Anxiety (Part 1)

This week, we take a deep dive into something that affects us all at some point in our lives: anxiety.

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Transcript

0:12

Welcome to Couple Counselling. I'm Anna Webster. And I'm Neil Webster. We are a couple of MBA CP counsellors, and yes, we are also a couple. This is a podcast aimed at anyone who has considered counselling, is considering counselling, or has never considered counselling, but has a passing interest in how a married couple of counsellors speak to each other when they're not at work. Each episode we'll be giving you tips on how to use counselling techniques for yourself, how to get on better with your partner, and just generally how to make life a little bit easier. All wrapped up in some light bickering from a couple who've been together for over 30 years. Hello. Hello. Hello. Episode two, we made it. We did. How have you been? What have you been up to? Uh well I have not been doing CPD on a sun lounger this week. I have been counselling. Yes. Oh that's good. Here? In Forest. Yes. Oh that's good. That was almost a plug. Hmm? We could do that, can't we? We can plug our business. Yeah. I mean it is called Forest Counselling. Doesn't it? I love that. You're so natural at this. Yeah, we could do it because it is called Forest Counselling. But it does what it's and if there was a website. Well, what would that be? Probably Forest Counselling.com. Oh my god, this is so easy. We're seamless as well. People don't know this is like absolutely seamless. I don't think people got that at all. Is this that NLP? Yeah. Yeah. It just dropped into their consciousness without them realising. Brilliant. Well, well done. We've done we've got that out of the way. But I have been doing that in Forest. And I have been counselling, so there we go. I feel like you're overdoing it a bit. Alright, what have you been doing then? Counselling in Forest. Same, same. Um yeah, so let's do let's do notices. We've had a few people get in contact with us, which has been very exciting. I love, yeah, it's gone out into the world and people have gone, oh, you know, it's I don't think we're top of the uh podcast charts. Are we not? No, I don't think we're I don't think top five, maybe. But people have been in touch. That's been really lovely. Thank you. If well, thank you for listening again. I'd say thank you if you only listen to the first one, but this that will fall on deaf ears because you're not listening to this one. Um but pass that off the song. If you know someone who listens to the first episode and isn't listening anymore, thank them for even listening to one. Uh that's that. So, yeah, so people have been in touch. They have, and uh what are our notices? It's like we'll it's like we're running a a local council meeting now. Notices from previous. Notices, yeah. Okay, well, um one of our listeners in Edinburgh pointed out that CPD, which we were describing as continuous personal development, is also more usually known, I think, particularly in other industries, as continuous professional development. Correction. We've had a correction. I'm not sure if that is a correction, in fact, because counsellors do often refer to it as continuous personal development. I think the emphasis in uh in our business being that um you need to work on yourself in order to be able to help your clients. So I think counsellors and psychotherapists often view professional and personal development as very much wrapped up together in that you cannot have one without the other. Yes, okay. Well that's good. But thank you for that person getting in touch. Yes, nice, and personal or professional. Hey, that's almost like a good way of describing actually what's going on in the room. It's about the personal through a professional lens, right? It's kind of connection. Yep. Absolutely that. So um, yes, CPD, continuous personal development, and let's not say or yeah, or okay. So that I've had someone get in contact. Oh, it's just someone who left a like nice message. Uh saying left a package. That was Amazon. Oh, yeah. Someone got in contact and left a package. It was very nice. It was some dog food. They were not interested in the podcast. Sorry, go on. Someone left a nice message going, oh, this is a great idea. Uh, this is a friend of mine. Oh, this is a great idea. Couples counselling, like tag team. Oh, right. I thought, yeah, it's probably worth clarifying that we don't I think we may have mentioned this last time. I'm not sure if we did. We don't do it in the room together. That's a very it's probably something to really stress. That would be weird and unethical. And the idea of tag team, like it's some kind of fight. I've had a go, now you go in. Yeah. Um I think we did cover it, but I think in the intro, and it was possibly obscured in me getting lost in a numbers game. So thank you for getting in touch and saying, Oh, that's a great idea. Uh, and we are a couple, and we do couples counselling, but it's a terrible it it would be a very bespoke niche if we were uh a kind of tag team partnership doing counselling. We are not. We offer separate counselling, we are not in the same room at the same time. Oh yeah, there is one counsellor, yeah. Only ever. Only ever one counsellor, and if it's an individual session, there is one client. If it's a couple's counselling sessions, there are two clients. Yes. Couples counselling session. Yes. So do we want to uh was there some somebody else got confidence? Yeah, yeah. There's been that's I was going on to that. Yeah. Okay. So this now a massive vindication of the comment I made last week when I was talking about where in your body you experience certain emotions. Oh yeah, yeah, yeah. Remember that? Right, yeah, yeah, yeah great. You said that I'd never revealed this piece of information before because what I revealed was that I said that I experience annoyance with other drivers in my third rib down on the right hand side at the back. And we discussed the the niche nature of that particular somatic experience. Yeah, yeah, yeah, yeah. And one of the listeners has been in touch to say that she experiences excitement only in her knees. Wow. Yeah. Oh, I want that. Right. She's got excited knees, so she was uh very much identifying with my experience, validating me. It's so good though, right? Because like if you think about like knees knocking, shaking knees, that's all to do with excitement and adrenaline. Yeah. And it is like when people have slight doubts over that kind of somatic thing, you go, there are so many things that butterflies in our stomach. Absolutely. I mean, we point to it with language all the time. My heartaches, all of those things, right? People talk about having a heaviness in their chest, they talk about being weighed down by things. Yeah, absolutely. But I love that. So we point to it all the time. So that was excitement in the knees, is it? Was that her excitement? Yeah, she experiences excitement specifically, not fear, excitement. So, anyway, that's a vindication and a validation of my somatic experience in the world. Absolutely. I love it. I love it. I'd love to be able to choose where I feel things, just as a kind of I don't know that you necessarily get a chopped. I know you don't, but I'd love to have that. That would be like a strange little thing. Yeah. Today I'm gonna feel excitement in my ankles. Yeah. Well, you could maybe try that. Yeah. Um, right, so today. And there's an oh there's not one more. There's more there's more. I'm sorry I cut you off. I didn't know there's so many people for this. There's there's several more, but I'm gonna just drop in, I'm gonna drop in one more. Okay, save the others in case no one ever gets in touch again. I know that's gonna pretend that they got in touch next week. Yeah. Do get in touch. But this is the thing, right? Please get in touch because it's really exciting. You know, if you've got a question. Yeah, or a correction is good. Corrections are great. Keep us on the corrections are great if we've missed something out, if you weren't uh if something wasn't very clear, do let us know. We like that. We like feedback, don't we? Yeah, of course, it's all communication. It's all communication and we like feedback. Yeah, another listener got in touch to uh we were talking about fight and flight last week. Yes. Um, and she got in touch to say, is the freeze response part of that stable of reactions? Of course it is. So it is. And that's something, God, that's a whole massive topic, isn't it? So everyone's kind of heard of fight and flight, I think. They have. Um I think talking about the freeze response, which absolutely is is related to f fight and flight, is something that needs its own podcast. It's quite own separate, but separate to us. Welcomed. Not done by us. What it needs is somebody else to actually talk about it. No, no. Fight and flight sounds like two kind of rappers from the nineties. Welcome to the podcast with fight and flight. Like Pepsi and Shirley. They were rappers and they weren't the nineties. But good swing. I was gonna go for Dempsey and Make Peace. They're not musicians, they're not the nineties, they're not rappers. No, but she had not real. See, this is why this is a bit. I think that trumps uh return legitimate. I was saying with straying into that territory. So I think this nicely illustrates why a discussion of the freeze response would need its own podcast because we can't even get it. It's an episode. That's what I was getting rather than utopia. Yeah, it needs its own episode. Um there's loads to say about that. About trauma and how the brain works to say about the vagus nerve and about the parts of the vagus nerve and the parasympathetic and the sympathetic nervous system. Oh my god. This is like we're such nerds, I love all that. Oh, I love it all too, but it uh not today. Not now. But it was a good question. To go back, the the question was yes, so is freeze part of that. Related to and it is. It is related. So there's fight and flight, and there's freeze and fawn and flop. All the F's. All the Fs, and then your normal state, your resting state, yeah, is rest and digest. Yes. So yes, all the Fs will do Well, rest and digest and not. All the Fs and rest and digest. That's if you need an easy way of remembering all the Fs. We said lots of words that begin with F. And then two words that definitely did not begin with F. Yeah, okay. But we will come back to that. We will come back to it as well. It's really good and it's a really helpful way of understanding your body's reaction is doing, again, is doing what it thinks is best for you in that moment. Yeah, absolutely. And it's it's trying to deal with what it thinks are very real threats, it perceives very real threats. And that obviously I know what we're talking about today because we've discussed it beforehand. But there is some crossover with the stuff we're going to discuss today. There is, there absolutely is. I mean, actually, when you talk about psychotherapy, there tends to be a crossover between almost everything. We will come back to the freeze response. Uh it just I think it's it's such a a big one and you know has some quite kind of serious implications and also serious causes that it it deserves its own space to discuss. Yes, good, agreed. Uh Anna, what are we going to discuss today? I would like to uh do a slightly deeper delve into anxiety. Uh, the reason being that it uh came up on the podcast in the last episode just as an example. We were talking about sort of initial work on dealing with difficult thoughts and feelings, and I kept using anxiety just as an example. Yes. Um, and a few people got in touch to say, yeah, anxiety is a big one for me. I'd like to know more about anxiety specifically. Yeah, great. And it's pretty much number one of what people kind of come with. They come with a version of anxiety. A lot of people, a lot of clients turn up and go, I've I'm feeling anxious. It's quite a kind of common presenting issue. Yeah, really, I would say the most common. I think if you look at the stats on the most common mental health difficulties that actually depression is still out in front. However, I would say that in terms of what people tell you when they come into a counselling room, anxiety is either usually first or it's in the presenting list pretty high up. Yeah, yeah. And it's unsurprising. We live in an anxious world. We are bombarded with frightening stuff the whole time. Yeah. But most of us at some point feel anxiety often during the day. Yeah, I think it's worth jumping in here to talk about the problematic and non-problematic anxiety, because anxiety is an emotion and it's an absolutely normal human emotion. And in fact, we would be very dangerous if we didn't experience anxiety. You know, we'd be wandering into the middle of busy roads or falling off cliffs, or you know, that so being anxious uh about something that feels threatening is a normal human response and is actually in addition to being normal, it's helpful. Yes, so it's uh it's like with all all emotions and feelings, it's telling us something. Yeah, and in its non-chronic state, yeah, it is telling us be careful. Yep, it's illuminatory. Illuminatory, that's good. It's telling us, be careful, there's some there could be something dangerous. There's a potential risk here, yeah. So and and so that's as you say, stepping out into a busy street. A natural level of anxiety crossing a busy road is meeting a new person, even walking into a pub on your own. I mean, yeah, it it doesn't have to be anything uh uh uh huge and dramatic. Um but we are programmed uh to be anxious in unfamiliar situations with unfamiliar people in unfamiliar settings. So anxiety in that regard is a normal human emotion. So it's not like anxiety is the devil, and we are trying to eradicate that feeling from our lives. Indeed, as you discussed on the last episode, it's not about eradicating anyway, it's about existing with. Yeah. However, people don't usually come to counselling because they were nervous before they did their driving test or before they did an exam, because the anxiety feels better to them to be proportionate to the level of threat uh and also subsides. Yes. Um it's also worth saying that uh that sort of non-problematic anxiety, or I think what the psychologists would call adaptive anxiety. Adaptive. So that's you know, anxiety you can do something with. Yeah. Um it doesn't prevent them doing the thing that they intended to do. So, you know, I feel anxious for my driving test. It probably helped me focus on the task, it probably primed me to be responsive to what was going on, and it didn't stop me doing my driving test, and it went away afterwards. It was kind of helping you get ready, it was getting sorry, it's getting you kind of focused and notice this quite literally, is what the anxiety is telling you. Yeah, it's always useful to ask us what's that emotion telling me? Yeah. And so that's that's adaptive. Yeah, let's talk about non-adaptive anxiety. Maladaptive. Maladaptive. That's that's when people come to therapy typically. In a nutshell, that's when the anxiety is existing to a level that is inhibiting people's life experience. Yeah. It both has triggers, but also exists in a sort of non-anchored form. And actually, that's uh that's quite a useful description, I think, of that problematic anxiety. That non-anchored anxiety is really fear without an anchor is often the way people describe problematic anxiety. Yeah. Okay, so they will often come to therapy saying that uh their anxiety uh is stopping them doing things. Yeah. Maybe stopping them interacting with people, stopping them going to certain places, stopping them fulfilling things in their lives that they would like to do. Yes, it's also stopping them sleeping often, stopping them concentrating, stopping them relaxing and also stopping them being able to be present with any other experience because what they're focusing on all the time is the anxiety, and actually it's not just the anxiety, it's the fear of the anxiety as well. So the fear of it is the loop. Yeah, coming back, getting worse. And I think it's important the thing that really pops up there is the stopping, right? All of those things that are stopping, and what anxiety is telling you there could be something dangerous or something that you should be scared of. Yep. So the stopping is do less, don't expose yourself to any situation where you may feel uncomfortable. Which again, it's trying its best to help you. The idea is that anxiety is saying don't do that in case something bad happens. Okay, so this does come back to what we were talking about in the last podcast, which is that anxiety is telling you don't do that, avoid that. But unfortunately for us, our uh threat warning system doesn't distinguish between physical threat and psychological threat. So if your anxiety is telling you to avoid something physical, that's broadly speaking a good idea. So if you go and stand right at the edge of a crumbling cliff and feel pretty anxious about that, then yeah. Well done. Well done your anxiety, come away from the cliff. Yeah, I will talk about the bear in the woods. We are programmed through evolution to be scared of a bear in the woods, right? So uh of a physical threat. So if your anxiety is peaked because you're walking through some woods and you think there's a bear, that's right, because it's preparing you for fight or flight, which we will deal with at a later time. But that anxiety is real and it's as you say, based on a physical threat. Yeah, and encouraging you to avoid the bear, which avoid the bear. It's a good idea to avoid bears. So our system has been designed with that in mind. Yeah. And that's for I was talking about things in terms of mass. If if it's something that you can see or hear, it's a real thing that you're running away from what you asked a bear. Yeah, or like a cliff, something real. Yeah, something real. However, it hasn't no, hang on, let's be careful about the word real because people's fear of psychological threat is also real. Yes, it's real, but it's it's physical, I think. Yeah, physical, yeah, physical is better. If it has physical form, if it is a physical threat. That's what I mean. If there's something there. I just try to I try to avoid the word real in therapy because people's fear is real, yeah, it is real, of course. Yeah. Okay, so most of the threats to us in in modern life are psychological. Let's take the example of a large supermarket. Yeah. Large, busy supermarket. I'm not gonna name a particular supermarket. Are we going down the co-op route again? No, you now you've named a supermarket. I think I'm angling for co-op sponsors. Co-op supermarkets tend to be quite small. Yeah, okay. I'm talking about massive supermarket, busy, loads of people, kind of crammed in quite tightly together, up and down the aisles. Clients who struggle with anxiety are often scared of supermarkets. It comes up a lot. It's I guess because something you could do unless you get home delivery is pretty much forced to do. Yeah. Uh you know, on a regular basis, it brings you into close proximity with other people. You're sort of funneled into parts of the supermarket to get through the tills. Um, you feel that other people are looking at you, you feel it would be harder to get out if you needed to because you've got to go through the system of paying for your shopping. And does it look like I'm trying to steal something? Supermarkets come up a lot. Yeah. So this is a situation in which what your body will do is tell you to avoid the supermarket. Yeah. And that's what people tend to do. They find that their anxiety expands. So to start off with, they're frightened to go into the supermarket at busy times, yeah. Then they're frightened to go into certain parts of the supermarket, then they're frightened to go into the supermarket at all, so they go to smaller shops, then the anxiety expands again, and then they're frightened to go shopping at full stops. So when you avoid something, the anxiety tends to grow. Yes. And that's where the human brain has really been quite unkind to us in its kind of evolutionary process. That avoiding a physical threat is a good idea. Avoiding a psychological threat tends to make it worse. Yes, it makes the boogeyman bigger. It's the boogeyman bigger. I think you said last week what we resist persists. Yes. I would even add to that, what we resist grows. Grows. Yeah, yeah, that's it. Unfortunately, it doesn't rhyme. But no, sorry about that. But what we resist. I'm now trying to think of a winner. Let's not do that. Let's not go there. It's like you trying to rhyme experience last week. There are certain words. I've got this whole thing of trying to rhyme stuff. The unrhymable word podcast. But it is that thing what we resist, it grows because it becomes it becomes scarier. It becomes reinforced. Yeah. Let's talk about why that happens. So what happens if I go to the supermarket car park, feel uh very, very anxious. Or I'm going to use the word panicky at that point because people often talk about panic and anxiety interchange interchangeably, and I will come back and talk about anxiety slash panic in a minute. Yeah. But let's stay on this piece for now. If I'm in the car park of the supermarket and I'm experiencing very intense anxiety slash panic, and that leads me to come away to maybe get as far as sort of standing in the car park looking at the doors and thinking, nope, this is absolutely overwhelming. It feels like it's going to kill me. I'm going to get back in the car and go home. What I have done is given my brain evidence, that's how my brain interprets this, evidence that there is something to be frightened of. It was you were right to feel right. Feel anxious. Look at what happened, says your brain. You were so scared, that was so overwhelming, that was such an unbearable feeling that you had to come away. That means something bad is going to happen. And the net result of that is that we keep coming back to is that you're experiencing less of life because this is going to the supermarket, which may not, it's not like the most exciting thing you do in your in in your day or your world, but all of these things are life-limiting. Yeah. And so all of these things are reducing your experience of life. And a big part of tackling anxiety is we want to experience we want to expand into life. We want to have a fuller experience. Absolutely. Yes, nobody with anxiety wants their sort of horizons to be getting narrower and narrower. But that is what people notice. They feel like they can do less and less. Yeah. So what is actually happening is every time you avoid whatever it is because of your anxiety, your brain says, aha, see, there was something to be scared of. And we make a false connection in our head. What we decide is that I feel bad equals something bad is going to happen. And we are absolutely convinced that that equation is right. Yeah. We bond those concepts. Yes. What we're doing in psychotherapy is breaking that bond between I feel bad and something bad is going to happen. Because actually, it is possible to experience 10 out of 10 anxiety, full anxiety, and for nothing bad to happen. The equation is false. But your brain is not interested in being told. So by being told, I mean that critical negative voice that we've all we're all familiar with. Yeah. Just push through it. Just make yourself do it. Come on, why are you being so weak? Why are you being so stupid? Why are you being so irrational? Which is what we covered in the last episode. Yeah. Which is that idea of pushing these things away. Yeah. Again, it's a kind of your brain trying to do the best for you. It's going, don't do that, just stiff up a lip. Yeah. Your brain, however, isn't interested in being told. It's a think of it as a very cynical beast, your brain, not interested in chat. What your brain does respond to is evidence. Your brain needs evidence that it is possible for you to experience maximum anxiety and for nothing bad to happen. Yeah. Just because you think it's bad doesn't mean it's going to be bad. No. However, we are fully acknowledging that when you are standing in the car park of the supermarket experiencing 10 out of 10 anxiety, it it literally feels like you're going to die. That's how people describe extreme panic or extreme anxiety. It feels like you're going to die, like something really awful is about to happen with all the accompanying, impending doom type emotions. It's an extremely intense experience. And you know, this is stuff for the therapy room, but there's a reason for that. There's a reason that you are you have this anxiety. Something in your past will have taught you the lesson that some things are scary. Yep. A bad experience, or some kind of uh lesson or condition you've learned in in often in childhood. And also the wiring of the human brain. So your brain is wired to respond to its um threat system by avoiding. That's the only thing. Yes, in the quickest possible way as well. It's the only trick it has up its list. Yes, it is the only trick. It's like, well, it's again, it's the fight or flight, it's avoiding or fighting. And avoiding and anxiety are a really kind of key part of that. This episode is brought to you by forestcounselling.com. Are you struggling with thoughts, emotions, or behaviours that seem out of your control? Maybe you're experiencing anxiety, depression, trauma, low self-esteem, or issues with addiction. There could be conflict in your relationship that you feel you can't resolve. We can help. Contact us at forestcounselling.com where we offer face-to-face and online therapy. Okay, so the question then becomes right, so I'm standing in the supermarket car park. I am absolutely overwhelmed by anxiety/slash panic. I can't. I can't go in, I can't move, I feel sick, I think I'm gonna pass out. I'm certainly gonna make an exhibition of myself. Embarrassment is a big factor here as well. I just want to get away from this. I want to get where people can't see me, I want to get where I don't have to interact with anybody and where I feel safer, which is completely understandable. Yeah. But it isn't helpful because every time that happens, every time you come away from the anxiety, you are giving your brain more and more evidence that there is, in fact, an experience there that you will not be able to tolerate. That's what you're giving your brain. And we want to give it evidence. If you imagine that in the sort of negative side of the scales, what we want to do is put some evidence in the other side of the scales to kind of write this balance a bit. Yeah, okay, so the question is how do we do that? So how do we do that? Thank you. Okay, so uh how we do it broadly speaking is by approaching our anxiety rather than running away from it. And this comes back to what I was talking about in the last episode, which is that you know, the uh the way through something is often counterintuitive. It's and that's and it is that thing that we go that happens a lot in the therapy room where people come in and say, I've got this horrible thing, I want to avoid it. How do I stop? How do I stop feeling anxious? I want that to go away. Yeah. And what they invariably want is some technique to make it disappear. Yeah. And the can counterintuitive thing is what we need to do is the thing that you want to do the least, which is turn and walk towards it. Yeah, exactly that. So we want to approach our anxiety. We want to get closer to it, we want to be with it however, however. What we don't want to do is overwhelm people because that makes them more likely actually to avoid the experience. So, what we're trying to do is allow you to approach the anxiety, but we're titrating that so that you can approach it in manageable steps. And for uh listeners who may not know what titrating means, and even other podcasters or husbands who may not know what titrating is, could you please expand on that? Uh titration. Okay, so uh sounds like something from my uh no, I feel like I'm in the I'll put you on the spot. It does look like chemistry. I'm I'm imagining a pipette. Yeah, I could barely say pipette. Okay, titration is to do with the concentration of something. Okay. Okay, so we're let's think about the concentration of our anxiety. Yes, right. That's good, thank you. So yes, we don't have said that in the first place. Well, sorry, okay. We do not want the anxiety to be too concentrated initially, because you will feel overwhelmed. You will almost certainly come away from the experience, thus giving your brain more evidence that there is something to be scared of. Because the overwhelm is this is the fear. That the anxiety and the overwhelm that is as you said, it's the fear of anxiety. You don't care. This is an unbearable experience. This is gonna kill me, I'm gonna collapse, I'm gonna die. Right. We don't want you to avoid this experience. So we are titrating this and manipulating the concentration so that you experience your anxiety, yeah. But not too much. Yes, like experiencing it is uncomfortable, but to a level that is uh withstandable. Yeah. So there's I don't know why this is coming to my head, but this I'm gonna say this anyway. Go for it. David Bowie uses an analogy of of um there's a quizzical look. This is only an audio podcast. Stay with it, go on, David Bowie. Of this, of being outside your comfort zone when you're creating, right? And it's there's a fair this a this does correlate. If you're standing, if you're standing on your tiptoe, if you go into water and you're standing on tiptoes, you're just getting out of your comfort zone, but not too far, is is the analogy. So he talked about it in creative terms. So you go when you're in that space where you're just on your tiptoes in the water, yes, that's a place where you you feel like you've just got a foot, you're just about hanging on to it, and that's what we're kind of doing when we're experiencing anxiety. We can we don't want to go too far and feel like we're out of our depth and we're drowning because that's overwhelm. Oh, this analogy is really. I'd like I love thank you to David Bowie or you, like we both wrote space on the thing. So, but yes, standing in that space, and that's what we're doing with and we'll move on to exposure and experiential elements of this anxiety uh and how we deal with it. But that standing in that space, going how far can we go to be out of our comfort zone without feeling like we're drowning? Yeah, okay, so good good analogy, good analogy. Let's use a swimming pool analogy and for which we'll thank David Bowie or whoever came up with that. Absolutely. We would like to initially dip our toe in the water of anxiety. We do not want to jump in at the deep end. Yeah. Right. So how do we do that? How do we do that? Let's go back to the uh the supermarket, the anxiety-inducing massive supermarket. Yeah. I have driven to the supermarket, I am experiencing uh massive amounts of anxiety. What do I do first? What you do first, uh as is so often the case in psychotherapeutic interventions, is you notice, notice what's going on. And a useful way of doing that is to give your anxiety a rating. Yeah, uh percentage. If that uh means most to you, or a number out of ten for some people, is easier. So what are you experiencing? Are we talking about 90% anxiety, 95% anxiety? Where's it sitting for you? Yeah, as you approach the anxiety, uh notice uh how it changes and be as specific as you can possibly be, like a curious scientist. When you think about going to the supermarket, what happens to your anxiety? When you get in the car, put your shopping bags in the back to go to the supermarket, it probably goes up. Where does it go up to? When you pull up in the car park and choose your parking space, where's your anxiety now? As you get out of the car and you're looking at the front of the supermarket, now where's your anxiety? The more specific and sort of plotting a graph like you can be about it, the better. And then what we want to do is do something, and it can be something really small to push your anxiety slightly up from the point that you would normally avoid. So if what normally happens is you pull up in the car park and then drive away again, pull up in the car park, get out of your car, go and stand in front of the supermarket, notice where your anxiety goes up to, and then come away. Yeah. And that's that is the counterintuitive walk towards it in an actual that is literally walking together. But yeah. But that and that works, that idea of going, I'm at a nine or I'm at an eight. Let's say I'm at an eight in a car. Yeah, in it. I've got to get out of the car, get my bags out of the boot, and walk, walk to the front entrance. The front entrance. And I and as part of that, I know I'm not going in. Yeah. So there's so there's an element of the safety there. Yeah. But I know I'm not going in, but walking up to it, I'm getting the anxiety's increasing. And then I walk away, and what I have learnt by not avoiding, so the avoiding avoiding reinforces the anxiety and makes it grow. By not avoiding, I have survived. Yes, you have. And so my brain has now been shown precisely through behaviour, through experience, yes, that walking up to the front of Tesco's didn't kill me. And also that it is possible because you're not oh, you said Tesco's. Yeah, I know. I was just going to We were keeping specific okay, Tesco's. Sorry, Tesco's. Okay. Other supermarkets are supermarkets. I say that like that's a thing. Like, yeah, we all know other supermarkets are available, we're not. No, no. I was gonna say other supermarkets are just as frightening. Yeah. Um so uh okay, uh because actually we are not avoiding Tesco's. What we are doing is avoiding anxiety. So what that actually not avoiding anxiety but what that experiment has shown us is that it is possible for me to experience more anxiety than I thought I could, and for nothing bad to happen. That's the crucial part. Yeah. We are breaking that bond between I feel bad and something bad is going to happen. And that's so crucial. I feel bad and something bad is gonna happen is is the knot at the heart of this. Yes, it is. It's the the feeling is tied to what is actually happening or is going to happen. And so loosening that knot again, I can feel and I and again validating that experience, I can feel awful, but that doesn't mean that something bad is going to happen to me. No, exactly. And yeah, we're absolutely validating uh the awfulness of anxiety, it's a horrendous feeling. And as I said, people do feel uh when experiencing extreme anxiety as though they're going to die. I wonder if this is a good point uh to talk about the difference or similarity between anxiety and panic, because definitely is that a good point? People use the phrases uh interchangeably. Uh panic is usually categorized as something which occurs very suddenly. So it it kind of comes out of nowhere. Yeah. A big panic attack. Uh anxiety is more usually described as something that builds or is or or is ever present. Yeah. Uh however, when people are talking about a very intense uh high level of anxiety, they will often use the words anxiety and panic interchangeably. Yeah. And so in the UK, we we're not as as worried about that really. I just let clients use the phrase that means something to them. Yeah, and there is and there is, you know, we get into the semantics of the definitions of the two things, but having anxiety can produce panic attacks. Yeah. Yeah. Uh during a and so I'm just going to use anxiety attack and panic attack interchangeably because clients often do. Yeah. But when people are talking about panic or severe anxiety, they will describe feelings of intense impending doom. A feeling that they are imminently going to uh collapse or possibly die. Yeah. Very, very intense physical symptoms. So um outracing heart, intense flushing and heat, weakness in their limbs, dizziness, ringing in their ears. So these are extremely intense physical symptoms. Yeah. And those physical symptoms are a manifestation of bodies can use some incredibly sophisticated methods to try and deter death-like symptoms to try and convince you. Yeah, because your body's good at this. I mean, your body is very good at at getting you away from danger. Yeah. Because feeling that way, I mean, why would you not avoid that feeling? It makes absolute sense. So we are totally validating people with anxiety who avoid things because how would you not want to avoid that feeling? Yeah, and possibly in another podcast on anxiety, because it definitely deserves more than one podcast. We can talk about the the thoughts that go with this as well. We're talking mainly about um somatic, i.e., physical experiencing at the moment. But there's all sorts of thoughts that also prop this up. Yeah. Okay, so I am in the supermarket car park, I am feeling eight out of ten anxiety. Yeah. I go up to the door of the supermarket experience nine out of ten, I've now got lots of physical symptoms of the kind I was just discussing going on. And that feels like enough. So I go and get back in my car and go home. However, what I have done is given my brain evidence that it is possible for me to experience higher levels of anxiety than I thought I could tolerate and for nothing bad to happen. I have survived. I have survived. And your brain is telling you you won't survive at its core, at its root. You've given your brain evidence that this is not the case. Yeah. Okay. This is very much the first step on this journey. Yeah. And and I should also add that for some people, their anxiety has been so life-limiting that even leaving the house is difficult or impossible. I've got lots of clients who couldn't put the bins out, for example, because that involves leaving the house. So this is all about meeting you where you are. Always. And that's always the case in good therapy, is always about meeting the client where they are, because where they are is is going back to the word real is absolutely real. It is real to them. And the good news is that however much your anxiety has has limited your life, however much it's restricted it, there is always work we can do. Yeah. Yes. So it might be, and I've done this with clients, that going and standing outside your front door with your back resting against your front door for 30 seconds, yeah, pushes your anxiety up to a nine and a half out of ten. If that's the case, that's absolutely fine. Do that. Yeah. Do that. Yeah. And well done for doing that because it's scary. Yeah, because it's terrifying. All of those um symptoms that we were talking about just now, those awful symptoms, are probably going to be going on. Yeah. If we kind of set an experiment, I think that's a CBT term, isn't it? They like experiments. People might recognise this as some CBT techniques. C Bt kind of behavioural, how your behaviours are linked to your thoughts and feelings. Thoughts and feelings. And so this is the start that I would, you know, again to expand out, there are there are deeper routes that we go into down the line. But in terms of your the starting point and addressing anxiety, this behavioural technique is the starting point to address bringing some relief into your life. Absolutely. And I think that's a very good point to make. Often in therapy, we are working on two tracks. So we are working on coping in the here and now. What's going to happen when I try and go shopping tomorrow? Yeah. But as you absolutely rightly say, that will have roots. So we will also frequently be working in the past. We will be working on things that have happened to you that have distressed you, traumatized you, things that happened in your childhood. So we're kind of working on two tracks. We're working at the sort of the what's at the bottom of the well, but we're also working on, you know, what what does this mean in my life now? Yeah. And I guess that this anxiety approach work that we're talking about is is the is on the in the how do I cope in my life now. Yeah. And so that to go back to that experiential or exposure therapy, expose yourself to the thing that is scary. But titrate it. So titrate it. Just a bit. Just a bit. Just do a bit more than you want to. If you wanted to use, you know, people who are into their kind of weightlifting and their physical exercise, do one extra rep. Yeah. Yeah, yeah. Just one. Yeah. Not ten, one. Yes. You don't want to injure yourself. No, you don't want to injure yourself. You don't want to push it too hard, but you do want to make some gains. Make some gains. Thank you. Well done. That's good, isn't it? That's very good. And and sorry, to go back to our CBT uh, you know, to talking about this being CBT worker, the CBT therapist will often talk about experiments, behavior experiments. So if you set yourself a goal, for example, you know, like we said, getting out of your car and just going and looking at a supermarket, or whether that's just being able to go and stand outside your front door, whatever the goal is. If you set yourself a goal, possibly with your therapist, with your counsellor, and you don't manage it, it doesn't mean you've done something wrong. It means the goal was wrong. Yes, that's a really, really good point. Because we don't want too high. We don't want to build failure into this. Because failure will feel like a reinforcement of anxiety wins in that in that fight. Yeah, absolutely. So if the experiment doesn't work, it means that the bar was in the wrong place. It doesn't mean you've done it wrong, and we will move the bar. Yeah. Yeah. Yeah, that's that's so key because it's work again, working at the client's pace. Yeah. And we talk a lot about trying things, and if they don't work, it's because we've chosen the wrong thing. It's not that the that the client's done anything wrong. And that kind of calibration or titration that that goes, right, this is this thing is scary for you, and that's and that's absolutely fair that this is scary for you. There are reasons this is scary for you. And now we want to work on taking addressing that fear, but the level at which we address it has to be a bit uncomfortable. We have to be on our tiptoes in the water, but if it's too uncomfortable, that's not going to help us. That's gonna that's just gonna reinforce this fear. So finding that level is the work. Absolutely right, absolutely right, and that often takes a bit of time. It's very individual to the client, it depends how their anxiety is manifesting in their lives. So that takes some exploration. But what people do find is that when this begins to work for them, it really works. Yeah, yeah. And I mean, I have seen phenomenal changes in people, phenomenal people who couldn't leave the house, yeah, who have gone back to work, who have maybe gone into some additional training, who have started doing classes, who have started interacting with people in a way that they never thought they could before. Yeah. I get and that's uh another important part of this. The validation of that feeling is one side of these scales, but the hope and possibility of that going away is the other side of this of these scales. And so, as you say, once you start to slay that dragon or that thing starts to get smaller, it's like, well, if it can get a little bit smaller, it can get a lot smaller. That's right, yeah. Once you once your brain starts to get this idea, a sort of taste for the evidence in the other side of the scales, then it's a little bit more confident. Like, well, I've done this before and it did work, so I'm gonna do this again. And and actually what you find is when clients start to get into this work, they will start setting their own, their own anxiety approach experiments. So they'll come into a session and say, Oh, I've booked a workout class or I have looked at college courses online, or so they'll start to do those things on their own. To to start off with it will often be you leading the anxiety approach work, so kind of maybe making some suggestions and them being quite hesitant. And the more confidence they get in the work and the fact that the work works, yeah, the more they'll start picking up that ban and running with it. But people people make amazing progress on anxiety. And like we said, the anxiety approach work isn't the only anxiety work that we'll be doing. But this is a good it's a good starting point. I I guess it's looking at a real feeling, it's really experienced and really validating that experience, and then it's moving towards it and then it's realizing it won't kill you. Yeah, so what we're not doing at any point is trying to get rid of the anxiety. No. That's not a thing, as we said last week. But what we are doing is leaning into it for just a bit. Yeah, and it's uh just to go back to that thing of once we start that work, sometimes people kind of leap on that, and in its own way, that's the brain kind of taking credit for that. It's going, Oh, look like we could do more of this. Told you, because it's got experience now. Yeah, absolutely. The key thing of moving towards the anxiety or the difficult feelings or the difficult emotions is a big part of the work. Yeah. But if there's like one big takeaway, is that anxiety won't kill you. Is that your 10-second takeaway? No, that was almost a 10, that was almost in 10 seconds. But yeah, but anxiety won't kill you, I think it's such a key fundamental because anxiety is telling you it will this thing will kill you. And it won't feeling those feelings are awful and can be uh horrific for people, but it won't kill you. No. And so if in the interests of giving our listeners something to do, if they, you know, pe it's uh almost certain that uh somebody listening to this either is struggling with anxiety themselves or has somebody close to them who is struggling in that way. So what you can do, first step, notice become the the mapper of your anxiety. Yeah. So start to look at in this situation, you know, what percentage is it or what is it out of ten. Yeah. So start to notice that's the first the first uh step, if you like, on this path. Yeah. Good. Oh, I thought it was a list there, but there you're just going that's the table. It's first. No, no, first, I'm just I'm just giving the thing you can do. Here's the here's the 34 things here's the thought 34 things you have to do. Here's a massively anxiety-inducing list of stuff that you absolutely must do in the next 24 hours. No, one step, one simple thing you can do. One step at a time. Yep. Um, well, great. Anxiety, right? So we're we were we started a format last week. Yes. Of going, well, let's do two things, and and then we when we started just before we started recording today, we we said, well, let's start with anxiety. But that is a big one. And I think that's been shown that today, today we'll just stop at anxiety. Anxiety is it's a huge one. It is a huge one, and and the more you talk about it, the the kind of more doors it opens, and the more sort of avenues there are to pursue. So I guess it's uh we're trying to acknowledge the enormity of this issue for people whilst trying to keep a some boundaries around. Yes, and the more you talk about it, right? Then let's go back to the more you talk about it, that's talking therapy. The more the more that this stuff is builds up inside you and you don't talk about it, the more it it kind of dominates because it becomes the sole voice. Yeah. So having another voice to talk to about that is a big part of dispelling that hold that that anxiety gets on us. Like all of us, the act of talking about it puts a puts a pin in that balloon of anxiety. Yeah. Well maybe not a pin in the balloon, that's too much, but it lets a bit of air out of it. Yeah, and and for people to discover and feel that this is valid. This is valid, this is this is absolutely explainable. The things that have been happening to them do not mean that they are weak or mad or losing the plot. They're explainable. Yeah. They are explainable, they are a common experience. I mean, the thing about anxiety is people imagine that they are the only person experiencing it, and that everybody else walking around out there is supremely confident and completely in control. And they, you know, we all experience anxiety, and yet all of our experiences are unique. Yeah. Oh, you like that. I'm stopping now. I was gonna say you like that bit. Let's stop there. Well, no, thank you for listening. So that's anxiety. That's the start of that chat about anxiety. I hope that's been helpful. But do get in touch, let us know what your experience is, let us know what your thoughts are, let us know what else you'd like us to cover. Yeah, or if you've been through that and you've had a particular way that you dealt with anxiety, that's all's really good because again, people often bring things into the room and they go, Well, I did this. And you go, Wow, that haven't thought of that before. That's amazing. You know, it becomes part of the the toolkit that we can all use. So if you've if you've found a way through your anxiety, yeah, please share it with us. And actually, I would like to do a podcast talking about uh, as we were earlier, about the uh fight flight uh freeze response. I would like to do a podcast. Are you gonna list all the podcasts you want to do? No, but just when you were inviting people to talk about what works for them. Yeah. So uh there are several techniques for calming uh your nervous system, particularly to do with certain breath techniques. And I think it would be really useful. Well, we could do a little special of that. Maybe not a whole you know, or we could do a whole podcast, or we could do a little thing where we just go, why don't we do a little one where we go, here's some breathing techniques. Some useful nervous system calming techniques, but we'd be really interested to hear from listeners who've got their own, because there are lots and lots. Um, but but not just breathing techniques, you know, whatever whatever works for you in terms of uh anxiety, we'd like to know. Yeah. Well, that's us. Yes, it is. That's still us. Uh Dempsey and Mate piece. The Dempsey and Mate piece of couples counselling. That's oh that's if we're branding. So I mean, who's I've got who's who, but I have to be Dempsey because he's the guy, right? Is he? I don't know. It's been a long time. She had nice hair. Glennis Barber. Glennis Barber. Yeah, she had good hair. That's all I remember about Dempsey and Mate piece. And and if you're listening, Glennis Barber, do get in touch. Yeah. Um I don't know what way to end the podcast. Uh thanks for listening, everybody. Uh, I will speak to you again next time. Okay. Goodbye. See you next time. Bye.