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.

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.

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.

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.

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.  

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.

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.

A Lesson on Living Life to Its Fullest

by Shoshana Shea, Ph.D.

“You must defeat your reason before you can start” – Patrick Star

If you want to live life to the fullest, it’s not about forgetting all your troubles and checking out, it’s about slowing down, checking in, and recognizing you have choices. One of the greatest examples of this came from the imagination of Stephen Hillenburg, “SpongeBob Squarepants” show creator, and his writers. The character is Larry the Lobster; the name of the episode, “A Life in a Day.” As I watched that episode for the 100th time, I was thinking more about Larry’s secret to living life to the fullest; he pronounces, “You got to take risks. Live on the edge…by living each day like it was your last.” Larry goes on to say, “By livin’ like, me, Larry!” 

Living life to the fullest does NOT mean that we should try to ignore all our fears and worries.

Patrick The Starfish, states, “This is the moment where we redeem our miserable lives,” and decides that he must live moment to moment and find the most dangerous of feats; then he will truly be living! To Patrick, ‘Living life to the fullest’ seems to mean that we should try to forget reality and just live without regard for the long-term consequences. I think many of us can relate to that idea, that we wish to live completely free of fear and shut off our worries like a faucet. If only it were that easy! Patrick pronounces, “You must defeat your reason before you can start.” This is my absolute favorite line! It can sound so appealing to ignore that voice in our head that urges us to be cautious and go the opposite direction. But as appealing as it might sound to have no fear, as Patrick discovers, this can have pretty big consequences.

Cautious isn’t necessarily the same as stagnant or boring…

While Patrick is out thrill-seeking within inches of his life, Spongebob interprets living a full life to mean not taking any risks at all. He embodies that voice in our head that tells us to stay firmly planted inside our comfort zone. That familiar voice which can paralyze us, and which can make life stagnant, boring, and small.

Moving towards our values is not easy; otherwise we’d all be doing it!

When we are heading in a direction that is deeply meaningful to us (TOWARDS our values), we have to remember that the short-term is usually not easy at all. When we are moving AWAY from our valued direction, the short-term is usually a relief and can be enthralling at first. What we later find out is, ultimately, an AWAY move reveals that the hard stuff is still there and there are usually negative consequences to whatever method of avoidance we chose in the first place: Drinking excessively, overeating, acting impulsively, reckless thrill seeking (like Patrick), or staying well within our comfort zone (like Spongebob), etc. 

Mindfulness is a useful tool to help us move towards are values.

Mindfulness is often misunderstood to mean that we are only “allowed” to be in the present moment, and not think too much, or to not think at all, about the future. Being mindful is about non-judgmentally NOTICING and having awareness of what we are thinking, feeling, and experiencing, while we are in the present moment. For example, if we are aware that we are feeling sad about our work situation, we can notice the physiological sensations that arise, any other emotions that might be present, and any thoughts that emerge. We can make deliberate decisions about the direction of our life based on these observations. Mindfulness helps us stay the course. It can help bring us back if we have strayed or feel stuck. Contrary to Patrick’s version of “living in the moment,” it’s not about making quick, impulsive, reckless decisions and remaining cut off from our thoughts and emotions. After all, our thoughts and feelings can have really important information for us. Opposite of Patrick: Slow down.

Once we recognize thoughts that help us to move towards what’s meaningful, we have choices about our actions.

A mindfulness tool we use in Acceptance and Commitment Therapy (ACT), is to look at whether our thoughts and actions are serving the function of moving us TOWARDS our values or are they moving us AWAY from what’s most meaningful. Often life throws up some curve balls. We can decide how we are going to relate to those barriers and take action. For example, using the example from above, if we notice we are unhappy at work, we might start researching other job opportunities, setting up informational interviews, and continuing to show up to work every day (all examples of TOWARDS moves), rather than quitting the next day (an example of an AWAY move), and putting ourselves in a bad position.

What will you decide?

At the end of the episode, Patrick has convinced Spongebob that really living is about engaging in a series of dangerous acts. As they are heading towards their demise, Larry saves them, but only after they are all severely injured. Larry chides them as they are heading towards the sharp rocks, “Look guys, my advice wasn’t meant to be taken literally, I meant to live life to the fullest; not to maim yourselves!” So what will you decide? To live like Patrick and “defeat your reason before you can start;” to live like Spongebob, and not take any chances or go outside your comfort zone; or to live like Larry…where risk is absolutely encouraged but in a calculated deliberate manner?

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.

Therapy in the Time of COVID-19 and Shelter in Place: What is Teletherapy?

By Annabelle Parr

During this incredibly stressful time of COVID-19, we are having to make major life adjustments.  With the new shelter in place restrictions, you might wonder whether psychotherapy is still an option available to you. The short answer is yes!

Telehealth, also known as video conferencing or online therapy, has been available long before COVID-19, and is an important alternative to in person care.

Traditionally, therapy is done in person. However, with the emergence of new technologies, there have been an increasing number of telehealth / video conferencing options and platforms emerging and available in the mental health field over the last decade. This means that not only do we have the infrastructure available to offer confidential, HIPAA compliant virtual therapy, but also that there is already plenty of research on telehealth and its efficacy in mental health treatment.

Prior to coronavirus, teletherapy expanded access to care to individuals who were not able to get to a therapist’s office, whether that was due to scheduling difficulties or a lack of mental health care options in their community. Now, shelter in place poses a barrier to accessing in person care for all of us. Thus, telehealth via video conferencing offers convenient access to care for everyone as we are required to stay at home as much as possible.

How effective is telemental health care?

According to the Anxiety and Depression Association of America, “from a large body of research we know that telemental health leads to high patient and provider satisfaction ratings and achieves health outcomes equivalent to in-person care across all diagnostic groups” (Yellowlees, 2020). So as long as the client is willing to engage in therapy virtually and is not an extreme risk to themselves or others, research shows that telemental health is as effective as in person treatment.

How does virtual therapy work?

Typically, telehealth involves video conferencing with your therapist using a secure, HIPAA compliant platform. No extra equipment or complicated applications are required.  Clients can use their smartphones or a laptop computer with a built-in camera. Therapists are able to offer telehealth services to patients located in the state in which they are licensed. So a therapist licensed in and practicing in California is able to offer teletherapy services to patients located in the state of California. Though not all therapists were offering telehealth options prior to COVID-19, given the current situation, many have adjusted their practices to offer video counseling options to patients in need.

What should you look for in a telehealth provider?

The same things you would look for in a therapist you would see in person: you want to ensure that the therapist you choose has expertise in the areas in which you are seeking treatment for, and you want to make sure the therapist feels like a good fit for you personally. One thing we know for sure is that the quality of the therapist-client relationship is the most important factor in producing successful treatment outcomes across settings, in-person or online. This means that in order for therapy to be effective, you have to have a solid trusting rapport with your therapist. Assuming those two conditions are present, telehealth is likely to be just as effective as working with the same therapist in person.

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. Dr. Shoshana Shea can help. She can be contacted at 619-269-2377.