Recently, Matt and I did a couple of videos exploring intrusive thoughts or anxieties and why it’s useful to look at why we’re afraid of the consequences of those thoughts or anxieties coming true. There’s an exercise for doing that, The 5 Whys, which I shared in my book, The Mind Workout, and Matt explains near the end of this video:
He very helpfully offered to go through the exercise, exploring why anxiety was coming up in social situations, and to hear the results of that, check out this video:
There’s a really important reason for doing this type of exercise. It’s not to obsess about problems or search for some deep subconscious hidden secrets in our brains. This is an exercise to expose all of the very obvious things we’re doing in our every day lives to fuel the symptoms that bother us.
Mental health challenges are like mountains. These challenges have peaks. We like sticking names on the peaks. The peaks of these challenges catch our attention and we go to get help for the name we’ve stuck on that peak. Somebody might say something like: “I need help being less anxious in meetings.” They’ve noticed Anxious Meeting Mountain.
But that peak is only a tiny piece of the mountain. There’s much more mountain leading up to it, although maybe that was never tall enough or pointy enough to catch your attention. If that mountain is getting in the way of your life, taking off the top won’t make much of a difference. There’s still the entire mountain on top of which was that peak. You have to blow up the entire mountain and the 5 Whys exercise shows you how.
If somebody struggling with anxiety in meetings does the 5 Whys, you could find a bunch of different things. Let’s assume you do it and discover you’re afraid of saying something wrong and you believe people won’t like you if you make mistakes and do the “wrong” thing. The next step is to look holistically at your entire life and all of the ways you try to cope with, check on, or control uncertainty about doing the wrong thing or making mistakes or trying to control what others think about you. That will show you the complete mountain:
For recovering from mental health challenges, it can help to see them as the result of the practice that makes up that mountain. Those beliefs at the foundation, and the compulsions that result from those beliefs, naturally lead the brain to being terrified of saying something stupid in a meeting. Through your practice of trying to avoid and control those uncertainties, your brain very naturally and logically learns to be afraid of all the other ways you could say something wrong and people could judge you. Because it’s a practice, focusing in on a particular situation, like meetings, while continuing the compulsions throughout your life, won’t solve anything. This is a mountain that grows its own peaks. Cut out compulsions in meetings but keep doing them every day in other areas, and it’ll simply grow another peak about another specific topic. You’ve got to rip up the mountain’s foundations.
To get over this, you can take all of those compulsions, arrange them in a list ordered from the easiest to cut out to the most difficult, and then progressively work your way through them, eliminating and replacing them with proactive actions that help you build and create the things you actually want in your life.
As you do that, it’s important to look at unhelpful beliefs and work on changing those as well. If you believe that saying the wrong thing will make everybody hate you and you’ll be alone and being alone is the worst thing ever, then you’ll feel an ongoing pressure to get back into compulsions to control uncertainties about being alone. Learning how to be comfortable with being alone and enjoy that can actually be an amazing support for building healthy relationships because we’re not doing from a place of insecurity and fear, but instead to grow something of value we want to build between ourselves and others.
Hi Mark!
I’m an italian boy (23) and I am struggling with anxiety and also OCD (I beg your pardon for my english, grammar etc…)
I would like to ask you two questions:
– By placing the adjective “intrusive” to the thoughts we don’t want, aren’t we adding a negative label to them? By watching your videos I think that those thoughts shouldn’t even be considered as intrusive.
I have very often those thoughts “in background”, and even if I don’t trust them anymore, the still bother me.
I get frustrated over the fact that I know that I should accept them but most of the times I don’t succed so I start to obsess myself over my reaction to the thoughts.
Do you have any advice on how I can handle this situation?
– Does the common pattern for OCD (anxiety/urges/unwanted feeling -> compulsion) also apply to people who don’t have OCD? After all this is a pattern about anxiety, and I think that many people unconsciously apply it. Am I right?
Yes, I find it’s useful to just see it all as “stuff”. I only use the label “intrusive thoughts” because that’s what people search for online.
Learning to not judge yourself is very useful. It’s ok if you struggle to accept something. You can notice that and take another step forward and make that next step one that you’re happy with. We don’t have to carry around judgments from the past. It only slows us down.
And yes, these patterns apply to anybody with a brain. The majority of people struggle with uncertainty.
Hi Mark 🙂
I’m Natalie I’m 29 and living in England, apologies for this long message I know you’re a busy guy but you’re videos are really great and have helped me in other aspects and I just wanted to get some advice about what I’m currently experiencing regarding social anxiety please.
I’ve probably had anxiety since about the age of 14 but it was never anything too significant.
I started getting obsessive thoughts back in 2013 out of the blue one day and have had them ever since. The things that bothered me back then don’t bother me as much because you get better at dealing with them with practice and I had a bit of therapy but this is really difficult to deal with as it’s physical symptoms which people and I’ve had it for about a year now.
My anxieties at the minute are in ANY social situation.
I feel like people are noticing my strange eye contact because I find it really difficult to maintain eye contact recently but I try to do it because I’ve always been good at it usually (never thought about it before) so I am over compensating and staring too much and then rushing conversations because I want them to end and talking rubbish because I’m so anxious. Always monitoring how I’m reacting so I can’t seem to react normally in conversations.
My eyes start watering my hearts racing the whole time and I just don’t want to speak to anyone even though I actually do but while I’m feeling like this I don’t. I obsess about when I’m listening to them they can tell that my face is strained like I’m finding it difficult to listen to them or being fidgety or over reacting to what they’re saying and interrupting and getting words mixed up and generally being on edge, talking really quickly and just making things really awkward, I know I am because of their reactions at times, almost look at me as if I’m crazy and need to calm down. My mind is going quite blank and then I’m thinking of what to say next all the time so it’s like I’m having vanilla (boring) conversations because this has taken over and I have it with everyone now even my family and it’s such a horrible feeling and making me feel really alone!I’m avoiding lots of things now like seeing friends and I need to drink to have a good time, my best friend came to stay a couple of months back and I was full of anxiety and the whole weekend was awkward because of my obsessing and me not acting natural or being relaxed and knowing what to say even though I’ve never had this with her before! I had to keep going out and driving around in my car with her because then I wouldn’t need to keep looking at her because I’d be concentrating on the road and that’s with my best friend who I’ve known for 15 years!I feel ridiculous!
I’m not being my natural self whereas before the thoughts are in your head and no one knows but when you’re outwardly acting weird it’s so embarrassing!
I keep going from job to job because I’m almost nervous about making connections because I’m just gonna make it awkward with me being the way I’m being and I start a new job tomorrow which I’m so nervous about (naturally) but with this on top it’s rubbish!
How would you get over something like this? I see family a lot and I still keep feeling the same way!
Thanks Mark and sorry for the long message and probably sounding so ridiculous!
Natalie
What you described there actually shows you the roadmap out of this. It can really help to shift the focus away from the feelings and towards the actions. When we engage in compulsions to avoid and control feelings, it works like any addiction: the more you react to escape the feelings you don’t like, the more you encourage your brain to give you those feelings. Each time we choose to not be ourselves, we’re choosing to have those unwanted feelings more. Like when you drove around in your car with your friend–that might have seemed like you had to do that, just like somebody might feel they have to do some drugs to get rid of some feeling they don’t like, but that actually results in those unwanted feelings being even worse next time or in a new situations. And it just spreads. But we can reverse this. We can go into situations we would have avoided in the past and practice being ourselves. We can do the opposite of what our brains try to make us do. We can learn how to have anxiety while doing the things we care about. I found that Acceptance & Commitment Therapy was a great approach for tackling these types of issues. If you can work with a therapist that’s experienced with helping people overcome mental health challenges, that can be a great place to get started.
Thank you so much for the answer! I’m looking forward to reading more from your blog.
Greetings from Italy 🙂
Hi Mark
Yes you’re right, it did feel like I had to drive around and then I wouldn’t have to deal with the thoughts as much, but I still did after so it didn’t really accomplish anything like you said!
Thanks for your advice Mark, will definitely look for a therapist who does Acceptance and Commitment Therapy in my area.
Many thanks
Natalie
Hi Mark,
Thanks for the work you do. Really excellent and most helpful. Glad I found you.
Question: For me, I have a lot of “somatic” battles as well as the hand washing stuff. And various other “body symptom issues.” Sometimes I have a physical symptom like “tightness or spasms in neck and shoulders area.” I can get so hyperfocussed and locked I to it..the world shrinks to anxiety and trying to eradicate the symptoms. And of course..they just grow. Enter all the powerless and Crappy thoughts and emotions.
But here’s the dilemma…I had a car accident many years ago…some neck injuries. ..and a few years ago I was diagnosed with “fibromyalgia.” So I actually get spasms and a lot of tightness in neck and shoulders..esoecially if stressed.
Usually I can mitigate or medicate some of the neuromuscular tension down. Sometimes its very difficult..especially in cold weather. Recently I get “dizzy spells” from the tension which can be disconcerting. And of course after an episode..the hypervigilance and apprehension abound…which doesn’t help..whether its “mental” or “actual physical” in origin. It just grows into a very undesirable state mentally and physically.
The same can happen during “flu and cold season.” Sure I see the “brain misfiring and freaking out..wanting to get me to wash hands endlessly”..but another part of me (from working in health care) knows that there is a definite increase of risk of contamination during the season.
So…the question is how do we know when its “just OCD” and when its “legitimate” and we need to “take action” for examples in the spasm case?
I ask because when I started to see just how far I have crossed over into “OCD Land” I was quite relieved to know there is hope in that awareness…but also alarmed ..because one wonders “how can I trust myself?
Navigated that “is it ocd or something I need to act on” is tricky. Especially when beginning ACT ….or when trying not to give in to compulsions…that “uncertainty curve” gets pretty steep..and VERY somatic for me.
How can one become more comfortable in ones skin? And not be tossed around by symptoms and sensations?
Thanks for your suggestions or insight.
Willowman
Thanks!
One thing I found very helpful was starting to see all experiences, physical or mental, as just that: experiences. At any moment, I can experience many different things in my body or my head. The question is always: how am I going to spend my time and energy in life?
If I get caught up in labeling and judging the different experiences, I’ll always be able to think of reasons why this thought or this physical sensation is something that’s “real” or “dangerous” or “true”. So I’ve found it useful to switch the focus to actions. Personally, I wouldn’t trust anything coming out of my head–and that includes the physical sensations my brain is perceiving. I just work on actions that I want to engage in. And that helps me see what issues to address. If I make space for a physical sensation or an emotion and keep moving forward, is that experience really a barrier? And sometimes it is and then we need to adjust our path or tackle that issue.
But coupled with this, it’s been important to cut out compulsions, like the hypervigilance you mentioned. If we’re constantly checking things throughout our lives, then it’s only natural to experience a lot of anxiety and physical symptoms because of that. Our brains get hooked on compulsions and they’ll pull anything to get us to react with more compulsions.
I’ve also found it useful to work on having physical experiences and exploring how to make space for them, in the same way we do that with feelings like anxiety. One of my favourite exercises is to sit down to meditate; Very quickly, my legs or my back will be uncomfortable. And then I explore how to have that feeling and be curious about it and explore it. Where do I feel that discomfort? Do I have to see it as bad? What happens to it if I choose not to move or control it? How can I be happy that it’s there? How can I relax my body while feeling that discomfort? How can I let that discomfort run all over my body without me trying to control it?
Enjoy this valuable exploration of experiences!
Thanks for yiur response Mark.
Yes..ACTIONS are a better focus…as long as they’re not some kind of avoidance or compulsion as well ☺ so yes…the connection to values and “what I want to do with my life and time” ia always paramount to me…yet the “sensations” are pretty loud. Extremely. Fibromyalgia loud. I dont take pain medication. So sometimes pain IS real and can make a slow burn on the adrenal..physically and over rime by eroding one’s confidence in being able to ACT on one’s values as effectively as one would like.
Some stuff does not present an obstacle. Some stuff tangles up the brain in overload…kind of like having too many browser windows open and things “freeze.” So during meditation things can just sound VERY LOUD.
I do gon
after the things I want…but it feels like I’m juggling the activity with the burden of compulsions/hypervigilance all the time. Like a monkey on my back kind of?.
Maybe trauma plays a factor…maybe its just decades of having the operating program running below the conscious level and now its more in view.
I’m not trying to analyze it. I knkw that painful avenue. I AM taking actions…and its like having hijackers board the plane midlflight. Its a pain in the ass. To put it simply.
Perhaps I should try your course..I need some structure to the liberation practice.
W
Hey, Mark. Thank you for this informative article. I have a question :
I was wondering about the nature of the intrusive thoughts that are especially about our personality and character. For example, if I hate being “X” and have intrusive thoughts of being “X”, would letting these thoughts stay or accepting them somehow brainwash me into becoming “X” ?
The best antidote I know of to the fear of not being ourselves, is to be ourselves. When we experience uncertainties about losing control, we can accept those uncertainties like any other, and pour ourselves into the practice of being ourselves. We can show our brains that we’re in charge, we’re making choices, we’re empowered to live our lives.
It can help to see that asking questions like this is actually the compulsion. It’s like any health anxiety–what if this feeling means I have an illness? Can’t do the things I want to do? Lose control? etc
Hi Mark,
Thanks for your previous response.
Unfortunately I’m still dealing with the occasional panic attack (usually around my health.) I had one this morning and feel super drained now.
Is it common to get an uptick of intrusive thoughts and/or images after experiencing an attack?
Example,
Im laying here and suddenly picture a cartoon/man holding a sword on a mountain. I then worry about “what if” I lose touch with reality and start believing I’m a part of this image. Sounds silly when writing it out.
Im doing my best to leave these thoughts and images alone like the bad apples.
Thanks.
It really helped me to see that judging experiences and then trying to get rid of the uncertainty created by those experiences is the compulsion. Our brains can throw up any thought or question. As soon as we start reacting to that and trying to control it, then we just encourage our brains to come up with even more stuff to get worried about and try to control. I found it helpful to recognize that as long as I want to avoid something, my brain will keep obsessing about it. This is why it’s useful to look at our beliefs, judgments, and desires. If I desire not losing touch with reality, then my brain needs to check and worry about ways that could happen.
Hi Mark,
I had a major relapse after dealing with primarily rOCD. My themes have shifted a lot this time. Before it seemed that the only thing that triggered me was relationship-related things. But now, the obsessions seem to change by the hour. The fear feels something like this “Oh no, what if THIS becomes my new obsession?”
It’s gotten really difficult, as it has spread so widely to so many topics. First it was “what if every time i see the color red, i won’t be able to stop thinking about it?” then it was the color blue then the number 3, then it was cracks on the sidewalk, etc. The worst part is, I’ve associated this fear with mindfulness, so whenever I try to be mindful, I immediately start checking to see if my mind will latch onto a new obsession.
I did the 5 whys and realized that this all stems from the fear that my brain is broken and unfixable. It came from when I had my first panic attack and was terrified that i was “going crazy”. (I fear that I have a form of OCD that is untreatable and there is no hope for me, it will continue to spread like a cancer in my brain and take all the things i enjoy away from me).
Do you have any tips on how to tackle this? I’ve been trying to just meditate, practice acceptance, and even some ERP imaginary exposure letters. But the rate of new obsessions is so high it feels like I can’t keep up. There is now just this dreaded feeling following me that something bad will happen if i focus or pay attention to anything too much. It’s like i become hyper aware and it freaks me out.
There are a couple of things I’d look at here:
1) There aren’t types of OCD or themes or forms. Believing in that just creates this problem you’re running into. There’s just a thought or feeling you don’t like and then there’s the compulsions you do inside and outside of your head as a reaction to that. So it’s useful to tackle OCD at that fundamental pattern level. The topic never matters. You can just notice there’s another uncomfortable uncertainty in your head. It’s no different than any other.
2) I find it most useful to cut out compulsions. If you’re doing lots of checking and controling to “fix” and “solve” symptoms, then your brain will just very helpfully give you more things to fix and solve. THE SOLUTION IS THE PROBLEM.
3) People seem to use “imaginary exposure” scripts/letters a lot as a compulsion. I’d watch out for what you’re trying to do with those.
4) The fear of getting stuck with OCD is the same as any illness/health compulsion. So I found it very useful to just agree with my brain: of course I’ll be stuck with this problem forever! But, right now, I’m going to spend my time and energy on things I care about. When we can embrace a fear, it loses its power over us. As long as we’re reacting to and trying to control fears about OCD, we’re stuck in it.