Anxiety Files

How to Think More Like a Cat… and Overcome Your Worries

Robert L. Leahy, Ph.D. — Mon, 08 Feb 2010 22:06:51 +0000

I've been interested in the nature of worry for a number of years, devouring the research on this important topic, writing articles and a couple of self-help books, and giving talks. Before I give a workshop I obsessively check my powerpoint slides, double-check the hotel reservation, and make a couple of copies of my electronic files and email them to myself and the workshop coordinator. I like to think of this as "productive worry" and to congratulate myself on being conscientious. I do all of this while my cat, Franky, demands attention, jumps on my lap, sits on the keyboard, and -on a regular basis-steals my food right under my nose.

It never occurred to me that he has all the right attitudes. He doesn't worry. He doesn't ruminate. He is a cat.

OK. Since I do have an interest in ethology and since I am a devout follower of the Darwinian revolution, I thought that perhaps cats have something to teach us. Let's face some evolutionary facts. Humans have been evolving and changing continually, perhaps suggesting how unsatisfactory the new model is and the continual need for nature to make a recall. Take a look at our sorry fossil record and I can assure you that you will not come away with a "bravo" for permanence:

If you read this the way I do, we have continually faced recalls and redesigns. You might think that a couple of hundred thousand years beats the warranty on your recently recalled Prius, but when it comes to evolutionary time, we are constantly finding faults with our own design. We may think of ourselves as "homo sapiens", giving greater emphasis at our conceited moments in the sapient nature of our character, but we are hardly well-adapted and happy. We worry, we pout, we suffer from depression, some of us commit suicide. Now, I ask you: Does that sound like a cat?

Well, no, of course, not.

Here's why. Worry is based on our belief that any intrusive thought that occurs needs our attention. If I think, "I am going to make a fool of myself", then I have to pay attention to it. Worry follows from our incredible ability to anticipate the future-far beyond the next few seconds. We anticipate how people will think of us at the next party, how our finances will collapse in the next year, and how we won't be able to take care of our sick parents ten years from now. In fact, our evolved ability to think about other minds provides us with the ability to think about how they think---and we think that they think we are losers, buffoons, boring, and annoying. We think so much that we also think we are going crazy, because we have a standard of normality. If you want to find out more about the rules for being a worrier or just a plain nervous wreck then do us both a favor and go out and get my two self-help books, The Worry Cure: Seven Steps to Stop Worry from Stopping You or Anxiety Free: Unravel Your Fears Before they Unravel You. I try to give you the very rules for being a worrier, social phobia, panic disorder, or obsessive-compulsive disorder---and, of course, how to cure yourself.

But what is interesting is that it takes a lot of thinking to be a neurotic. Think about it. I rest my case.

While we have constantly been fixing ourselves through the process of natural selection-which is really "natural rejection"---cats have remained largely the same for the past 10 to 20 million years. There are no cat-recalls of paws that accelerate suddenly or tails that don't rise when one desires. There are no whiskers of discontent, and even six-toed polydactyl cats are immortalized as "Hemingway" cats. They have been worshipped, reviled, hired again to rid Europe of bubonic rats, made it to the cover of magazines, and been imbued with both Satanic and ethereal qualities. Throughout it all, cats have remained aloof, assured, demanding, and cool.

How to Think Like a Cat

Cats don't have our problems.

Now cats have an advantage. They only rely on four general thoughts. Look at your cat-or call someone who has a cat-and observe the following "cat cognitions":

THIS FEELS GOOD

THIS DOESN'T FEEL GOOD

I WANT THAT

WHAT'S NEXT?

Like a laser-beam focused on mindful awareness of the present moment, with Zen-like immediacy and the ability to adapt to a sick and disturbed world, cats look at the world through feline felicity and think,"This feels good". OK. They are hedonists. They like a warm radiator. They prefer your food. They sleep more hours than you will ever live. It all feels good. Except when they think, "This doesn't feel good". And they let you know it--perhaps a meow, perhaps a glare, a frown, a distasteful condescending look behind those whiskers. You get the message. It has to be restored to "This feels good" as quickly as you can shift your seat in the chair to make it more comfortable for your cat. Now, "This feels good" and "This doesn't feel good" hardly result in rumination and worry. It's hardly anticipation of all the possible mishaps that might occur. No, it's like a tasting menu for life. "I like it" or "I don't like it". Period.

Not the ingredients for worry. How about "I want that"? That's quite simple. As your cat ascends into conscious awareness from his third-eyeball position, glancing across the room and notices a piece of chicken on the counter, the thought comes into cat-awareness, "I want that". Immediately, your cat activates his predatory capabilities to leap in a manner defying the law of gravity to within one inch of the chicken and steal it for HIS MEAL. Yes, your cat, the predator with style, has momentarily returned to his primary cat strategy: "Find it, kill it, eat it". The simplicity is thrilling, liberating. Cat-like. Worry-free.

Or, your cat has the ambitious, but momentary, thought, "What's next?" This is not the kind of planful, problem-solving thinking that led to Google. No, this is more like a cat eye scanning the room and seeing a ball moving. "What's next?" mobilizes the predatory chase to catch the ball, repeat the motion, think again, "What's next?", into an apparently endless recursive process that ends with "This feels good".

In fact, all of it comes down to, "This feels good".

What's missing in cat-cognition? All of your worries. Cat's are not thinking, "Have I done a good job?" or "What will other cats think of me?" Cats are not overwhelmed by all the tasks listed on the Outlook calendar. Cats are not concerned if they gain a little weight and their stomach hangs down as they prowl around. They aren't thinking, "Did I offend someone?" They don't carry a watch, there are no cat blackberries. Phone calls and emails go unanswered. They are beyond indifferent. If Buddha were to evolve a little more he might come back as a cat.

They may have four cognitions-and, yes, you may take pride in the four thousand thoughts that you are having today that are making you anxious, worried, angry, confused, guilty, ashamed, overwhelmed and perfectly human. You have the thoughts---but cats have the thoughts that work. They have evolved not to think about the worrisome intrusive ideas that are not relevant to the life of being a cat.

Now you may say, "No cat can write an article"---true-but why would they bother? Or you might add, with a smirk on your anxious face, "Cats never meet deadlines." Good point. OK. So, you won't hire a cat, you won't use one for your financial planning, and you might not ask your cat for advice on buying a Toyota. Smart of you. But just think if you went through the day as a cat, hedonistic, living in the moment, indifferent, playful, sleeping a lot, using humans as furniture to sleep on, and getting your way. Maybe your family and friends would say, "What happened to his ambition?" As you stretch after a deep sleep that is repeated hourly, you look up with disdain and a small touch of momentary curiosity walking ever so slowly toward your food. Not a worry in the world. Purring softly, "This feels good" with an occasional, "What's next" on the immediate horizon.

Not a bad life.

Social Anxiety: How to Be a Better Monkey

Robert L. Leahy, Ph.D. — Fri, 05 Feb 2010 17:25:49 +0000

How You Look is What They See

People with social phobia or social anxiety often give out signals of their own apprehension that inadvertently send the wrong message. For example, many of my patients over the years with social anxiety often don't smile, they avoid eye contact, and they remain silent because they are so anxious that they will either sound foolish or look anxious. Ironically, these attempts to remain "closed" result in the "wrong impression". Many of these people appear to be cold and aloof-and, in some cases, conceited. It's the wrong message and they don't even know they are sending it.

Ironically, they fear that they will appear anxious, but they actually appear arrogant. They also fail to "mirror" or "match" the emotions that others are displaying. For example, other people may be smiling, but the anxious person may remain cool and aloof. This sends the wrong message-that you are not interested and you don't care.

As a therapist I can see this kind of non-verbal defensiveness in our sessions. A young man doesn't smile, avoids eye contact, and speaks in a low, monotone. I suggested to him that he might wonder how this appears to others. Initially, he had no awareness that he was doing this, but-on reflection---it occurred to him that other people might be smiling and looking at him, but he was pulling away. Since he was a good looking and intelligent young man, it was surprising when he learned from friends that some people thought he was unfriendly-even conceited.

Be a Better Monkey

If you watch monkeys in a zoo you will notice that they are continually communicating with each other. Of course, monkeys lack the sophistication of a large vocabulary and they have yet to take advantage of email or Facebook. But they communicate friendliness, interest, warmth, kindness and the willingness to play. They do it non-verbally---or, in some cases, with the appropriate grunts. Monkeys who are good at this kind of communication have other monkeys to pal around with, play with, share bananas, and -if they are especially rewarding-have sex with.

Unfortunately, many people with social anxiety are sending out the wrong monkey messages. My patient was one of them. He was avoiding eye contact, had no intonation or energy in his voice, had a closed-down body language, and didn't mirror the smiles and gestures of the people around him.

I suggested that he "be a better monkey". This started with noticing the non-verbal communication of other people around him and noticing how actors communicated emotion. He was astounded to see how much he had not observed. (Because he was so focused on whether he appeared anxious, he didn't notice the emotions that others displayed.)

The second step was to make more of an effort to smile, make eye contact, nod his head in agreement, ask questions, validate other people, and even occasionally touch the arm of someone he was talking with.

His friends began noticing a change. They told him he seemed like a different person. They complimented him. Women began showing an interest. He had "evolved" to be a better monkey.

Stop Procrastinating: What to do and when to do it

Robert L. Leahy, Ph.D. — Mon, 07 Dec 2009 21:35:39 +0000

I was meaning to get around to writing this for some time, but other things got in the way. Like many of you, I had to google some nonsense, watch a re-run of the CNN news, look out the window, ruminate a little about why I'm not getting this done. And then it occurred to me, JUST DO IT.

OK. If you procrastinate then you realize you are not alone. Most of us procrastinate some of the time. There's a true story about a graduate student who took over twenty years to finish her dissertation-and the topic was "procrastination". Really. Do I look like the kind of guy to make this up?

Think about it. What are you procrastinating on? Here's a simple list of some possibilities: calling up or emailing a friend, getting your taxes done, writing that paper, joining the health club, starting a diet, working constructively on your relationship (rather than complain about it). What's your thing? What are you late on? What are you not doing?

1. Identify THE TASK

Let's call the behavior you are putting off--- THE TASK. The task could be any of the behaviors I mentioned above-it's the primary thing that would be worth doing. Only, you aren't doing it.

2. List the advantages and disadvantages of getting the on-task behavior done

Be honest with yourself. There are always some disadvantages of doing the task you want to get done. List the disadvantages: perhaps you might find it hard, unpleasant, or you'd rather do something else. What are the advantages to getting it done? You might feel more effective, less guilty about wasting time, more in control. But getting the task done will cost you something. Are you willing to pay the price? Has the "price" really been as unpleasant as you have anticipated it to be?

3. List your off-task behaviors

Let's take "Bill" who works in an office, sits in front of his computer all day, and manages to get very little done. He says, "I waste a lot of time doing nothing". Well, you are always doing "something" and if that something is googling, shopping on-line, sending out emails, visiting news websites, or calling friends-then you are doing something. But it's not productive and you are really wasting time. Make a list of these off-task behaviors. Post it in a conspicuous place-such as on your computer screen--- and catch yourself off-task. Keep track of the amount of time you spend "off-task". In Bill's case, he estimated that he was spending about three hours each day wasting time. That's 15 hours each week-almost 700 hours each year. That's like working 40 hour weeks for l7 weeks-and getting absolutely nothing done. Wasting time accumulates-without interest. How much time can you afford to waste?

4. List the advantages and disadvantages of the off-task behavior.

Isn't googling fun? Isn't it fun to send out emails, forward idiotic stories and cartoons, read the paper on-line, look out the window, complain about yourself? OK. List those advantages of goofing off. Now list the disadvantages. You will feel guilty, fall further behind, feel less in control. Moreover, the advantages of doing the on-task behavior may be longer-lasting than the advantages of goofing off. Look for longer-term gains. How will you feel if you are more on-task, less off-task-for six months? Procrastinating is like walking backward and feeling surprised that you are getting nowhere.

5. Schedule a time and place for the on-task behavior.

It won't get done unless you schedule where and when you will do what you need to do. For Bill, it was to get to work, start his work at 9 AM and spend at least two hours on-task before he allowed himself 15 minutes to goof off.

6. Give yourself some goof-off times.

You need to step away from work every now and then to refresh your attentional resources. You won't get much done if you burn yourself out. However, the goof-off time needs to be a reward for the productive behavior. Schedule it and limit it.

7. List all your negative thoughts about doing the task.

You have lots of "good reasons" for goofing off. You can say to yourself, "I can do it later. I won't be able to get much done anyway. I'd rather do something else. I need to be spontaneous ...or motivated... or ready...or want to do it. I need to be sure about it before I start it. It's too late anyway". These have been your recurrent self-defeating roadblocks. Tear down each one by using some rational, empowering thinking.

Here's a start: "Doing it later is an excuse that reinforces never getting it done. Better get it done sooner than later. Better to feel it's out of the way rather than hanging over your miserable head. Better to get it started than think you have to do the whole thing. You always want to do something else-so what? Choose what's in your long-term interests, not your short-term impulses. It's never too late to make progress. Forget about perfection--- you will never see it and you don't need it.

NOW-WHAT ARE YOU REALLY GOING TO DO?????

Afraid of Being Rejected?

Robert L. Leahy, Ph.D. — Mon, 19 Oct 2009 15:02:36 +0000

One of the central problems for you if you are anxious is your fear of making a mistake and your fear of being rejected. I don't know about you, but I sure have a long history of rejection---only because, I think, I have constantly been trying to be productive. When I was single I was rejected by girlfriends-but accepted by some. I have had book proposals and articles rejected. I view rejection as part of the cost of playing the game. You won't be able to win unless you can tolerate losing some.

If you wonder if other people have made mistakes, here is a list of authors and books that have been rejected by publishers when first submitted. The authors include James Joyce, Vladimir Nabokov, Sylvia Plath, Jack Kerouac, Jorge Luis Borges, Isaac Bashevis Singer (who won the Nobel Prize), Marcel Proust, Stephen King, Oscar Wilde, and George Orwell. Famous books that have been rejected include The Diary of Anne Frank, War and Peace, The Good Earth, Gone with the Wind, Dr. Seuss, To Kill a Mockingbird, The Rubaiyat of Omar Khayam, Watership Down, Lolita, Angela's Ashes, Harry Potter and The Hobbitt. The editor who rejected the classic book, Animal Farm, by George Orwell had this piece of wisdom: ‘It is impossible to sell animal stories in the USA'. Another brilliant observation-and a classic mistake- was the following: "Everything that can be invented has been invented", claimed the forgettable Charles Duell, Commissioner of the US Patent Office in 1899. Or consider this: "I think there is a world market for maybe five computers."(Thomas Watson, chairman of IBM, 1943). Or, one of my favorites: "We don't like their sound, and guitar music is on the way out" by Decca Recording Company when they rejected the Beatles in 1962.

Well, it's not just publishers and business people who make mistakes-we all do. Here's how you can find out. Ask every one of your friends about mistakes that they have made. If they are honest, they will reveal some great stories.

Mistakes are the pathway to success---if you persist and learn from them.

Time Urgency and Anxiety: The Seventh Step for the Final Week

Robert L. Leahy, Ph.D. — Fri, 07 Aug 2009 20:01:17 +0000

Our anxious brains were evolved to respond to a threat that was immediate. The tiger in the bush wasn't going to wait around for your ancestor to carry out probabilistic calculations about false alarms. Danger was imminent and your response-to escape-needed to be instantaneous. Reflection was the hallmark of the" soon to be eaten".

Time Urgency and Everyday Anxiety

So, how does this time urgency translate into your everyday anxieties?

You are stuck in traffic and you say to yourself, "I can't stand this. It's driving me crazy!" So you blow your horn, bang the dashboard, scream expletives. And you still can't move your car. But you feel a sense of urgency to get out of here. You feel trapped.

You start breathing rapidly. Your heart is racing. You are sweating. You are thinking that you will have a panic attack if you don't get the hell out of here immediately. But then you look around at your leather interior car with its Bose sound system and its luxurious air conditioned interior and you wonder, "What am I worried about?" The rational part of your brain knows that it's safe. But your amygdala is screaming, "Get out of here!"

Your panic seems to come on more strongly. This is the sense of "suffocation" that you have feared as you gasp for breath. Your brain keeps pounding away with the alarm, "You have to get out!" You think, "If only I could get out of the car and run like a madman, then I'd feel better." But you know that you would then think you are crazy.

You wake up in the middle of the night and you think, in your dreamy, somewhat intoxicated state, "Will I ever find the love of my life?" You look next to you-and that person is not the love of your life. And now you panic, "When will I find my true love?" You lie in bed, ruminating, twitching and turning, impatient. You've got to know right now. But you don't.

You notice a spot on your skin and it's Friday night and you think, "This could be cancer". But you also know that you can't see your doctor until next week. You have to know right now. So you Google skin cancer and drive yourself insane with worries until your next appointment.

Your brain tells you that you need to know right now. You can't stand waiting. You can't accept uncertainty. Like everyone who is anxious, you are plagued by time urgency.

Seven Steps to Putting Time on Your Side

Let's think this through for a few minutes. Take your time.

1. What is the disadvantage to you of time urgency? Doesn't it make you continually anxious and worried? Doesn't it deprive you of the ability to enjoy the present moment? Aren't you irritable and sometimes difficult to be around? Wouldn't you be better off with a cooler head and more patience?

2. What if you don't know right now? Why is that so bad? Are you thinking that if you don't know right now, then you will never know? Or, that things will turn out badly? Not knowing right now is exactly that-you might know later. In fact, you will know later. Just wait.

3. Is your body and mind keyed up to take action? Your adrenaline is shooting through you as you are prepared for immediate action. Turn down the adrenaline. Practice relaxing, let go of your breath. Surrender. Your brain may be telling you, "Don't surrender".

Let it go. You will find that nothing happens. No emergency.

4. How many times have you been wrong about needing to know right now? False alarms and emergencies constantly deprive you of your life. When you didn't know right now, was it always a bad outcome? Aren't you still here?

5. Set aside your worry until five hours later. Revisit the issue of urgency at that time. Does it now seem irrelevant? Why?

6. Get into a time machine. Go five years into the future. Eventually you will have the answer to your question. So why not simply enjoy the time in between?

7. What can you still do even if you don't know right now? Plan all of the positive and meaningful activities that you can do even if you don't have your answer right now. Fill your life with action and appreciation and you will crowd out the alarms.

Not knowing right now doesn't have to mean not living right now.

Practicing Your Obsessions: The Boredom Cure

Robert L. Leahy, Ph.D. — Mon, 13 Jul 2009 15:18:44 +0000

Have you ever read a book that seemed so dry, so repetitive that you just couldn't keep your eyes open? I remember a number of years ago saying to my wife, "I have this great book on the history of Russia. I can't wait to read it". Like most things dealing with Russia it was long, complicated and had a cast of characters that would leave the ordinary mind numb. I reclined on the couch, put my feet up and began to read. A few minutes later I was snoring. We call this "chest-reading" because the book is on my chest and I am happily dreaming about the Siberian winter.

There is nothing that will turn your anxiety around like sheer boredom. Anxiety is a readiness to run away-or, if necessary, to attack. Boredom is your readiness to-well---do nothing but fall asleep. Just writing about it makes me tired.

Can Obsessions be Boring?

OK. What does this have to do with obsessions? I've been saying that you have been repeatedly using the same failed techniques with those intrusive thoughts---you've been yelling at yourself to stop them, you've been neutralizing by washing your hands (repeating prayers, checking locks-whatever). You've been thinking -ruminating - about your obsessions: "Why me? Why am I thinking these things?" We've already seen why this never works in my previous blogs, How do Obsessive Compulsive People Think? and Those Damn Unwanted Thoughts!

Your strategy has been to get rid of those thoughts. They're "intrusive", barging in on you. "Throw them out", you say to yourself.

In my last blog I described the "Guest House" where you invite that intrusive thought in, show some kindness, make space to let it be--- Having a New Relationship to Your Obsessions: Welcome to the Guest House. I had one of my patients imagine that she was rollerblading with her intrusive thought. She pictured it as a funny clown-like figure on a skate-board zooming along with her. It was cool, she said, like she knew she wouldn't get rid of the thought, but she could take him along. These techniques allow you to make room, accept, take care of and share fun with your bothersome thoughts.

But there is another technique that you might try that allows you to inundate yourself with those miserable thoughts. Immerse yourself. Rather than reject them, you flood yourself.

This is the "boredom technique".

Imagine this. You are going to watch your favorite movie five times every day for the next week. I guarantee the outcome-if you are crazy enough to do this. You will be so bored you will either fall asleep the third time or you will start screaming. If you repeat something enough you just lose interest. Call it habituation, call it desensitization, call it defusing a thought from a feeling. Whatever. I call it "boredom".

I will never fall asleep

A technique I use for insomnia is to repeat "I will never fall asleep" hundreds of times---over and over. Try it right now. After you read this, close your eyes, repeat very, very slowly, "I will never fall asleep". Do this for ten minutes.

If you tried this, you might have noticed that your anxiety initially went up and then it gradually went down. If you stayed with it, you might have noticed your mind drifting away to other thoughts and concerns-even, "Will this really work?" or "Does this guy know what he is doing?" If you did this exercise you might have found yourself getting sleepy, having a hard time keeping a focus on those words---"I will never fall asleep". And you may have noticed yourself getting drowsy.

One patient of mine had the recurring thought that he feared, "Maybe I am gay". He wasn't, but the thought bothered him. He would avoid gay people because it triggered the thought that he might be gay. He would make himself feel macho by saying anti-gay things. But the thought kept coming back. So, I had him practice saying hundreds of times-like a zombie---"Maybe I am gay". He got bored.

Another patient feared he had cancer. For years he was plagued with these thoughts, continually getting examinations that turned up nothing. We began with the feared thought, repeating "Maybe I have cancer". After a couple of weeks this got boring. So we replaced it with, "I definitely have cancer". This became boring. Now he was getting desperate to find something to fear. So he tried repeating, "I want to get cancer". After some initial spike in anxiety, this became boring. It was hopeless and boring. He complained, "Bob, I can't keep my mind on the words. It's so boring." Well, if you are bored you are not afraid. You're just tired of listening. You can't even pay attention to the fear. What a relief!!

I think it's time you took a nap, don't you?

To learn more about OCD and other anxiety disorders see my book, Anxiety Free: Unravel Your Fears Before they Unravel You.

Having a New Relationship to Your Obsessions: Welcome to the Guest House

Robert L. Leahy, Ph.D. — Fri, 10 Jul 2009 19:27:08 +0000

In my previous blog on OCD, Overcoming Your Obsessive Compulsive Disorder: Accepting and tolerating your obsessive thoughts, I suggested that you might think of allowing room for these bothersome and intrusive thoughts. You have been telling yourself that you have to get rid of these thoughts, so you yell "STOP THINKING THIS!" or you neutralize (perhaps you wash your hands or say, "No, I don't believe that").

You are continually trying to get rid of these thoughts.

One technique that can be helpful is to make friends with the thought. There's a wonderful poem by the 13th century Sufi poet called "Rumi". It's about the Guest House.

Imagine that your mind is a house in the woods, you are all alone and there is a guest that shows up uninvited. In the past you have been irritable with guests, angry that anyone would disturb your well-earned solitude. You have yelled at visitors to "GO AWAY" so that you can be alone. But visitors seem to pass on the road where you live. They ignore your no-trespassing sign.

One day this visitor knocks on the door. You don't know him. But you decide that rather than being angry, rather than push him away and pull the shades on the window, you have decided to show your hospitality.

Here are some lines from the Guest House:

This being human is a guest house.
Every morning a new arrival.

A joy, a depression, a meanness,
Some momentary awareness comes
As an unexpected visitor.

And this time you let him in. He is a lonely visitor, only wants to stay for a while. Give him some tea, ask him to relax. Listen to his story. You do not have to obey him or fear him. Like you, he has been alone. Let him be with you for a moment and then he will leave.

Your intrusive thoughts are like this. They only want your company for a short time. When you hear an intrusive obsession do not fear it, do not run away, do not shut the door. Simply say to your thought, "Ah, you are back again. Welcome. Sit for a while and rest. I have my other things to do, but I know that you need to come in out of the cold".

As the thought chatters away, let it have some space. It's a big enough world. Room for all of us. Observe him, if you can, listening in the background as he repeats what you have heard many times before. He is afraid. But you can see that he is only a lonely soul lost in the woods and he has found some warmth, some friendship from you, some moment of kindness.

You are less angry, less afraid. The thought, your visitor, is sitting in the corner relaxing, happy to chat away about nothing in particular. Take some joy in the fact that he has a place to sit on his journey because he has a long way to travel and you have provided some kindness and hospitality for a brief moment in time. A brief moment in an infinite universe.

To learn more about OCD and other anxiety disorders see my book, Anxiety Free: Unravel Your Fears Before they Unravel You.

Overcoming Your Obsessive Compulsive Disorder

Robert L. Leahy, Ph.D. — Mon, 06 Jul 2009 15:02:03 +0000

If you are like millions of people with Obsessive Compulsive Disorder (OCD) you know how your OCD has created problems for you. You feel persecuted by your thoughts about making mistakes, contamination, harm, or losing control. Your OCD prevents you from living freely, including using public rest rooms, shaking hands, feeling comfortable and satisfied with your work, and having the feelings, thoughts and images that the rest of us don't worry about. You are constantly battling yourself. And you feel you are losing the battle.

What can you do?

In my previous blog How do Obsessive Compulsive People Think? I describe eleven characteristics of OCD thinking:

1. Triggers for your obsessions
2. "Odd" thoughts or images
3. Negative evaluation of thoughts
4. Self-monitoring
5. Demand for certainty
6. Thought-action fusion.
7. Thought-suppression
8. "I've lost control"
9. Compulsions
10. Felt sense of completion
11. Avoidance of triggers

You probably have seen a lot of your own thinking in this. But what can you do about this? In one of my blogs, Those Damn Unwanted Thoughts!, I describe your "failed strategies", and why they fail. Just as you can't run away from your hips, you can't get rid of your thoughts. Thought control and thought suppression don't work. Worse---they make you feel more hopeless.

In my new book, Anxiety Free: Unravel Your Fears Before They Unravel You, I help you understand that OCD is largely a problematic theory of your own mind. Your perfectionistic theory of your mind is that you should only have pure thoughts, pure feelings, certainty in what you think, comfortable feelings, and control over what you imagine. You also have a problematic theory of how to make things better. All of your failed strategies to control your thinking and eliminate "unwanted" or "odd" thoughts and images are because of your theory of your mind.

I lay out a number of ways of changing the way that you relate to your thinking. Rather than view your thinking as the "enemy", you can try the following:

1. Prove that thought suppression doesn't work. Example: Try not to think of white bears for the next thirty minutes. Oops. There's another white bear. It won't work.

2. Prove that thoughts don't control reality. Example: If you think that Satan will possess you, beg him to possess you. It won't work.

3. Modify your image of the obsession. Example: You may imagine your obsession as some ominous, powerful, dark, large, all-encompassing cloud that engulfs you. Change the image to one of a silly looking clown. It's less frightening. Imagine he has a high-squeaky voice. He's silly.

4. Float your obsession. Example: Rather than trying to get rid of your obsession, imagine it is a tiny piece of wood floating ever-so-gently down a stream. Watch it in your mind's eye. Imagine yourself breathing out as it floats away. Let it return and float past once again and breathe it away. (I'm imagining that if you do this enough you will get sleepy.)

5. Bore yourself. Example: Repeat your obsessive thought very, very slowly. Imagine that you are a zombie. "I am contaminated". Repeat it as if you are slowed down and you are watching the words go by. Over and over. Hundreds of times. Boring.

In future blogs we will look at how you can change your relationship to your obsessive thoughts-rather than trying to suppress them, we will see how you can "make space" for them. It's like a relative at a big picnic--- you can tolerate him without feeling like he occupies your entire mind.

How Do Obsessive Compulsive People Think?

Robert L. Leahy, Ph.D. — Fri, 19 Jun 2009 15:19:45 +0000

In a previous post Those Damn Unwanted Thoughts I indicated how your anxiety often is a result of your fear of your thoughts and sensations. Let's say that you are obsessive and you have the recurring thought, "Maybe I have cancer". But you don't. You've seen the doctor, she tells you that you are fine, you go home and begin thinking again, "Maybe she's wrong. Maybe I have cancer". Then you think, "The fact that I'm thinking that must mean that there is something to worry about. I need to know for sure. I need to do something." So you Google endlessly every possible cancer and expect to see your pretty face appear on the screen.

People with Obsessive Compulsive Disorder have intrusive thoughts (or images) that bother them. These can be thoughts about making mistakes, harming someone, contamination, disease, religious preoccupation, fears of impulses or desires, or just about anything that you might consider dangerous, disgusting or dirty. Examples of obsessions are, "I made a mistake at work and it will blow up on me", "I touched the chair and it's contaminated", "I had a violent fantasy and now I will lose control", "I left the gas on (the doors unlocked, the cat in the washing machine)" or "I did something that God will punish me for". Once you have the intrusive thought you begin looking for more examples of these thoughts. "Oh God! I just had that thought again." You now are watching yourself, totally self-conscious, fearing every possible thought or intrusion that does not reflect a pure and good mind. Your theory of your mind is that you should only have certain thoughts. Everything else is bad or dangerous.

So what do you do when you have these unwanted intrusive thoughts? Do you shout at yourself, STOP? Do you try to get reassurance from someone, "Does this look like cancer to you?" Perhaps you pray for peace, or you have a drink, or you binge eat. Or maybe you ruminate, thinking over and over, "Why am I having these damn thoughts? Am I going crazy?"

How to Understand Your OCD

The diagram below (which, I admit, is a little obsessive itself) is from my book, Anxiety Free: Unravel Your Fears Before they Unravel You. It lays out a detailed schematic on the nature of OCD. Let's take a look at each step.

1. Triggers: These are the events or stimuli that set you off. It could be touching something (contamination), leaving the house (something is unlocked, the gas is on), driving at night (I ran over something), thinking of sex (God will punish me, I will lose control).

2. Odd thoughts or images: You have some thoughts or sensations that you don't like. "Why am I having those bizarre, sick, disgusting, unwanted thoughts?"

3. Negative evaluation of thoughts: You think there is something wrong with your thinking-as if you should only have pure and good thoughts and feelings. You have a lot of "shoulds" about the way you should think and feel. You think that now that you have the thought, you have a responsibility to get reassurance, get control or get rid of it. Having the thought is equivalent to being SENT ON A MISSION. You have become THE THOUGHT POLICE.

4. Self-monitoring: You watch yourself like a hawk-looking for those thoughts. Of course, simply because you have to think about what you are looking for ("I am looking for that disgusting and dangerous thought"), you always have to find it. It's like holding up a mirror to yourself and saying, "I am looking for a mirror. OH MY GOD! THERE IT IS!!!!"

5. Demand for certainty: You think you should know for sure whether you will act out, lose control, or are contaminated. Nothing short of perfection and certainty will suffice.

6. Thought-action fusion: You equate having a thought with committing an action. "If I think I will get violent, I will". Or, a thought is the same thing as reality. "If I think I have cancer, then I must be a dead man". Thoughts, actions and reality are all one. All in your mind.

7. Thought-suppression: Your first line of "defense" is to try to stop having these thoughts. You tell yourself, "Don't think that". It works, for three minutes. But your failure to permanently suppress these thoughts leads you to believe

8. "I've lost control": You now equate control in your life to eliminating unwanted thoughts. Now you feel more out of control as you desperately try to control your thoughts more and more. It's like slapping the water and drowning.

9. Compulsions: You now perform some neutralizing ritual. Perhaps you wash your hands excessively, pray, repeat "No", walk a certain way, wash a certain way, arrange things, go back and check, check again. You find yourself frenetically doing these things until you have a

10. Felt sense of completion: You say, "I can stop now because I feel I have done enough. This felt sense of completion now becomes your new rulebook for rituals. "I need to do them until I feel I did enough". You are hooked on your rituals.

11. Avoidance of triggers. You remind yourself, I wouldn't have any of these thoughts if I simply avoided the triggers. So you avoid touching things, avoid public restrooms, avoid shaking hands, avoid movies with Satan, avoid people that make you have feelings that are bad and disgusting feelings. Avoid, avoid and avoid. You are running away from the world.

This is how you think. All in the name of being responsible, conscientious---all in the name of avoiding losing control, going crazy or becoming irresponsible. All because you need to be in control. And it doesn't work. Take a look at the schematic and let us know where you see yourself. In a later post, we will discuss what you can do.

But the first step is understanding how your OCD makes "sense" to you.

From: Anxiety Free: Unravel Your Fears Before They Unravel You by Robert L. Leahy, Ph.D.

To see a bigger image of the chart, please click here.

None of these techniques will help for very long. So what can you do?

In my recent book, Anxiety Free: Unravel Your Fears Before they Unravel You, I lay out a number of things that you can do when you have obsessive thoughts.

Constructive Discomfort: How to do what you really don’t want to do

Robert L. Leahy, Ph.D. — Mon, 08 Jun 2009 14:55:04 +0000

If you are like a lot of us, there are a number of things that you know you should do, but you simply can't get yourself to do them. You know you should exercise, you should cut down on calories, you should spend less time on Facebook, and you should save more of your meager income. You know you should call up that friend who left a message and you know you should take out the garbage-now. But there is a little voice in your little head that says, "I DON'T WANT TO".

I don't want to!!!!!

Your implicit rule for your life is, "If I don't want to do it, then I won't do it". Or, you might even take a position-on principle--- "I shouldn't have to do it". You take pride in your autonomy as your self-discipline has evaporated. You fold your arms across your chest in defiance and then wonder, "Why haven't I gotten anything done?"

OK. I could say, "GROW UP!" But that might sound a little less empathic than you would care for. So, I will put it in a different way: "If you only do what you want to do, then you won't get what you want to get." It's that simple.

What is constructive discomfort? Well, think of it this way, my friend. It's really simple.

What do you want?
What do you have to do to get it?
Are you willing to do it?

OK. Let's take most people. I want to lose ten pounds. What do I have to do? Eat less, exercise more. Am I willing to do it? Hmmmmmm.

You probably noticed, I didn't ask what you wanted to do, I didn't ask about your motivation, and I didn't ask you about what your mother said to you when you were five years old. Why? Because none of that is relevant.

What is relevant is setting goals, committing to behavior, and practicing discomfort.

Think about discomfort as a means to an end. It's a tool.

Building Mental Muscle

In my book, ANXIETY FREE: UNRAVEL YOUR FEARS BEFORE THEY UNRAVEL YOU, I ask you to think about discomfort as a means to an end.

Here are some simple exercises that you can do to build up your discomfort tolerance.

Take a discomfort history---"What are some things you've done that were uncomfortable, but you did them anyway?"
Relate discomfort to pride-"What have you felt proud about? Was there some discomfort involved?"
Assign yourself some discomfort-"Keep track of things that you do that are uncomfortable. See if they are linked to getting things done."
Recognize that discomfort is temporary-" All discomfort is temporary. It won't kill you. In fact, it will make you stronger. Dancers say, ‘It was a good work out. It hurt good.'"
If you are not doing something that is uncomfortable every day, then you are not making progress.

You can use your discomfort as an investment-to do what needs to be done so you can get what you really want.

Practicing discomfort is like building mental muscle.

I asked a young man who graduated from West Point , "What is the most important thing that you got out of your training?" "Sir" (I liked that he said that). "Sir, I learned I was able to do things that I never thought I'd be able to do".

That's called self-discipline.

Discomfort is temporary. Pride is forever.