Anxiety, ACT, and The Happiness Trap w/ Dr Russ Harris (Episode 88)

SPEAKER_00 0:01

Anxiety is a normal human emotion that everyone experiences. But when we start responding to anxiety in unhelpful ways, it magnifies, it gets bigger, it gets more and more power, more and more control. And you either go into obey mode where we just obey our anxiety and do whatever it tells us to do, or we go into resist mode where we do anything we can to kind of you know fight with or run away from our anxiety. The fact that your anxiety is kind of spiraling out of control here is completely understandable. Almost everybody struggles with anxiety, and almost everybody gets jerked around by it and held back in life. It really is. In cultures all around the world, we're just not taught how to deal with anxiety. And almost always we find that when people are in the grip of anxiety disorder, they start dropping out of large areas of life. The life rapidly gets very small.

SPEAKER_03 0:53

Welcome to Disordered. This is episode 88. A really got a good one lined up today. This episode is entitled Acceptance and Commitment Therapy with our special guest, Russ Harris. And we're so delighted to have him. I'm Joshua Fletcher, also known as Anxiety Josh, psychotherapist and author based in Manchester in the UK. Um specializing anxiety and anxiety disorders. I prance around on social media. And today I haven't brushed my hair.

SPEAKER_01 1:24

We hadn't noticed. I'm Drew Linsolata, the other co-host of Disordered. I am a therapist still practicing under supervision in New York, also specializing in the treatment of anxiety and anxiety disorders, an author on the topic, also a social media dude, advocate, educator, former sufferer of these types of problems for many years, but doing much better now. And I am up at 5:30 in the morning to record this episode because Dr. Russ is in Australia. Russ Harris, introduce yourself. I know people know you, but tell us a little bit about your own.

SPEAKER_00 1:53

Well, as you said, I'm based in uh Melbourne, Australia. But in fact, uh, you know, I grew up in in England, not very far away from Anxiety Josh, you know, uh uh Liverpool, uh very close to Manchester. Um you probably can't tell. Uh certainly British folks uh are very familiar with the Liverpool accent known as the Scouse accent. And when I go back to Liverpool, people go, Where are you from? You're not from here. You no one talks like you, you know. You're born with a silver spoon in your mouth, where yeah you know, so it's um I have fond memories. Uh Manchester accent, it's it's pretty cool. It's not quite as cool, but there you go. You can't have everything, can you, Josh?

SPEAKER_03 2:33

I'll agree with that.

SPEAKER_00 2:36

Um, but yeah, I came out to Australia about 30 years ago or more trying to um escape all my neuroses and anxieties, and thinking that moving to a different country would fix all of that stuff, and it didn't. Um, so uh like you guys, uh I've experienced lots and lots of anxiety in my life, and I you know certainly handle it a lot better today than I did 30 years ago. Um, but my struggles kind of prompted me to shift careers. I was a GP um family doctor, and as I explored my own sort of anxiety and depression, I became very interested in the psychological aspects of medicine, uh, the psychological aspects of health, really, and ended up changing careers from doctor to therapist. And as a therapist, I explored a number of different models, but I really ultimately fell in love with acceptance and commitment therapy, which is officially abbreviated as ACT, okay? Act, not ACT. Um, I believe you've had Steve Hayes on the show. Um yeah, he you cleared that up too. Yeah. Steve is the originator of ACT, and if you call it ACT within earshot of Stephen Hayes, you see him start twitching and convulsing. Um so uh ACT, I I fell in love with it, and um, you know, it was uh I I ended up writing books about it and um self-help books. The my the best known one of those is the happiness trap, and um I've written textbooks about it, Act Made Simple. Uh and uh these days, you know, most of my time is actually spent kind of writing and teaching and training therapists in this approach for dealing with anxiety.

SPEAKER_01 4:18

Awesome. Well, we are thrilled to have you here. So Josh, what do you got? How do you what do you want to lob at Russ to start with?

SPEAKER_03 4:25

So I think hypothetically it'd be really nice. Um, because I wish there was like uh a Russ Harris when I first originally developed an anxiety disorder. So let's say I'll use my own example, why not? Transparency and all that stuff. So let's say one morning uh I'm I go to work, Russ, and I'm making a cup of tea and I'm really stressed, loads of stress going on in my life, and suddenly I'm making this cup of tea, and I look up and I feel dissociated. I feel I experience derealization, depersonalization, and I freak out. Followed by a panic attack, I think I'm losing my mind, I'm going crazy, I don't know what's going on. I leave work because I think something bad's gonna happen, and I go home and I spend the next two weeks worrying, ruminating, trying to fix myself, solve myself. Whoa, what the hell is going on? This isn't great. I can't return to the world unless until I find out one, what's wrong with me, and two, why the hell I feel awful and dissociated all the time. Well, what would be the first port of call you'd say for that?

SPEAKER_00 5:39

Well, um, if if you're gonna see a therapist, um uh you know, to see a therapist that is uh, you know, um there's different schools of therapy, right? And there's some types of therapy that explore your childhood in depth and you know look at you, uh analyze how that's affected you, and you know, there's validity in that. But if you've kind of got acute anxiety showing up and having such severe effects and such dissociative effects, uh, you really want a therapist who is trained in uh, you know, some form of behavioral therapy or cognitive behavioral therapy. Uh, the term CBT cognitive behavioral therapy is an umbrella term that covers about 30 different models of therapy, of which one of those is ACT, and obviously I'm biased, I'm a big fan of ACT, but what all of these different models of cognitive behavioral therapy uh have is at their core a very pragmatic approach to teaching skills to actually handle anxiety, handle those anxious thoughts, handle those anxious feelings, and um, you know, that's what you need is your first point of call, I think.

SPEAKER_03 6:48

You know, you can I would agree, it's nice as well. I have fights with other therapists, often physical in the car of a local harvest. And um what what happens is even here therapists like CBT doesn't get to the root of the problem. It's like CBT got me out of my house, yeah. You know, CBT allowed me to enjoy a burger again, you know. Like yeah, and this this whole I find that when you're in that mode, and a lot of people listen to this podcast, you know, they probably don't know the different modalities and approaches of therapy, yeah. But I always say if it's anxiety disorder kind of territory, yeah, go to particularly like third, fourth wave CBT stuff. I think it's really the first point of call. If you want to look at the other stuff later, that's great. Yeah, mom and dad were we're we're we're asses, and yeah, I need to work through that. But the the initial stuff, yeah, I 100% agree.

SPEAKER_01 7:46

Well, how about we let's let's case study you? How do you how do you feel about that? Should we just keep using that?

SPEAKER_03 7:51

Yeah, I'll be a case study. I'll love it. All you'll find is okay.

SPEAKER_01 8:01

So Josh gets has this initial episode. Young Joshua is like now beside himself because he's now afraid of his own thoughts and his own fears. Like, let's use the A. Let's bring the A into this. Where where are you gonna start to apply that? Like, what happened to poor Josh? I mean, we don't know his background necessarily because he hasn't told us. I mean, I know it, but unfortunately. But it's all it's all good. We don't know really. So, where do we where does the A fit in with what happened?

SPEAKER_00 8:25

Well, it maybe it might it might be helpful if it if I just kind of explain the basic principles of act, um, because the the term acceptance is often misunderstood. So basically, um acceptance and commitment therapy is based around three core principles, uh, which you can call being present, opening up and doing what matters. So it teaches you how to be present, how to focus your attention on what's important, how to bring your attention back to what's important after you've got distracted. When you're doing important things, it helps you engage in what you're doing. If you're doing something pleasurable, enjoyable to really appreciate and savour that experience. So being present, um, opening up, this means really developing openness to the world inside your skin, openness to your thoughts, your feelings, your emotions, the sensations in your body, allowing them to freely kind of come and go, not fighting against them, not running away from them, not trying to control them, but just kind of opening up to them and letting them freely flow. Change often use the analogy of it's a bit like the weather, you know, the weather changes from moment to moment, and you don't really get anywhere if you start fighting with the weather. You just kind of allow the weather to do its own things. And the same with your own thoughts and feelings, the sort of openness and allowing of them to be as they are in this moment without hiding from them or fighting them, and without letting them control you or dominate you. Um, so being present, opening up and uh and doing what matters. That means kind of getting in touch with your core values, how you want to behave as a human being, how you want to treat yourself and others, what you want to put into the world, what you want to stand for in life, and using those values as sort of compass to guide your actions, to guide what you say and do in life, um, acting effectively guided by your values. So these are the core principles of that. Be present, open up, do what matters. Um, and so being present and opening up uh is often kind of referred to as acceptance because I'm kind of present, I'm noticing what's here right now, I'm allowing it to be as it is uh without fighting or running away from it. But I personally not very keen on the term acceptance because almost everybody misunderstands it, and you're nodding your heads here. Like, what if what have you guys found of people's interpretations of the word acceptance?

SPEAKER_03 10:44

But but how do I accept? And I was one of these people, but I can't, I don't want to accept something that's so horrible.

SPEAKER_01 10:51

Yeah, I won't. I can't accept, I won't accept this. We always come back to a lot of our audience knows Dr. Claire Weeks and her work, that was her first and their first introduction to this sort of practical approach, and she used acceptance and floating, and they they immediately have positive connotations. Like, I like it, I want it. Like, no, I use the term surrender because it's brutal and says what it is, and Josh uses willful tolerance, they seem a little bit more like yeah, yeah.

SPEAKER_03 11:20

Yeah, I stole Siley Winston's willful tolerance. I like that. Like you're all you're you're already tolerating it, just do it willfully. Yeah, yeah.

SPEAKER_00 11:29

Well, yeah, I mean, there's a much better terms than acceptance. I mean, people fit often think acceptance means liking it, wanting it. Uh, some people think it means giving in, giving up, some people think it means settling, some people think it means you know, putting up with it or sucking it up. Um, so I'm not keen on the term. I kind of prefer terms like open up, make room, let it freely come and go in its own good time, let it flow through you, you know, allow it to be there without fighting or running from it. These are, I think, are better ways of speaking. Probably open up or make room are probably the terms I use most. So we're talking about, you know, that kind of opening up to the world inside your skin and allowing it in the opening up or like not fighting the weather, which I always I love the weather and the weather metaphors.

SPEAKER_01 12:14

I you know one of the things I love about actors, this is a never-ending string of metaphors that we can just take up, we leave them because you never know which one's gonna find. But let's say okay, so we take Josh as a typical, he's a client that walks in, and you know, one of the first questions that they're gonna ask is, but why? But why is this? I need to know why this is happening. Yeah, how would we frame that in in the act through the act lens?

SPEAKER_00 12:36

Yeah, well, so uh, you know, basically um it's not like there's one fixed way of doing this in act. The way that I like to do it is kind of say, well, look, you know, what happens is um anxiety is a is a normal human emotion that everyone experiences, but when we start uh responding to anxiety in unhelpful ways, um it magnifies, it gets bigger, it gets more and more power, more and more control. And that's what's going on. You're the way you're responding to your anxiety is just it's like a snowball roll rolling down the side of a mountain for another metaphor for you. The way you're you know, um uh the way you're responding to your anxiety is making it bigger and bigger and bigger and giving it more and more power. So it's completely dominating you right now, and of course that's terrifying, which creates even more anxiety. So it's like you're caught in a vicious cycle whereby the way you're responding to your anxiety is actually magnifying it and making it more and more um of a of an enemy um in your life. Um, and I would be quick to say this is normal, this is very, very common. Most people don't know how to respond to anxiety in in helpful ways. Uh most of us are we've you know, we just go into uh one of two modes. We either go into obey mode where we just obey our anxiety and do whatever it tells us to do. Anxiety says stay in your house, don't go out, and so you stay in your house and you don't go out, or we go into resist mode where we do anything we can to kind of you know fight with or run away from our anxiety, whether that's drugs or alcohol or trying to suppress it or push it away with positive thinking or whatever. And neither of these are really very effective ways of responding to anxiety, but they're the ways that we learn, uh, they're the ways that our culture teaches us. So, you know, um the uh the fact that your anxiety is kind of spiraling out of control here uh is completely understandable.

SPEAKER_03 14:31

Yeah, and um yeah, sometimes often uh Drew will use the analogy where people and I did this as well back when I was struggling like with panic disorder and OCD. I had this belief that, like, you know, if I find the magic thought or the root and ruminate all day, and that then I can feel better and then I can go back out into the world. Um, but actually, yeah, I got better when I realized, well, hold on, this is a snowballing anxiety, fear of fear cycle here. And Drew often used the analogy of you know, like when the when the fire engine turns up and the fire brigade get out to put out the fire, they don't run in going, How did this start? You know, they're like, Let's put out the fire, and then maybe afterwards you can be like, How did this start?

SPEAKER_00 15:18

Yeah, yeah, yeah. Exactly, exactly. Uh uh and so you know, I think um uh the I mean the statistics on are uh anxiety disorders are you guys probably more up to date with the stats than me, but the most common form of DSM disorder there is, um my memory's serving me correctly. Um but that's just anxiety that meets the criteria of a DSM disorder. That almost everybody struggles with anxiety, and almost everybody gets jerked around by it and held back in life. Um, so uh it it uh it really is in cultures all around the world, we're just not taught how to deal with anxiety, and it's it's sort of demonized in every culture that I know of, you know. As a little child, if you're scared or frightened, you know what what do adults say to you if they're not being very empathic and understanding? Um what what a what do scared little kids get called?

SPEAKER_03 16:24

Yeah, and the the the ability to hide uh your vulnerability is revered, isn't it? Which also doesn't help because it leads to a a belief that we have to fix anxiety, and that's where the first put tenant uh comes in, isn't it? Like acceptance, yeah. Actually, well, actually, let's let's not try fix, let's just feel let let the let the body feel what it needs to feel.

SPEAKER_01 16:48

That's the hard sell. That's really the hard sell because you know, yes, we are taught to resist or fight it or fix it. You must be able to hack. There must be a biohack for this, right? Or something, or some sort of like positive thinking there, fix it. And it's almost it's a really hard sell to get people to say, Well, I don't, you know, why don't why do you think this is so unusual? Like if we then you quote like prevalent 12-month prevalence of like panic disorder in the US, we'd have to rent Denver to have a panic disorder conference. That's how many people in the US alone will have panic disorder in the next 12 months. Like we would literally need to rent Denver to host the conference, the whole city, like to host the conference. Yeah, exactly. It's it's not unusual. So, but that's a hard sell. Like, what do you mean I have to just accept that this happened? But but it does.

SPEAKER_00 17:30

I mean, I I'm I'm very, very, very cautious about the language that I use uh as a therapist. Um, because you know it's funny, it's like I I I I in my trainings and my my I teach a lot of uh therapists and and I say don't use the word acceptance, you know, you're gonna get negative reactions to that. Um, so I uh I also even recommend don't use the word mindfulness skills. You know, a lot of people have negative reactions to the word mindfulness.

SPEAKER_03 17:56

You guys find that because they technically techniquify it as opposed to see it as a skill. Yeah, yeah.

SPEAKER_01 18:03

I recorded uh with an OCD therapist yesterday from my other podcast, and she doesn't say much, she will not say mindfulness or meditation, she teaches attention. She's like, we can do attention exercises, and people will listen to that. As soon as she says mindfulness or meditation, they're like, Oh, I tried that, that doesn't work. And they yeah, they're rolling their eyes and they're out.

SPEAKER_00 18:20

So what I I uh the terminology I use is unhooking skills. And as at the moment, you're getting hooked by these anxious thoughts and feelings, they're jerking you around like a puppet on a string, they're pulling you all over the place. If you want to uh kind of break out of this, then it's not gonna happen by just having a chat or a discussion. It involves learning some unhooking skills, learning how to unhook from these difficult thoughts and feelings, take the power out of them so they can't keep jerking you around. Uh, would you be interested in learning to do that? Um, so uh that kind of language. Yep. Unhook me, Ross. Unhook me. Well, you know, it's it's a much more user-friendly way of speaking, and uh it evolves, uh, you know, escapes all of those problems when you start using words like mindfulness and exceptions.

SPEAKER_01 19:06

Yeah, yeah, those those preconceived notions I think really do get in the way of some of this stuff. So that's a thing. Um okay, so we have this uh young client who is now experiencing these really difficult, you know, episodes panic, derealization, all the stuff. What else you have? You had all the things.

SPEAKER_03 19:22

Yeah, yeah, I understand the acceptance part now, but what do you mean by commitment?

SPEAKER_00 19:28

Well, see, again, you know, if you come to see me, what I what I would kind of say to you is look, there's kind of three pieces to your anxiety disorder here. So one piece is you're getting hooked by these difficult thoughts and feelings and jerked around. Another piece is you can't focus on anything, your attention's completely scattered. You know, as soon as you try to focus on what's important, you just get caught up in these thoughts and feelings. Uh, and and the third thing is you're kind of given up on doing the things that are important. You're staying in the house and you're and you're not going anywhere and you've dropped out of. I mean, obviously, I'd have to take a bit of history from you and find all this information out. But uh almost always we find that when people are in the grip of anxiety disorder, they start dropping out of large areas of life. We start avoiding any situations, activities, events, people, places that trigger anxiety. So life rapidly gets very small. So we've got those three components to an anxiety disorder. And um, you know, basically uh our work here involves really learning the antidotes to that, learning how to unhook from those difficult thoughts and feelings, learning how to kind of train your attention, bring your attention back, focus on what's important, engage in what you're doing, and learning how to kind of uh motivate yourself to get back to doing the things that are important, get in touch with your values, which are sort of like your heart's deepest desires for who you want to be and how you want to behave in the world, and using those as a compass to kind of guide your actions and get back into you know living the life that you want to live, you know. Um, and so again, our work here is very active. The idea is that you and I are a team, that we work together to help you build the sort of life you want, and um, you know, a lot of our work here involves really kind of practically learning those three skill sets so that you can uh put it into your life. And what I want you to do is after every session, I I at the end of each session, I'm gonna ask you to take a practical skill away or practice and ask you to try it out and apply it in your life. Um, because the real change happens when you take those skills and use them outside these sessions.

SPEAKER_03 21:30

Um yeah, a lot of the lots of the homework in between. So yeah, I mean I'm I mean that applies though. I mean when I started to get better, I didn't actually realize I was kind of doing the principles of of of of ACT. It was um I just got so tired that actually I I I think there was a part of me in my brain that was like, I do know what I don't really care how I feel when I do this now. You know, yeah if I go crazy, I go crazy. Whatever, I'm gonna go to the supermarket. I remember, I remember the first time I left out I went to the supermarket to buy five items. It took me forever. I remember having the thoughts like I'm gonna get carted away, locked in the asylum, doing all these things. I thought I thought I was losing my mind. But it was really interesting, actually. No, I I had kind of hit that acceptance part. It was like because I got so tired of being in my house. Very long time ago, this. Yeah. But it was just like, and I was like, actually, my recovery was pretty much you know, the the principles of acting, I just didn't realize it. You know, and it was just like, yeah. And then when I we we don't really use the word relapse, but like when we're when I became resensitized uh to my anxiety again, I fell into the trap of oh no, there's something wrong with me doing that, and I stopped the acceptance thing. Uh that I that that resistance had subtly come in, and obviously I've got history of OCD as well. So, you know, with uh Rumination King and it subtly subtly came in, but actually, yeah, I lost the tenets of of act and that and and it all makes sense now when I look through my my time.

SPEAKER_02 23:12

Yeah, well, I'm sorry, yeah.

SPEAKER_00 23:15

I mean, yeah, come, come.

SPEAKER_01 23:16

No, I was gonna say, I I think that's a common experience here. People, if they look back on it, they're like, Oh, I was I was accidentally doing act, who knew?

SPEAKER_00 23:25

Yeah, yeah, well, I that was my experience too. I mean, I I trained in a number of different models before I kind of discovered ACT, and it was like there were bits and pieces from those various models that I liked and took. And um uh, but when I discovered ACT, it would kind of brought all of those things together, uh, all of this really cool stuff. Um, and it was like uh yes, oh, I I've been doing this in that other model, and I've been doing this in that approach, and you know, and that self-help book had this, and that therapist that I saw had that, and it's like, ah, but it really uh, you know, whatever all of these kind of models of CBT that we're talking about, they all do have uh a fair degree of emphasis on being present, focusing attention, fair degree of emphasis on opening up and making room for the stuff inside you, and a fair degree of emphasis on behavioral activation, doing the stuff that's important, getting out there and living your life.

SPEAKER_01 24:20

So that last thing, doing what's important, you know. So open up, do what's important or committed action toward your values, however you want to say it. Yeah. Often the people who think, and I think I thought this too when I was initially struggling. Oh, well, I go to therapy and I learn methods that fix me, and then I go and live my life again. Really, like, you know, I what I've written before is like you don't recover to live, you start to you work on living to recover. Is that the application of like do what matters, which is let's take these principles and put them into things that actually do matter in your life? It's not that you walk out of it.

SPEAKER_00 24:56

It's like for the rest of your life, you know, it it's uh there's gonna be challenges for the rest of your life. There's gonna be obstacles and difficulties, and anxiety is gonna show up in a zillion and one different forms. You know, you're you're gonna age and get sick, and people you love are gonna age and get sick. I mean, you know, if if you live long enough, there's gonna be a lot of pain and a lot of difficulty in your life. So it's uh you know, these challenges will arise again and again, and the idea is that we apply these skills over and over, and of course we're gonna forget to do it. You know, it's like uh I say in the happiness trap, you know, there's times I've just forgotten everything that I've written in this book, it just flies out of the window. But I, you know, I I get kind of better at realizing that and faster at catching myself, you know. That's the uh so uh I'm just laughing because I just I I remember um my son's just just finished uh finished high school uh yesterday, but I was just having a memory of when he was about 12 and I completely uh I can't even remember what he was doing, but I just lost it with him. I was so angry and I was shouting and yelling, and I was like at this complete meltdown. And uh and then you know, um a few minutes later, I was very embarrassed when I realized what I'd been doing, and I went to him and I kind of said, Oh gosh, look at that. I got completely hooked by my thoughts and feelings there. I was so jerked around. Can you imagine the people that read my books? Can you imagine what they would say if they had seen me seen me doing that? And he's like, I'm gonna tell them.

SPEAKER_01 26:32

Your 12-year-old son just picking at his phone and recording it with just going on Instagram now, dad. So that's a great story because it illustrates our come our our share humanness. Even the guy that writes the book, you know, loses it sometimes. That's normal, that's that's not failure, right? So that's just the way it's gonna happen.

SPEAKER_03 26:57

We often say that on here, like sometimes Drew and I will have a panic attack. And it's just like but the the the difference is I mean, I love it when when Drew says like a lot of recovery from particularly from anxiety disorders is the gap between the oh my god to the oh well. And I love it again.

SPEAKER_00 27:14

I love that, yeah, it's great.

SPEAKER_03 27:15

Yeah, oh my god. Yeah, no, yeah. It's the gap you can spend weeks, you can weeks doing in that gap or just keep it short. And it's like, oh yeah, all right, I'll have you know, yeah, yeah. Uh and yeah, and it's that and obviously there's some people like, no, I I tuned in for the answers, these guys are still having panic attacks. Russ is beating his son with his own book. What's going on here? And it's just like, no, it's the reaction, it's that actually, oh yeah, I've got angry or I've got anxious, and ah, no things.

SPEAKER_00 27:47

I mean, you know, I one of you guys emailed me and said, you know, you've done zillions of podcasts, you know exactly what to do. This will be a toddler, but I'm still anxious. You know, whenever I do a podcast, uh, am I gonna say something stupid? Even though I know you can edit it, and if I say something stupid, you can chop it out. Even though I know that, I still get anxious. I'm like, like I don't know if you can see my hands on the camera now, they're like bright red and covered in sweat. Can you see that?

SPEAKER_01 28:10

Oh so before we come, all right. So here's next time you come on, before we hit the button right says, Well, I could if so you're saying if I I could always say, Hey, can you take that out? Next time you do that, we're gonna say, No, that's that's where you turn.

SPEAKER_00 28:24

It's like, you know, you guys are easy to talk to.

SPEAKER_03 28:32

It's like using his own terminology to manipulate.

SPEAKER_00 28:36

It's it's kind of you know, it's like uh uh you know, uh I anxiety is a normal response to a challenging situation with an uncertain outcome, you know. And so it's like you guys are easy to talk to and all of that, but still there's a there's a level of challenge here, and um you know, some people uh uh their bodies make their anxiety very obvious. Some people flush, uh blush and so forth. Some people shake with me, my hands just drip with sweat. So it's always really awkward for me when people want to shake my hands after a talk or a workshop or something. I'm like, you can, but they're soaking wet, you know. And and occasionally a brave person.

SPEAKER_03 29:17

You wouldn't make a good dance play, then Ross. No, no, yeah.

SPEAKER_02 29:26

But it's terrible.

SPEAKER_03 29:28

No, I'm the same. I've said I call it when I do when I do my talks, and sometimes like, hi everyone, I'm going to give provide a talk on anxiety. The irony is I am having very anxious, I'm having intrusive thoughts of projectile vomiting on the front row, and both my armpits look like Lido's. And I'm just like, but I'm like, let's go, whatever, who cares?

SPEAKER_01 29:49

Yeah, it happens. Um let's go to uh I mean we could you want to do find any questions from the audience? And we're we're at about 30 minutes, so we maybe go to the Q ⁇ A part of this, or um could I just raise the idea just the issue of disorder, you know.

SPEAKER_00 30:06

Um, because again, Axe is Axe is very big on moving away from the language of DSM disorders, and I gather you guys are too I quite like it.

SPEAKER_03 30:24

I quite like some labels. I have this argument with with with uh with um lots of people's like not all levels, not the over-medicalization of mental health. No, I'm against that. Yeah, but like I quite like like for me, it's accepting particular stuff like OCD. Like I have an OCD brain, you can see an OCD brain under a scan, a weird flap in their brain that just now and then, and my brain will always be like that, and that's cool. I accept that, I think that's helpful. Um, but when when you pin everything on a label and a diagnosis and a disorder, I think it's your relationship with it. So if you have a healthy relationship with it, I like that, right? But like, but if I'm using it as like avoidance, no, oh, I can't go there because of my dishes, or I can't go there.

SPEAKER_00 31:13

That would be that's very much the act take on it. It's kind of like a a DSM disorder. It it's the label is it's a double-edged sword, so it can you know give you that sense of acceptance and understanding and give you access to health services and social support. And if that's the way that it's functioning, then that's great. But as you mentioned, the the dark side of it is people kind of well, I can't do this because I'm OCD, or I can't do this because I'm depressed, or you you know, how can you expect me to do that because I'm this diagnosis? And yeah, we don't buy that.

SPEAKER_01 31:47

Yeah, so you know we find I often find that people will, and you know, everybody gets to decide, they get to decide from themselves. We don't get to decide how they view themselves, but I will usually say, well, I we can say the word disorder, and we've even talked about this. Well, the because the fear comes before the threat, so it is literally out of order. So that's one way to do that. And then that went over well. But some people really like the they don't and they don't like the idea. I don't want to say, let me revise that, but well, this isn't a mental illness. I'll say a panic disorder, I don't see it as a mental illness. You're not ill, you're not broken, it's not a disease state, it's just literally this fear goes out of order and we gotta put it back in the right sequence. And some people don't like that, they will they will say, No, it we need to call it an illness, it is, and that's how we get awareness. And okay, so I get it, it's a debate, but yeah, yeah.

SPEAKER_00 32:34

I mean, I like I say to people that that I say, you know, that like the label on the jam jar is not the jam.

SPEAKER_03 32:40

Um yeah, I like that. Oh, that's really solid.

SPEAKER_00 32:43

Yeah, it's so you know, the label tells you something about the ingredients, but you know, if you come here for therapy, we can't be working with the label. Let's have a look at what the ingredients are, let's look at what's inside the jam jar. Let's have a look at your thoughts, your feelings, your behaviors, the stuff you're struggling with. Let's just put the label over to the side of the room, yeah.

SPEAKER_03 33:00

Yeah, I I would love that. Um, yeah, but I like it as I use it as a part of the formulation, but I love the jam analogy. And particularly in the podcast, we have uh a character that pops up in almost every episode. Have you got it? It's Craig the Critic. And we talk about okay, you may have panic disorder, you may have agrophobia, social anxiety, etc. Gad, but uh your relationship with that is often dictated by the other facets of yourself. So, like if you've got a really harsh internal Craig the Critic, uh, you're not, you know, we need to deal with that stuff too. And and why are you aren't you accessing compassion for yourself and and and going easy and stuff like that? And just other things as well. Like maybe you you're going through bad stuff in life, maybe you've gone through lots of traumatic things, maybe your relationship with the word trauma isn't great. That's that's where I get really grumpy processes where people overuse the word trauma. It means nothing to me as a therapist anymore. I'm like, what's trauma to you? I'm not gonna dismiss your trauma, but yeah, we're talking PTSD trauma, like you can't sleep and your hippocampus is struggling to process memories, or are you just describing something that wasn't very nice as trauma? I don't know. So uh all these words complicating things, but yeah, I mean, as part of the formulation, yeah, just be like, yeah, I'm here, I think I may have OCD traits. Um, I did want to we've had a lot of questions, I'm just gonna put them all in one question. Yeah, that's one of these. A lot of the questions were here, Russ, is that okay, as opposed to me who found it maybe difficult avoiding stuff, what's the approach for things like overthinking and rumination? We get that all the time. I'm overthinking, I'm ruminating. Maybe I've got health anxiety and I'm you know ruminating and catastrophizing that you know my arm's hurting and my brain's about to explode or or whatever. What would be the kind of the the approach, the act kind of approach to overthinking and rumination where we've just stopped and we've gone inwards?

SPEAKER_00 34:57

Yeah, so the act approach really would be to teach some unhooking skills and some being present skills. There's two particular skills that are interconnected. Uh what one I call dropping anchor and the other I call dipping in and out of the stream. Uh, and and a dropping anchor skill is really a very simple technique where you you just kind of uh acknowledge the thoughts and feelings that are present, or you acknowledge your minds ruminating, obsessing, worrying. Um, you find a way to connect with your body, you do some physical movement or stretching or pushing your feet into the floor, or you know, taking a breath, some some way that kind of anchors yourself in your body, and then you refocus your attention on what you're doing right here, right now, and bring it back. And you may do that over and over. And that's I call that dropping anchor because you know, emotional storm blows up. Uh you guys, you've both got luxury yachts, you know that when there's an emotional storm, first thing you need to do is drop anchor, right? Otherwise, your yacht kind of gets swept out to sea, um, assuming that your yacht is in the harbour, right?

SPEAKER_03 35:55

It's in the Manchester to Liverpool canal.

SPEAKER_00 35:59

Exactly. Um, but dropping the anchor holds the boat steady in the harbour, it doesn't get rid of the storm, it doesn't control the storm. And so uh, you know, when an emotional storm blows up, an anxiety storm blows up, dropping anchor technique helps you to kind of anchor yourself without getting carried away by the anxiety. And then um dipping in and out of the stream is kind of uh a more advanced level skill where you get people to kind of practice getting caught up in a stream of their negative thoughts, their anxious thoughts, and then drop anchor, come back, get present, and then go back into the stream, and then come back and get present, and then go back into the stream and do that over and over so they really learn how to I can get all caught up in these thoughts and feelings, and I can drop anchor, come back, get present. Uh, and that is a very powerful antidote to remove. I love that.

SPEAKER_01 36:44

Yeah, that's such a great, like accessible explanation of what to do. Um okay, you gotta go because I got clients. I'm gonna do that. I love that. I don't know why I have this image of you and I with these giant yachts just parked next to each other talking shit on the railway. Morning books, morning drones from where you it's a premonition.

SPEAKER_00 37:08

This when your when your podcast goes global and you've got a hundred million hits per podcast, that's you guys.

SPEAKER_01 37:15

That's we're gonna get there. Well, we'll invite you on, no problem. Oh, oh cool. Yeah, to the odds, I mean that is so accessible though. The drive the that that except explanation is really, really equal.

SPEAKER_03 37:24

I mean, I'm just gonna use that anyway, even like sometimes I just get swept up in ruminating about life, and I quite like that. When you just know you're like, this isn't going anywhere, you know, just like leave it. I like that a lot. I particularly like when you said you have to keep doing it, yeah. Because a lot of my clients or listeners will get frustrated, they're like, Oh, I can keep ruminating. I was like, Yeah, but do you not notice that each time you catch yourself ruminating and using your attention and guiding out there, you kind of rewire in your brain each time you do that. Don't expect it to be one thing, like I'm never gonna ruminate again. I mean, that's impossible. Uh, but I like the idea of not, you know, keep keep catching yourself, you know. Um, I am a huge kind of believer, proponent, whatever, that attention is one of the most important factors in when you struggle with anxiety and stuff. And where is your attention? You know, and I looking back with my own struggles and working with clients and stuff, I always I just think most of it is an attention thing. Like, are you where where are you hyperfocused? Where are your body scanning? Where are you inwards? Are you outwards? We've got uh one of our favorite episodes we did is the inwards compulsion where we just go inwards with our attention, um, not helped with kind of common wellness advice, like go inwards, what's your body telling you? My body, you're not like no, no, no, our clients don't want that. Yeah, but don't tell our listeners to go inwards, they do it all the time. Uh, so yeah, how how much would you kind of say attention is the problem?

SPEAKER_00 38:52

Oh, it's it's massive. I mean, it's massive, you know. Uh it's again one of the things that again why I kind of like the language of getting hooked. Our our thoughts hook our attention and pull it away from where it needs to be, or our feelings and sensations hook our attention and pull it away from where it needs to be. Um, so the thing is these things are all interlinked, uh, because you know, it's not just a question of focusing my attention on what's important, it's also important to be able to unhook from the thoughts and feelings that are showing up, you know. Um but it is that process of just coming back again and again. I mean, everyone's attention wanders. Um Stolen Focus by uh Johan Hari. Did you ever read that book?

SPEAKER_03 39:36

I no, no, but I know what it's very famous book. I've heard very good things about it.

SPEAKER_00 39:42

I really loved reading it because, in a total, not coming at it from a therapist point of view, but as a journalist point of view, just talking about the increasing difficulty that everybody has paying attention and focusing. And you know, around the world we're we're seeing the this kind of massive increase in diagnosis of ADHD. Um, but if you talk to your friends and your family and your relatives, um almost everyone's struggling with uh you know paying attention, focusing attention as we live in this digital world, uh, it gets harder and harder to do that. So, you know, anxiety just adds an extra layer onto the difficulty that we're all having anyway.

SPEAKER_01 40:21

Yeah, I agree with that. And it I don't think we were built. Now we get I I tend toward the nerdy side for sure. So I dig the theory under Act, and there's that like not only are we bombarded with a continuous stream that we were probably never meant to process, we were probably not designed to process continuous input during every waking moment, but then that meaning making machine comes into play. Like, not only do I have to get input from the outside, and in my in me, now I also am trying to make meaning. What is this? What is this? What is this? What is this? And that that doesn't belong in a lot of places. So your attention goes to places where it doesn't necessarily need to be, and then you try it try to make meaning out of what you're feeling inside, which has nothing other than I'm really anxious or afraid or I feel threatened, and then really go off the rails. So it's hard to break.

SPEAKER_00 41:09

It is. I mean, I I I often say to clients, you know, your mind is like an overly helpful friend, it's like one of those friends. Have you ever had a friend that was trying so hard to help you they became a real nuisance?

SPEAKER_03 41:21

True.

SPEAKER_00 41:24

Drew Drew is pointing at Josh there. It's been terrible.

SPEAKER_03 41:28

Let me put your socks on for you. So true. This is inappropriate.

SPEAKER_00 41:34

It's so um, and this is what's doing all of those, you know, anxious thoughts, worrying thoughts, scary thoughts. That's your mind just trying too hard to keep you safe. It's saying, watch out, you might get hurt, things might get wrong, you know, bad things might happen. It's just doing it too much and too intensely that it becomes a nuisance to you. But it's not out to sabotage you and make your life miserable. It's not, don't think of it as your enemy, think it as an overly helpful friend and see if you can take what's useful from it, you know.

SPEAKER_01 42:04

Is it possible that you're unhooking from that process too? Like part of the unhooking is I gotta hit the clutch so we go into neutral so I can put the meaning-making engine is always running, but I don't have to be riding it, like let it do its thing. Yeah, so that's exactly yeah.

SPEAKER_00 42:20

Well, you know, that there's a popular act unhooking technique called uh thanking your mind. So when your mind starts doing its kind of scary anxiety stuff, you go, Oh, thanks, mind. I know you're trying to help, and it's okay. I'm dealing with it and handling it, you know. So you're not challenging or disputing it, you're not kind of oh my god, here's my mind, you know, getting into a fight with it. It's like okay, all right, I can see you trying to help, and it's okay. I'm onto it.

SPEAKER_01 42:43

Yeah, we got this.

SPEAKER_03 42:45

Yeah, you're suggesting that weird intrusive thought again. You're suggesting that it's some kind of danger, but it's not. I'm gonna show you it's not by willing to accept the feelings that come with this, and I'll show you.

SPEAKER_00 42:58

Exactly. You know, that's what intrusive thoughts are. It's basically your mind saying, Don't let these bad things happen, or don't let yourself do these bad things, or prevent these bad things. You know, it's just trying to help.

SPEAKER_03 43:08

Yeah, very good. Yeah, there's a and I I'm a huge believer of like the principles of act with stuff like OCD and intrusive thoughts as well. You know, like what I have to do that whilst feeling like trash, yeah, yeah, yeah.

SPEAKER_01 43:21

I I think the thing that I would probably bring our focus to as we sort of wind down would be the part where Russ says, do what matters. And I think so many people, you know, listening to the podcast, reading the books we write, reading the books that you write, Russ, they're so hopeful that they are going to see improvement just by listening to you speak or watching a video or reading a book. And I get that. I I totally I wanted Claire Weeks to fix me in her books too. I get it. But in the end, do the word do, I think is so critical in this. It's really hard to do, but the doing part is what makes the change. Do what matters. It's not just well, let me have different thoughts. Because you can't you can't do it.

SPEAKER_02 44:01

Yeah, yeah, yeah.

SPEAKER_01 44:02

Exactly. Is that what you find resistance when you're working with your clients? The doing part?

SPEAKER_00 44:06

Like Yeah, just use the analogy of getting fit. You know, you won't get fit, physically fit, by watching videos or reading books, uh you know, or listening to audio.

SPEAKER_03 44:20

Although I would I would challenge that on the tread belt at my gym. I put it on 45 degrees and I watch Orange, the new black on Netflix. All right, fair enough.

SPEAKER_00 44:31

So I can be a slob and walk up and I mean you've got to do something to get physically fit, and it you've got to do something to get psychologically fit. It's not a passive process. Uh and thus the importance, I think, of certainly from an app perspective, of saying to a new client on the first session, I'm gonna ask you to take something away every session and practice it and apply it because that's where the real change happens. Cool.

SPEAKER_03 45:01

Uh thank you so much, Russ. Where can people find you, Russ? Um, as in you know, hanging out in their garden, like stealing their stuff. Where can where can people where can people uh find you? And obviously the work that you do and things like that.

SPEAKER_00 45:18

Uh well, okay, so uh probably the easiest uh website to check out is thehappinisttrap.com. Um and uh the the best known in my books is the happiness trap. Um if if therapists are listening to this and they want to kind of they're interested in training in acts, then uh psychwire.com would be the place to look. Yeah, nice one.

SPEAKER_03 45:43

We do have a few therapists who tune into this as well, which is cool.

SPEAKER_01 45:46

Yeah, if you go to this this is episode 88. If you go to disorder.com this order disorder.fm slash 88. I will put Russ's links on there. So we got that. Yeah, great.

SPEAKER_03 45:56

Yeah, thank you.

SPEAKER_01 46:05

I will get up at 5 a.m. for you again. If you want to come on anytime, you're welcome here. Store's always open. So that was really good. Any parting thoughts?

SPEAKER_00 46:13

If you uh if you want, uh uh I'm happy to kind of shoot you some free um you know audio recordings of dropping ganker and uh dipping in and out of the stream. If I don't know if you do that, you just give that stuff away.

SPEAKER_03 46:28

Put them in the yeah, put them in the in the show notes as well so people come see. That'd be awesome.

SPEAKER_01 46:32

Yeah, 100%. Send them over. That would be great. Yeah, my email, just respond to the last one, and we'll we'll do it.

SPEAKER_03 46:36

So thank you. I really appreciate it though.

SPEAKER_01 46:38

Yeah, and thanks everybody for listening. And we'll be back again next week with another topic of undetermined origin. We make these up two minutes before we go, but uh if you're listening on Apple or Spotify, leave us a cool rating if you really dig it or a comment, especially if you'd like to hear Dr. Harris talk today. And that's it. See you guys in a week. Okay, cheers, thanks.

SPEAKER_00 47:00

That was fun, guys. A lot of fun.