guru. No, but stick with me. The issue here is if you did have shame, guilt, regret, like self-image issues, you work through them. So now you can actually say, well, that person clearly doesn't like me and isn't supportive of me and is very negatively judgment judgmental of me. But it doesn't make me feel a certain way anymore. It doesn't crumble me inside. So I can choose to end that relationship. If you are still struggling with the fact that that person's judgment of you actually just a mirror of your own self-judgment, it's not as easy as just saying cut them out because you can't cut yourself out and you still think that about you. Because there's always going to be another mirror. Exactly right. And it you you still think that about you and you can't get away from you. So be careful of you know what, it took us 34 minutes to get to this. But the stock advice that people would give you in any they're trying to be supportive, especially your friends and family, because they're there to cheer for you and be like team you, is just cut them out. Cut out. We don't have to you know life is too short for that sort of like toxic behavior. Yeah, but if you agree with their judgment, if you don't like yourself, who you gonna you can't cut yourself out. So like you gotta work on that. And then maybe you might get to the point where you could say, like, I don't I don't really care that that guy thinks I'm weird because I'm panicking. I truly don't, because I don't think I'm weird anymore. Or I'm okay with feeling a little weird for 15 or 20 minutes or 30 minutes today. I'm okay, I can handle that. It's not the end of the world. Yeah, so that's a really important point.

SPEAKER_04 35:30

Anyway, yeah, yeah, yeah.

SPEAKER_03 35:32

Should we get on to uh some questions or did it anyways?

SPEAKER_04 35:35

Yeah, we got we've got any uh we found an audio did it anyway, and you've found some written stuff, haven't you?

SPEAKER_03 35:40

Yeah, let's do it, let's do a written did it anyway. We have a written question, a written did it anyway. So we'll do two did it anyways and then we'll end it with a question. How's that? Sure. I did find an audio did it anyway. Yeah, we have that too. So I'll read one and then we're gonna do the audio one. So the first did it anyway. This person did not give us uh a permission to use their name, but that's okay. Coming coming from Scotland. Hi, great show. And I enjoy the humor you bring to the topic. We are two funny SOBs, aren't we? Um, no shame. See, we don't have this problem. Um, I wanted to share a Did It Anyway. I live in Edinburgh, and it's currently the Ed Fringe Festival here. Oh, Edinburgh Fringe. Yeah, one of the big biggest comedy festival in the world. Yeah, which is a great time of year. Plenty of opportunities to go to shows and socialize. Sounds great. I had tickets to a show yesterday and plans to meet up with a mate, but all day I had anticipatory anxiety, which culminated in a huge, powerful panic attack in the queue for the show. Who sounds rough. I did my best just to let it be and feel the release of adrenaline. I was able to sit in the cramped room for the comedy show surrounded by people. And although I was far from relaxed and comfortable, I did it anyway and managed to enjoy the show. The attack passed, and I even ended up staying for a few hours after and even went to a second show. Love it. Thanks again. Oh even went to a second show. You know why? Because he wasn't. Are you going for Billy Mays?

SPEAKER_04 37:05

Yeah, sorry, I'm I'm behind.

unknown 37:07

But I'm not done yet!

SPEAKER_03 37:09

There you go. I knew you were going for Billy May.

SPEAKER_04 37:10

I think you should have, I think you should have you've got a button as well. You could have introduced Billy Mays there probably throughout reading that. I don't think well done.

SPEAKER_03 37:17

I don't have Billy Mays programmed, but I will put him in there. Yeah, it was I don't have him in there. No, I have I have amygdala, I got I got all the usuals. I gotta put Billy Mays in there. He belongs.

SPEAKER_04 37:26

Uh no, that that was uh well done. That's that's incredible. Um and also a lovely kind of example of okay, I've got all this panic, and now I'm gonna go into a room where I can there's even a risk of being singled out by the comedian. Oh you know, so yeah, pulling in there and like there's no shame here. I'm you know, I'm I'm anxious, but I'm not ashamed. I'm gonna go in and yeah uh and and ri and risk in in air quotes being anxious, and and I ended up enjoying it.

SPEAKER_03 37:53

Well done. I think the cool thing about that is, and and he's not done yet, the Billy May's reference. I even stayed for a few more hours and went to a second show. If you can get to the point where you really just let it ride, you truly let go and just let it ride. This is such a common experience. Like, I'm surprised at how I didn't have that lingering hangover for more than a half hour, and I even stayed for a few more hours. Like, that's a sign of fully letting go in my book. So, anyway, um, excellent. Let's do an audio did it anyway, because this is another good one. Here we go.

SPEAKER_00 38:25

Hey Drew and Josh, my name is Haley from New Jersey. Have a huge did it anyway for you guys. So flight anxiety has been a huge one for me for my whole life. I've never wanted to fly very far or at all, but I have done it to short distances just because you gotta live your life. But I've been wanting to go to the UK and England for my whole life. I love the Beatles and the culture and all that great stuff. So I just decided screw it. I've been doing better with my anxiety thanks to therapy, your podcast, medication. I figured, what better time than now? Normally on a flight, I am extremely anxious the whole time. I have to squeeze my husband's hand so hard it goes numb pretty much. This past flight, I just took to the UK. I just got back from a two-week trip to the UK. I didn't have to squeeze his hand at all. So his hand is safe. I am safe. I am happy. I am thriving. I want to thank you guys so much for your podcast. Another part of this did it anyway, is I realized I actually have not listened to your guys' podcast in a couple months because I think I used it a little bit compulsively when I was anxious to kind of calm myself and see what other people are going through and know that they were going through the same thing. But I'm doing really well. So thank you guys so much. I appreciate it.

SPEAKER_04 39:46

Excellent. Superb. That's it. Adopting the principles, coming over to the UK, well done. Maybe you went to the end of a fringe. Oh, maybe at the same show.

SPEAKER_03 39:56

I will point out that part of that applause was from her husband and his not squeezed hands.

SPEAKER_04 40:02

He can't feel he's no feelings left in his right hand. I like how she pointed that out.

SPEAKER_03 40:06

My husband's hand is safe. Thank you for pointing that out. That was important. Great job. Super well done, Haley. Yep, yep. I love the going toward the like, no, I dig this. I want to visit the UK, love the culture, and I'm going there. Too bad. Like, what do I what do I care about? Move in that direction instead of the fear. So love it, love it, love it. All right, let's wrap it up with a question. I'm moving us right along, aren't I? Um this is a question that I will throw at you, Josh. I'll put you on the spot. Um, I edited it down, and the person didn't want me to use their name, so I won't. And the question is: can paranoid thoughts be intrusive? Can my brain be doing what it always does and putting the things I am afraid of in my head? This person says that she has this fear of developing schizophrenia. That's her, that's one of her themes that she's favorite of. Not sure if I've heard anyone talk about paranoid intrusive thoughts that come with the fear of developing schizophrenia.

SPEAKER_04 40:57

Um, fear of it's a form of fear of losing control, isn't it? Um, you can it's helpful to umbrella paranoid and anxious thoughts under the same thing. They're what if thoughts. You know, what if I'm developing schizophrenia? What if I'm going crazy? What if whatever? I'm not saying schizophrenia and crazy are the same thing, by the way. It's just some things I hear. Uh I've worked with people with schizophrenia and uh and similar presentations. Um, but what I'm hearing is, you know, what if I lose control of my mind? Yeah, is basically what I'm hearing in the question. Uh it sounds like you're trying to make it special, no? Uh it was a theme of my OCD many years ago. What if I go crazy? Yeah, you know, and so with that, that's the obsession and the compulsion is with this particular theme, is I'll keep scanning, monitoring my thoughts, monitoring my mood, checking to see was that sound real, was it not? Was that hallucination? Was it not? And avoiding things, caffeine, anything, anything that would not help me feel uh neutral and feel nothing. Um for me, it's yeah, it's very common. I think it's just how what your threat response is to deciding that's fearful. And I'd guess you've probably made it the center of your life. You're constantly threat monitoring for it, which keeps you in the cycle.

SPEAKER_03 42:12

Yeah, yeah. I think I would liken it to people who have that fear that they might snap or like lose control and hurt themselves, even though they don't want to. It's the last thing they want to do in the world. But what if? You know, did I just have a thought that was so sad that I might be heading down that road where I actually harm myself? So it's the same thing. Interestingly, it there was another part of the question where the person does talk about the thoughts they have. Did that did that person look at me? Is that homeless person on you know that on the side of the street looking at me? Are they following me? And and they were able to identify, no, I'm not worried about the actual thought. Like, is that person following me? I'm just worried that I had that kind of thought, and that's all you need to know. Like, I'm not, you know, I know I don't believe my my paranoid thoughts. I'm just worried that I'm even having thoughts along that theme. So, yeah, and honestly, is it an intrusive thought? Any thought that you do not choose to have that you don't want to have, you can technically call intrusive. Every human being has those all day long. Just get stuck to them, that's all.

SPEAKER_04 43:09

Yeah, I yeah, and I'd I'd be wary not to make it a special thought.

SPEAKER_03 43:13

Yeah, yeah, it's okay to have that thought. Like you're having you probably had that thought uh a hundred times before, you just didn't really notice it. Now it's important because of that fear.

SPEAKER_04 43:22

So yeah, and and it will feel different because of doubt. It's your literal doubt response.

SPEAKER_03 43:26

Yeah, yeah. What does that mean? Very good. Thanks for the questions. I did it anyways. Appreciate it. Thanks for like hanging out after two weeks off. We appreciate that too. How can people get in touch with us?

SPEAKER_04 43:36

You can get in touch at disorder.fm or follow us on social media, the.anxious.truth, or I am anxiety Josh. Uh, we'll catch you next Friday.

SPEAKER_03 43:45

Yeah, thanks for following along, and we'll see you next week. We're out.