Hello, everyone! Great to be back recording a normal Q&A episode this week. Between the unexpected non-episode a couple weeks back and the re-run episode last week, I haven’t actually sat down and addressed your questions in a while.
Hey, I just got into your podcast and I wanted to take my chances with you seeing one of my questions in hopes you may address it in your podcast. I’ve been struggling with nightmares, borderline personality disorder, major depressive disorder, and anxiety for a few years and suicidal ideation is no stranger to me. I also have a girlfriend who I can picture a future with, but my self deprecation makes me feel as if I’m in the way constantly and even after her reassurance I fall back into the same cycle. I want to let her know that her help means the world to me and I want to improve on accepting love so I don’t seem distant. Any advice?
It sounds like you’ve had a rough go of it. I first want to say that I feel for you. It sucks to feel like you are ruining good things in your life and with the mental health issues that you talked about, it can feel like you are running in circles, playing out the same patterns over and over. I want to instill in you that there are many people in situations similar to yours – with mental health challenges and even personality disorders that find a way to live a satisfying life and have lasting relationships. But it is a challenge. It’s good that you are being prompted by a desire to make something work rather than trying to claw your way out of a rock bottom.
First off, communication is going to need to be the bedrock of your relationship. If you don’t have open communication, that’s the first thing that you are going to want to work toward. Reason being is that emotions and behaviors may vary, but if you are able to be honest, break down what has happened, and outline what your boundaries and expectations for one another are, that is what will pull you through.
When in doubt, go with honesty and clarity. If you don’t know the most eloquent way to say something, say it in a fumbling way and continue to clarify over time. Let her know exactly what you told me – that you can see a future together and you are scared that your symptoms are going to get in the way.
It may be helpful to establish a pact with your girlfriend in which you accept that the things you tell each other are true to the other person, even if they don’t feel true to you. For instance, if she tells you that your symptoms don’t make her sad or interfere with your life, you can admit that she is telling the truth even if you feel like that’s not your reality of the situation.
Keeping a journal can also be really helpful. When you have a discussion with her or have some sort of significant interaction, write down some notes about it. That way when you no longer have the same mental clarity, you can go back and review what your previous thoughts were. This is also obviously helpful for doing cognitive activities and general journaling.
If you aren’t in therapy right now, you probably should be. If your symptoms are significantly interfering with your life to the point that you feel you might lose this relationship and have thought about killing yourself, you definitely are at the level where you should be getting some help. This would also be a good gesture to your girlfriend as well that you are making an active effort to work on yourself.
It’s important to notice whether you are making a problem where there already isn’t one. If you feel like your girlfriend might be unsatisfied, mad, etc. ask her. Don’t make assumptions, jump to conclusions, or believe the terrible imaginary scenarios in your head. If it doesn’t feel safe to ask her about it, check in with her close friends, family etc. But the deal is you need to commit to the answer. You don’t need to believe it, but you need to act as if it were true and see how that works out. This will help you avoid being dependent on the reassurance and feedback.
I’ve talked about this in a previous podcast, but in your case, you may need to work on gaining exposure to the uncertainty that your anxiety causes. Normally, the process is you have a thought that makes you feel uncertain about yourself or the relationship and then that feeling builds and builds. Due to emotional reasoning, that increased sense of tension convinces you that your fear was right and that something really is wrong. This in turn prompts you to try to reduce that tension somehow, which is usually by checking in. By asking questions to be reassured that everything is okay.
Instead, you need to work on trying to trust that the unease is just a trick that anxiety is playing on you and challenge yourself to act based on the available evidence rather than on your gut feeling. Allowing yourself to sit in that uncertainty and try to function. This will help you become more tolerant of the uncertainty and will also give you an opportunity to call bullshit on your negative assumptions.
Overall, you are going to feel like you are failing and that things are going terribly, but I’d like you to figure out how you can move toward basing your self-evaluation more on the facts. What has actually happened?
For example, I worked with someone in therapy who would mentally beat the crap out of themselves for having thoughts about cheating on their wife with another woman. The thing is – this never happened. It would never happen. But they treated themselves as if it actually did happen and as a result acted treated themselves like total shit.
This can be done in a variety of ways. As I mentioned, therapy is great for this. Aside from this, it can also be helpful to have a group of trusted advisors in your life. Friends and family that are willing to be totally honest with you and call your bullshit if necessary. These are people that you can tap into to pull your toward reality rather than letting your thoughts spiral out of control.
The last thing I will say is that even if this relationship does not last the rest of your life, that doesn’t mean that it can’t be a really important milestone in your life. One of the most helpful things for growing through problematic patterns is to have corrective emotional experiences. Use this relationship as practice for a different way of being in a relationship.
You’re in good shape. You have a good awareness of your issues and like I said at the beginning, your motivations are coming from the right place. Keep trying. This will take some trial and error and that’s okay, but you’re oriented in the right direction. Just keep swimming.
Hi Duff, I just came across your spotify platform and love your episodes! I’m at work right now listening secretly through my earbuds. Lol. SO, I have an interesting topic for you.. I have a fear of wrists. It’s not terribly bad and it’s not in the way where I’m suicidal of cutting my wrists. It’s more like I’m afraid of them being so vulnerable. Makes me squirm a lot thinking of anyone being near them. Thinking about them being touched right now is quite overwhelming actually. I told my therapist about it and she said she had never heard of this before and we haven’t really gone back to it cause every week I always have other stuff that is a priority to talk about above my fear of wrists. I don’t even like the word honestly. It freaks me out so bad seeing other people touch their own wrists or cutting themselves in real life or movies makes me want to crawl into a shell and throw up, it’s too much in my mind . Have you ever heard of this before? What should I do? I’m at a loss…I’d like to deal with it cause it’s very overwhelming. Thanks for your help.
Awesome that you’re listening secretly at work. Stick it to the man.
I haven’t heard of this specific one, but I have heard similar concerns about other vulnerable things, like holding babies or delicate baby animals, or the thought of driving and running off the road. It’s like partially an irrational fear and partially just really bad heebie jeebies.
I suspect that using an approach similar to the way you would treat a phobia would be really helpful. By that I mean going through an exposure protocol would help train your body to be less sensitive to the thoughts and mental images that currently freaking you out.
I did a whole episode about exposure and building a hierarchy on episode 98. The gist of it is that you are going to want to first build some coping strategies like breathing exercises, cognitive exercises, and grounding exercises so that you are well equipped to handle the discomfort that will inevitably pop up. From there, you want to start at the bottom of the ladder. Find something that gives you a dose of exposure to the thing that causes you anxiety, but not at the level that makes you totally flip. You want to find something that gives you a moderate about of anxiety.
You might start with literally just looking at words. Wrist, bone, delicate, etc. Anything that starts to give you that feeling and taps into the part of wrists that gives you some anxiety. From there you can move up to looking at images of wrists, videos of wrists, touching other people’s wrists, allowing other people to touch your wrists etc.
You work your way up the ladder step by step. The goal is to master each step so that it’s easy and boring before moving up.
Making a PowerPoint of words or images and building a video playlist can be helpful tools for this and if you’re working with a therapist, they might be able to help you construct and work through your courage ladder.
The point of this exposure is that you don’t want to just build up to a 10 level of over the top anxiety and then quickly abandon it. You want to generate a moderate amount and then sit with it. You need to teach your body that there is nothing dangerous about what you are feeling and that it does not actually indicate danger. Naturally, this will cause you to start to build a tolerance and the same level of stimulus will no longer cause you that high level of anxiety. You want to learn that just because you think about it or have a gut feeling about it, it is not actually more likely to happen.
In some cases, I would say that you don’t even need to worry about this. Just let it be, but it sounds like it is actually practically affecting your life and getting in the way. So you deserve to change things a bit. I think the exposure strategy would be helpful. If you find that this isn’t doing the trick and you also find that your therapist doesn’t really get it, you may think about switching to a therapist that has some experience in dealing with things like phobias or OCD, as there are some similarities here.
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Sometimes when I have time to myself I can’t really decide what I want to be doing and what’s more important, or how to prioritize. For example, there’ll be a number of things I wouldn’t mind doing, like read a book, play a video game, watch a movie etc but I can’t really decide which one I want to do and I get overwhelming feelings of wanting to do them all at the same time because I want to do them equally but I cant decide where to start so sometimes I’ll just sit there and not really engage in any of the things I want to do because of indecisiveness, or I’ll kind of do a hybrid of all three, like play a game at the same time as putting on a movie but then I feel like I’m cheating on the movie and not giving it the time I want so I get a bit flustered that I can’t decide what I want to be doing. Sometimes I’ll go overboard into one thing, like video games for hours on end and completely neglect the other things I wanted to do. Other times because I can’t decide which thing I want to do I end up doing something else aimlessly just as a way to fill the time.
You are super not alone in this. I think a lot of people get paralyzed by decisions. If you have a mental health issue like anxiety or depression this just makes it even worse, as you feel like there is more weight to the decision, even if it’s something with realistically few immediate consequences.
There are a couple of approaches that we can take here, but the first underlying thing that I want you to keep in mind is that you aren’t doing anything wrong right now. You are essentially beating yourself for being indecisive about how you spend your leisure time. It sounds like you are getting the necessities and important shit done and this is more about relaxation and personal development. There is not an outside pressure for you to dive headfirst into these things or stay super organized in how you are spending your time, so it’s natural for this to be less of an easy decision.
The other thing is that as humans we get decision fatigue. The more stuff we have to figure out in a given day, the harder it is to figure things out and make decisions later on. This is why some people will wear the same thing everyday or have other fairly rigid, consistent routines. It helps to free up your decision making energy for other stuff.
So what can we do with this information?
Well one approach is to plan ahead and decide on what sort of content you want to engage with on which days. I’ve been experimenting with this approach myself with the types of things that I listen to. I do a lot of listening to content of different types while I drive to work, do dishes, score assessments, and stuff like that. But sometimes I find myself in a similar situation to what you are describing where I am sitting in the car waiting to leave for work and I waste a bunch of time trying to decide if I want to listen to a podcast, audiobook, old music, new music, or the news.
So what I’ve been playing around with is just deciding ahead of time which days focus on which type of content. Mondays might be for new learning through podcasts etc, Tuesdays might be listening to new music, Thursdays might just be all audiobook etc. The other option that I’ve played with is pairing a certain type of content with a certain activity. This is a good one for audio content because it can help you stay more motivated. Like if you have an awesome audiobook that you are into, but you only listen to it while cleaning, then you will be more motivated to clean.
So you could do something similar with your situation where you decide on which days or circumstances will correspond to which types of content and then put that in your calendar or write a note that you hang up on the wall to remind yourself. Once you have that set up, you don’t need to expend any more mental energy deciding and you can just “follow the rules”. Of course you don’t have to be rigid with t his. It’s not your job we are talking about here, but use that as your default. If you get a new game and want to binge that for a night that you had reading scheduled, just substitute the activity and get back to the schedule on the next day.
The other option that you can use is to randomize your activities. I recently sent out an email newsletter to my subscribers where I describe the “abort list” strategy. That means you have a list of activities that you would like to engage in, but are not things that have any sort of due date. Keep that master list somewhere – in a journal, on your phone, etc. Then when you find yourself completely wasting time in a way that you don’t want to be like endlessly scrolling your social timeline or 12 tabs deep into a Wikipedia hole, you simply abort what you’re doing. Close all the tabs, exit out of everything, and pull up your list. From there, you just pick one at random. Use a random number generator, roll a D-20, throw a dart, whatever. Let chance decide for you.
So those are a couple things you can do to work around the decision fatigue and the sense of getting locked up. Overall, I want you to remember that there is not as much of a risk as your mind makes it feel like there is. The opportunity cost is not that high. And no matter what, just making a choice of any kind and DOING something is going to be more productive and satisfying than freezing up and doing nothing, which will likely cause you to beat yourself up and feel less motivated etc.
Thanks for listening!
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