anxiety therapist

Just because you are capable of doing something, doesn’t mean you must

By Dr. Shoshana Shea

Simply put, when someone asks us to do something we are capable of doing, we often feel guilty, anxious, and obliged to do it; that doesn’t mean we should though.  Ever notice how being efficient and competent can sometimes feel like a punishment? Or when no one else is taking responsibility for a task, and the task needed to get done two days ago, and that even though you are screaming “No!” inside, you absolutely won’t do it this time, the other side of your brain betrays you, and tells your foot to step forward?

The paradox in all of this is that, in an effort to be helpful and connected, we end up feeling resentful and disconnected.

From an evolutionary biological standpoint, individuals who were able to live in cooperative societies, were able to survive, thrive, and pass on their genes; i.e., our ancestors. So not only is it in our ‘hard wiring’ to say yes without thinking about it, we have many societal and familial reasons to not say no as well. A compliant easy-going child gets praised, and a ‘difficult,’ more independent one often gets punished and shamed.

Don’t get me wrong; I’m not advocating for people to not be helpful and amenable; I’m asking that we pause to consider a few factors before proceeding with an action.

Here are a couple of points to take into account the next time your co-worker, mom, PTA president, the dog groomer, or even the dog asks (or implies that) you should be doing something:

1.     Just because you are able to do something, doesn’t mean you should! Make this your new mantra, “Just because I can, doesn’t mean I should.”

2.     Do you truly have the capacity? Especially in the larger scheme of your life, is the balance tipped all the way towards doing things for others, while there isn’t enough time, energy, and/or space left over for you?

3.     Saying yes is not necessarily always good for the other individual;

4.     Even more important, saying yes is not necessarily good for the RELATIONSHIP.  *See paradox above.  The intention may be that you are saying yes to preserve the relationship, but the outcome may end in you feeling resentful, and ultimately destroy the relationship.

5.     It’s OK to say no. Period. End of story; actually, there is no story; no explanation is needed.

6.     Even extremely kind compassionate leaders say no sometimes.  Saying no clears the path to say yes and build consistency and trust in a relationship.

7.     Check your body; what is it saying? When you get that anxiety drop in your stomach and your thoughts start spinning, your body is trying to get your attention.

8.     Pause next time this comes up; ask yourself if you really want to.

9.     And lastly, and just as important (if not the most important), check to see what emotions are there. Are you feeling anxious, guilty, sad, frustrated?

IF YOU FIND YOURSELF STRUGGLING, FEELING STUCK, AND/OR COULD USE SOME HELP NAVIGATING YOUR FEELINGS, YOU COULD BENEFIT FROM COGNITIVE BEHAVIORAL THERAPY, ACCEPTANCE AND COMMITMENT THERAPY, MINDFULNESS, AND TELEMENTAL HEALTH SERVICES. SAN DIEGO PSYCHOTHERAPY CAN HELP. WE CAN BE CONTACTED AT 619-269-2377.

Cognitive Defusion: How Thanking Your Mind for Its Worst Thoughts Can Help You Get Some Distance

By Annabelle Mebane, MA, AMFT

In Acceptance and Commitment Therapy, the overall goal of our work is to help clients increase what we call psychological flexibility, which is basically the ability to do what matters most to you in your life no matter what uncomfortable thoughts and feelings show up.

One of the skills we teach to help people respond more effectively to their thoughts is called “Cognitive Defusion.”

Our default mode is to take our thoughts at face value and to believe that they are true and important. Like a fish doesn’t know it’s in water, we don’t typically notice that we are thinking. We are so accustomed to looking out the lens of our own thoughts that we forget to recognize we’re wearing glasses at all, and that there might be more than one way to see things.

Cognitive defusion is the ability to notice that we are having a thought

that our mind is “languaging” about our experience. Defusion involves creating a little bit of space that allows us to recognize that just because our mind thought it, doesn’t necessarily make it true or important. Why should we make that space? Because if we can recognize a thought for what it is – words our mind is generating – we can make a choice about how we want to respond to it. Instead of automatically buying into our thoughts or viewing them as directives or imperatives, we can tune in to our values – who and how we most hope to be in a given moment – and decide whether listening to a particular thought and behaving accordingly is going to move us toward or away from our valued direction.

There are a whole bunch of exercises

that we use in ACT to help you learn how to defuse from your thoughts. One of them goes like this. First, you state the thought exactly as your mind has it. For example, “if I go out on this date, I’m going to embarrass myself.” Then you pause, and notice what it’s like to sit with the thought. Next, you preface the thought with “I’m having the thought that…[thought]”, and notice what it’s like to sit with that. Finally, you preface it with “I’m noticing that I’m having the thought that….”, and tune in to what that’s like.

And then you can decide, do you want to listen to that thought, and stay home and avoid the possibility of being embarrassed because it feels more comfortable? Or are you someone who wants to be open, vulnerable, and show up anyways because it’s meaningful to you to try to find a fulfilling connection, even if it’s a risk?

Notice that when we are ‘defusing,’ we aren’t getting caught by the content of the thought, trying to prove or disprove it.

We are simply creating enough distance to allow us to choose how we want to respond.

But here’s the thing, sometimes it feels pretty hard to get that distance and to make a choice based on values.

Why? Because sometimes, or maybe even usually, the stickiest and most painful thoughts our minds have are designed to try to protect us from something painful. And probably, it kind of works. If we continue with the above example, your mind might be trying to protect you from the pain of rejection or disconnection. And yeah, if you stay home, you get the relief of know you can’t embarrass yourself and you can’t get rejected. But the thing is, if you avoid going out on any dates because you might get rejected or feel embarrassed, you are almost certainly also going to miss out on the possibility of a really meaningful connection.

The thing about pain is that it doesn’t show up around stuff that doesn’t matter to us; it shows up around the things that we care most deeply about.

On the flip side of our pain, we can usually find our most cherished values.

Your mind comes up with these painful stories to try to prevent you from feeling pain or loss around the things that matter to you, but a lot of times, when we listen to those stories, that’s what keeps us from accessing the richness of moving toward what really matters.

So for those especially sticky thoughts that seem so powerful and that are really deeply painful, sometimes the best defusion tactic is pretty counterintuitive.

Instead of beating yourself up for having such self-critical thoughts, you can actually thank your mind. You can thank it for trying to help you and for trying to protect you, and then you can let it know that you are going to take it from here.

It sounds nuts to thank your mind for telling you that you are weird or a failure or incompetent or unworthy or too sensitive, but when we meet our pain with compassion, understanding that our minds are just trying their best to do their job and keep us safe, we sometimes can start to take away the power of that really painful story and get just enough space from it to decide to respond based on something other than the avoidance of pain.

IF YOU FIND YOURSELF STRUGGLING, FEELING STUCK, AND/OR COULD USE SOME HELP NAVIGATING YOUR FEELINGS, YOU COULD BENEFIT FROM COGNITIVE BEHAVIORAL THERAPY, ACCEPTANCE AND COMMITMENT THERAPY, MINDFULNESS, AND TELEMENTAL HEALTH SERVICES. SAN DIEGO PSYCHOTHERAPY CAN HELP. WE CAN BE CONTACTED AT 619-269-2377.

Anxiety Is Like A Metal Detector

By Annabelle Parr

I spend a lot of time reading articles related to enhancing mental health, to highlight and repost relevant pieces, as I value spreading awareness in this area. It’s wonderful that the conversation around mental health and anxiety is more open than it used to be, reminding us that our struggles are deeply human and we are not alone. But one thing I notice is that sometimes the way anxiety is discussed – even with the utmost compassion, can still imply that anxiety is bad. 

Don’t get me wrong; anxiety can lead to problems in our lives. Anxiety can turn into a full blown anxiety disorder, and by definition, anxiety disorders cause significant distress and impairment in a person’s life. And even if we are not in the realm of a full blown anxiety disorder, it can be very uncomfortable. So uncomfortable that sometimes we make choices designed to avoid or get rid of anxiety at the expense of what matters to us.

It’s true that anxiety, and the way that we respond to it, can be a problem.

However, I think when we focus exclusively on the negative parts of anxiety, we are missing a big piece of the picture that can empower us to change how we relate and respond to it. Anxiety – like any feeling – is information. And most of the time, at least part of that information has to do with what is most important to us in our lives.

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For example, if someone experiences a lot of social anxiety and fear of judgement, what might that say about what matters to them? It might mean that they deeply value connection and relationships. Maybe it is really important to them to show up in their relationships as kind, compassionate, engaged and authentic, and maybe the anxiety has to do with worrying that something they could say or do will be incongruent with those values.

The problem with anxiety occurs when we take our anxious thoughts at face value,

and when our behavior is driven not by our values, but by trying to avoid the feared outcomes our minds generate. For example, social anxiety might involve thoughts like “I can’t go to that party. What if I make a fool of myself or say something stupid or am too anxious to even talk, and my friends don’t want to hang out with me anymore?” Such thoughts can feel very real and powerful, and our instinct is not usually to get curious about what they might indicate about what is important to us.

Instead, our instinct is often to think that outcome is likely, and to decide to stay home from the party to avoid anxiety and try to prevent rejection. But if instead, we can notice that thought, get curious about why it is visiting us and what it says about what is matters to us, we might recognize that in fact we deeply value connection. So much so that it feels excruciating to risk the possibility of rejection. And yet, in not going to the party, we are certainly missing an opportunity for the connection we so deeply crave.

When we can identify the values underneath the anxiety, we then get a choice about what to do next.

Getting curious about our values and what is really meaningful to us in our lives then allows us to identify actions that would move us in our valued direction. For example, you could choose to go to the party even though you are feeling anxious in service of your value of connection, or you could choose to stay home in order to experience relief from the anxiety.

From an Acceptance and Commitment Therapy perspective, our pain and our values are like two sides of the same coin: if we flip the pain coin over, we find what means the most to us in our lives. Or, as one of my clients said, anxiety is like a metal detector: when it starts beeping and getting loud, it means there is treasure under the surface, and that treasure is your values.

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Sometimes it can take some curiosity and creativity to get to the core of what the value is, because anxiety can be sneaky and tricky and it’s not always immediately apparent. But if we can look at anxiety as important information, it can help us change how we relate to it. We don’t need to make it go away, we just need to figure out what really matters to us and make choices toward our values.

IF YOU FIND YOURSELF STRUGGLING, FEELING STUCK, AND/OR COULD USE SOME HELP NAVIGATING YOUR FEELINGS, YOU COULD BENEFIT FROM COGNITIVE BEHAVIORAL THERAPY, ACCEPTANCE AND COMMITMENT THERAPY, MINDFULNESS, AND TELEMENTAL HEALTH SERVICES. SAN DIEGO PSYCHOTHERAPY CAN HELP. WE CAN BE CONTACTED AT 619-269-2377.

What If Everything You Know About Anxiety Is Wrong?

By Annabelle Parr, MA, AMFT

When we experience anxiety, our minds are really good at coming up with all kinds of “what if” thoughts. And those worried thoughts often deal in extremes and absolutes, like the title of this post.  

Good news: it’s unlikely that everything you know about anxiety is wrong.

If you’ve ever experienced anxiety, at the very least you know what it feels like in your mind and your body. But it is possible that some of what you’ve learned about anxiety is not workable (that is, it doesn’t move you toward the kind of life you want to live).

Anxiety in the information age:

These days, the internet is filled with articles and podcasts discussing stress, anxiety, and self-care. It is so important to make information accessible and to talk openly about the difficult and painful parts of being a human. When we are suffering, knowing that we are not alone in our experience can make all the difference.

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As much as it is wonderful that these topics are getting so much air time, the way we talk about them matters.

As anxiety is a rather hot topic these days, we decided to bust some of the common myths that, though well intentioned, can actually keep us stuck.

Myth #1: You can self-care your way out of anxiety.

There is a fair amount of content out there that sends the message that if you just take enough bubble baths, do enough yoga, or drink enough herbal tea, your anxiety will finally go away. Or that if you’re ever going to get a handle on your anxiety, you have to eat healthy, get good sleep, and exercise regularly. None of those activities are bad or wrong, and they can help us feel good.

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But when we engage in a behavior (ANY behavior – even “healthy” behaviors) where the purpose is to control or avoid our internal experience, we may paradoxically find ourselves even more stuck. Our anxiety might go away momentarily, but we may find that in the long term (or even in the middle of downward dog) our anxiety actually gets more powerful. And then when anxiety doesn’t go away, we think that we are doing self-care wrong, or worse, that there is something wrong with us since it’s not working. Cue cycle of chugging herbal tea and feeling anxious about the fact that we are still feeling anxious. 

Myth #2: If you just got the hang of positive thinking, you’d be anxiety-free.

If positive thinking works for you, helps you cope, and allows you to be the person you most want to be, carry on. But if it doesn’t, you are not alone. When I am at my most anxious or upset, trying to convince myself to believe a more positive thought often makes me feel worse. I might be able to come up with a more positive thought, but then I just feel frustrated that I can’t make myself believe it. Research supports that trying to suppress our thoughts can actually increase the frequency and intensity of the very thought we are trying to avoid.  

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While traditional Cognitive Behavioral Therapy works on helping people to engage in more balanced thinking (NOT unrealistically optimistic positive thinking), Acceptance and Commitment Therapy can help us change our relationship to our thoughts. Our thoughts, after all, are just words. Sometimes they have helpful information to share, but they aren’t always great at communicating it to us. 

Myth #3: You need your anxiety to go away before you can do the things that matter to you.

Anxiety is good at convincing us that we can’t or shouldn’t do things that matter to us until we feel less anxious. But the best antidote to anxiety is doing what matters to you even when anxiety is at its loudest. Because here’s the thing: anxiety typically shows up around the things that you care most about. So if you wait for anxiety to go away before you go after the life you want or before you show up as the kind of person you want to be, you may end up waiting forever.

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So is your anxiety coping skills toolkit workable?

Workable simply means: does this behavior help you move in the direction of your values (who and how you want to be in the world) and does it have a cost to you? So if you have a stellar self-care routine that helps you feel more present, engaged and able to show up in your life as the person you want to be, keep doing your thing. And if positive thinking has helped you live a more meaningful, fulfilling life, keep it up.

But if you find that you are trying to control your anxiety and make it go away, and instead it just keeps getting more powerful, more intense, and more uncomfortable as your life gets smaller and more restricted, Acceptance and Commitment Therapy (ACT) may help. ACT is designed to help you change your relationship to anxiety and help you develop psychological flexibility: the ability to do what matters to you no matter what.

IF YOU FIND YOURSELF STRUGGLING, FEELING STUCK, AND/OR COULD USE SOME HELP NAVIGATING YOUR FEELINGS, YOU COULD BENEFIT FROM COGNITIVE BEHAVIORAL THERAPY, ACCEPTANCE AND COMMITMENT THERAPY, MINDFULNESS, AND TELEMENTAL HEALTH SERVICES. SAN DIEGO PSYCHOTHERAPY CAN HELP. WE CAN BE CONTACTED AT 619-269-2377.