How To Support an Anxious Flyer
Traveling with someone anxious about flying? Check out this article on Travel and Leisure Magazine that Jenny contributed to for helpful tips on how to support your loved one.
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How to Handle Big Feelings
Dropping Anchor: A Helpful Tool for Handling Anxiety, Panic, and other big feelings
Dropping anchor is a tool from ACT (Acceptance and Commitment Therapy) that can be really effective for any big feelings-anxiety, anger, shame, etc.
The 3-part excercise is meant to help you gain more control over your actions (instead of freezing up, ruminating, or lashing out). This exercise also helps reduce the impact or power of the big feelings.
Please note, the goal is NOT to eliminate the big feelings or difficult thoughts. When that becomes the goal, we can easily get hooked further by these experiences.
Remember this acronym: ACE
It stands for Acknowledge, Connect, and Engage
Check out the exercise below. If you prefer to practice this exercise through audio, check out this recording I made that will walk you through it.
Acknowledge your thoughts and feelings
Notice them with curiosity and without judgment. It helps to say them in a matter of fact way, like “here is worry,” or “I’m noticing a racing heart.” You can also be more vague such as “here are difficult thoughts/feelings” or “I’m noticing pain.”
This part of the skill is critical. Many other strategies like grounding, deep breathing are good at getting you connected with your body but they are also aimed at distraction. The acknowledge part of this skill is helping you to not avoid or distract, by naming your experience you are actively accepting it and creating distance from it.
Come back into your body
Do any small movement to reconnect with your body. Have a gentle stretch. Wiggle your toes and fingers, walk, or shift in your chair.
While doing this movement, continue to practice acknowledging your thoughts and feelings (so this doesn’t become a distraction technique).
Engage in the world
Now it’s important to refocus and engage with an activity. The purpose of this exercise is to help you be able to take effective action, even if you are experiencing difficult thoughts or feelings. This can be done in several ways:
Actively notice the environment you are in right now. Name something you can see, hear, smell, touch, or taste.
Take note of where you can put your attention next to make the most of this situation. Maybe that means returning to some work you were doing. Taking the dog for a walk. Or maybe engaging in a game with your kids.
Dropping Anchor Audio Recording
When practicing a new skill, it can be more effective to listen and be guided through the exercise instead of reading instructions. So I made an audio recording that you can use to listen to when you are practicing this skill. After awhile, you won’t even need the recording, the skill will become natural to you.
Written by Jenny Matthews, LMFT, LADC
Jenny is a therapist that specializes in helping over-thinkers and worriers get relief from anxiety so they can be more productive + do what matters + be present with their loved ones.
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How to Overcome Your Fear of Flying
5 Strategies to Help You Overcome Your Fear of Flying
Get Started with Our Flight Anxiety Toolkit
What’s Your Core Fear of Flying?
Your afraid of this behemoth machine crashing?
You’re afraid of turbulence breaking the airplane apart?
You’re afraid of flying into a thunderstorm and crashing?
You had a panic attack on the airplane last time and you’re afraid that the panic will return?
You’re claustrophobic, so the slightest idea of sitting in this tiny cylinder would drive you mad?
You’ve seen media stories of passengers losing control on the airplane and trying to escape out of the emergency exit and now you’re afraid that could be you?
You have a history of health anxiety and the idea of being too far away from a hospital is keeping you from boarding that airplane?
Why Do You Want to Fly?
Is it something else? If so, dig deep to see if you can extract your core fear.
I yearn to participate in a family vacation (without having to drive alone)?
I yearn to apply for a job that requires air travel?
I yearn to tap into my adventurous side and see the world?
I yearn to break away from the shackles of fear and develop confidence in myself?
Is it something else?
3. take action
If your fear is centered around not understanding how airplanes operate or weather/turbulence related fears, commit to learning how airplanes work.
If your fear is FEAR OF FEAR, try to become more mentally flexible with scary, uncomfortable thoughts, feelings, memories, and bodily sensations:
Practice using your attention muscle (that thing you use to read and communicate) to not engage with all of the “What if’s” that pop into your awareness. Learn more about attention vs. awareness and rumination here.
Increase your willingness to FEEL ANXIETY and not try to push it away, fight it it, or pull you into more avoidance or rumination.
Remind yourself why you’re willing to expand your comfort zone and face your fear. (I want to be able to get away in the winter months, I want to visit my relatives, etc)
4. Anxiety is uncomfortable but not dangerous
Remind yourself that after you face your fear, you will learn that fear is simply an emotion that can’t harm you. You will also learn that fear loses its power after you face it head on!
5. Seek Additional Support for Your Fear
Overcoming fear is not easy, and you don’t have to do it alone. Having a professional, like a therapist that specializes in treating anxiety disorders and phobias, that can walk you through this challenge can be a game changer.
A therapist can help you create an individual plan to how to work on facing your fear. Therapists can be great for accountability if you know you have a tendency on letting avoidance take over.
At State of Mind Therapy, our therapists are skilled at treating flying anxiety. We work with clients one-on-one and have digital courses that you can join to give you the tools you need to overcome your fear.
Scheduled a free 15 minute phone consultation to get started working with one of our therapists at State of Mind Therapy.
How Rumination May Be Keeping You Prisoner to Anxiety and OCD
Let me guess...
It feels like there's a never-ending NASCAR race in your mind—the cars being racing thoughts that produce scary thoughts, intrusive images, distressing memories, and catastrophic predictions.
Your mind just keeps spinning, spinning, spinning.
Eventually, it makes you feel like a prisoner to an endless race you never even signed up for.
We get it. And we can help.
As clinical mental health therapists, we often hear clients describe themselves as "overthinkers." They tell us they can't relax because their minds are constantly spiraling out of control.
But here's what often surprises them:
They're not just having anxious thoughts—they're doing something with those thoughts, often without even realizing it.
That process is called rumination.
When working with us, clients are often surprised to discover just how much they've been ruminating without knowing it. Once they begin recognizing this pattern, many finally understand why their anxiety or OCD has continued to feel so persistent.
What Is Rumination?
Professionals in the mental health field have traditionally described rumination as repeatedly thinking about past or future life events.
You've probably heard it explained like this:
Thinking about the future is anxiety.
Thinking about the past is depression.
While there's truth to that, our understanding of rumination has expanded significantly over the past several years.
Today, we recognize that rumination isn't simply what you're thinking about—it's also how you're engaging with your thoughts.
This distinction is important because it helps explain why so many people continue to feel stuck in anxiety, panic, or OCD recovery.
One of the biggest misconceptions about rumination is that it feels productive.
Most people aren't ruminating because they enjoy worrying. They're trying to solve a problem, prevent something bad from happening, or finally feel certain.
Unfortunately, the very thing that feels protective often becomes one of the biggest things keeping anxiety alive.
What many people with anxiety disorders or OCD don't realize is how much rumination contributes to both their anxiety symptoms and their reluctance to engage in exposure therapy.
As specialists continue learning more about rumination, greater attention has been placed on how people mentally respond to fear—not just the fear itself.
Dr. Michael Greenberg, a specialist in anxiety and OCD treatment, has identified several common ways people engage in rumination.
As you read through the list below, see if any of these feel familiar.
Ways We Can Ruminate
Rumination doesn't always look like obvious worrying.
Sometimes it happens so automatically that we don't even recognize we're doing it.
Common forms of rumination include:
Trying to figure something out
Directing attention toward thoughts or feelings
Mentally staying on guard
Trying to push thoughts away or prevent them from entering awareness
Using mindfulness or distraction with the goal of making thoughts disappear ("bad mindfulness")
Engaging in excessive self-talk
Many of these behaviors feel helpful in the moment because they create the illusion that we're solving the problem.
In reality, they often keep us mentally locked onto the very thing we're trying to move away from.
Rumination Is a Choice (Even Though It Doesn't Feel Like One)
Many of our clients tell us,
"I overthink."
"I worry constantly."
"I obsess."
But what's actually happening is a little different.
They're engaging in rumination—they just don't recognize it yet.
This distinction matters because it changes how we approach treatment.
An obsession is an intrusive thought, image, urge, or sensation that shows up automatically.
That's something we don't have control over.
A compulsion, on the other hand, is effortful.
It's something we do in response to the obsession.
When you respond to an intrusive thought by trying to figure it out, monitoring your body, mentally reviewing evidence, or repeatedly reassuring yourself, you're actively directing your attention toward the obsession.
Those mental behaviors are compulsions.
And rumination is one of the most common mental compulsions we see.
One reason rumination keeps people stuck is because it doesn't feel like a behavior.
It simply feels like thinking.
That's why so many people believe they have no control over it.
The good news is that once you learn to recognize rumination as something you're doing—not just something that's happening to you—you can begin practicing a different response.
That doesn't mean you'll stop having intrusive thoughts.
It means you can gradually change how you relate to them.
A Real-Life Example
Let's say Johnny has health anxiety or OCD.
Johnny's core fear is that he has a serious illness, but no one has been able to diagnose it.
He recognizes there's very little evidence that anything is medically wrong, and he's been evaluated by multiple healthcare professionals.
Yet the fear still feels convincing.
Whenever an intrusive thought about his health appears, Johnny immediately begins engaging with it.
He may monitor his body throughout the day, scanning for abnormalities—a new ache, a tickle in his throat, an unusual sensation, or a small change in his skin.
He may spend hours researching symptoms online, hoping Dr. Google will finally provide the answer everyone else has missed.
Or he may mentally review every food he has eaten, every chemical he's been exposed to, or every illness he's encountered, trying to solve the mystery.
Johnny might even repeatedly tell himself,
"I'm going to be okay."
Or engage in excessive prayer in hopes that it will prevent something bad from happening.
Here's what's important:
Johnny isn't doing these things because he wants more anxiety.
He's doing them because he's trying to feel safe.
That's what makes rumination so deceptive.
It masquerades as problem-solving.
But each attempt to gain certainty teaches his brain that this fear deserves more attention.
Instead of reducing anxiety, it quietly strengthens it.
But What If There Really Is a Problem?
At this point you may be thinking,
"But what if there actually is a problem?"
Or,
"Why is it such a big deal if I do this?"
Fair questions.
After all, our brains are designed to solve problems. If there really is something wrong, we want to pay attention to it.
However, there's a reason Johnny is seeking mental health treatment.
He's suffering from anxiety that's interfering with his ability to live a normal life.
Now, Johnny could continue searching for answers by visiting more specialists, spending more time researching on the internet, or constantly monitoring his body for evidence of illness.
But all of those behaviors come with significant costs:
Time
Energy
Worsening anxiety
Conflict within relationships
Avoiding places or situations that trigger anxiety
Here's the irony.
Johnny believes he needs to ruminate so he can finally feel better or feel safe.
But once he begins recognizing rumination for what it is, he realizes that he's actually fueling the very anxiety he's trying to eliminate.
That's one of the biggest traps anxiety sets for us.
The behaviors that feel protective in the moment often become the very behaviors that keep anxiety going over time.
So What Do We Do Instead?
Once we understand that rumination is a mental compulsion—and something we actually have some influence over—the goal changes.
Instead of trying to make the thought disappear, we learn to let the thought be there without continually directing our attention toward it.
This is often easier said than done.
Your brain has likely spent months—or even years—learning that every scary thought deserves your full attention.
Changing that habit takes practice.
Fortunately, one concept makes this much easier to understand.
Attention vs. Awareness
Attention is the mental muscle you use to intentionally focus.
You use it to:
Read a book
Watch a movie
Have a conversation
Solve a math problem
Notice a beautiful sunset
Awareness is different.
Awareness includes everything that's happening in the background of your experience.
For example, as I type this article, my attention is directed toward my computer screen and keyboard.
At the same time, I'm aware that my neighbor is using an incredibly loud leaf blower.
I'm aware of birds chirping outside.
I'm aware of the wind moving through the trees.
Those sounds exist in my awareness, but they don't have my attention.
The same thing can happen with anxious thoughts.
An intrusive thought can remain present in your awareness without becoming the center of your attention.
This is an important distinction because many people believe they only have two options:
Solve the thought.
Get rid of the thought
But there's another option.
You can allow the thought to exist in your awareness without continuing to engage with it.
It's worth noting that there isn't always a perfectly clear line between attention and awareness.
Sometimes they overlap.
That's okay.
As you begin practicing this skill, you'll gradually become better at recognizing when you've shifted from simply noticing a thought to actively engaging with it.
Why Redirecting Your Attention Matters
Johnny does have some control over where he directs his attention.
The difficult part, of course, is resisting the powerful urge to direct that attention back toward the fear of a possible illness.
Like any new skill, this takes practice.
It's also important to recognize another common fear among people with anxiety and OCD.
Many people believe their anxiety will stay forever if they stop trying to solve it.
They think,
"If I don't keep thinking about this, I'll never feel better."
Or,
"If I stop trying to figure this out, something bad will happen."
Fortunately, that's typically not what we see.
In our clinical work, we often find that when clients begin reducing rumination and become more intentional about where they direct their attention, they start noticing meaningful changes over the next several days.
The anxiety may not disappear overnight.
The intrusive thoughts may still show up.
But the urge to engage with them often begins to lose its intensity.
That's because the brain is slowly learning that every intrusive thought doesn't require immediate action.
Isn't Redirection Just Distraction?
Some therapists may argue that this approach is simply another form of distraction.
I see it differently.
Distraction is often used to escape uncomfortable thoughts or emotions.
What we're talking about here isn't escaping anxiety.
We're allowing the thought to exist while choosing not to engage with it.
That's a very different process.
In fact, this is an exposure exercise.
Rather than chasing certainty by answering every frightening question your mind demands, you're exposing yourself to uncertainty by allowing those questions to remain unanswered.
This is exactly what Exposure and Response Prevention (ERP) is designed to teach.
You're practicing uncertainty instead of trying to eliminate it.
And that's where meaningful recovery happens.
Interestingly, we've also found that once clients become more skilled at reducing rumination, exposure exercises themselves often become less overwhelming.
Instead of exhausting themselves mentally before the exposure even begins, they're approaching it with a different relationship to their thoughts.
That shift can make a tremendous difference.
Putting This Into Practice: The Choice Point
Once you've determined that your obsession or fearful thought isn't rational or helpful, you've arrived at what I call the choice point.
At this point, you have two options.
You can continue directing your attention toward the perceived threat by continuing to ruminate...
Or...
You can choose to respond differently.
That doesn't mean the thought disappears.
It means you're making a different choice about where your attention goes.
Here's what that can look like.
1. Acknowledge and Label the Thought
When the thought enters your awareness, simply acknowledge it.
For example:
"I'm noticing a thought related to my health anxiety."
Or,
"There's my OCD trying to pull me back into figuring this out."
You don't need to do this every single time.
The goal is simply to notice what's happening before automatically getting pulled into rumination.
2. Make Space for the Emotion
Allow the emotion to be present with openness and self-compassion.
You don't have to like feeling anxious.
You don't have to convince yourself everything is okay.
Instead, practice allowing the discomfort to exist without immediately trying to make it go away.
3. Redirect Your Attention
Intentionally direct your attention somewhere else.
That could be the conversation you're having, the task you're working on, your surroundings, or even simply sitting quietly.
The important part isn't what you direct your attention toward.
It's that you're no longer directing it toward the obsession.
4. Let the Thought Remain in Your Awareness
Allow the feared thought or feeling to stay in the background for as long as it wants.
Don't argue with it.
Don't reassure yourself.
Don't try to solve it.
Simply allow it to exist without engaging with it.
5. Expect to Slip Up
You're human.
You'll catch yourself ruminating again.
That's okay.
Rather than criticizing yourself, simply notice what happened and gently redirect your attention again.
Recovery isn't about doing this perfectly.
It's about practicing the skill over and over until it gradually becomes more natural.
A Helpful Check-In
If you notice your anxiety continuing to climb, pause and ask yourself:
"Am I ruminating right now?"
Then follow it with another question:
"How am I directing my attention toward this thought?"
Sometimes simply recognizing that you've slipped back into rumination is enough to help you make a different choice.
If You Remember One Thing...
If there's one idea I hope you take away from this article, it's this:
Thoughts are automatic. But rumination is what we do after the thought shows up.
That distinction is incredibly important.
You may not be able to stop intrusive thoughts from entering your awareness.
But you can gradually learn to change how you respond to them.
Like any new skill, redirecting your attention takes practice.
Some days you'll notice yourself ruminating dozens of times.
That's okay.
Every time you notice it and choose a different response, you're teaching your brain that uncertainty doesn't always require immediate action.
Over time, that's often when anxiety begins to lose its grip.
Frequently Asked Questions
Is rumination a compulsion?
It can be.
When rumination is used to gain certainty, reduce anxiety, or make yourself feel safer, it functions as a mental compulsion. Although it isn't visible like handwashing or checking, it can keep the anxiety cycle going in much the same way.
How do I know if I'm ruminating?
Ask yourself:
"Am I trying to solve, analyze, or gain certainty about this thought?"
If you're repeatedly reviewing evidence, mentally debating, researching, monitoring your body, or reassuring yourself, there's a good chance you've shifted from simply having an intrusive thought to actively ruminating.
How State of Mind Therapy Can Help With Rumination
Let's be honest—these skills can be difficult to put into practice on your own.
Rumination often becomes such an automatic habit that many people don't realize they're doing it until someone helps them identify the pattern.
Working with an anxiety or OCD therapist can help you recognize the subtle ways rumination shows up, understand what keeps it going, and build practical skills for responding differently.
At State of Mind Therapy, we use evidence-based approaches like Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) to help clients reduce rumination, develop a healthier relationship with uncertainty, and regain freedom from anxiety and OCD.
If you're ready to take the next step, schedule your free 15-minute phone consultation to see if we're the right fit to help you.
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![[Video] 5 Minute Guided Mindful Break For When You Feel Overwhelmed](https://images.squarespace-cdn.com/content/v1/579013142994cad3347cf4b9/1660754727477-NHEA9RDH5Q05TRE9T681/Screen+Shot+2022-08-17+at+11.28.01+AM.png)
[Video] 5 Minute Guided Mindful Break For When You Feel Overwhelmed
When you feel stressed, anxious, and overwhelmed it can help to take a break to regain a sense of peace so you can focus and be present in the world around you.
Written by Jenny Matthews, LMFT, LADC
Jenny is a therapist that specializes in helping over-thinkers and worriers get relief from anxiety so they can be more productive + do what matters + be present with their loved ones.
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State of Mind Therapy in Bloomington can help. Click the button below to sign-up for your free 15 minute phone consultation today.
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How to Stop OCD Compulsions: Strategies for Resisting the OCD Cycle
We know that overcoming OCD isn't easy. And you have probably tried to reduce or stop engaging in compulsions many times and found it to be really difficult. In this post, we want to share some tips with you about ways to prevent yourself from engaging in compulsions.
First of all, why is this important? I'm sure you have many of your own personal reasons why you want to stop. No matter what is motivating you, it can still be really hard. The important thing to remember is that if you don't stop the compulsions, then you just keep feeding the OCD cycle and will stay stuck.
Stopping compulsions isn't as simple as just deciding to stop (you already know this, though!)
There are some strategies that can help you be more successful. There is no right or wrong way, so you may want to experiment with different ones and find out which ones help you the most.
One important thing to keep in mind: the goal isn't to make anxiety disappear before you can resist a compulsion. The goal is to practice responding differently to the OCD urge, even when you still feel uncomfortable.
Ways to Resist OCD Compulsions
Delay the compulsion: If it's hard to completely stop a compulsion, then make a plan to delay it. Give yourself a specific amount of time and set the timer. Increase the delay by a few minutes over time. Delaying gives you an opportunity to experience the urge without immediately responding to it.
Do it wrong: If your compulsion involves doing something in a particular order or a particular amount of time, you can choose to do the compulsion in the incorrect way (ex: touch 5x instead of 3x). The point here isn't to create a new "correct" way of doing the compulsion. You're practicing breaking the rigid rule that OCD has created.
Do something that is active and brings joy: This sounds like distraction, and in some ways it is (more about the difference below). But when you are just starting out, it's hard to know what to do when you are choosing not to do a compulsion. And if you are just sitting there and feeling really uncomfortable, then you might be more likely to engage in ruminative, worried thinking, which won't help you either.We want to work on helping you be able to function with anxiety, which will help you resist rituals in the future. So pick something you will do instead. Maybe it's picking one cute puppy video and sending it to a loved one, playing a game of tag with your kids, or completing a Sudoku/crossword puzzle. Pick a specific amount of time you will do this activity so that you have a clear way to measure your success.The important distinction is why you're doing the activity. If you're choosing to do something because you want to engage with your life while allowing the anxiety to be there, that's different from frantically trying to distract yourself so the anxiety will go away.
Write a script: Grab a note card or place to jot notes in your phone. Write down all the reasons you want to get better. What would your life be like without OCD? Write down any encouraging or motivating phrases. If you are struggling with resisting the urge, take out your note and read it. This may give you just what you need in that moment to resist, even if it's just for a few minutes.
Try responding with uncertainty: Examples include: "maybe," "we'll see," or "what's done is done." These responses don't give OCD the certainty it is demanding. You're practicing allowing the question to remain unanswered instead of continuing to search for reassurance or a perfect answer.
If one of your compulsions is to seek reassurance from others: Make sure they know how to respond so that if you are unable to resist asking for reassurance, they can help you by not giving you the answer. This doesn't mean your loved ones can't support you. It means they can support you without participating in the OCD cycle.
What If I Still Feel Anxious?
It's important to remember that resisting a compulsion doesn't necessarily mean you will immediately feel better.
In fact, you may feel more anxious at first.
That's okay.
The purpose isn't to prove to yourself that nothing bad will happen or to get rid of every uncomfortable feeling. It's to practice not responding to OCD with another ritual.
Over time, you're giving your brain a different message: I can experience this uncertainty without having to solve it.
And that's an important part of getting unstuck from the OCD cycle.
If you find that you're repeatedly struggling to resist compulsions on your own, working with an OCD therapist can help you identify the compulsions— including mental compulsions and reassurance seeking— that may be keeping the cycle going and develop a treatment plan for addressing them.
Final Thoughts
Stopping compulsions is hard work. You don't have to do it perfectly.
Each time you notice an urge to perform a compulsion and practice responding differently, you're getting an opportunity to break the OCD cycle.
Start small if you need to.
Delay the compulsion.
Respond with uncertainty.
Choose to keep living your life while the discomfort is there.
And keep practicing.
If you need help learning how to resist compulsions and respond differently to OCD, our therapists at State of Mind Therapy can help you develop practical strategies for breaking the OCD cycle.
Schedule your free 15-minute phone consultation to get started.
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Exercise: "I Notice I'm Having The Thought"
When you have constant what if thoughts it can be hard not to pay attention to them.
We love to teach our clients how to create more distance between their thoughts and them so that you aren't running on auto-pilot anymore.
If you have more distance from your thoughts, it's easier to see them for what they are (streams of ideas in your head) and not get hooked by them.
Try this exercise to help you get more distance:
“I’m having the thought” exercise
Write down a thought that hooks you with anxious feelings
Say that thought 10 times, how does that make you feel? (rate it from 1-10)
Now say same thought, except add “I’m having the thought” in front of it
Now add “I notice I’m having the thought.”
What did you notice about the difference between the first, second, and third change? If you found it helpful, we recommended that you practice this skill daily to help you be able to use this tool more easily.
You might find it helpful to have a log, journal, or note section on an app to keep track of your progress.
Written by Jenny Matthews, LMFT, LADC
Jenny is a therapist that specializes in helping over-thinkers and worriers get relief from anxiety so they can be more productive + do what matters + be present with their loved ones.
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Our Favorite Books for Help with OCD
Learning all you can about OCD can make a big difference in your recovery. By reading self-help books, you can increase your understanding of how OCD works, feel less alone, and learn helpful strategies to deal with OCD.
There are so many great books available today to help you on your journey. We wanted to share a few of our favorites with you.
These are not affiliate links, just ones we think are great.
Freedom from Obsessive Compulsive Disorder by Jonathan Grayson, PhD
The Mindfulness Workbook for OCD by Jon Hershfield, MFT
Overcoming Unwanted Intrusive Thoughts by Sally Winston, PsyD
ACT Workbook for OCD by Marisa Mazza, PsyD
Written by Jenny Matthews, LMFT, LADC
Jenny is a therapist that specializes in helping over-thinkers and worriers get relief from anxiety so they can be more productive + do what matters + be present with their loved ones.
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Ready to work with an anxiety therapist?
State of Mind Therapy in Bloomington can help. Click the button below to sign-up for your free 15 minute phone consultation today.
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How to Stay In The Present Moment
Our minds drift to many different places throughout the day. What should I eat? Did they like my presentation? I need to remember to call the doctor. And so on.
It's normal for minds to drift.
But if you have a mind that is prone to worry thoughts, then you can find yourself distracted often which makes it hard to do the things in life that matter most to you, like focus on your job, enjoying time with you family and friends, and working towards your goals.
Although it's normal for minds to drift, we can work on strengthening our ability to stay in the present moment through attention training. We can do exercises for our mind, just like we may exercise our body through running or lifting weights. Below are two ways to help you strengthen your ability to return to the present moment. (Remember, the goal isn't to never drift, because that's just what minds do. Your goal is to get better at noticing when you drift and bring yourself back to the moment)
Attentional Training in Two Ways
Self-focused Attention
This is where you notice thoughts, feelings, and sensations that are occurring inside of you. The point isn't to try and control them or make them go away, but instead notice them without judgement. For instance, you may say "I notice my heart racing" or "here's anxiety." By doing this in a matter of fact way, we stay curious and in the present rather than pulled into a story our mind tells us.
Task-focused Attention
You can practice staying present in the moment through an everyday task, such as washing the dishes. While doing this task, you can focus on:
Touch: what does the water feel like? What is the temperature like?
Sight: What catches my eye? What colors or patterns do I see?
Hear: What sounds do I notice?
Smell: What smells do I notice?
Taste? what flavors do I notice? what is the quality of the flavor? Strong? Mild?
Written by Jenny Matthews, LMFT, LADC
Jenny is a therapist that specializes in helping over-thinkers and worriers get relief from anxiety so they can be present with their loved ones.
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State of Mind Therapy in Bloomington can help. Click the button below to sign-up for your free 15 minute phone consultation today.
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5 Ways to Handle Setbacks
It's not uncommon for people to make great progress on handling stress and anxiety to then really struggling. Sometimes the struggle is small and sometimes is a major setback. Here are some tips to help you get through tough times like these:
Remember that your progress can never be unlearned. Even if you have a setback, it likely won't be as difficult as it was back before you got the help you needed. You will bounce back much sooner because of the previous knowledge and changes.
Evaluate changes in your life. Was there something that contributed to this setback? Life changes and stressors can often cause setbacks. If you can identify a contributing factor, it can help you to assess what you need to help you get back on track.
Have you been taking care of yourself? If we are not meeting our most basic human needs that can be enough to impact mental wellbeing. You can remember the acronym HALT (Hungry? Angry? Lonely? Tired?) to help you check-in with yourself.
Go back to therapy. Even if you haven't seen your therapist in awhile, it can help to go back and work through the setback. Reviewing your skills and getting support can go along way. Even just one session could be enough to get you back on the right track.
Remember that you are human. Setback are not a sign of failure. They are common. Life is stressful so setbacks are bound to happen from time to time. We can't stop it but we can learn from it. And you will get stronger each time.
Written by Jenny Matthews, LMFT, LADC
Jenny is a therapist that specializes in helping over-thinkers and worriers get relief from anxiety so they can be present with their loved ones.
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The One Thing Families Should Stop Doing
OCD impacts individuals and their loved ones. You may need your loved ones to reassure that nothing bad will happen or maybe they participate in compulsions so they can make you feel better.
In OCD treatment, it's important to learn about all the ways you try to get rid of anxiety or other distressing feelings to add them into your response prevention plan. One important piece to consider is ways your family participates in this.
This is called family accommodation. This means any changes your family member(s) does to prevent you from being triggered or to make you feel better.
Examples of Family Accommodation
Participating in compulsions by changing clothes when they get home, handwashing, or showering
Saying "you won't get sick from that."
Changing their work schedule or other activities because of your compulsions
Why Family Members Should Stop Accommodating OCD
They are reinforcing the message that your fear and anxiety are "bad" and can't be handled
It is impacting their life by creating anger, frustration, burn out, anxiety
The accommodations make your OCD worse in the long-run
How to Reduce Family Accommodations
It's best to do this together as a team
Sit down with your loved ones and educate them about family accommodations. Many times families don't know that this is harmful and/or don't know how to stop. They can think they are helping you.
List all the accommodations they do and make a plan on how to start to remove them
Give your family permission to remove one accommodation at a time so it's not so overwhelming
Written by Jenny Matthews, LMFT, LADC
Jenny is a therapist that specializes in helping over-thinkers and worriers get relief from anxiety so they can be present with their loved ones.
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How Should OCD Be Treated?
One of the most common things we hear from clients who come to us for OCD treatment is that they have done years of talk therapy without much improvement.
This doesn't mean talk therapy isn't helpful. Many people find it helpful to talk with someone about their feelings and get validations. But most people with OCD will not see improvement in their symptoms by talking alone.
In fact, much of the time talk therapy can involve "co-compulsing" with the therapist by analyzing thoughts, seeking reassurance, and making meaning out of thoughts by looking for hidden traumas.
It's important for you to know that there are treatment approaches for OCD that have been backed by research. And this may come as a surprise to you, but most therapists have no idea how to use this treatment approach.
The majority of graduate school programs for therapists do not include training on OCD assessment, diagnosis, and treatment. Therefore, the only therapists that can adequately treat OCD are ones that have sought more specialized training.
What is the most effective treatment approach for OCD?
Research has shown that Exposure and Response Prevention in the most effective way of treating OCD. There are some additional treatment approaches proven to be helpful as well. A combination of medication has also shown to improve OCD symptoms. There is also a growing amount of research on the use of Acceptance and Commitment Therapy (ACT) for the treatment of OCD (which blends very well with ERP!)
At State of Mind Therapy, Jenny and Justin use both ERP and ACT in treatment of anxiety disorders and OCD.
What is ERP?
ERP stands for Exposure and Response Prevention. In its most simple form, it means to gradually expose yourself to your fear while not engaging in any behaviors that may serve to reduce your anxiety.
When you engage in an anxiety reduction behavior, you reinforce the need to keep doing the behavior. This prevents you from learning that anxiety is safe and tolerable. And it can make your world a lot smaller by keeping you from doing the things you love in life.
ERP helps you to change the relationship you have to the feared stimuli. Its helps you to be more flexible with how you respond and makes you better able to handle difficult thoughts and feelings.
We know it can feel scary but it's worth it.
You can check out some related videos here that we did on this topic:
How to Effectively Treat OCD (video)
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Emotions: Friend or Foe?
Many of us (including myself) never received education about what emotions are and their purpose. However, the truth is - scientists continue to struggle to meet a consensus on what emotions actually are. Russ Harris, an Acceptance and Commitment Therapy pioneer has been so kind to gather the current data regarding emotions, and here’s what he’s discovered: scientists in the field of emotions have agreed on two conclusions about what emotions are:
An emotion is a complex network of neurological, cardiovascular, musculoskeletal, and hormonal flux within the body.
This physical process prepares us to react.
Most of us notice these physical changes as “butterflies” in our stomach, a “lump” in our throat, clammy hands, or watery eyes. When we experience these physical sensations, we sometimes have an urge to take action.
For example, if one is preparing for an upcoming speech, one may begin to feel various anxiety symptoms days leading up to the event (muscle tension, thoughts of failing, sweaty palms, difficulties concentrating, body temperature changes, etc.).
These physical sensations may urge us to behave in a certain manner (avoidance around preparing for the speech or nudge us to get off our butt and get prepping). The key here is that we may or may not act on these urges to react.
Ultimately, we have a choice (avoid or prepare).
In other words, we can still dictate our overt behavior (actions), even when we can’t control how we are feeling. So if a co-worker pissed you off, you may have an urge or desire to scream at them or maybe even give them a good wack! Many of us let the urge pass and do our best to be civil during the confrontation, but some of us may choose to react and engage in a behavior that leads to severe consequences - but remember the choice is yours.
The ultimate aim here is to be authentic to ourselves and to honestly acknowledge to ourselves how we are feeling, accept those feelings, and at the same time act in a way that mirrors who we want to be seen. So how can we use emotions as allies? It begins with understanding what they can do for us.
What Emotions Do
Our emotions can serve 3 main purposes: communicate, motivate, and illuminate.
Emotions communicate by allowing others to see your facial expression, body posture, physical movement, breathing pattern, and vocalizations (expressing your feelings). Unless of course we decide to “hide our feelings” by “putting on a happy face,” for example. This can be helpful or not so helpful - it depends on the situation (more on this in a future blog post).
Emotions motivate us to run or hide (fear response). Anger may urge us to stand our ground or to fight our enemy. Sadness may urge us to take a pause, reflect, isolate, and rest. Guilt may urge us to make things right with someone if we compromised trust in a relationship or in society. Love motivates us to be caring and nurturing.
Emotions illuminate the importance of safety, defending our territory, maintaining boundaries, fighting for what is right, grieving, how we treat others and the importance of repairing social bonds, and the importance of intimacy, connection, bonding, and many more.
How to Effectively Use Your Emotions
Emotions can offer a palette of wise data if we’re willing to tap into it, and if at the same time we’re able to differentiate a helpful or not so helpful emotion. Often, people become anxious or depressed because they’ve become so good at not noticing when the emotion rises, not being able to name the emotion and link it to a thought or situation, and then ultimately engage in avoiding the emotion. Many also do this on autopilot, which can hinder one’s self-awareness surrounding their mental illness. So let’s start practicing noticing what’s showing up (emotion), name it, and determine if there’s any wisdom to gain in the emotion, and then redirect your attention back to what matters in that moment.
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How to Be the Architect of Your Life
The Common Struggle
I see many clients who are struggling with anxiety, depression, or OCD who come to me after numerous attempts to fix their mental health symptoms. Many of these individuals have become their own expert in mindfulness and have been doing a great job at allowing their anxious thoughts and physical symptoms to just be (acceptance), but they continue to not find relief from their malaise. Some of them have also committed to going to a Yoga class, increased their physical activity, switched from coffee to chamomile tea, and on and on.. While some of these changes can be occasionally good, often it can lead us down to a path to engage in activities with the hope that it gets rid of something (anxiety, OCD, depression). Suffers do these types of things because that’s what our culture tells them to do when you are mentally ill. However, when we engage in control efforts to get rid of a symptom we don’t like, we fall into a continued trap of anxiety or depression.
Often when someone has been suffering with a mental illness for sometime, they’ve begun to avoid things in their life that use to bring them meaning, purpose, and joy. When someone begins to avoid activities such as building and maintaining relationships, engaging in the workforce, being playful, tinkering with their hobbies, being adventurous, etc., their lives become small, boring, lonely, and simply unsatisfying. In other words, one can become very isolated from their values, which in itself can create human suffering.
Using Values to Build A Meaningful Life
So what do we do when we’ve mastered mindfulness and attempted activities that are suppose to cure us of our disease but have only failed to do so? In Acceptance and Commitment Therapy (ACT), we engage in a values exercise called “Flavor and Savor.”
How To Identify Your Values
Pick 2-3 values that stick out to you instinctually. Choose from the list of values below (This is the flavor part of the exercise).
Pick a value that you feel you crave (like how you feel when your stomach growls for your favorite food).
It’s important you don’t pick a value that you feel like you should have, or that culture or religion says you should have.
What does this value means to you?
Acting on Your Values
Write out 2-3 sentences about how you will ACT on this value.
Create a SMART goal in order to make acting on our values a little more realistic.
For example, one of my values is growth. What growth means to me is to continuously pursue opportunities to expand my knowledge in business, my therapy practice, my role as a father, and my photography skills. A couple of ways that I ACT on this value is by creating a goal to read books about photography and books on the latest science around mental health, and then incorporate this new knowledge into my sessions with clients or in my photography process.
After you have practiced picking a value (flavoring), at the end of the day reflect on how it felt to intentionally incorporate this value into your day (savoring). You may have noticed a big difference in your day, or maybe you didn’t. Have no fear if you didn’t notice anything, but then try choosing another value to practice incorporating into your day. For more about the difference between values and goals, check out this great video: Values vs. Goals.
Here’s a list of values to start from, excerpted from Brene’s Brown’s book, “Dare to Lead”:
Written by Justin Matthews, LGSW
Justin is a therapist that specializes in helping individuals get relief from anxiety and OCD by teaching them how to be more flexible with their unhelpful thoughts so they can spend more time doing what matters.
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How to Unhook From Thoughts Using Mindfulness Meditation
Justin Matthews, LGSW will show you how to use mindfulness to learn how to accept and allow thoughts in 2 minutes
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Common Sub-Types of OCD
Many people think OCD is characterized by symptoms of excessive handwashing, counting, checking, and having things be "perfect." Although these are indeed symptoms of OCD, it is a limiting description of the possible ways OCD presents itself.
Why are sub-types helpful for OCD?
Because the symptoms of OCD are not widely understood, many people are still under-diagnosed with OCD. And this means people are not recognizing it and likely not getting treated...especially the most appropriate type of treatment. So by identifying sub-types and talking openly about them, more people may get the help they really need. Many of our clients with OCD had thought they were "just weird" or "had anxiety." There is relief in knowing there is an explanation and name for your symptoms.
The downside of sub-types for OCD
Although sub-types are helpful in some ways, it can common with some issues too. It's important for people to know that these subtypes are not separate diagnoses. They are under the OCD diagnosis. It can actually be a slippery slope to over-identify with a subtype because it can make people more susceptible to relapse. For instance, if you are focused on your symptoms of Harm OCD, you could make great improvements in therapy but years down the road OCD could come back in a different theme, such as sexual orientation OCD, you could struggle with applying your previous skills to this theme because it "feels different." This is why it's important in treatment to not focus too much "on the content" of what OCD says, but instead understanding the ways it can play it's game and suck you in. This way, no matter what theme shows up, you can use your skills
Common Subtypes of OCD
Contamination OCD-fear of getting sick, fearing of spreading illness, fear of disgust, fearing of becoming a "dirty" person
Responsibility/Checking OCD-fear of items (like appliances) being left on, items being unlocked or properly secured
Just Right OCD-excessive awareness of something not being symmetrical, unease when completing routine activity, concerned an item doesn't belong somewhere
Harm OCD-fear of snapping and harming others or yourself, fear of acting on intrusive thoughts, fear of being responsible for a tragedy caused by an error you made, fear of hitting someone with a car and not knowing it
Sexual Orientation OCD-fear of living in denial of your sexual orientation
Pedophile OCD-fear of snapping and becoming a pedophile, fear of touching a child inappropriately, fear of being in denial of being a pedophile
Relationship OCD-fear of not really loving significant other, fear of partner leaving
Scrupulosity/Moral OCD-fear of interpreting scripture incorrectly, concern about words/symbols being a sign of condemnation, fear of being judged for not following religion perfectly
Hyperawareness OCD-excessive awareness of involuntary bodily processes such as breathing, swallowing, blinking, etc.
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Asking to be cured of OCD is for dead people
Wait, I can’t be completely cured of OCD?
Let’s begin by first acknowledging that OCD SUCKS!! There is a reason you are looking for help, and I’m guessing it’s because you’re suffering and becoming sick and tired of being sick and tired. Trying to get rid of obsessive thoughts through compulsions is exhausting. And it makes your world smaller and smaller. The suffering is often evident once OCD begins to rob you of your time, relationships, work performance, and simply just makes you feel very uncomfortable under your own skin. However, asking to be completely free of OCD can only be achieved once you’re 6 feet under. I know, that sounds dark and dramatic - but it’s true. OCD is a chronic disorder, which means it cannot get better without treatment. When I tell my clients that I can’t completely cure them of their OCD, I often see their body posture almost collapse. But the truth is - there is no magic Men in Black device that can delete our thoughts and memories - they’re now in our repertoire. HOWEVER, there is hope - so please stay with me.
How Acceptance and Commitment Therapy (ACT) can help treat OCD
Exposure and Response Prevention (ERP) has been (until recently) the only gold standard for treating OCD. However, there is a new treatment in town, and it has not only been shown to be just as effective as ERP, but also incredibly influential with helping people design a life that is more rich and meaningful. This treatment is called ACT. I describe how ACT works by having my clients visualize a glass of water that is about 25% full of water, but also completely saturated with salt. I explain that the water represents their lives and everything in it that brings them meaning and joy, and the salt is their OCD symptoms. During this exercise, I confess that I can’t remove that salt, but what I can do is help my clients fill their glass with more water, which decreases the significance of that salt in their lives. I also teach my clients skills to help them deal with that salt more flexibly as we move forward together -filling their cup with more purpose, meaning, and value.
Do you use ERP to Treat OCD?
Yes. ERP is certainly still very useful and I incorporate ERP into my practice. I like to describe working within ERP and ACT as a marriage - each model having their own unique benefits that contribute to the treatment process. For more information about ACT’s usefulness with treating OCD, please go here: https://iocdf.org/expert-opinions/expert-opinion-what-is-act/
My role as a therapist in treatment for OCD
I describe myself as more of a coach than as a “healer.” I often use a metaphor (I use metaphors a lot!) to describe my role in treating someone with OCD. Here we go, let’s begin by imagining two mountains that are right next to each-other. These mountains represent “life.” Life is hard and it is much like climbing a mountain. Mountains can be incredibly dangerous to climb if you don’t have the right tools to help you get to the top. So now imagine your mountain being right next to mine, and let’s pretend that we can magically hear and see one another. The benefit of this circumstance is that I know some tips that can help get you up this mountain, and maybe even enjoy this climb. I can give you strategies for feet placement, how to sharpen your pick axe, I may even see an alternate route up that you can’t see from your perspective, or I may see an avalanche racing your way before you do. Assuming I don’t slip and face my own adversity on my mountain (hey, I’m human too!), I can coach you up your mountain with the help of scientifically-proven skillsets. I may even have us pause occasionally, and just take the time to enjoy the scenery up there, because that’s important too!
What I’m trying to say here is that I’m not this magical healer that is just basking in the sun on top of my mountain - free from any anxieties or curve balls that life throws at us. I’m just like you, a normal human trying to climb this mountain we call life. And the truth is, this mountain only ends when the credits to our story begin to roll. So let’s make the most of what we can out of this adventure.
Written by Justin Matthews, LGSW
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"I know I need to sit with anxiety...but HOW?"
It sounds so simple, right?
As you start to learn about the strategies that help and don’t help with anxiety, you’ve likely come to learn that running from discomfort is only making matters worse.
So everything you have been learning tells you to not avoid, distract, or do a compulsion but to “sit with anxiety” instead.
I get this isn’t easy. If it was, you wouldn’t be avoiding in the first place.
I find that there are important skills I need to help my clients learn in order to effectively “sit with” anxiety. So here are my tips on how to “sit with anxiety.”
My 5 Tips on How To Sit With Anxiety
Be curious about what your body is doing
Close your eyes to really allow yourself to be present with your mind and body. Do a scan of your body and notice where you are experiencing sensations. Just name the sensation you notice in a matter of fact way. For example: “I notice chest tightness” or “here’s nausea.” Draw an imaginary circle around that area.
Acknowledge the sensation for what it is
When we feel anxiety in our body, we can begin to interpret these sensations for real danger. If you find your mind doing this, remind yourself “this is just a sensation” or “here is discomfort.”
Be curious about what your mind is doing
Close your eyes once again and notice what your mind does. Is it giving demanding threats? Is it spinning with a bunch of random thoughts? Is it desperately trying to focus on something else? You don’t have to do anything here, just sit back as if you were sitting in the chair of a theater and watching a show.
Be gentle
Sitting with anxiety isn’t easy. You need to give yourself relentless grace and encouragement for doing something difficult. No judgment allowed here. Tell yourself “this isn’t easy” or “I can do hard things.” Beating yourself up for having anxiety is not helpful in moving you forward, so commit to being more kind to yourself. If you had a close friend who began to panic, would you say “what’s wrong with you?” I doubt it. So don’t tell yourself that either. Treat yourself like you would treat a friend.
Remove temptation
If you are working on sitting with anxiety without avoidance or compulsions, you may want to modify your environment to make it more challenging to access those. For instance, if you are working on reducing handwashing, remove extra soap or hand wipes. If you are working on not checking the rear view mirror, flip it up or cover it. If you seek excessive reassurance (online or with loved one), leave your phone/computer and go for a walk so can’t research the internet.
Practice, practice, practice
If you are working on relating to anxiety differently, then these skills are crucial to your success. If you are doing exposure therapy, then you are moving towards situations that make you uncomfortable all the time.
If you are struggling to sit with the anxiety, then you will likely abandon the exposure exercise quickly and end up avoiding the situation (or doing a compulsion).
If you are struggling with “sitting with anxiety”, then I would recommend practicing these skills on a regular basis before doing exposures. If you only practice these skills during times you are highly anxious then it may make it more difficult to sit with the uncomfortable feelings.
If you need help with applying these skills, then you may want to think about starting therapy for anxiety or OCD. Our therapists are trained in using the most effective strategies for treating anxiety disorders and OCD.
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It's Not Your Mental Health Symptoms That Are The Problem
What is this guy talking about!? My mental health symptoms are terrible and are ruining my life!!!
Look, I get it.. Anxiety, panic, and depression symptoms suck! They make us feel like we can’t concentrate, feel joy, be happy, get sleep, and so on. However, many of us are quick to blame our symptoms for the hell we feel we are stuck in.
What I see over and over in my sessions with clients is a tendency for clients to become hyperaware and obsessed with their symptoms, to the point where they begin avoiding being around their loved ones or engaging in the activities they enjoy.
The worst thing you can do when your symptoms show up is to stop doing the things in your life that bring meaning, joy, and purpose into your life. When we engage in the things we care about, and are able to become present with what matters, our “feel good” chemicals are released in our minds and bodies, which help reduce the impact of anxiety and depression.
The truth is, anxiety, panic, and depression are part of being a human being.
Let’s be honest, we are living in unprecedented times (oh, I said it!). There’s a million reasons why you may be feeling anxious, panicky, or depressed - but the key here is to not become anxious about being anxious or depressed because you’re depressed.
We do this by applying the skills you will learn in ACT. Can I promise you a total cure of anxiety or depression? ABSOLUTELY NOT. And if someone says that they can - run away!
The truth is, anxiety and depression are part of the human experience, but if we don’t have the tools to ride out some of these storms, your symptoms can become chronic and you may lead yourself down a road that only keeps the unhelpful and painful cycle on repeat.
We don’t have full control of all of our thoughts and emotions, but we do have full control with how we REACT to difficult thoughts and emotions. How you choose to RESPOND to your symptoms is your ticket out of suffering.
So how am I suppose to do these things when I’m totally consumed by my thoughts and emotions?
Acknowledge the difficulty you are experiencing right now. Example: “Here is anxiety” or “I notice the urge to cancel plans today.”
Come back to your plans for the day or the task in this moment. “What am I supposed to be doing right now?” or “What was I planning to do before this thought/feeling showed up?”
Ask yourself “What action does this thought/feeling want me to do?” If I followed that, would that bring me closer to the kind or person I want to be? Or would it bring me further away?
Recommit to the plans you had or the task you were working on. Don’t let feelings be the decision maker. Let your values the decision maker.
Remind yourself that the goal isn’t to “feel good” before you take action.
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4 Types of Reassurance Traps
Do No Harm
This type of reassurance seeking involves looking for certainty that you are not a bad person. Intrusive harming thoughts (with violent, sexual, or embarrassing content). Examples include: having to always be careful to avoid accidental harm to yourself or others. Overwhelming fear of offending God that leads you to constantly try to prove to yourself that you in good grace.
2. Guarantees Forever
This type of reassurance seeking is meant to find certainty that everything will be ok. Examples include: seeking constant reassurance to prove you don't have a serious illness can look like checking your pulse or temperature when not told to do so by your doctor. Needing to know if you are going to get fired by studying others reactions and excessively asking others if they think you are not performing well. Having to know your partner is being faithful by scanning partner's face, checking phone and emails, becoming upset if a text is not answered right away.
3. Banish All Doubts.
This type of reassurance seeking involves trying to know the answer the questions that are unanswerable. These can include questions like "what if I'm gay?"..."how do I know I'm not going crazy?...or "how ca I be sure I'm really here on earth?"
4. Don't Mess Up.
This type of reassurance can look like having fears about messing up at work, which can lead to endless checking over emails or working excessively to avoid imperfections. It can also look like doing endless research and planning on a simple purchase to be sure to make the perfect decision.
If you struggle with anxiety and reassurance seeking, State of Mind Therapy can help. Ready to get started?