Deep Breathing in Action [Video]

In this video, Bryan Piatt discusses how to use your breath effectively to manage anxiety symptoms.

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Traveling with Anxious Flyer? Sidestep These 5 Common Pitfalls

If you are traveling with someone who is nervous about flying, it can be hard to know what to say or do. Most people have good intentions when attempting to alleviate another person’s anxiety. But sometimes those good intentions can lead to your travel partner feeling upset and unsupported.

5 mistakes to avoid when traveling with an anxious traveler:

1. Do not encourage the anxious flyer to drink alcohol or use drugs to handle their anxiety. Although alcohol can help people relax, it isn’t effective for everyone. It can cause additional problems for anxious traveler. For example, getting dehydrated from alcohol can increase their anxiety symptoms. If your travel partner gets intoxicated on the flight, it could cause other problems like saying something embarrassing or passing out and unable to wake in the event of an actual emergency. And some people are on medications that could be dangerous to take with alcohol, so it’s important not to suggest it if you don’t know the impact it could have on them.

2. Do not tell them to calm down. Rarely is this ever effective. If it was that simple then they would do this on their own. it is never helpful to hear that when you are anxious. Instead try offering something specific like a back rub or “lets take some deep breaths together” or “I’m here with you, you’re safe.”

3. Remember that there is nothing you can say to "talk them out of their fear." Most anxious flyers know that they are safe but their brain tricks them in the moment. Validate their feelings and let them know you understand how hard this for them. If you try to “fix their thinking” then you will only cause them to shut down and feel frustrated.

4. Don’t be late. A person who is nervous to fly does not need added stress on top of their worry. Allowing for plenty of time will allow them to keep their stress low so they keep their worry at bay.

5. Be aware of your behavior. Someone who is anxious is going to be easily irritable. So if you have any habits that they other person finds annoying (like chewing with your mouth open or talking loudly) then that may add to their stress. Try not to take it personally and realize that their tolerance for anything bothersome is really low. Do your best to mitigate the behavior to help them feel more relaxed.

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Guided Meditation for Intrusive Thoughts

Meditation for Intrusive Thoughts

Bryan Piatt

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Created by Bryan Piatt

Bryan Piatt is a practicum provider that helps people get untangled from obsessive thoughts and worries so they can find freedom and joy in their life. Interested in working with Bryan? Schedule a free 15 minute phone consultation below to get started.

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How To Stop Playing Whack a Mole with Worry

Do your worries change topics? Maybe you have spent tons of time squashing one worry, only to have a different one pop up. This can lead you to an endless game of "whack a mole." Where the game of getting rid of worry only keeps going, and going, and going...kind of like the energizer bunny.

If you don’t learn about this game that worry likes to play, you can easily get stuck in the worry trap for years. In this blog, you will learn our top tips for handling those jumping worries.

Identify the Theme Across All of Your Worries

Worry tends to be pretty predictable and thematic. It may not seem like it on the surface, but if you spend some time exploring this, you will find that there is a common theme across all of your worries.

Understanding the theme of your worry can really help you to not get caught off guard the next time it shows up.

So how do you find the theme?

• Make a list of all your worries. Include current worries and ones that you have had in the past.

• Put your worry into a “what if” question

• Ask yourself, if that were to happen, what would that mean about me or about my life? What’s the bad thing that would happen?

• Take a look at your list. What do your worries have in common? Maybe it’s about fear of accidentally harming someone you love. Or maybe it’s about you getting sick. Or maybe not being able to enjoy your life.

• Write down the theme. This is the scary story that worry wants you get absorbed in. And once you aren’t absorbed into it, then it tries to find another way. This is when whack-a-mole shows up.

Acknowledge the Worry

So now that you know your theme (or scary story) of worry. You need to get really good at spotting it. Because worry will try to trick you into getting caught up in different way. It’s like the worry put on a different halloween costume to spook you. But don’t be fooled.

When you notice that this worry has the same scary story as you’ve had in the past, acknowledge it.

You can practice saying “here is another scary story about being responsible for harming someone. I know what this is, I’ve seen it before.”

Or you can say “I don’t like these scary stories, but I can allow them to be there.”

Recognize Your Choice to Go Further

Believe it or not, you have to choice to engage in the scary story. It’s not an easy choice, but you do have one. Recognizing that you have a choice to begin with is very empowering. You don’t have to play the game. You can drop the rope.

You may find it helpful to think about what has happened in the past when you have bought into this story before. Did you get stuck in rumination? Did you seek endless reassurance from others? Did you spiral into panic?

Remembering the consequences you have experienced for engaging in the scary story can be useful for you in avoiding the trap. You can remind yourself “Yes, there is a scary story here. If I buy into it, it’s going to make it hard to enjoy time with my family, take away my energy, and so on.”

Once you have acknowledged the scary story and made your choice to not buy into it, then get back to being involved in your life. Get involved with what you want, regardless if worry wants to come with.

You don’t need the worry to be solved to get back to living your life (that can be another trap). Just get out there and keep living and use the skills along the way.

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 so they can be present with their loved ones.

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A New Way of Treating OCD (A Non-Exposure Based Way)

The New Kid on The Block

For years we have known that ERP (exposure and response prevention) is the gold standard treatment for OCD. I have been using ERP with my clients for years, and many have been able to get their life back using this approach.

But the truth is, the research says that only 60% of clients will get better with ERP. So then what? Do those individuals just live with the suffering that OCD has caused them? Should they just give up? Accept that this is as good as it’s going to get?

Hell no. There has to be more. And luckily, there is.

For the past 9 months, I’ve been seeking ongoing training and consultation with hundreds of other OCD therapists across the country on a therapy called Inference Based CBT.

Is it new? Sort of, but not really.

What is Inference Based Therapy (ICBT)?

Inference Based Therapy has been around since the early 2000s. It has undergone many randomized controlled studies comparing it to ERP, and the data has shown to be just as effective as ERP.

This is great news. This means that we have more than one way to effectively treat OCD.

ICBT is a cognitive therapy for OCD. ICBT aims to resolve “inferential confusion.” Which is when someone confuses imagined possibility with reality.

ICBT works “upstream” by addressing the doubt (or what if?) that set the OCD into motion.

By working upstream, when you can resolve the doubt, then the anxiety and compulsions do not occur.

ICBT looks at what is behind the doubt. There is a reasoning process you use with obsessional doubts that you don’t use with normal doubts. You reason differently in OCD situations than every other area of your life. We teach you how to see the difference.

ICBT says that intrusive and obsessive thoughts do not occur by random, there is a story behind them. The story is absorbing and takes you behind your senses.

ICBT aims to help people return to trusting themselves and their senses.

What I love about ICBT

I’ve been using ICBT with the majority of my clients with OCD for the past 6 months. I still consider myself a beginner but many of my clients feel like this makes so much sense. It’s also common for some of my clients to feel confused. Because this is very different than what they were previously learning through an ERP approach.

This was my experience in learning ICBT too. It has (and still does) take a lot of work to see how this approach works.

I love how well rounded this model of therapy is. In ERP, there is no real in depth discussion about how a person came to become so consumed with their worries. And in ICBT, we really help people understand this and I have seen this be so validating to my clients to have a deeper understanding of themselves.

I love how interactive it is. We use games and exercises to apply the concepts so that clients can arrive at these conclusions on their own.

And mostly, I love having an additional treatment option for clients. Exposure will still be a treatment I use in my practice but when a client isn’t making progress or isn’t ready to try ERP, it’s nice to have other ways of helping them regain their life.

Questions about ICBT? Send me an email at jenny@stateofmindtherapy.com

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 You Can Change Your Relationship With Anxiety and OCD

Created by Bryan Piatt

Bryan is a practicum provider that specializes in helping people get untangled from obsessive thoughts and worries so they can live more freely in a life they love.

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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:

1. Actively notice the environment you are in right now. Name something you can see, hear, smell, touch, or taste.

2. 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

GIVE ME ACCESS

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:

  1. 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.

  2. Increase your willingness to FEEL ANXIETY and not try to push it away, fight it it, or pull you into more avoidance or rumination.

  3. 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

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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Response Prevention Tips to Help You Stop Engaging in Compulsions & Rituals

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 OC 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 helps you the most.

• Delay the compulsion: if it's hard to completely stop a compulsion, then make a plan to delay it. Give yourself a specific time and set the timer. Increase the delay by a few minutes over time.

• 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)

• Do something that is active and brings joy: this sounds like distraction, and in some ways it is (more about the difference later). 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 complete 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.

• 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" or "we'll see" or "what's done is done."

• 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 than they can help you by not giving you the answer.

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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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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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

1. 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.

1. 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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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:

1. 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.

2. 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.

3. 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.

4. 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.

5. 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)

What is ERP?

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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:

1. An emotion is a complex network of neurological, cardiovascular, musculoskeletal, and hormonal flux within the body.

2. 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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