Anxiety Disorders - Primary vs Secondary Fear (Episode 83)

SPEAKER_01 0:01

And they have the initial fear, that initial like shock or whatever, startle, whatever you want to call it. And then they think that's a problem.

SPEAKER_03 0:08

You're allowed the that's not something we fix, we need that. But it's the subsequent behaviors and feelings towards it.

SPEAKER_01 0:16

Really, it was the expression of the secondary fear that mattered. What did I do when I was afraid that I was disintegrating because I was depersonalized?

SPEAKER_03 0:25

You can't speak to it. It is not wired that way. It is only wired one way.

SPEAKER_01 0:28

So, like, I'm expecting frantic action and movement and escape, says the amygdala, but I'm getting stillness.

SPEAKER_03 0:35

What you can do is play charades with it and be like, okay, well, you can say and send me all these signals, but I'm this is what I'm gonna send back to you. Yeah. Which is nothing.

SPEAKER_01 0:52

Welcome to Disordered. This is episode 83 of the podcast. Today we're talking about secondary fear, specifically primary fear and anxiety disorders versus secondary fear and anxiety disorders. It's gonna be good. I'm Drew Linsalata. I am a therapist practicing under supervision in the state of New York, specializing in the treatment of anxiety and anxiety disorders. I am a three-time author on this topic. I'm a social media dude, an advocate, an educator, a former sufferer of anxiety disorders, depression, and OCD for many years on and off, but doing better now. And I am joined by my esteemed co-host from the UK. Introduce yourself, Josh, if you could stop bouncing on your bosu ball long enough.

SPEAKER_03 1:28

Yeah, hi, I'm Josh.

SPEAKER_01 1:31

Josh is bouncing around on his exercise ball as we record it. I'm loving every minute of it.

SPEAKER_03 1:35

I'm Joshua Fletcher, also known as Anxiety Josh on social media. I'm a therapist specializing in anxiety and anxiety disorders based in the UK, author of several books, co-host of his podcast, previous sufferer, although quite anxious today because I've got a dentist appointment coming up in a couple of days, and I am worried about it. Just don't not be afraid of panic attacks. I'm afraid of like them like hitting a nerve or something, and I get a bit scared, but that's okay because that's not secondary fear, that's a primary fear.

SPEAKER_01 2:06

Yeah, why wouldn't you be afraid? I don't want that to happen either. Hell, I don't want it to happen to you, and it's not even my teeth.

SPEAKER_03 2:11

So I know a lot of people that want that happening to me. Yeah, probably right.

SPEAKER_01 2:15

I probably know the same people. Jamie in there, you're right. It is nerve. Get him. So, what's the difference? Primary fear versus secondary fear, and why does it matter? What do you think?

SPEAKER_03 2:25

Really important. It's uh a concept that I read in um Marty C. Sally Winston's work, and you see it in other kind of third-wave CBT people. It's like this episode's for people who get really disappointed when they get anxious, or get anxious, oh, I'm doing something wrong. Well, not really, because you could you don't get rid of anxiety. Recovering from an anxiety disorder is kind of getting rid of secondary fear, or like you said in the past, Drew, the gap, the time difference between the oh my god, to the hour well, oh well, whatever. Uh, secondary fear is what kind of defines a lot of anxiety disorders, whether it's panic disorder, agrophobia, OCD. I'm afraid of how I'll feel. I'm not only am I getting anxious, I'm afraid and I'm misinterpreting that anxiety and what that means. Yeah, secondary fear.

SPEAKER_01 3:24

Secondary fear is where you are that's the fear of fear. I am afraid of not the thing, the dentist. Yeah, I'm afraid of the dentist, but I'm also afraid of how I feel. How I the state itself is the problem. That's secondary fear.

SPEAKER_03 3:36

Yeah, fear and misinterpretation of it though, so as well. So, like, yeah, for a lot with panic disorder, I'm afraid of panic attacks, I'm afraid of getting anxious. That's secondary fear. But then a lot of people like, oh no, I'm I I don't like how I feel, I'm afraid of my thoughts that are happening during it. Yep, because I'm misinterpreting what this means. And yeah, and that and then and if you fall, if you're one of those two, we're gonna look at, I mean, ultimately anxiety recovery, Drew. I don't know if you agree with this, is turning off secondary fear.

SPEAKER_01 4:06

Oh, yeah, I I would I would agree a hundred percent. It, you know, and a lot of times people get a little bit upset because down the road they'll say, like, oh, I'm 90% recovered, which is awesome. And then maybe they'll have something comes up and they have the initial fear, that initial like like shock or whatever, startle, whatever you want to call it. And then they think that's a problem. Like, oh well, but how do you stop that? You don't, you never stop that. If something scares us, we need that to happen. Because if you're legitimately in trouble, you need that response. So it's okay to once in a while, even as a recovered person happens to me, right? It can happen, I'm sure it can happen to you. I'll still have the initial, like, uh-oh. But but then the secondary fear isn't there. And I think the secondary fear also do is has to do with the meaning you make from the like non-anxious people might say, Oh, I hate feeling this way. You know, I oh, I hate when I have to do public speaking because I get super anxious and I almost panic and I hate that, but they don't make any extra meaning of it other than what it is, which is I'm terrified to speak in front of a crowd or whatever it is, and I I know why this is happening and I don't like it, but okay, I'm do the best I can with it. That that's what they get.

SPEAKER_03 5:11

So yeah, and that's but and and I think a lot of people fall into the trap of any sign of anxiety or intrusive thought. I'm doing something wrong, and then I you know enact the inwards compulsion, I give it all my attention, and I get pulled into compulsions and rumination and trying to fix, etc. Which subsequently fuels secondary fear. So the first piece of massive integral mandatory advice for this episode is like Drew said, You're allowed the just what you do afterwards. That's not something we fix, we need that, but it's the the subsequent behaviors and feelings towards it.

SPEAKER_01 5:52

Yeah, and I think this the secondary fear episode, and by the way, like shout out to Claire Weeks, because she did first fear, second fear too. And I know a lot of people listening to us would listen to, you know, heard read her work or listened to the audiobooks. She said first fear, second fear. And I think one of the things that's important is I work with people who are well down the road, and then maybe they go through a really stressful moment in their lives, like they lose a loved one or something big is happening in their relationship or something, and they start to feel stressed, and they immediately start to try to figure out why they're not recovered anymore. But I think secondary fear speaks to like not every expression of anxiety and fear is an anxiety disorder problem. Not sometimes it's just a stress expression, or you are anxious about something. And I'm like, well, are you freaking out over this? Are you did you run back home and lay in bed for three weeks? No. Okay, well, then you have a you have a life problem right now. You don't have an anxiety disorder problem, and that's the absence of second fear. That's when anxiety becomes regular again, if you will.

SPEAKER_03 6:48

Yeah, this did this ties in nicely with uh resensitization, desensitization episode, in the sense that desensitization is oh, look, I've got fear of secondary fearing. I'm getting secondary fear, maybe my stress jug overflowed. Refer to the last episode, really enjoyed that one. Yep. Uh, and I'm resensitized again. And I know I'm resensitized because I'm noticing that I'm avoiding, scanning, monitoring for that fear that I got so good at tolerating, or or I was okay leaning into that uncertainty. Now it's become my modus operandi. I must have built my life around it, and that's when you know that you've you you're fueling secondary fear. Yeah, whereas a nice kind of response to it is just yeah, I'm I'm sensitized, my stress resensitized, maybe my stress drugs overflowed. Uh, I'm just gonna have to take it. I'm gonna, whatever it is, I'm gonna do, I'm gonna have to go there and be anxious. I know I I didn't feel like this last week or several years ago, but but I'm just gonna have to be willing to do that, and hence why we talk about willful tolerance, etc. But yeah, yeah, it's that secondary fear, that fear of fear. It's what makes you feel isolated when someone says to you, I have anxiety, and they explain all conventional anxiety, and you're like, actually, I don't really struggle with that. My fear is very much what if I freak out, lose my mind, or whatever in this situation.

SPEAKER_01 8:13

Yeah, and I think um, and we'll get we'll do a dead end anyway, too, I think, next, because it speaks to the primary fear and not adding the secondary fear. And I think part of it is that's where when if you can eliminate the secondary fear, which I agree, that's really the definition of recovery. Now that conventional wellness advice starts to enter the picture. And so your friend who says, I have anxiety, and they tell you about their, you know, the chamomile tea, and they and they make sure they listen to comic movies music every night, and you're thinking, like, go to hell, dude, because that is like bullets off a Superman for me. Like, and you can't relate to it, or you're like, well, they don't really have anxiety. Well, no, no, they just don't have the secondary fear. That's that's the difference, and that's why those folks can use that stuff a little more productively, if you will. So let's do a uh community thing. Let's do a did it anyway because this speaks to like primary fear. So I'm gonna read it, but I got music too. We got all the stuff today.

SPEAKER_04 9:06

Yeah.

SPEAKER_01 9:08

So this person did not give us permission to use their name, but he says, Hello guys, first of all, I want to say thank you for everything that you guys are doing. I just recently found the Anxious Truth broadcast, and now this one, and I've been stuck about four years now with all of this, and I never worked on getting out of bed. I would just lay in bed from three to one the next day, and now I'm out of bed at night. And today I had what was probably one of my biggest fears happen. We were at a drive-thru uh in the Burger King, which is uh US fast food, uh, and they never go fast, and I was stuck there. My mom was with me, but it was very stressful because I haven't been getting out as much. So I I remembered, here's the good part I remembered to let my anxious body do what an anxious body needs to do and what my anxious brain needed to do. And I just listened to the music, talked to my mom, and felt the anxiety and just let it happen. And by the time we got our food, it was not just a victory, and not only did it feel better, but after that we continued to drive around town for another half hour, which is quite long for me. Before this, I wasn't out for more than maybe 15 minutes. Today is overall about an hour and 15 minutes. Wow, that's awesome, right? Great job.

SPEAKER_03 10:16

Where's where's the studio audience?

SPEAKER_01 10:19

I'll tell you what the problem here is. The problem is this.

SPEAKER_03 10:23

There, there we go.

SPEAKER_01 10:24

There you go. There you go. Great job by the uh did it anyway sender inner. And that is a first.

SPEAKER_03 10:35

Such an Americanized view of things, isn't it?

SPEAKER_01 10:38

Yeah, we just assume that we that you don't have that.

SPEAKER_03 10:40

Yeah, no, we've got a burger. It's all right. It's okay. Yeah, if you don't have to be.

SPEAKER_01 10:49

Okay, fries. That's okay.

SPEAKER_03 10:51

I I we I also say fries, but chips being very conventionally brushed. Where's that rule button your button? Never mind.

SPEAKER_01 10:58

I haven't, it's in here somewhere.

SPEAKER_03 10:59

Do you?

SPEAKER_01 10:59

Yeah, I just don't know where it is. Here's what I love about this did it anyway. It speaks to primary and secondary fears. So, like when he says, I let my body do, and I can see he listens to my other podcasts because I know that's where he got that. Let my I let my body do what anxious bodies do, and I didn't interfere with it. That's the primary fear that's gonna happen. That's chemistry. We cannot de-engineer that out of being human. And so he was able to recognize it and like, oh yeah, this is happening. Now I have to let this happen. Very well done.

SPEAKER_03 11:33

Yeah, and he dropped the resistance from that second that originates from that secondary fear. Like, oh no, I hope I don't get anxious in the drive-thru. I feel trapped, or I don't like driving around my town. And no, you you addressed the fear, which is the secondary fear, which is I'm gonna allow my body, my anxious body to do what anxious bodies do. Yep. Perfect. Well done.

SPEAKER_01 11:52

Yeah, very good. Thanks for sending in and appreciate it. Speaks also to the what did we do? Shock, shock, fear, resistance. That was another episode we did just recently. Same thing. The shock is the first fear. Yeah, yeah. Uh, and then it's dropping the resistance, which means not adding the second fear. How did you do that? What was your second? What does your second fear look like?

SPEAKER_03 12:12

My second fear was always along the lines of misinterpreting and fearing the uncertainty. So, I mean, I've had lots of secondary fear. So sometimes it was I don't want to be anxious because I don't like DPDR. I don't want to be anxious because I don't like racing thoughts and I can't concentrate and can and converse with people. For many years, it was what if this feeling means I'm going crazy? And so I didn't like feeling anxious. And then the secondary fear was I hate feeling anxious because I feel like I'm gonna go crazy. Uh, I thought I was gonna have a heart attack or something like that. Maybe I'd the secondary fear. This is why I always say the fear of and misinterpretation of what was happening, because as we know, anxiety can manifest very physically, and a lot of people can fixate and obsess about that. Yeah. Um, but yeah, in general, yeah, the secondary fear was I just don't I hope I don't feel that way in that situation.

SPEAKER_01 13:17

You know what I think is as you're talking, it's dawning on me like, okay, well, what would what did my secondary fear look like? Same, same fears, right? Uh I didn't have the going crazy fear, but I did have the slipping away when I would get DPDR. This means I'm disintegrating. I still cannot tell you what that actually means, but that's what I was worried about back then. And I think the secondary fear is not so much, well, I thought that. I thought that I might have a heart attack. I thought you can't not have a thought, right? We cannot decide to not think things. And you can't just decide tomorrow, like, okay, cool, I'm just gonna turn off that secondary fear. Really, it was the expression of the secondary fear that mattered. What did I do when I was afraid that I was disintegrating because I was depersonalized? I can't just decide to not be afraid of that. But the secondary fear was perpetuated by what I did in response to the secondary fear. Frantically count the bumps on the steering wheel, open the car window in January and get 10 degree Fahrenheit, you know, air in my face, turn up the radio, try to sing along, count backwards from 100 by threes to make sure I was still intact. That was the expression of secondary fear. That's probably what we care about more than the fear itself. What did you what do you do with that secondary fear?

SPEAKER_03 14:26

Yeah, yeah. It's like when you it's the prolonged period of your own behavior. Yes, yes, after the oh, that's it. It's like the secondary fear is and bear in mind recovery is you know, teaching the amygdala to shut up. Keeps firing off, keeps misfiring, and we're telling it to shut up, but we can't do that instantaneously. We show it with repetition and commitment, yeah, uh, and being brave over time. And so, yeah, and narrowing the gap in time between oh my god, to uh well, but it's defined by the behavior in that time. So my secondary fear would be immediately my attention would go inwards and I just threat monitor. To be honest, threat monitoring is probably the number one compulsion for me when I was anxious. That was the epitome of my secondary fear. Yeah, was like I was enjoying this, I was enjoying the sport, I was enjoying this day out, this walk, and now my attention has gone inwards. The inwards compulsion is there. I'm threat monitoring, scanning, checking. That is secondary fear epitomized, mine anyway.

SPEAKER_01 15:39

Yeah, all right. So for me, the the frantic checking the bumps and the all that stuff, or I would be poking and prodding and like you know, pulling in my ear and like doing all kinds of like ticks and different that ticks the way you would define it in an official diagnosis. But like I had a lot of body language that was resistant body language. I was trying to wiggle away from the feeling and get away from it and stop it and distract from it. And in the end, people would say, Well, I but I can't, I can't believe that it's just anxiety. I still have that secondary feeling. Yeah, okay, no problem. But in that moment, what I had to do was take the risk of like, no, no, I'm gonna put my hands down. Once I became aware that I was doing all the poking and prodding and then playing with my shirt and doing all kinds of stuff, that's when I recognized, oh, I got to put my hands down, or I just have to keep my hands when I was driving on the steering wheel. Like my job is to, even though I really, really want to play with my shirt and poke and pull on my ear and all do all that stuff, I'm just gonna have to keep my hands on the steering wheel. So I would get rid of the secondary fear behaviors little by little, and over time the secondary fear starts to come down because the lesson that I fed down to this guy was that we were okay. Like we're okay. I couldn't tell it to shut up, I had to show it that it was okay to shut up.

SPEAKER_03 16:49

So important you show it, yeah, you know, because it is watching your performance.

SPEAKER_01 16:55

That's you know, yes, that's so good. It is watching the performance, that's how it gets its its its info.

SPEAKER_03 17:00

Yeah, so when you're sat there replicating what non-anxious you would do with two hands on the wheel driving, minimizing compulsions, sitting with that secondary fear and the primary fear, yeah. Um, for ages you probably were in a in a cycle of doing the same thing, resisting the window down, poking, prodding, sweating, water, etc. Amegdla's watching, it's going, you're clearly not safe if you're behaving like that.

SPEAKER_01 17:29

Yeah, it's interesting too. I wouldn't get too nerdy. I'm gonna do on my other podcast and do that this week expectations and that predictive processing model, but there's proprioceptive data that's like, what is your body doing? What is your position in space and time that goes into that generation of subjective experience and the amygdala is watching? What are you doing? Are you are you quiet? Like, so if amygdala is expecting frantic and running and fighting and movement, and you're giving it nothing, stillness, then there's a conflict in the model there, and it has to adjust.

SPEAKER_03 17:59

Because uh you're playing charades with your amygdala because you can't speak. That's the rule of charades is you're not allowed to speak, yeah. And it's the same communication with the amygdala, you can't speak to it, it is not wired that way, it is only wired one way, so it can trash talk you and send you voice notes about your mum and your girlfriend and all these things and insult you and things like that, and you can't respond to it because it's horrible, it's a bully. So, what you can do is play charades with it and be like, okay, well, you can say and send me all these signals, but I'm gonna this is what I'm gonna send back to you, yeah.

SPEAKER_01 18:35

Which is nothing forward, sounds like yeah, that is so good.

SPEAKER_03 18:46

The blank of the blank fellowship of the blank. I don't know. I I I I don't know. I'm stuck.

SPEAKER_01 18:52

And in a way, uh this is so good. See, this charades thing, that's brilliant, dude. Like that was where if you're listening, that was I just came up with it then because of what we're talking about.

SPEAKER_03 18:59

Yeah, you're playing charades with your McDonald's. That's exactly it with your behaviors and actions, what you want it to do.

SPEAKER_01 19:05

I think more than anything else, you're showing it and you are forcing it to interpret the it has to solve the puzzle. So, like, I'm expecting frantic action and movement and escape, says the McDubble, but I'm getting stillness. Like, I gotta, I gotta reconcile the difference here. Like, I have to modify the model of expectation that I'm putting forth here. I expect movement, I'm getting stillness. What does that mean? Well, it means there's no threat. So over time it recognizes, like, oh, that's not a threat, which means the initial thought or the initial first fear is not itself a threat. Now I can stop and say, Well, wait, is something actually going on? No, it's not. Okay, well, my heart's gonna pound for a minute or two because I had some first fear, and now we're moving on with our day. Charades, play charades with your so good.

SPEAKER_03 19:50

Yeah, the initial all right, that's my call to perform.

SPEAKER_01 19:54

I'm just right.

SPEAKER_03 19:55

So it feels like instinctually, like, oh, I need to avoid, I need to seek reassurance, safety behaviors, I need to do everything to resist this feeling. The initial adrenal dump is a call to perform, and your challenge, yeah, is literally to behave like non-anxious you would do despite all that threat. And the more you do that, it is literally fake it till you make it, but not you're not really faking it. Some of you feel like you're faking it because it feels dangerous too, but non-anxious you is saying, actually, not this is what I want for future me. Yeah, so so I'm not really faking it, it just feels like I'm faking it and acting, performing, and playing charades now because I want to teach my brain, I don't want to live with this secondary fear. Look, I'll show you. What? Yeah, I am gonna I am willing to have palpitations when I'm driving. Yeah, I am willing to have those scary thoughts when I'm in a work meeting. Yeah, I'm willing to sit with my partner despite having relationship OCD and doubts. I'm gonna I'm gonna do that and show you. Yeah, you know, it's good. I'm tired of the secondary fear, it's what's dictating my life.

SPEAKER_01 21:02

You know, fake it till you make it is true, and act like you want to feel is another one of those silly things that you like you gotta act like you want to, you gotta act like you want to feel, like you can't decide to feel a certain way. First, act that way, and the feeling and should come along on the back end of that. You gotta be patient, but remember it's not the first, like, oh my god, I had that startle. Oh my god, and it might be a physical sensation or it might be a thought. You know, a thought might trigger that initial. That's okay. Don't do you can't be focused on like I gotta try and stop that. No, we don't care about the first 30 seconds or first minute. I care about all the minutes after that. So if I'm working with the client, I don't care about the first minute, I care what you do after that. Forget the first minute.

SPEAKER_03 21:42

It's so important, yeah. Yeah, it's so important. Yeah, it doesn't matter. You're not failing, yeah. You are gonna be a bit startled, and you're not gonna be like I mean like do things immediately. No, and also like aim for like don't aim to be perfectionistic with it. You are gonna compulse, you are gonna threat monitor, yeah, but you're if you can. Lower that by like 80%, you're winning.

SPEAKER_01 22:02

It's huge. And then what happens is that's that shortening of the time distance between oh my God and oh well. So like oh well is when okay, I would feel depersonalized, but I would put my hands on the steering wheel and try and relax my body and just let myself feel that. That was the oh well moment. And it would never come, and then it started coming sooner and sooner and sooner after the oh oh my god, OMJ to oh well. But I I think the thing that's so important is people would say, Yeah, but am I always so I'm just gonna be on a hair trigger all the time and I have to keep doing that? Well, not really, because the only way to kind of bring that first fear back to its regular place where it doesn't happen that often is by working on the second fear. If you work on the second fear, then you do find over time that, like, well, your startle, the first fear, that initial jolt does become less and less fewer and further between. Yeah. Yeah. So but you can't work on it directly, you have to work on the second, the secondary fear first.

SPEAKER_03 22:56

Yeah, I remember many years ago when I was like uh my most confident coming out of an anxiety disorder, and it was when I was coming out the midst of it, like really bad agrophobia, etc. And I just sat on a bus and it was like I had the and I was like, and and it was literally, oh well, yeah, and then my attention external. I was confident enough to keep my attention external. Yeah, because for me, I was a ruminator, a threat monitor, or inwards compulsor, and I just remember I had this distinct memory where I was like, I've nailed this, you know, like I'm on the bus, you can't get off, whatever. I'm like, oh well.

SPEAKER_01 23:32

What a great moment, right?

SPEAKER_03 23:33

Yeah, just like it's just adrenaline, I don't care. And I was still having this conversation whilst feeling this, and I felt confident. I was like, I know this will pass in a minute.

SPEAKER_01 23:41

Yeah, it's so important.

SPEAKER_03 23:42

Yeah, I remember that. Yeah, distinct dear.

SPEAKER_01 23:44

And interesting that, you know, how often does that happen in comparison to you know, back in the day when you were really struggling? I mean, how often do you get triggered like that?

SPEAKER_03 23:53

I used to trigger like all the time. I still get uh the odd trigger like that now.

SPEAKER_01 23:57

You had one the other the other week, didn't you? Yeah, yeah. We were recording, and I was like in the middle of like near panic, if not panic, while we were recording. Yeah.

unknown 24:05

Yeah.

SPEAKER_01 24:05

Like that's pretty rare now.

SPEAKER_03 24:07

Yeah, and you're just like, meh, oh well.

SPEAKER_01 24:09

Yeah, I guess what am I? I mean, I know you don't like it, but the point would be that in terms of primary versus secondary fear in the episode, like, yes, primary fear will begin to become less and less. You just can't operate on it directly. So, like, you you gotta operate on the secondary fear first, which is so hard for people to accept. And when they want to work directly on the primary fear, that's when we get regular and like all that stuff, right? I gotta manage my triggers and I gotta make sure my gut health is in line. I got to, yeah, be healthy, but like we start to use that general wellness advice to try and stop the primary fear, and that's not okay because your amygdala is oversynthesized right now, it's a little bit on you know, active duty. Like, you gotta give it time to go home and put its feet up. You can't just send it home, it doesn't do that.

SPEAKER_03 24:52

Yeah, I I also dislike how like the term for I need to go home and chill out, I've been stressed, was hijacked with like this like faux therapy speech of I need to go home and regulate. No, why the how is that better than I just need to chill out? I've been through a lot. Yeah. Well, and I guess there's no difference, you know, it just sounds more technical, like needlessly, like like you have suddenly unlocked something that you didn't know. So you've done this your whole life, you've regulated because your body does it, you know. But when you're like trying to force it, it's like, well, it has the opposite effect.

SPEAKER_01 25:30

I think you know, if you want to look at it that way, and I I didn't mean to get us off on a rant, which I would gladly participate in, but like the regulation is again trying to get the primary fear in line. Like, no, we got to stop it from firing off. Well, it knows how to regulate if you give it a chance, and that is instead of frantically trying to interact with your anxious state all the time to control it, fix it, and regulate it. What if you let it come and go? Hey, guess what? Your brain will re-regulate, it will get the message sometimes, and it knows how to regulate. You just got to get out of its own way. Oh, when you're gonna be able to do it. Forcing regulation. Yeah, by trying to force, like, I'm gonna cut down the primary fear, or I have to find some sort of special mantra or like meditation practice that instantly makes me believe that it's just anxiety and I'm gonna be totally calm and have no secondary fear tomorrow because Drew and Josh said, so that's not right. You got to give it time, and you will re-regulate over time. That's the way that works.

SPEAKER_03 26:28

It's important to realize as well, like all your efforts, not all your efforts, but like you know, the majority of your efforts to rid yourself of secondary fear, you know, ironically, becomes the fuel that keeps it there.

SPEAKER_01 26:42

It's a shame, isn't it? Like that paradox just get us stuck. Had me stuck for a long time, had you stuck for a long time, a lot of people stuck for a long time.

SPEAKER_03 26:49

Yeah, and then this you know, the metacognitive belief of the more I give something attention and the more effort I put in, the better it will be. And you can't blame people for having that. I had that, you had that, yep. And getting your head around the fact that hold on, I if I leave it alone, then I'm actually signalling to the brain, my threat response, that secondary fear isn't an issue. I'm trying to turn off secondary fear, but if I behave like anxiety itself is a threat, I often use the dog analogy and hear bore my clients to death with it. You know, like if a dog's bitten you and your amygdala's remembered it, you need to show the amygdala dogs aren't dangerous. And you do that whilst being scared, you know, a little bit of time. Principles of exposure therapy. But it's the same here, it's like less is more. Don't get me wrong, less can be exhausting because it's like, oh no, turning my back on something makes me feel in the short term very afraid. Yeah, but yeah, leaving it alone, allowing your own body to regulate, turning off secondary fear, teaching the amygdala that anxiety and the symptoms itself are not a threat. It is not a rabid dog that's trying to bite you. Yeah, and you do that by showing it, play charades with it, you know.

SPEAKER_01 28:05

Like, and the same goes through for thoughts, too. It's not just the symptoms because people, I know if you're listening, a lot of people will be tempted to say, Yeah, but what if my anxiety is thought-based? But what about thoughts about my kids? But what about thoughts about my parents? What about thoughts about my own health? Like, it's the same. It's like it's the same. You will just react, your primary fear will get triggered by like, I might hurt my kids when you don't want to, it disturbs you so much.

SPEAKER_03 28:27

Like with exposure therapy and ERP, it's fun. Like, what about my thought about hurting my kids? Yeah, you know, as I get out of the guitar in here sometimes, so we make songs about it's crazy, right? So why do we make songs about the themes? Because you're literally showing the threat response that you're not a danger. I'm willing to mock you. I'm willing to mock you and write a song about it. That's the opposite of what you want me to do. You want me to go home and sit in a dark room and ruminate, feel guilty and and shame myself. And what if I'm a horrible person? Well, actually, the opposite of that would be to pick up a song and make a funny song about my horrendous intrusive thoughts. Yeah, uh, I mean, I shut the window in here before we do those.

SPEAKER_01 29:07

So the authorities don't come screaming after you do it.

SPEAKER_03 29:10

It's like, I want to kill my family and laugh about it. And it's like, yeah, maybe not. And I'm actually it's okay, everyone, it's ERP. It's all good. Fine. I promise. I promise. I'm a registered trained therapist. Yeah. Where were we? If I'm alone, I want to kill my family.

SPEAKER_01 29:25

Yeah, if I'm the only one on the mic next week, you know that Josh forgot to close his windows during an ERP test and he's been hauled off to prison in the UK. But that feels like the other thing that we have to acknowledge, like, yes, the same holds true for thoughts as it does for symptoms, but like that feels like such a risk. So if we stay on the thoughts, you know, side of the equation, like, yeah, but I what a risk to invite that in. I don't even want to say the words. Like, I can't say the word. Like, you know, I had words. I didn't want to hear the words dead or death. I could not hear those words. I they were banished in my home. And but in the end, like it felt so risky to even hear the words because it would trigger me and then I would freak out and I would try and like prove that there was an afterlife and it was insane.

SPEAKER_03 30:08

So that was a trigger for your secondary fear. That was.

SPEAKER_01 30:11

Those words were triggers. And in the end, it might feel very risky whether you have physical sensations and you're just gonna relax in the face of the physical sensations. That will feel like a huge risk to you. It requires courage. There's bravery there. So if you're struggling with that, uh we get it. Like you can't just decide to take this advice and like I'm just gonna do it today. Maybe, but it's you're going against like some very base instincts there. Like, no, no, no, no. I I can't, I should never say the word vomit, because then I might actually, I mean, why would I invite that in? I shouldn't say the word suicide. I might invite it in, right? I don't uh I'm afraid I'm gonna snap and hurt myself even though I don't want to, like, so I don't even want to say the word. No, no, no. It feels really risky to do this, but it's not a it just feels risky, and that's how you learn.

SPEAKER_03 30:53

And all you're teaching the amygdala there is right, it is a problem. Those words are scary. Yep, the thing is scary, it's a threat, and it'll just keep trying to warn you and keep trying to get you to do safety behaviors and avoid.

SPEAKER_01 31:05

Yeah, it's kind of tough. The feelings we get when we get those sensations, those are scary. You're right, we got to get away from this and fix it and manage it and you know, avoid. That's that's tough. So that's you know, secondary fear.

SPEAKER_03 31:16

You get it, guys. Secondary fear, notice it's always the first step. Um, should we move on to some community wins?

SPEAKER_01 31:23

Yeah, what the hell? Let's do it.

SPEAKER_03 31:25

I've got a nice did it anywhere here.

SPEAKER_01 31:26

Okay, should we play some music? I could do that. I'll be I'll get it right this time, too.

SPEAKER_03 31:30

Sure.

SPEAKER_01 31:31

Well, I I think I'll get it right. Here we go. Ready? So you go whenever you're ready.

SPEAKER_03 31:35

Cool. Um hi. I have health anxiety and also a fear and lack of trust in doctors and the medical sector. I found a lump in my neck and was advised by my GP that I need an endoscopy. I fell off with anxiety for days leading up to my appointment and felt so out of control when I got to the hospital for my appointment. After I had the numbing spray before the procedure, my fight or flight went into overdrive and I was pacing the room and ready to run. But I told myself there at there that I just needed to accept that this was uncomfortable and made me feel anxious and went ahead with the endoscopy anyway. I cried the whole way through the procedure, but I did it anyway. Even though everything in my body was screaming at me to run, I knew it was something I had to do, and the discomfort would pass.

SPEAKER_01 32:28

Oh, that's really, really great. Love it.

SPEAKER_03 32:31

That's a scary one. Well done. I'd be scared of do having that as well. Well done. And you did that not only with primary fear, you did it with secondary fear. Now they didn't give me permission to use the name, but that's a brilliant one and well done.

SPEAKER_01 32:45

Yeah, another great example of like that's a scary procedure for sure, right? So primary fear, but I'm not gonna feed into the secondary fear. I'm sure it was still difficult to do. So very well done.

SPEAKER_03 32:57

Yeah, but yeah, because you were willing to be anxious, if you had to do that again, you'd odds on you'd feel a bit more confident.

SPEAKER_01 33:03

Probably. I might still might be apprehensive, I might be nervous, I might be a little bit uncomfortable at this point, more confident, but a bit more confident. I can handle the feeling, I can handle feeling that way. Like I gotta get this over with. It's important to do it. So very good, very, very good. Um, what else we got from the community? Got anything else? We got a question. I know that.

SPEAKER_03 33:20

Yeah, let's let's let's answer a question.

SPEAKER_01 33:22

Let's answer a question. It's an audio question, so let's get at it.

unknown 33:25

Here we go.

SPEAKER_00 33:27

Hello, Josh and Drew. This is Niels from Germany. You may use my name. First of all, thank you very much for your podcast, which is very helpful um to me so far. Um, currently I'm struggling with anxiety every now and then, um, every two weeks, whenever I um awake from sleep early in the morning. I was just wondering whether this is due to uh cortisol levels, increased cortisol levels in the morning, and how you would advise to um to deal with that. Secondly, um I would like to hear your opinion on tapping um in order to accompany therapy. And maybe you also have experience uh in in tapping techniques. Thank you very much, and hope to uh hear from you soon. Bye. That's a good question. What do you think?

SPEAKER_03 34:26

Thanks, thanks, Niels. Good question. Um yeah, I mean, everyone has increased cortisol levels in the morning, but when you are sensitized and have that secondary fear, you yeah, you not only will you fear that cortisol rise that we all have in the morning, um you will could actually add extra cortisol because you're afraid of it. Yeah, so a lot of people we did an episode on morning anxiety and evening anxiety, etc., many moons ago, and yeah, I mean it's it's natural to wake up with that feeling of doom sometimes when you're sensitized, but I'm also noticing there that you have developed that secondary fear around it. So you're monitoring for it, you don't like it, you've gone inwards, you're trying to fix it, you're sending questions to us about it. I'd look at particularly on those mornings, what are you doing with your behavior though?

SPEAKER_01 35:20

Yeah. And I think the indicator there, we talked about secondary fear, and like it's the how does it express? Well, it expresses in this must be cortisol. So, does anybody have any tips for lowering my cortisol levels in the morning or controlling that? And then what about tapping? How can I fix this through tapping? Is tapping a good thing to do? Now, listen, you could tap if you want. I'm not gonna say that that's wrong, but how does that what does the tapping do? Is it a is it a way to bring you back to present so you can focus on the task at hand and like let the symptoms be there? Cool, then maybe you can use tapping. But notice that the secondary fear is expressed in resistant things, which is I need to figure this out, solve it, and then fix it. I need to remedy this. Or I'm I yeah, I do have more cortisol in the morning, and then I add even more, like Josh said, because I'm trying to fix the natural functioning of my body.

SPEAKER_03 36:10

Yeah, yeah, yeah, yeah. Ask yourself why, like, why why am I tapping? Oh, I don't like how I feel, I want it to go away. Yeah, then no, don't do that.

SPEAKER_01 36:20

Yeah, I wouldn't do it, yeah.

SPEAKER_03 36:21

Yeah, I I wouldn't either. But if you're tapping because, yeah, if as part of an exposure with horrible feelings, I think that's okay. And no, um, there's there's there's actually like weirdly some evidence for tapping. Um, and I think my theory is because it is literally bilateral stimulation, and there's plenty of evidence, particularly in the EMDR world, where you're when you're processing difficult emotions and if you've got bilateral stimulation, the brain can process it a bit quicker, but that doesn't mean you should all start walking around tapping temples and all that stuff because it means nothing if you've not practiced willful tolerance, you know. If you you haven't got that, then you know, if you're not willing to feel those things, then yeah, and that's what it sounds like a bit, Neils. Feels like I I'm not willing to experience this in this morning. Yeah, so I gotta fix it, you know, and I want I wanna I've got to fix it. You know, yeah. Um really good question. Thanks for sending it in, Niels.

SPEAKER_01 37:12

I think it speaks to a little bit of as we kind of wrap up the episode, there's a per there's an overriding concept I hear, I think, that goes in every one of the episodes that we record in and in this context. We are somehow convinced, and maybe it's a Western construct as opposed to an eastern construct, that we should, and this fits into like we are independent, we are the masters of our own domain, we control nature, we can control the planet, we can control, we can figure out science, blah, blah, blah. Cool, true, in a lot of instances. But if I feel bad, I can fix that. I should be able to fix that. There's no reason to feel bad. I can't, I should be able to fix that. There must be an answer to this. And sometimes there isn't. Like you just have to feel what you feel. And that's a hard one to say. Where you know, that's contextual. Remember, we're always in the context of an anxiety disorder, right? You don't sit and feel abuse and things like that passively. But in this situation, it always comes down to am I willing to be human and go through human experiences sometimes and and learn from that.

SPEAKER_03 38:12

Full circle with Burger King did it anyway. It's like, I'm gonna just let my anxious body do what an anxious body does, and then yeah, that way you can address the secondary fear. Um I wonder if they want a Burger King now. No, I was ranting on about food in the last episode. I'm not gonna do it.

SPEAKER_01 38:29

Yeah, no. Oh, that's right.

SPEAKER_03 38:32

I had so many messages about that hot sauce thing. I was like, I'm really sorry.

SPEAKER_01 38:36

That was my favorite ending of an episode we've ever done where it just kind of faded you out. He did not know I was fading him out when you went on your last rant and I was just hitting the fader on his mic. Shut this guy up.

SPEAKER_03 38:48

Uh anyway. Uh anything else, or are we leaving it there?

SPEAKER_01 38:51

I think we can leave it there 40 minutes. We've been a little wordy lately, so we'll shorten this one a little bit.

SPEAKER_03 38:55

Keep the disordered round table signups coming. Go on to the um the news, uh, subscribe to the newsletter at disorder.fm. You can always also send us um did it anyways. Yeah. Or questions there, yeah, or or just say hello if you want. And um, yeah, you can get us on disorder.fm. Follow us on social media, anxietyjosh the.anxious.truth. And thank you for tuning in every Friday. We really appreciate it.

SPEAKER_01 39:20

Yeah, yeah, definitely. We'll be back next week. And if you really like this podcast, by the way, maybe give us five stars on Apple or Spotify. Just saying. See you next week. We're out.