Health Anxiety and Somatic Hyper Focus (Episode 77)

SPEAKER_04 0:01

Josh and Ruth, thank you for your uh podcast. I'm Luca from Italy. So my my anxiety disorder started 12 years ago with uh, in a very clair, weak way, nocturnal panic attacks, days of war, second panic attack, full anxiety disorder. Uh now I I wanted to ask, um, in the beginning, I mistook the second panic attack as a heart attack. Uh, due to a physical sensation while running, I think I hurt a nerve in the back and it just shoot pain, shot pain in my body when I thought I was dying. But in the following months, I developed very, to me, very scary uh um sensations in my stomach for which I've done endless uh checks, uh, always hoping to find uh an organic nature. Now, I've checked off basically all the possible tests, and all of them, apart from gastritis, all of them came up negative. So, in the end, I asked myself, are these sensations just normal sensations that I perceive as amplified and threatened just because I've been scanning my chest so much? Uh I think this is called somatic hypervigilance. I ended up asking Chat GPT if some of my symptoms were normal. Some of my uh what I call symptoms were normal, and ChatGPT said yes, this is this is a normal body sensation, not related to anxiety, everybody has it. But to me that was that still is very, very upsetting. I think willful tolerance is the key here too. But can you speak about somatic hypervigilance?

SPEAKER_01 1:39

Welcome to Disordered. This is episode 77 of the podcast. Today we're talking about health anxiety and somatic hyperfixation. It is a thing. I'm Drew Linsolata. I am a therapist practicing under supervision in New York in the U.S., specializing in the treatment of anxiety and anxiety disorders. I am a three-time author on this topic anxiety and anxiety disorders, a social media dude, an advocate, an educator, former sufferer, anxiety disorders, OCD and depression for many years in my life, on and off, but better now. Thank you very much. And one of the co-hosts of Disordered, who's sitting next to me.

SPEAKER_02 2:10

I'm Joshua Fletcher, also known as Anxiety Josh. I'm a psychotherapist based in the UK who specializes in anxiety and anxiety disorders, previous sufferer, uh, Instagram prancer arounder, um, and I do stuff on TikTok as well now, makes me feel quite old. Um yeah, uh, author of an of and how does that make you feel and co-host of this wonderful podcast.

SPEAKER_01 2:33

Welcome, dude. Here we are for another one. What do we talk about today?

SPEAKER_02 2:36

Well, Luca sent in a very interesting question, uh, somatic hyperfixation, which is uh often falls under the the branches of health anxiety and panic disorder, really. So you know, it depends when we we fixate on somatic sensations, anything our body's doing, you know, what's it what's that doing? What's that doing? And little aches, pains, symptoms can latch on and be um kind of singled out by the threat response, and our lives start to be built around it. They start to become the center of our lives.

SPEAKER_01 3:09

Yeah, that's true. I can relate to Luca's little narrative there. I was I was definitely this.

SPEAKER_02 3:15

Yeah, so I'm looking forward to talking about that today. Um should we should we start with a a Did It Anyway and celebrate a community win?

SPEAKER_01 3:22

Let's do a Did It Anyway because it's a good one, and it's going to introduce sort of the musical theme of this episode. So let's get at it. Here we go.

SPEAKER_05 3:33

Hi guys, I wanted to share uh Did It Anyways and also to let you know that your podcast is hands down the best thing that's happened to my anxiety. So at the start of this year, I had a summer goal to attend social salsa dances that we have by the beach where I live. So I did dance classes during spring, but I knew I had to do a lot of social dances too in order to improve. I often got so anxious going up the stairs to the social dance, sometimes turning around, only to force myself to get back in there. Uh often, you know, with my phone wanting me to call my sister to help her calm me down. But I convinced myself not to give away the credits. Each time I panicked, I told myself, you know, just do one dance. That's what the non-anxious you would do. And it actually only always just took one in order to keep going the whole evening. So when summer came, I was good enough to have an amazing dance experience, and I also made so many new friends in the dance community. So thank you so much for sharing your wisdom and lots of love to the anxious community.

SPEAKER_01 4:39

Oh, what a great did it anyway.

SPEAKER_02 4:41

That was so good. Well done. That was good. It only took one, and then I was away. I like that. Really good. Uh such a good uh Daniel. Thanks for sending that in. And uh thanks for allowing us to um be children and find some self some music that we could dance to. We were dancing throughout that, by the way.

SPEAKER_01 5:00

We really were. I have this equipment in front of me, and I can't help but just be silly with it. So but thank you for sharing. That was really great. I love how it even turned into you know more stuff. So like I I've noticed I'm good at this, so I do it more. Like, awesome, really great.

SPEAKER_02 5:13

Yeah, you Billy Mays' it.

SPEAKER_01 5:14

Yeah, but I'm not done yet. That's right. I still don't have Billy Maze on the soundboard.

SPEAKER_02 5:18

I really need to get him there, but you've neglected Billy Mays that.

SPEAKER_01 5:20

No, it seems so wrong. I shouldn't have done that.

SPEAKER_02 5:23

Anyway, what does somatic fixation look like?

SPEAKER_01 5:26

Somatic fixation. Somatic fixation, it's interesting because I think a lot of people, I like how you said this could be part of health anxiety, which it definitely is for so many, and also part of like panic disorder and agoraphobia. Sometimes OCD people have somatic themes of OCD where they get fixated on particular sensations or functions in their body. But I think a lot of people with panic disorder will say, I have health anxiety because their panic attacks are interpreted as health dangers, and that is part of the somatic fixation and panic disorder. But like, no, no, you're not worried that you have a health problem until you get really anxious. And then you're worried that you're having a hell an immediate health problem. So it's that's one of the things that we would differentiate. But to me, I was just like Luca. I would walk around checking my heart all day long. Checking my breathing, how am I breathing? Trying to get a deep breath. Like, I can't get a deep enough breath. I was always trying to fill my lungs all the way and always, always aware. If I was awake, I was aware of my heartbeat until I was got distracted, which is a thing that I learned over time. Like, oh, wait a minute, what does this mean? Like, my heart isn't gonna stop beating if I'm get you know distracted playing with a dog. Could it be?

SPEAKER_02 6:32

Like did you distract yourself with salsa dancing?

SPEAKER_01 6:35

I I should have, but nobody wants to see that. My whole family would be in therapy now, still, if I had done that. So PTSD. BTSD from dad's salsa dancing, but yeah, I was fixated on my heart and my breathing all day long, all day long. And then I started having like benign, what is it? Benign fasciculations where you're having muscle twitches throughout your body that don't mean anything. Then I get focused on those.

SPEAKER_02 6:58

Like uh yeah, I I can relate to that same heart stuff, uh, chest stuff, chest tightness. I mean, what are some of the ones we hear in the community with somatic fixation? Muscle twitches, spasms is one, eye twitches. Um tense jaw is a bit is a good one as well. I can't stop fixating on how my jaw is tense, and the more we fixate on it, the more it happens. Aches and pains, dizziness, um, shortness of breath and air hunger. Um, there's so many things that you can fixate on. Stomach sensations. Oh, stomach, yeah, a big one for me. Stomach sensations. I feel like the the the stomach one that we spoke about in Dr. Sewler's episode way back, I was obsessed with why I was bloated and my sternum and the pressure under my ribs. And basically, my threat monitoring system was going from my scalp to my to my toes, trying to find the anomaly. And then my threat response thought, well, yeah, we must find the anomaly because that must be the threat. And like Lucas suggested, it sounds well sounds the situation Luca's in, yeah, which is your threat response system is scanning you head to toe, like a scanner, and it's suggesting to you, you know, there's a threat here. There's a threat here. It's why Luca went and had all the medical tests and all that, and still wasn't convinced. Even sat and spoke to Chat GPT, which by the way, obsessive compulsive people with health anxiety try not to do that, uh, because you're not going to get the 100% assurance that you want. Yep. Um, and yeah, and you're stuck in this ham, you're on the hamster wheel of kind of trying to find 100% assurance, but your awareness sounds good, Luca. And you know, you suggest actually I start to realize that willful tolerance is the way out here because I'm noticing the patterns in my behavior. Yeah. So all is not lost.

SPEAKER_01 8:50

Keep going. Yeah. They knowing that you're doing it is is a big part of the you know, the first step. Because I think what you find is that people who are somatically fixated initially will defend that. They think it's the right thing. So, Luca, for what it's worth, the fact that you're recognizing, oh wait, I I think I thought this was helping me, but now I can start to see it's a problem. That's a big deal. If you are in that mode right now where you are listening to us and you feel like these guys are crazy because why would they tell me to not pay attention to my breathing or my heart? You may not have reached the point yet where you've recognized that this is actually hurting you more than helping you, being hyperfixated. But uh, I like how you say it's your threat detection system scanning, it's like a scanner. And then you mentioned medical testing that Luca had done. I like to think of it, and we'll get to this, we'll bring it back, as like a really overzealous doctor that lives inside your own head. And that doctor is constantly ordering every possible test that there is to order. Not really, but your internal doctor, your internal physician, is constantly testing your body all the time for signs of disaster.

SPEAKER_02 9:49

We'll get to that because there's just thinking, I was just thinking of Dr. House, Hugh Laurie. I'm like, you're at a bar and you're sat there. Two people walk in and one says, I want a whiskey, and I can't. So you stand there and you look at one with distinct it's amyloid doses hiding behind the cancer.

SPEAKER_01 10:08

If I, you know what? If I have a doctor to that, that's exactly right. If I if I'm having a doctor living in my head, I want it to be Dr. House, to be honest with you. Uh if I could choose, I want it to be that guy. Nobody else. I don't even want my own doctor in my head. I'll take Dr. House. But it's important to recognize I the reason I bring that up is we're gonna get to that because I know everyone's gonna say, well, what do I do about it? Well, we'll we'll get to that part. But initially, it just seems ridiculous when people like Josh and I even suggest that you have to turn your back on some of this fixation. Like, what but it's my heart. Did you ever think that? Like when you were at your worst, what do you mean don't worry about it? It's my heart, it's the most important organ I got.

SPEAKER_02 10:43

Yeah, yeah. Because it's your threat, there's literally threat detection. It it makes you feel urgent and doubtful. That's literally anxiety, so it's okay, but you need to use your rational brain, your wise mind. Um, I'd love to get um we'll get Sally Winston on the show to talk about that because it's really good. But you know, your rational brain, wise mind, worried voice. And you've got to there are two perspectives there. One feels more urgent and real, and the other is like this is the thousandth time we've done this this month, yeah. And we've got kind of empirical evidence to suggest that we're okay, maybe this is an anxiety problem. Yeah, also, as well, the the element of uncertainty that we need to lean into into life in life as well is is really important. Yeah, it's true. Um, and so actually the seeking of certainty um is it can be the problem here.

SPEAKER_01 11:40

Yeah, and that urgent feeling because it it feels like an emergency or it feels urgent, that's not an indicator that it's true. Well, when you say it's literally anxiety, that is the job of that guy to make you feel like everything is urgent and an emergency. Like it's literally what it is designed to do to get you to act right now. So it's not a something broken, it's just something inappropriate, I would say, at the moment. Like my heart, I gotta check my heartbeat all the time.

SPEAKER_02 12:16

Yeah, I remember when I was fixated on my heart and remember there was an attitude shift. Again, one of the first episodes we did of this podcast, the attitude shift was I need to change my immediate response to this. I can't change the anxiety, I can't change the thoughts, but I can change the immediate response. I remember day to day, like the trigger, then the attitude shift would just nope, I'm not going down that way. I'm going to do what non-anxious me would do, and also test this hypothesis that my ridiculous anxious brain is suggesting.

SPEAKER_03 12:48

Yeah.

SPEAKER_02 12:48

So it would be things like I'm sat on the sofa and my, you know, I'm fixating on ectopic beats or whatever, and then I then I go for a walk and actually increase my heart rate rate. Sometimes I'd use it if I felt brave enough, interoceptive exposure, and walk up the stairs. And my anxious brain's going, no, no, your heart's skipping. You can't give it exertion. And I'm like, nah, rational brain says differently. So then I test it and be like, oh. So I did the opposite of what you wanted me to do was to avoid threat monitor and scan like a mere cat, because that's what they want us to do. We turn into mere cats. Instead, I was like, nah, I'm gonna do what Josh is doing and what Josh would like to do. I remember that the more I did that, the less the amygdala fired off, and the less I started to become anxious with it because there was no evidence for the amygdala to hold on to. It thrives off hypothesis, and when you challenge the hypothesis of like, I think that's rubbish, mate. Um, it encodes that memory.

SPEAKER_01 13:51

Yeah. I mean, I think it's important in that, and I get that. Uh, two things I would add to that would be notice that Josh wasn't doing it to make his anxiety go away. He was going, he did it to test the hypothesis that his heart was you were screwed. Like, so that nothing to do with trying to calm down or regulate or anything like that. Regulate but you know, it it was not a technique for calming down. That's really important. And it took action. It you had to do a thing. So when you test a hypothesis and you have to show the amygdala that there's an there's no evidence, I have to show it in my actions. I can't just tell it because no amount of talking to my brain, talking to myself, like trying to, it's okay, it's okay. The doctor said it's okay, it's just it's benign, it doesn't matter. Because I had the same thing, benign PVCs. And so I had to shift from like I would have the initial, like, the initial startle would be there when I would feel like it's like the same exactly the same. But within it, I would have to like literally like exhale, just go ahead. Let's see if there's another one. Like that was scary and hard to do, but it was only that action that changed it. No amount of talking from a cardiologist, my GP, a second cardiologist, none of it sunk in. It would for a few minutes, but then I'd be crappy again the next day.

SPEAKER_02 15:05

And if you're obsessive and compulsive, it's action and focus. So the same example. If I'm sat watching television, I feel a benign PVC. My initial reaction, sometimes I couldn't help it, it was automatically I'd stand up, be like, Yeah, you know, startling. And and then there was a moment where I'd be like, no, I know what this is now.

SPEAKER_01 15:23

Yeah.

SPEAKER_02 15:24

I remember my homework and I'd sit down and I'd focus away. Uh a bit like the the the salsa did it anyway, was that um the question sender in a said, I'm not sure if we're allowed to use their name, but yeah, uh, the question sender inner said, um, you know, I was gonna avoid. I was gonna avoid, I've I've done all these anxious behaviors, and and I went anyway. But where was the focus? Not only were you doing the salsa dancing, were you doing the salsa dancing whilst also body scanning and checking and where no, the focus was probably outwards on the moves, on the dance partner, on wherever. And so the focus is also really important, particularly with health anxiety. You're never gonna get 100% focus because the urge of the screaming urgent omeg de la anxious brain saying, no, no, that there's threat over here. But in past episodes, as I always say, aim for 51%, and some really great brain rewiring occurs.

SPEAKER_01 16:19

Yeah, if you're dealing with somatic hyperfixation, the focus is really important, but you also have to be a little bit patient and nice to yourself because that 51% is sometimes hard. It's hard to get that because people will say, like, well, I'm trying to focus away from it, but I just keep getting sucked back in. Yeah, that's okay. Like the win is in the practice. So for me, I I even started to practice, I had to practice it in the gym. So I would literally be like deadlifting and having PVCs, and all I wanted to do was drop that weight and run the hell out of that gym. Like, I would look for where like the uh the defibrillator is, they would tell me about it. And it would be like, wait a minute, what am I doing?

SPEAKER_02 16:55

Yeah, and I'd have to scanning the compet scanning and judging the competency of the gym stuff. I couldn't use that. Yeah, you remember that, right?

SPEAKER_01 17:02

I remember thinking, that's a nice guy at the front desk, but did he know how to use that thing? And I would I would find myself getting caught up in that, which was okay because it still felt important and urgent to me. And then I'm like, oh, wait a minute. So it was a constant resetting, resetting. That wasn't failure, that was learning. I just had to give myself time to learn that. So be patient. You're not gonna just decide to focus away today and like, oh, look at that, I'm better. It's not gonna happen that way.

SPEAKER_02 17:27

The general rule here, as well, is the more you focus on something, the more aware of and the more anxious you're gonna feel about it.

SPEAKER_03 17:35

Yeah.

SPEAKER_02 17:35

So I had the same, the same thing as like uh twitches, stuff like that, jaw pain. I had jaw pain for months because and and then I went home and tried to force jaw exercises, tried to force you know relaxation exercise. I was just sat there with a TV with my jaw on my chest. Yeah, like I just need to keep it relaxed. But actually, what's more relaxing, doing doing reactionary kind of relax, uh relaxation exercises to stop the jaw, or actually being like, well, actually, if I work on just being okay with anxiety and working on the willful tolerance of the symptoms and the uncertainty, I'm gonna be more relaxed in the long term. And I remember one day I was out with my mate and he was like, Oh, it's got jaw pain. And I just remembered that I had that for months and I'd forgotten about it. It just there was just a moment where it just went. Yeah, and I didn't actively do anything, just the brain got bored because I wasn't reacting to it. That's so important with health anxiety. And anyone who's obsessive and compulsive, whether it's with anxiety or with health anxiety, you'll realize uh your rational brain will soon realize as well like I'm fueling the fire with the attention I give to this. Yeah, I've done, and if you've done all your due diligence, given all the rational brain things like, you know, I know this is okay, doctors said it's okay, specialists said okay. Now's the time to leave it alone. When you turn your back on it, it's not gonna feel safe. When you do what non-anxious you are gonna do, it's not gonna feel safe. But like Drew said, the more you practice, the easier it gets.

SPEAKER_01 19:10

Yeah, it feels reckless or irresponsible in many, especially people with OCD and health anxiety will use those words. That feels highly irresponsible. Like, why would I focus away from jaw pain, which is an indicator of a heart attack? I have kids, I have a family, I have responsibilities. I can't afford to take that kind of I hear that a lot. I can't afford to take that kind of risk. Okay, but you've been mitigating that risk for four years now. Like, have you, you know, let's look at the evidence here. You've seen, but I've seen the evidence. I just I can't find myself, I can't find a way to believe it. Then you're gonna have to be reckless. You'll have to be reckless today.

SPEAKER_02 19:41

It is right. Oh, yeah, like pins and needles in your hands and feet. Yeah, that's a sign of the stuff. Well, stroke, right?

SPEAKER_01 19:47

That's ALS, that's MS, that's whatever.

SPEAKER_02 19:49

Like, yeah, yeah, or a heart attack, or blood a blood clot ones I hear all the time. Yeah, you know, and then ironic ironic, not ironically, but like counterproductively, you fixate. Oh, is the tingling there? Is it gone? Is it there? And you and you fixate, but the more you're fixating on the body, yeah, you're keeping it in a stress state, so you're more likely to have it called self-perpetuating anxiety symptoms. So, Luca, if you're obsessing about your stomach, your body's gonna be releasing cortisol and adrenaline. Your your body is not going to prioritize digestion because you're anxious and worried, so it's a self-perpetuating anxiety symptom where you're gonna feel bloated. I had that for years. You know, I would eat the cleanest salad ever, and I'd bloat and I'd have these pains because my body's like, we're not interested in digesting this. Yeah, one, because it's salad and it's boring, but two, also, you know, the the we're in threat mode. We need to prioritize and move resources to threat mode. Same with a headache. If you've got a headache and you're obsessed and checking compulsively, Googling, looking at screens, trying to make it go, you're gonna keep yourself in a stress state. Is that gonna help your headache? No. I once had a headache, Drew, for nine days straight. I can't believe that. Just and and I was and then of course I started to get worried. Like, oh, what's this? What's that? Um, and yeah, I just it's one of those things where to try and step off the hamster wheel and notice that the obsession and the compulsions are perpetuating the hamster wheel.

SPEAKER_01 21:23

Yeah, you think it's helping, like it's clearly keeping me safe, it's making me feel better to put my finger on my my carotid artery and check my pulse all day long. I thought that was making me feel better. I'm in sometimes in session with clients now, and I have to remind them put your hand down. They don't even know they're doing it. Like, I I see you checking your pulse, put your hand down. And that becomes a real challenge. Like, oh, I didn't I don't even recognize I'm doing it. But well, when I put my hand down, now it feels oh, it's really hard to not put my hand back up there because I think this keeps me. It's automatic, yeah. Yeah, it's like automatic. So it's it's practice, it's practice, it's practice. It is a thing, that's the way it goes.

SPEAKER_02 21:55

I have bruises in my abdomen where I was constantly checking my abdomen. Poking. Bruises from just my finger pressing into my into my abdomen. That happens. What's this? What's that there? And yeah. And just yeah, it's but again, it's part of somatic fixation.

SPEAKER_01 22:09

I had my sternum, you know, was literally sore because I would walk around all day poking at my rib cage and my sternum. Like I I don't know what I was thought I was doing, like massaging it. Like, I mean, you know, you know how that goes. Like the amygdala is really fast, but it's not very smart.

SPEAKER_02 22:26

Like that's it's an attempt to self-soothe, isn't it? But it's counterproductive.

SPEAKER_01 22:30

Yeah. And I'm like, what in retrospect, I have to look back and think, well, what did I think I was doing? If I thought my fear was that my heart was just gonna stop, it would just spontaneously stop, which like hearts don't do. But I don't know what I did. I think that like massaging my sternum would keep that from happening. I don't know what I was doing, but it it was an attempt to try to soothe. But all I was doing was paying attention, paying attention, paying attention. And it's interesting because you have sensations, your body makes sensations all day long that you don't even notice. Like the only time I notice my stomach right now is if I'm, I guess, really hungry and it's making noise. But if I was hyper focused on what my stomach was doing, I would feel everything it did all day long. And it's doing stuff all day long. I just don't notice it. Or I have a twitch still in my right shoulder that occurs regularly. And the other night I what is with the balloons? Is that macOS? Just do all kinds of stuff. I said I have a twitch in my shoulder and it launched balloons like we were at the opening ceremonies at the Olympics. Like, what up with that? But uh my twitch appears now and then, and the other day was the first time that I even like noticed it. I'm like, oh yeah, that still happens. So I remember when I got down the road to recovery thinking, either I not only I'm getting better at my anxiety, but I've literally cured eight diseases in my body somehow magically, or I was just really paying too much attention. I had I ultimately had to face that fact. Could it be that I just somehow fixed my body? I don't think I did. I think I just stopped paying attention to it so much.

SPEAKER_02 23:56

Attention's so important though, isn't it? All mine is like it was just attention.

SPEAKER_01 24:00

Yeah.

SPEAKER_02 24:00

And it's so difficult when your attention becomes automatic. Think about anyone listening now, including you, Drew. How automatic do you pick up your phone and scroll it?

SPEAKER_01 24:11

Oh, it is so hard to break. I've been working so hard at that, it is hard to break that habit.

SPEAKER_02 24:16

Yeah, and and if that's hard to break, and you know how automatic it is when you're picking up your phone to scroll, yeah, or whatever. Under that automatic behavior category is the attention to go inwards if you're a somatic fixator.

SPEAKER_01 24:29

Yeah, a hundred percent. Well, I mean, our our uh the when we go back to the default moat network, we have nothing else to occupy ourselves, we will think about us. That is true. That's all humans do that, yeah. And then anxious humans will think about themselves in a in a threat monitoring kind of way. How do I feel? Is that right? Should I feel this way? How am I gonna feel?

SPEAKER_02 24:46

How do I feel like I call it the very in my first ever book, which I wrote in my twenties, was like I call it the default thought. Yeah, you know, like I feel when people say I feel different from normal people, it's like, yeah, but what's their default thought? You know, and often it won't be inwards, it's not an inwards compulsion. Yeah, it's often, or if it is an inwards compulsion, it's a it's a conceptualization of something in their life, you know, or but like it was the inwards compulsion for anxious people, particularly with health anxiety, is check, scan, monitor. Whereas someone else might be, um, I wonder what I'm gonna have in my burrito later.

SPEAKER_01 25:27

Or it is check. I mean, I think we might be able to argue that the thoughts of an anxious person are not all that different than the thoughts of a non-anxious person. It's the duration of the engagement that makes the difference. So all human beings will ask themselves all day long, multiple times a day, is this okay? Am I okay? Those are probably default questions for humans to ask themselves. Just that a non-anxious person asks the question, answers it quickly, is sure enough. That's a Marty Stevens Hallie Winston thing, sure enough, learning to be sure enough, that they answer the question really quickly and they move on. An anxious person asks, am I okay? And maybe that comes out as somatic fixation, and then spends the next hour and a half trying to get a good answer to that. Where is my concrete evidence? Right, exactly. So, like non-anxious people are concerned about these things too, but for very short amounts of time. Whereas people with anxiety disorders are concerned about these things constantly. They have not learned to shorten that duration. And really, and when you're dealing with hyperfixation somatically, or even on a thought, if it's a cognitive fixation, what you're actually learning in recovery is to shorten the duration of that fixation back to the normal thing, which is a couple seconds, maybe.

SPEAKER_02 26:41

Here's a game, Drew. You ready? Name the ingredients of a burrito. Beans. Correct.

SPEAKER_01 26:48

Yeah, what's in a burrito? What about you? Well, which one is a burrito? A tortilla. Yeah.

SPEAKER_02 26:53

Yeah, obviously, yeah, definitely. I'm not having one of these naked burritos. Give over.

SPEAKER_01 26:57

What are we, savages? Yeah.

SPEAKER_02 26:59

What else would you have in the there's cheese in a burrito, right?

SPEAKER_01 27:02

Cheese, yeah. Salsa! There's salsa in a burrito, too. Disordered dance party.

SPEAKER_02 27:12

They can't see us dancing.

SPEAKER_01 27:13

They can't see us dancing. Sorry, we're out. So children, how do you guys even listen to us every week? We had a good time, huh?

SPEAKER_02 27:20

So yeah, it was uh where were the balloons when we needed burrito?

SPEAKER_01 27:24

Yeah. Like that was a moment that the my Mac should have showed us balloons and it didn't.

SPEAKER_02 27:28

No, it it was just Monday, you know. It was judging us.

SPEAKER_01 27:34

Like, I know you want balloons, but no, children. What would be your advice to Luca? So my I'm gonna bring back my overzealous physician that lives in your head, but your Dr. House that lives up in your amygdala and like sets up in your limbic system.

SPEAKER_02 27:47

Not not Dr. House, because he goes through six most of the most controversial, highly expensive tests. He never gets it first right first time, does he? That's true. Yes, they have to fill an hour in this episode. And he's like, well, maybe it's this rare kind of South American uh tropical disease or something that you've got from the Amazon rainforest. Uh, and then it's never that, is it? You're watching House, you're like, That's true.

SPEAKER_01 28:13

It's never that.

SPEAKER_02 28:13

So maybe you don't want Dr. House in your head in your head.

SPEAKER_01 28:16

You might be right, because he's always changed, and they're the other doctors like, you know, there's only like four recorded cases of that ever in the history of man. Doesn't matter, test him for it. And then he's wrong. It's like, oh, wait a minute. Have you eaten Kiwis lately? And he comes up with some sort of obscure latex allergy and solves the puzzle. But like, I I okay, so it's not Dr. House, but Luca and anybody else with somatic fixation, if you think of that somatic fixation as I like to use the overzealous, like a new doctor literally just graduated from med school and like wants to be overly cautious so they don't get sued. Like I'm gonna keep running tests, says your the doctor in your brain, again and again and again. And every eight minutes, I'm gonna hand you test results. So one thing that you can really do is to resolve to say, I can't make that doctor forcibly stop make doing the test. My internal physician will keep testing me until they finally get the message that I am not reading the results. So when that internal physician hands you a printout full of test results, you have to crumble it up and throw it on the floor, which feels super reckless. But that's essentially what you're doing. Could you imagine just throwing away the test results that you get from your physician? And then be like, but what are you doing? And then it runs the test again and hands it, but look, look, look. Crumble it up, throw it away, crumble it up, throw it away. Feels really wrong, you got to keep repeating it, but sooner or later, your your overzealous rookie physician that lives in your brain is gonna say, I guess I I guess I'm not gonna do this anymore. They're not reading the test anyway.

SPEAKER_02 29:39

And you mentioned like willful tolerance, reframe it. This is here's a time for me to practice willful tolerance. And maybe that is with aches, pakes, and twin and twinges and not feeling 100%. But you practice that like you practice the guitar and you get better at it the more you do it.

SPEAKER_01 29:53

Or you know, there's a realization that like this is happening now. Don't let anybody tell you that the feeling is in your brain, it's not like it's not all in your mind. You literally feel, say, chest pain or shoulder pain or jaw pain or a twitch. That's really happening in your body. So, can you, as part of that, crumple up the test results and throw them away? You're gonna have to accept the reality that this is happening right now. I have pain in my jaw right now. Correct. But I ain't gonna do anything about it and see what happens. So that but that's a slow, repetitive process that involves doing things that feel like you should not do. Then you learn that it's okay to do them.

SPEAKER_02 30:27

So if you're a hyperfixator, somatic hyperfixator at home, catch yourself. Yeah, don't go easy, don't listen to Craig the Critic. Just go easy, but okay, I've caught myself now. How can I create a new habit, change this automatic behavior, and kind of you know, learn to practice this willful tolerance, leaning leaning into uncertainty and keep catching your attention, you know? The more I focus on this symptom, the more likely it is to stick around. It was certainly the case for me and Drew as well.

SPEAKER_01 30:56

Yeah, let's say one more question, I think, before we start to go to community stuff or wrap up the episode. But I hear all the time, okay, but what if I miss what what if I get so good at this that I actually learn to ignore a heart attack? That's it. Yeah, yeah, that one all the time, right?

SPEAKER_02 31:13

You're not gonna avoid that. Also, people misinterpret or have a belief that only their anxious mind is capable of making decisions. Your rational brain can also tell you when something's not right.

SPEAKER_01 31:25

That was worth the price of admission, right there. That was excellent.

SPEAKER_02 31:28

Yeah, because the thing is that's the only one voice that's looking out for me. No, yeah. Rational brain is also there to do that too.

SPEAKER_01 31:35

It'll know. You'll know if something is really wrong. You really will. And like you're learning to be sure enough. So you might make a mistake in two years and misinterpret something, but okay, then I'll move on from that. It's all right. You know, you might err on the side of caution because you always might tend toward that. That's not a crime, it's okay. But uh, yeah, you're not gonna learn to be a robot and ignore health problems. They're worried about it.

SPEAKER_02 31:56

No, it's it's a good point, yeah. Cause it's yeah, because it fee again goes back to that point of it feels irresponsible to leave it alone. No, it doesn't. You're at your rational brain's always there.

SPEAKER_01 32:05

Yeah, it's got your back. It's got it knows when something is up, but it'll tell you when it needs to. It just doesn't need to all day long, anyway. Yeah, yeah. Absolutely. So, what do we got? We got uh questions, other did it anyways. What do we got? We got another audio. Uh I've got I've got um a written did it anyway, and we've got a audio did it anyway. We do have an audio did it anyway. So, what's your written one? Why don't you do that one?

SPEAKER_02 32:26

Sure. Uh questions sender in a did it anyway, sender in a didn't give permission to use the name, but here we go. Did it anyway. I suffered panic disorder and overcame it with CBT, ACT, books and techniques, SSRIs, and the holy grail willful tolerance. Well done. This changed my attitude completely, and I've been recovering since December 2022. However, in the last four months, I've changed jobs, graduate on a master's course, moved cities, and found out my mother-in-law has aggressive cancer. The weekend pass was tough. For the first time in almost a year, I've had really intense anxiety, panic, and DPDR. My family encouraged me to go home, to take diazepam, to not go to work, etc., and rest. And I was so afraid to go to work in case I had an episode of panic there or in the car. But I did it anyway. I am typing this from my desk. The waves of anxiety are still coming, the intrusive thoughts, the fear of relapse, the DPDR, but I am not changing my behavior. I hope I can keep go doing this and not fall back into a difficult pattern. P.S. You guys save my life. Oh, thanks.

SPEAKER_01 33:37

I love that.

SPEAKER_02 33:39

I love that. That's the way your stress drug's full. And yeah, you're you're you're when our stress drug becomes full, expect the anxious response to start misfiring. It's okay. But what you're trying to do, and it sounds like you're doing really well, is to not let the anxious response go into disordered territory. You're gonna feel anxious, you're gonna feel stressed. You can't stop that, but we're just trying to stop the anxious response from folding in on itself, or you end up on a really small hamster wheel where we're just obsessing about the symptoms itself. You've got this. Well done, and thanks for sending that in.

SPEAKER_01 34:11

Yeah, it's a really good point. That's one thing that I do hear people say all the time, like, oh, you know, I'm moving house, I just changed jobs, my cat died. Like they tell me 18 different things that are happening in the last two weeks, and my anxiety came back. Or you're human and you're feeling some stuff that you're gonna feel. Not everything is an anxiety disorder problem.

SPEAKER_02 34:27

Supposed to fear, uh, feel anxiety doesn't mean we have to develop a phobia, right? That's exactly right.

SPEAKER_01 34:32

Excellent. Thank you for sending that in. Let's do an audio did it anyway. We got another one, and it might have some salsa music, it's possible. Oh, it does. Yes, it does.

SPEAKER_00 34:42

Hi, Drew and Josh. Um, my name is Jack. I'm from Leeds. You can uh you can use my name. I I just thought I'd um drop in with a did it anyway. I've just got back from my stag weekend. Something I was really nervous about for weeks building up a lot of my um anxiety comes from it. Nausea, headaches, how am I feeling, and that kind of thing. And I knew there'd be an expectation to drink.

SPEAKER_01 35:07

I didn't know when Can I just say for a second how how horrible we are? This guy's telling us all these horrible anxiety symptoms, and we have some music. Hang in there, Jack. We don't mean to be disrespectful, let's get back to it.

SPEAKER_00 35:21

Nausea, headaches, how am I feeling, and that kind of thing, and I knew there'd be an expectation to drink. I didn't know where it was gonna be, and I was getting picked up by a friend, even though normally I've drives, so I've got an escape route. Um the day came, it was a three-hour drive over to the Lake District, and then we didn't have a great time when I was there, had a few drinks, and I survived the three-hour trip back um with the kind of hangover you can imagine. Um yeah, I don't think I could have done that uh a year ago, so hopefully this helps someone. Um, and yeah, just want to thank you guys for your help.

SPEAKER_01 36:04

Why wouldn't it help? That was excellent.

SPEAKER_02 36:07

Well done, Jack. That was brilliant. I love that. And again, I should have brought in Billy Mays there. He did so many things, he was afraid to go. Um, I don't know if they've salsa music in the lake district, but I highly doubt it. Uh, but well done, Joe. That's really good. So many different things as well. The anxiety was telling you, beware of that, beware of that, that might trigger it, that might trigger it. And you and you threw yourself into it, and not only that, but you ended up having a good time. So, yeah, well done, man.

SPEAKER_01 36:33

Yeah, definitely. Uh he's not done yet, just kept going, love it. And uh, it definitely would help somebody. And by the end, it deserved the salsa music. Although today I learned that the Leeds accent and salsa music are not they're not really a match, just saying. Sorry, Jack. But thanks for sharing, we appreciate it. Anyway, we got anything else or should we wrap it up? What do you think?

SPEAKER_02 36:50

Oh, we could wrap it up there. Thank you everyone for tuning in. If you uh got a did it anyway or a question, you can get in contact with us at disordered.fm. You can leave a voice note, or you can um to send us a message or an email. Uh follow us on social media, the.anxious.truth and anxiety charge. And yeah, we'll be back here every Friday.

SPEAKER_01 37:12

Yeah, thanks for hanging out, guys. We will see you next week. We are out.