Unsticking from Anxious Thoughts

By Annabelle Parr, MA, AMFT

Our capacity for language allows us as a species to be excellent problem solvers. It’s the thing that allowed us to invent cars that transport us over large distances quickly, and it’s also what gives us the ability to notice if we have a flat tire, pull over, and replace the tire with a spare (and if you are not the savviest with automotive issues, to understand a YouTube video explaining how).

When we are anxious or afraid, our minds come up with thoughts to try to help us make sense of our fear and problem solve potential threats.

If you get a flat while you are driving, before any languaging kicks in, you might notice yourself feeling a jolt of fear. Fear is an acute feeling that shows up when we are facing a perceived threat. And fear is really adaptive. If we never felt fear or anxiety, we wouldn’t survive long. Usually, right after fear or anxiety (or any other emotion) kicks in, our mind jumps in with some thoughts to try to make some meaning out of that feeling and help us address it. In this case, fear might tell you to “pull over as soon as you can.” Listening to that thought will likely help you resolve the issue and ensure you are once again driving a safe, secure vehicle.

However, sometimes the thoughts that our minds come up with when we are feeling afraid or anxious are not so helpful.

For example, if you feel anxious the next time you get in the car, and your mind says “what if something else goes wrong and I crash? This isn’t safe, I should just stay home”, listening to that thought is probably not so helpful. Sure, listening to that thought would probably give you some relief from the anxiety you are feeling in that moment, but it would also restrict your life in a really significant way.

Anxiety and the thoughts it generates are designed to help protect us, so those thoughts usually feel really true and important.

The problem is sometimes we feel anxious or afraid in the absence of any real, likely, or catastrophic threat, and sometimes the anxious thoughts that visit us are not accurate, helpful, or important. Cognitive defusion – the process of noticing that our thoughts are simply sounds and syllables – can help us create enough distance from those sticky anxious thoughts that we get to choose how to respond.

When we are able to create some space between our selves and our thoughts,

we get to become skilled observers of our experience in a way that allows us to decide whether a particular thought is going to help move us toward our values or if it will move us away from what is meaningful and important to us. We do not have to figure out whether the thought is “true,” we just need to figure out if doing what it says is in line with what matters to us.

So how do we get a little bit of distance from our thoughts?

There are a whole bunch of exercises that can help us get some distance from thoughts that are tripping us up. One of my favorites goes like this. First, you identify the thought and state it as it is (“this isn’t safe, I should just stay home”). Pause, and notice what shows up in your body as you sit with it. Next, restate the thought but preface it with “I’m having the thought that…” (“I’m having the thought that this isn’t safe, I should just stay home”). Again, pause and notice what shows up. And finally, restate the thought but preface it with “I’m noticing that I’m having the thought that…”. Again, pause and notice what shows up.

And the final step is to check in with what matters most to you in this moment

and choose whether that is a thought that will help you engage with your valued direction. Sometimes the answer is yes. But when it’s no (or not entirely), your values can inform what you choose to do instead.

Defusion is a process, and sometimes it can be hard to get unstuck on your own. A therapist trained in Acceptance and Commitment Therapy (ACT), can help you learn the ropes.

If you or someone you love needs support and might benefit from cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT) for anxiety, panic, phobias, stress, PTSD, OCD, or stress related to COVID-19, or if you would like more information about our telehealth services, please contact us at (858) 354-4077 or at info@csamsandiego.com

How Do I Control My Anxious Thoughts?

By Annabelle Parr, MA, AMFT

The human mind is a meaning making machine; it searches for patterns (even where there are none) and does it’s best to make sense of the world around us so that it can help keep as safe and surviving. But if you are reading this, I’m guessing while you are surviving, you might not feel like you are thriving. Because sometimes the thoughts our minds generate feel less than helpful. Sometimes, they get us stuck.

Anxiety tells us all kinds of stories about ourselves and the world around us.

If you’ve ever experienced anxiety, you are probably familiar with all the catastrophic stories your mind can generate in a difficult moment, from “I’m going to fail” to “nobody likes me” to “this is going to be a disaster!” Anxiety disorders, OCD, and PTSD all include sticky thoughts that tend to govern and restrict behavior and continue to drive the anxiety and emotional difficulties. And it makes sense that if your anxious thoughts seem to be controlling your life that you might want to control your anxious thoughts for a change. 

So what do we do when our thoughts seem to be holding us back or getting us stuck? We have a couple of options.

Cognitive Behavioral Therapy works on changing the content of our thoughts.

From a traditional Cognitive Behavioral Therapy (CBT) perspective, we might try what is known as cognitive restructuring. CBT challenges sticky thoughts, examining evidence for and against the thought, and then replacing it with a new, more balanced thought in place of the original. In addition, CBT asks you to act in new ways that might allow you to directly experience evidence that challenges your thought.

For example, say you are stuck on the thought, "I always fail at everything I do." CBT might invite you to consider that although you did fail your last 2 math tests, you aced your last 5 history tests, you are great at taking care of your dog, and you make a mean lasagna. Significantly, this isn't just about "thinking positive." And you aren't replacing the thought with it's complete opposite ("I will never fail at anything I do" or "I am the best at everything"). Those thoughts would not be helpful or true either. You are instead aiming for a more balanced and helpful way of viewing the situation: "I failed this time, but that doesn't mean I have or will always fail at everything.

What if I can’t control my thoughts?

But what if you have tried to challenge those thoughts that tell you how incapable you are or how dangerous the world is, and no matter how many times you try to replace the old thought and control your pesky mind, it doesn’t seem to work? What if trying to change your thoughts only makes you feel like even more of a failure because it’s not helping? Some thoughts are too sticky to challenge. You might be able to come up with a more balanced thought, but you still may have trouble believing it to be true. And guess what? The more we try not to think something, the more present and entrenched it tends to become. (For example, DO NOT THINK ABOUT PUPPIES. SERIOUSLY. DON’T THINK ABOUT A BUNCH OF CUTE, FLUFFY, SNUGGLY PUPPIES…I bet you just thought about puppies.)

Maybe you don’t have to fight with your mind.

Acceptance and Commitment Therapy (ACT) comes at our thoughts from a different angle. ACT says that the problem is not that your mind has thoughts, but rather that you believe that those thoughts reflect the truth about how things are and you behave accordingly. ACT is not concerned with whether a thought is factually correct or incorrect. Instead, ACT asks, is this thought workable? Does it help you to move around in your life effectively? Does it move you closer to what matters most? Or is listening to it preventing you from engaging in your life in important, meaningful ways?

Getting a little distance from your mind is different from controlling it.

In ACT, rather than trying to “correct” a thought or control the content of your mind, the focus is on helping you to step back, get some space from those sticky thoughts, and observe them for what they are: words. This process is known as cognitive defusion. 

A simple trick to get some space from your mind is to refer to it as a separate entity. So when you have a sticky thought, you might think, “my mind is telling me that I can’t handle this.” Or you might give your mind a name: “Neville is telling me that I can’t handle this.” Then, rather than trying to convince yourself that you can in fact handle it, you would focus on connecting with what matters to you, and choose to act in service of your values regardless. Because the thing is, you can have a thought and choose to behave in direct opposition to it. And this can be really powerful. Let’s try it right now. Say to yourself, “Self, I cannot raise my hand.” And raise your hand. See? No matter how sticky the thought is in your mind, it doesn’t have to keep you stuck with it.

If you can change your mind, great! If you can’t, no problem.

Whether you choose to replace a sticky thought with a new, more balanced thought or whether you choose to remind yourself that a thought is just your brain trying to make sense of the world, you do not need to fight with your mind. You just need to give it a little wiggle room. Minds can change. But what matters is that you know that your thoughts are not in control, even when it feels like they are. No matter what your mind is saying at any given moment, it is the YOU that has those thoughts that gets to decide what you do.

CSAM Is Here to Help

If you or someone you love needs support and might benefit from cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT) for anxiety, panic, phobias, stress, PTSD, OCD, or stress related to COVID-19, or if you would like more information about our telehealth services, please contact us at (858) 354-4077 or at info@csamsandiego.com

5 Life Lessons From Taylor Swift’s Miss Americana and Acceptance and Commitment Therapy

By Annabelle Parr

In her new documentary, Miss Americana, Taylor Swift not only gives her fans a whole new window into her life, she also beautifully exemplifies a way of being that is remarkably consistent with the principles of Acceptance and Commitment Therapy (ACT).

The documentary takes us through Taylor’s life and her rise to fame. She shares how for the first part of her career, she was consumed with a hunger for approval from others. Her entire persona was built on the premise of being a “good” girl: sweet, agreeable, likeable, pretty, thin, reserved, perfect.

A nice girl doesn’t force their opinions on people. A nice girl smiles and waves and says ‘thank you.’ A nice girl doesn’t make people feel uncomfortable with her views. I was so obsessed with not getting in trouble, I’m just not going to do anything that anyone can say anything about.

In ACT, we would say that Taylor was caught in “self-as-content” mode. She viewed herself as equivalent to the content of her thoughts and the content of others’ opinions about her. She was fused to an idea about who and how she was and had to be. And for good reason. She was and is constantly bombarded with both positive and negative messages about herself from millions of people.

1. We are designed to crave acceptance and connection.

For Taylor, just like for every one of us, there are very good reasons for why we come to view ourselves in a particular way: we exist in a context in which we pick up messages about who we are or how we should be, and our minds latch on to those ideas to try to protect us. Back in our hunter-gatherer days, our literal survival was tied directly to social acceptance and cohesion with the group. So we are hard wired to need connection and acceptance.

2. Often we seek that acceptance out by trying to make ourselves into who we think we are supposed to be.

Taylor, like so many of us, tried to fit herself into the mold of what others wanted from her. However, as Taylor found, this strategy often comes at a high price.

First, it cuts us off from parts of ourselves that are absolutely integral to who we are.

Our wholeness suffers when we are required to squeeze into a box of who we think we “should” be. We lose touch with who we truly are as we seek approval and try endlessly to please others. Taylor notes, “I became the person who everyone wanted me to be.” She literally stopped feeding herself in an effort to make herself small enough to fit into the mold of what was expected of her. 

Second, no matter how desperately we try, we will never please everyone.

Approval from others is a fragile foundation on which to lay our self-worth, because inevitably we will disappoint some people sometimes. Even as Taylor was starving herself, she saw that “there’s always some standard of beauty that you’re not meeting.” There are a number of double binds that are particularly present for women, and they include more than just paradoxical beauty requirements (e.g. be skinny, but also have a big butt). As Dr. Jill Stoddard noted in Be Mighty: A Woman’s Guide to Liberation from Anxiety, Worry & Stress Using Mindfulness and Acceptance Strategies, “we are evaluated as less competent when we are seen as likeable; when we are considered competent, we are more likely to be labeled unlikeable (Heilman et al., 2004; Rudman and Glick, 1999)”. This likability bind is another that Taylor is intimately familiar with. As Taylor states so poignantly,

When you’re living for the approval of strangers, and that is where you derive all of your joy and fulfillment, one bad thing can cause everything to crumble…When people decided I was wicked and evil and conniving and not a good person, that was the one I couldn’t bounce back from because my whole life was centered around it.

Most of us are not mega-famous like Taylor, but her words are incredibly relatable for anyone who has ever relied on approval from others to feel okay.

3. The thing is, we cannot avoid discomfort.

It might seem like if we just make ourselves perfect enough, we could avoid rejection or criticism or failure. But even if we could be perfect and avoid all of those things, we then would have to wrestle with the pain of making ourselves smaller to be more acceptable. ACT teaches us that pain is inevitable, and that the problem is not the pain itself but the rigid and inflexible ways we respond to it and the ways we restrict our lives to try to avoid it. 

4. It’s not your fault, and it is your responsibility to do something different if you want to see change.

Taylor describes feeling muzzled for most of her career. She says that it was her own doing, which is true to an extent in that she discovered that she could choose to speak up and be true to who she really is. However, it’s also important to note that she was muzzled by a culture and a context that told her in order to be liked, accepted, successful, and safe, she was not allowed to have an authentic voice. It was not her fault that she was muzzled, but it was up to her to break free. And in doing so, she is setting a powerful example for other women, pop star and otherwise, that authenticity and success are not mutually exclusive. She is helping to shift a culture that has muzzled women for centuries.

I want to wear pink and tell you how I feel about politics. And I don’t think that those things have to cancel each other out.

5. Our values can help set us free.

As viewers watch Taylor descend into isolation and depression resulting from others’ negative opinions of her, we also see her begin to change and grow in really powerful ways. She transforms from the stereotypical picture of a “good girl” into a bold, strong, mighty, authentic woman. She is no longer driven by the opinions of others, but grounded in what is important to her: being present with her family and her partner, and using her voice to stand up for what she believes in. She displays a willingness to risk rejection and discomfort in the service of speaking up for women, the LGBTQ+ community, sexual assault survivors, and minorities. She is often advised to stay small and quiet, but chooses instead to be true to who she is.

ACT in ACTion.

In cultivating a willingness to risk pain and rejection, getting present to who and what matters most, and recognizing she is far more than the stories told about her, Taylor is able to make choices in line with her own authentic, personally held values. The documentary finishes with Taylor saying,            

I want to still have a sharp pen and a thin skin and an open heart.

This last piece of wisdom is important: the key is not to stop caring, but rather to get grounded in who you are and what you care about. Our pain points us toward our values. It hurts precisely because we care. Vulnerability is a strength, and it is only when we are willing to risk discomfort that we are truly able to connect with what matters.

Rather than let her experiences and her pain harden her, Taylor allowed herself to feel her feelings and to use them as fuel to get clear on who she wants to be in the world. Her thin skin and open heart are not only the things that give her songwriting such power, but also the things that empower her to stand strong in herself even when it isn’t easy or comfortable.

My Horcrux Diary

guest blog post by Dr. Nic Hooper

Have you read the quote below by T.E. Lawrence?

"All men dream: but not equally. Those who dream by night in the dusty recesses of their minds wake up in the day to find it was vanity, but the dreamers of the day are dangerous men, for they may act their dreams with open eyes, to make it possible.”  

I’m a dreamer. Always have been. Ever since I could remember, I wanted to do remarkable things that would make the world a better place. Over the years, I’ve had lots of ideas for how to do this but often I would ‘wake up in the day to find it was vanity’. In other words, the ideas remained just that; ideas. On a recent project, I became a ‘dreamer of the day’.

I research an approach to human suffering named Acceptance and Commitment Therapy (ACT). The pitch of ACT goes something like this: if we can be willing to experience all of our thoughts and feelings, both positive and negative, whilst continuing to move in valued directions, then we will do a decent job at this game of life. One night, after delivering an ACT intervention to teachers, I had this thought: “It is really easy to forget our values; I need to create something that will remind people of what is important to them.” In the following weeks I came up with the idea of an annual diary. For the most part, this diary would be like any other diary i.e. it would have days and dates and spaces to record meetings. However, it would also provide an opportunity for the user to record what is important to them at the beginning of each week.

Ok, so there was the idea. Now I had to do something with it. The first step was easy; I loaded Microsoft Word and spent hours and hours and hours (with my co-author Dr. Freddy Jackson Brown) shaping the words and lines that would make up the inside of the diary. The second step was more difficult. I had to figure out how to take that file and turn it into a product. First question: a publisher or a printing house? No publisher was interested so we went with a printing house. Then, more questions. What sort of spine to go for? How thick should the paper be? How many copies should we buy? How should we sell it? What are the best postage and packaging options? How should we advertise it? How should we accept payment for it? How do we pay tax? Who is going to post them? How should we grow the product over time?

During the first and second steps I faced a fair bit of discomfort (i.e. seemingly powerful negative thoughts often crossed my mind: “this is a waste of time”, “nobody will like it” or “you should be spending this time with Max”). However, the third step of making my idea a reality brought the most discomfort: once I had the completed product, I sent it out there into the scary world. And given that success or failure has implications for how I feel about myself, my diary is a bit like a Horcrux in the Harry Potter story. In that story, the bad guy (Voldemort) poured his soul into a number of items and placed them out there in the world. Those items were called ‘Horcruxes’. His thinking was that this strategy would make him more difficult to kill.

Like Voldemort, I poured my soul into this Horcrux. And like Voldemort, any attack on the Horcrux feels like it kills a part of my soul (‘attack’ is an extreme word that is possibly misplaced here. By ‘attack’, what I mean is any evidence I see that the diary is not worthy, whether it be a lack of sales, little interest on social media or negative feedback). My Horcrux diary is now out there in the world fending not just for itself but, in some ways, for me also. A bit of my soul is unprotected; it can be scrutinized, criticized or ignored. It can fail. And if it fails then it will hurt like hell.

The feeling of vulnerability that comes with trying to do something remarkable is tiring, and it often makes me question whether it would have been better to stay a ‘dreamer of the night’. If my Horcrux is inside my mind then nobody can see it; nobody can hurt me. However, every time I think about this I come to the same conclusion. Although being a ‘dreamer of the night’ comes with built-in safety, if I didn’t do something with my dreams then I’d be living a life out of step with my value of making the world a better place, and consequently, I’d feel empty.

Why am I telling you all this? For two reasons. Firstly, I want you to see how ACT is in my blood. Just in this blog you will spot how I used important ACT processes (willingness, defusion, self-as-context, values). Secondly, and more importantly, I want you to see that having ACT in my blood helped me to chase my dreams, and that it can help you to do the same. Chasing dreams will bring vulnerability but if you know what to do with vulnerability then you will be free.

Interested in checking out Dr. Hooper’s Annual Diary for Valued Action? Check it out here.

CSAM IS HERE TO HELP

If you or someone you love might benefit from cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT) for anxiety, stress, PTSD, insomnia, or chronic illness, or if you would like more information about our therapy services, please contact us at (858) 354-4077 or at info@csamsandiego.com