🗂️ [[Indices/Sources]] # Pure O OCD (`$= dv.current().publishDate`) 📰 *`= this.logline`* 📇 [[Chad LeJeune]] 🏛️ `= this.publisher` 🔗 `= this.url`  ```dataviewjs if (dv.current().completed) { dv.paragraph(`> [!SUCCESS] \Finished Reading \n **Last read**: ${dv.current().lastCompleted.toLocaleString(DateTime.DATE_HUGE)} \n **My rating**: ${dv.current().rating} out of 10 \n *${dv.current().ratingWhy}* `); } else {dv.paragraph(`> [!WARNING] \Not yet read`); } ``` >[!abstract] > `= this.abstract` 🔑 [[obsessive-compulsive disorder (OCD)|OCD]], [[acceptance and commitment therapy (ACT)|ACT]] 👉🏼 Chad LeJeune (2023). *[[Chad LeJeune - Pure O OCD|Pure O OCD]]*. New Harbinger. [Link](https://www.newharbinger.com/9781648480409/pure-o-ocd) ## 📝 Notes ## 📃 Selected Quotes Compulsions may include subtle avoidance of triggers, reassuring thought-based rituals, questioning of friends and family to gain reassurance, or even just “confessing” to the thoughts by talking about or around them with others. While all of these responses offer temporary relief in the short term, they are much more a part of the problem than a part of a solution. ([[Chad LeJeune - Pure O OCD|LeJeune, 2023]], [Location 293](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=293)) ^35b2f8 Because the uncertainty they are intended to address can never be completely eliminated, cognitive rituals tend to be repeated over and over again, often in increasingly elaborate ways. The time and energy devoted to these rituals can be a huge drain on personal resources that could be better applied to activities, relationships, and other pursuits that add value to life. ([[Chad LeJeune - Pure O OCD|LeJeune, 2023]], [Location 296](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=296)) ^1958dd ## 📋 Table of Contents ## 📖 Annotations # **Template**: [[Book Search Template]] **Created**: `$= dv.current().file.ctime` **Last Modified**: `$= dv.current().file.mtime` %% >[!Question] > Do you need to edit the metadata on www.readwise.com? > Do you need to edit the properties (YAML) e.g. to distinguish Date from publishDate? > Do you need to update the file's title and/or author link above? > Do you need to add a logline via the Summary in Reader? > If there are no significant notes made, can you delete this page and re-sync? ## Readwise Highlights and Notes ### Imported from [[Readwise]] on [[2024-05-23]] Contents Introduction: “Pure O” and Sticky Thoughts Part One: How Thoughts Get Sticky Chapter 1 The Thing in the Bushes Chapter 2 Stickiness and Suffering Chapter 3 As Above, So Below Chapter 4 The Arrow of Time Chapter 5 Song of My Self Part Two: Making Thoughts Less Sticky Chapter 6 The Alarm Is Not the Fire Chapter 7 The Opposite of Struggling Chapter 8 Tilting Toward Acceptance Chapter 9 Bringing in the World Chapter 10 The Compass and the Barometer Chapter 11 Unstuck Acknowledgments References ([Location 71](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=71)) ### Introduction: “Pure O” and Sticky Thoughts ([Location 93](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=93)) Thoughts have allowed us to flourish as a species. They make it possible for us to anticipate and plan for the future, and to learn from the past. Thoughts allow us to solve complex problems, walking through limitless iterations without treading a single step. Thoughts provide a sense of orientation, not only to where we are, but to who we are. With their help, we organize and structure raw experience, weaving together the threads of our moments and narrating our journey. ([Location 96](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=96)) This book is about how our thoughts become a source of suffering. In it, we will meet people who fear and struggle with their thoughts, exploring what causes and contributes to this struggle. Then, we will look at five skills that can help us to recognize and let go of this struggle, allowing us to live more fully in the moment and to move forward with a clearer sense of purpose. ([Location 103](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=103)) The closeness he felt to his son when they play ed together in the sand only intensified the thoughts of them inevitably growing apart. Lou was heartsick and distraught. What had happened to his good life? ([Location 247](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=247)) ### OCD and “Pure O” ([Location 250](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=250)) Paradoxically, their fear of these thoughts, and their efforts to avoid or control them, actually serves to keep the thoughts there, and to refresh them over and over again. This cycle of anxiety about thoughts leading to more anxiety-producing thoughts constitutes an obsession. ([Location 252](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=252)) ==These efforts to escape from the anxiety of obsessive thoughts are called compulsions. They are moves that anxious people feel compelled to make to escape from anxiety. These moves can take the form of simple avoidance or of more complex behavioral or mental rituals. Unfortunately, the escape these moves provide is only temporary. What’s more, the relief they provide reinforces the compulsion, making the avoidant or reassuring behaviors addictive in a certain way. When this pattern happens repeatedly, is distressing to the individual, and interferes with their daily life, we can say that the person is struggling with obsessive-compulsive disorder (OCD). This is simply a label used to describe a pattern of feelings (anxiety), thoughts (obsessions), and behaviors (compulsions) that appears often enough to be labeled and studied by behavioral scientists. ([Location 257](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=257))== Many people with OCD struggle with obsessions that have nothing at all to do with contamination or cleanliness, and engage in compulsions that are more subtle than washing or ordering objects. In many cases, the compulsions are literally invisible and take the form of avoidance or thought rituals intended to provide reassurance. ([Location 270](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=270)) Avoidance can be subtle and harder to detect than an overt compulsion like washing or cleaning. ([Location 279](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=279)) ...talking with a therapist about those feelings, examining them over and over again in detail, and getting reassurance about them can become a compulsive ritual in itself. ([Location 285](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=285)) Because their obsessions don’t fit the stereotype of germaphobia, or because their compulsions are invisible, many people struggling with OCD are misdiagnosed by therapists. Therapists trained in cognitive behavioral therapy or acceptance and commitment therapy—the basis of this book, which we’ll discuss shortly—tend to be more familiar with the full range of forms that OCD can take. ([Location 289](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=289)) ==Compulsions may include subtle avoidance of triggers, reassuring thought-based rituals, questioning of friends and family to gain reassurance, or even just “confessing” to the thoughts by talking about or around them with others. While all of these responses offer temporary relief in the short term, they are much more a part of the problem than a part of a solution. ([[Chad LeJeune - Pure O OCD|LeJeune, 2023]], [Location 293](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=293))== ==Because the uncertainty they are intended to address can never be completely eliminated, cognitive rituals tend to be repeated over and over again, often in increasingly elaborate ways. The time and energy devoted to these rituals can be a huge drain on personal resources that could be better applied to activities, relationships, and other pursuits that add value to life. ([[Chad LeJeune - Pure O OCD|LeJeune, 2023]], [Location 296](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=296))== ==Constantly requesting reassurance and confessing or discussing obsessive thoughts with others shifts this burden to loved ones and can take a serious toll on relationships. Finally, the persistent avoidance of people and pursuits that trigger obsessive thoughts can be the most insidious and costly compulsion of all. ([Location 298](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=298))== ### Treatment of OCD ([Location 301](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=301)) ERP is an effective treatment approach and is fully compatible with the ideas presented in this book. Because it emphasizes a change in behavior, it is often part of cognitive behavioral therapy for OCD, which also focuses on changing, or “restructuring,” the distortions in thoughts caused by anxiety. Acceptance and commitment therapists also tend to make ERP a central part of their treatment for OCD, though they emphasize the development of a different set of skills that focus more on changing your relationship to distorted thoughts, rather than changing the thoughts themselves. ([Location 305](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=305)) If you can learn to struggle less with your thoughts, you will obsess less. Less obsessing leads to fewer compulsions. The other element emphasized here, which is often missing in treatment focused solely on ERP, is what to do instead of compulsive behaviors. If my choices are not driven by my anxiety and obsessions, how will I decide what to do or how to act? An important part of our discussion will be about identifying and acting on your values. When we focus on what we value and on translating that into action, we are often moved to act in ways that run counter to compulsive behaviors. ([Location 316](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=316)) Changing the relationship between your self and your thoughts and increasing an awareness of and commitment to acting on your values are the key components of acceptance and commitment therapy (ACT). ([Location 321](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=321)) Aside from being a treatment model, ACT is sort of a way of thinking about thoughts. It helps us look more closely at how we experience the world, asking questions like “How do thoughts relate to reality?” “What is the difference between you and your experience?” “How do we decide what to do at a given moment?” It takes a little patience to examine questions like this, but they happen to be just the right questions for a person struggling with OCD to ask. ([Location 327](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=327)) ==Cognitive fusion refers to the failure of the anxious part of the brain to make a clear distinction between a thought and the reality that the thought refers to (its referent). In other words, the thought becomes more sticky, “fusing” with the corresponding reality in our experience of it. ([Location 335](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=335))== - [I] Note: What is the relationship here to [[cruel optimism]]? Intellectually, we may be quite clear that these thoughts are not the same thing as the reality they reference, but on an experiential level, they are the same. ([Location 341](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=341)) # 🏁 Cognitive fusion can cause us to become afraid of our thoughts. This is essentially a description of OCD, and why I think ACT is so well suited for addressing all forms of OCD, especially Pure O. When we struggle to control or avoid certain thoughts, it’s because cognitive fusion has led the mind to perceive these thoughts as a threat. Understanding and interrupting this phenomenon is key to shifting the relationship between you and your obsessive thoughts. ([Location 343](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=343)) About This Book ([Location 347](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=347)) ### New imports from [[Readwise]] on [[2024-05-23]] at 11:38 PM Part One: How Thoughts Get Sticky ([Location 367](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=367)) Chapter 1 The Thing in the Bushes ([Location 369](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=369)) New patients call my office because they “have anxiety.” The clear implication is that anxiety, in and of itself, is a problem. One of the first things I try to point out to any new patient is that we all have anxiety. ([Location 371](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=371)) Not only that, far from being a problem, per se, anxiety is crucial for our survival as individuals, and as a species. ([Location 373](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=373)) Our struggles to reduce anxiety can escalate it, and our efforts to mitigate or avoid it can lead to any number of very serious problems. ([Location 376](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=376)) A Brief History of Fear ([Location 380](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=380)) Over millennia, those bodies developed a complex system for anticipating, preparing for, and responding to this and other threats to our well-being. This is our famous, ancient fight-or-flight response. It is key to both our survival and our struggles. It contributes to our success, as well as to our suffering. ([Location 383](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=383)) Anxiety is not so much the lion, tiger, or bear that’s chasing you. That’s not anxiety, that’s a lion, tiger, or bear. And when you’re being chased, you’re not exactly anxious. You’re running. Anxiety is what happens just before you’re being chased. It’s also what happens before you’re not being chased. That is the problem. ([Location 388](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=388)) - [I] Note: [[anxiety]] Anxiety is the response that protects you from threats, as well as from opportunities. ([Location 394](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=394)) Fight-or-Flight Below the Neck ([Location 397](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=397)) Once all of these changes have kicked in, you’re good to go. You are physically ready to run much faster and fight back much harder than you were before fight-or-flight kicked in. Unfortunately, you are also a bit of a mess. All these physical changes bring a degree of discomfort, which can, in itself, be a trigger for more anxiety. ([Location 407](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=407)) once you’ve scrambled to the top of the tree and can see that you are safe, all systems slowly return to normal. Most of us call this relief. Biologists call it a parasympathetic response, which is the opposite of the fight-or-flight response. It involves things like sighing, crying, laughing, and eventually yawning and sleep. All of this helps our body return to baseline. ([Location 411](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=411)) When it comes to OCD, the amygdala can learn to respond to something as simple as a word or an image with the full fight-or-flight response. ([Location 426](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=426)) Whether or not, and to what degree, fight-or-flight is triggered by our thoughts depends on two things: the content of our thoughts, and our relationship to that content. ([Location 427](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=427)) - [I] Note: Relationship to thought Fight-or-Flight Above the Neck ([Location 433](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=433)) When something is coming through the bushes, we become hypervigilant. In other words, we are more aware of certain sensory information that could be relevant to the threat. Our hearing becomes sharper, but only for certain, threat-related sounds. Our vision becomes more focused, but only on the area directly in front of us. In fact, we lose a certain amount of peripheral vision. All of this contributes to what we call a threat bias, or a tendency to perceive things as more threatening than they actually are. This threat bias applies not only to what we notice and attend to in the environment, but to what conclusions we draw from that information. ([Location 435](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=435)) Often, anxiety can cause us to run away from rewards and opportunities as well as threats. In fact, the modern world often rewards a certain amount of risk taking. Think about applying for a better job, investing in the stock market, or asking someone out on a date. ([Location 445](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=445)) It’s not just the content of our thoughts that changes as part of fight-or-flight. There is also a contextual or relational shift in the way we experience our thoughts. When we’re anxious, we often experience our thoughts as more than just thoughts. In other words, we respond to the thought of a lion, tiger, or bear the same way we would respond to an actual lion, tiger, or bear. This is cognitive fusion. It means that the thought of a lion coming through the bushes, and an actual lion coming through the bushes, are fused in our experience. The amygdala and the body respond to the thoughts the same way they would respond to the reality that the thoughts refer to. This leads to more anxiety and more running, whether there is a lion or not. ([Location 447](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=447)) Language and Suffering ([Location 466](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=466)) Like spoken or written words, thoughts are symbolic, analog representations of the external world. ([Location 470](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=470)) Cognitive fusion is an instance of what semantics scholar Alfred Korzybski (1933) referred to as mistaking the “map for the territory.” He put it even more succinctly when he said, “The word is not the thing.” ([Location 471](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=471)) Our capacity for language has allowed us to solve very complex problems, plan ahead, and share our complicated ideas with one another. It has also made us the only animal that can be safe, dry, rested, and well fed, and still be completely miserable. This is because language allows judgment. Before language, we simply had an experience. After language, we could compare that experience to other experiences, even imaginary experiences, and find it lacking. We can also judge the past and the future. ([Location 473](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=473)) Adam and Eve and Steve ([Location 481](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=481)) Experiencing Thoughts as Thoughts ([Location 501](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=501)) Buddhist meditation practices emphasize separating ourselves from the content of consciousness through mindful observation and regarding thoughts as thoughts, rather than the reality they refer to. ([Location 503](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=503)) Struggling: The Gorilla in the Room ([Location 515](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=515)) Nobody likes anxiety. Like having a gorilla in the room, it’s very uncomfortable. It’s supposed to be. It’s the function of anxiety to get our attention and to hold it…to get us to do something. When faced with an out-of-control situation, we try to either escape it or control it. ([Location 522](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=522)) Most of us know intuitively that the harder we try to get rid of a thought, the more insistently the thought is just there. One paradox is that it’s impossible to think about getting rid of a thought without thinking about that thought. Once we are struggling to keep a thought out of our consciousness, that thought has already breached the wall. Struggling with it only makes the thought more central to our experience. There’s a similar paradox at work when we struggle to control the anxiety itself. ([Location 532](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=532)) Control Is the Problem ([Location 536](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=536)) The more we try to control our anxiety, the more anxious we feel. It pushes against the lid we try to put on it. The reason for this paradox is surprisingly simple. The one thing that your brain and body give you to help you control anything is…anxiety. Arousal, activation, energy, fight-or-flight. Call it what you will, control and anxiety are pretty much the same thing. ([Location 537](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=537)) Trying to control anxiety and get rid of anxious thoughts is like trying to clean up a little spilled water with more water. ([Location 545](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=545)) Most obsessions start out as just thoughts. Granted, they are usually unpleasant thoughts. We have unpleasant thoughts all the time without necessarily trying to change or get rid of them. We have thoughts about unpleasant developments: It’s going to rain, and I don’t have an umbrella. We have unpleasant judgments: This music sucks! These thoughts aren’t obsessions, though, because we are willing to have them. Good or bad, thoughts come and go all day long. There’s sort of a flow to thoughts. ([Location 551](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=551)) An obsession is simply a thought that you’re not willing to have. If you’re not resisting the thought, if you choose not to struggle with it, if you are willing to have it…it’s just a thought. ([Location 556](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=556)) It’s About the Relationship ([Location 559](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=559)) What’s true for your relationships with people applies to other aspects of your life as well. For example, think about your relationship with your job or career, with your role as a parent or as a child. What about your relationship with your body or your relationship with food? Obsessing and the struggle it involves has everything to do with the relationship between you and your thoughts. Or if you prefer, your relationship with the gorilla in the room. ([Location 562](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=562)) The most fundamental thing about a relationship is that it involves two entities. Before you can work on your relationship with your thoughts, it’s essential to make a distinction between the two entities: (1) you and (2) your thoughts. Because we experience our thoughts as happening inside our heads, which is the same place we ourselves reside, we tend not to make a clear distinction between our selves and our thoughts. ([Location 566](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=566)) With all of this talk about two entities, it’s important to emphasize that we’re not talking about two selves, or even about two parts of yourself. Your self is the you that has been there all your life, watching, listening, experiencing—the enduring context of all that you experience. Thoughts, on the other hand, are just another part of your experience. They’re content. You experience what you see; what you hear; things you touch, taste, and smell. You experience emotions, and you experience thoughts. The two entities in all of these cases are you (your self) and your experience. You are the observer, and the experience is whatever you observe. ([Location 580](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=580)) The problem with obsessive thoughts is that this relationship is characterized by a struggle for control. ([Location 586](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=586)) Chapter 2 Stickiness and Suffering ([Location 588](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=588)) Cognitive Fusion and Fear ([Location 596](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=596)) Each of the problems we’ll discuss in this chapter can be broken down into three components: anxiety, avoidance or control, and thoughts. ([Location 597](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=597)) Avoidance or control strategies can include things like procrastination, overwork, or substance abuse. ([Location 598](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=598)) Each of these three components both feed into and are influenced by the other two components. For example, while more cognitive fusion (i.e., the thought component) leads to more anxiety, more anxiety causes our thoughts to be more fused. While anxiety leads to more avoidance, the more we avoid something, the more intensely we fear it. And while more cognitive fusion often means more avoidance, struggles to avoid certain thoughts often make those thoughts stickier. To see how this works, we’ll start by looking at the role cognitive fusion plays in problems like phobias, social anxiety, and worry. ([Location 601](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=601)) Phobias ([Location 606](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=606)) Perhaps the most straightforward and easy to understand problematic fear is a phobia. ([Location 607](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=607)) When you talk to someone about their phobia, it becomes clear that their fear is largely a response to their specific thoughts about the things or situations that they fear. Often these thoughts take the form of a narrative, or story that supports the phobia. ([Location 610](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=610)) They may have learned this narrative at an early age. Consider the mother who notices that her two-year-old son is hesitant and fearful around dogs. Encountering someone with a dog on the street, she might pick the child up and say, “Timmy is afraid of dogs.” Through cognitive fusion, this narrative can become a sort of verbal rule that Timmy learns and follows. ([Location 613](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=613)) Being able to fly means being willing to have thoughts of crashing. This is not the same thing as being willing to crash. ([Location 630](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=630)) The heightened sensory awareness can lead them to actually “feel” a spider crawling on their skin, resulting in even more anxiety, and sometimes even panic. Just as with flying and thoughts of crashing, it may not be unusual in certain settings, like an attic or crawl space, to have thoughts of spiders. It’s when we experience these thoughts as fused with the experience of actual spiders that we have a problem. ([Location 634](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=634)) Thoughts of negative outcomes are an unavoidable and even important part of situations where caution increases our safety. Let’s say you are visiting an apartment on the twentieth floor of a high-rise. If you step out on the balcony for some fresh air, it’s actually a good idea to remember that you are several stories above the ground. Because of this awareness, while you might approach the railing and even lean over it, you would probably not hop up and sit on the railing. If you paid close attention, you might even notice thoughts or images related to falling, or even jumping, coming to mind. This is your brain’s way of saying, “Don’t fall” or “Don’t jump.” ([Location 639](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=639)) Phobic Narratives in Pure O ([Location 647](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=647)) While cognitive fusion plays a role in all problematic fears, with Pure O, it’s pretty much the main event. The anxiety is explicitly a response to the thought. The avoidance or rituals are explicitly about getting rid of the thought. ([Location 652](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=652)) This is what makes it “Pure O” OCD rather than a phobia. ([Location 655](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=655)) Sophie’s anxiety is also a response to a narrative. Her story is “If I don’t feel constant love for my parents, I may be a sociopath.” Compulsively calling her parents and professing her love to them and her cognitive ritual of imagining their funerals are efforts to temporarily dispel that narrative. If she can conjure some feeling of love for her parents, it provides some reassurance that the narrative is not true. This can offer a temporary escape from her anxiety. Because the goal is reassurance, these types of rituals are often referred to as reassurance seeking. ([Location 656](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=656)) Social Anxiety ([Location 666](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=666)) Cognitive fusion is not so much about believing that our thoughts are true or real. On a rational level, we may doubt the truth or accuracy of our thoughts, or even believe that they’re unlikely. ([Location 667](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=667)) The problem is that we experience them as more than that. An example of this phenomenon that most of us can relate to is what happens when we experience anxiety about social situations. Imagine attending a networking event with a group that you are new to, but hope to impress. While some people look forward to this sort of thing, many of us feel at least a moderate prick of increased vigilance going in. ([Location 669](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=669)) ### New imports from [[Readwise]] on [[2024-05-25]] at 2:24 AM More relevant to our discussion is what happens to our thoughts. Our increased anxiety creates a threat bias, leading us to assume the worst when reading social cues that are ambiguous. If we have trouble reading someone’s response to us, we are more likely to have thoughts like He doesn’t like me or She thinks I’m boring. ([Location 680](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=680)) Not Being Good Enough ([Location 688](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=688)) A related example of cognitive fusion that many of us have experienced is when we respond to new or challenging situations with an overly critical assessment of our worth or abilities. Since the anxious part of the brain wants to protect us from failure or falling short in some way, it can respond to these situations with fight-or-flight and the impulse to escape or avoid. ([Location 689](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=689)) Worry ([Location 697](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=697)) When our thoughts are negative, it can seem like they are just there to torment us and beat us down, discouraging us from traveling, meeting new people, and trying new things. ([Location 698](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=698)) - [I] Note: God yes!!! In fact, our thoughts also point us in the direction of potential rewards and desirable outcomes. Thinking allows us to solve complex problems in the present, come to peace with the past, and even access hope about the future. Thinking changes, however, with the fight-or-flight response. ([Location 699](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=699)) Because survival is their primary function, as perceived danger increases, thoughts will lean increasingly toward avoiding risk. Worry is the mind’s attempt to predict future threats and possible negative outcomes. These thoughts usually take the form of “What if…” ([Location 702](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=702)) To better protect us, the anxious brain overestimates the likelihood of negative events and outcomes. When we experience these thoughts in a fused way, our body can respond as though these negative events are happening now. Worry involves both excessive thoughts about negative outcomes and an accompanying physical arousal in response to those thoughts. Like carrying an open umbrella everywhere you go, carrying this chronic overarousal in your body can lead to many other very real problems. ([Location 708](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=708)) Not all thoughts about the future are worry. If we anticipate possible negative outcomes calmly, and can generate possible solutions to future problems, we are simply planning or problem solving. However, most anxious thoughts are not so productive. If you aren’t generating a list of solutions, you aren’t problem solving. If you aren’t creating a plan, you aren’t planning. Worrying is when thoughts are not productive and instead just lead to even more anxiety. ([Location 712](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=712)) When a person has a pervasive pattern of worry and chronic overarousal that interferes with their ability to function in daily life, they may meet the criteria for a diagnosis of generalized anxiety disorder (GAD). This is when the body has a “high idle” and the mind has the habit of looking for trouble. I think of GAD as a close cousin of OCD, especially the Pure O variety. ([Location 715](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=715)) OCD and Worry-Like Obsessions ([Location 718](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=718)) Worry and OCD are very similar in that they are both anxious responses specifically to thoughts. Like worry thoughts, the thought part of OCD often takes the form of “What if…” thinking. ([Location 720](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=720)) Both worry/GAD and OCD can lead to excessive preparation, checking, reassurance seeking, avoidance, and other behaviors that specifically lead to temporary relief from the anxious thoughts. The difference is that in the case of OCD, the thoughts can be a bit more irrational and unrealistic, even to the person thinking them. ([Location 723](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=723)) While GAD and OCD are officially classified as two different disorders, I tend to think of them as existing on a continuum. Cognitive fusion is the key, operative factor in both. ([Location 728](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=728)) Two types of worry that commonly reach the threshold of obsession are safety concerns and contamination fears. Life presents endless opportunities for obsessing about these two areas, and both can generate a wide range of checking and correcting behaviors that can readily become compulsions. ([Location 734](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=734)) Safety Concerns ([Location 738](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=738)) Sometimes, safety concerns are not just about staying safe. They often have more to do with our personal responsibility in the world. It’s not just that we don’t want bad things to happen, it’s that we don’t want them to happen on our watch. This fear of making even small mistakes that could inadvertently lead to harming someone else is often referred to as scrupulosity. ([Location 750](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=750)) Compulsions related to these thoughts range from checking behaviors to “confessing” small oversights that might create a slight risk for others. In many cases, what ([Location 754](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=754)) drives scrupulosity is not so much a fear of harm as a fear of the guilt one would feel if such harm came to pass. ([Location 755](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=755)) I’m feeling anxious, cognitive fusion leads me to experience this narrative as not merely possible, but likely. It also results in a strong feeling that the door I have just locked and checked may, in fact, still be unlocked. ([Location 767](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=767)) Contamination Fears ([Location 770](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=770)) Common “Pure O” Obsessions ([Location 803](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=803)) It’s when we are literally afraid of a thought that we experience cognitive fusion in its most explicit form. When this is the case, any struggle to stop or change our thoughts can lead to more anxiety, and therefore more fusion. This obsessive cycle is a positive feedback loop that can lead to rapidly escalating anxiety. In this Pure O pattern of OCD, the compulsive behavior may not be readily apparent. ([Location 804](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=804)) As mentioned earlier, it could be avoidance, very subtle behaviors meant to give reassurance, or an invisible thought-based ritual. Subtle or not, the compulsions play a key role in reinforcing and maintaining the obsessive cycle. While Pure O can take on an unlimited variety of forms, there are several common patterns. ([Location 807](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=807)) Intrusive Thoughts and Images ([Location 810](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=810)) Sometimes thoughts that become obsessions are less like a narrative and more like a bumper sticker or pop-up ad. It may be an emotionally loaded word or phrase or a disturbing image that repeatedly comes to mind, eliciting a startle response and an immediate struggle to avoid or banish the thought. Sometimes it’s a thought that encapsulates broader negative beliefs, like the word “loser.” ([Location 811](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=811)) Other times, it’s an unpleasant memory from the past, like the image of a loved one in pain or a gory scene from ([Location 814](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=814)) a movie. ([Location 815](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=815)) A good definition of an obsession is “a thought you are not willing to have.” If you’re not struggling to stop or control a thought, it’s not really an obsession…it’s just a thought. ([Location 819](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=819)) ### New imports from [[Readwise]] on [[2024-06-02]] at 9:21 AM “Harm OCD” ([Location 822](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=822)) It’s not unusual for intrusive thoughts to include violent imagery, like thoughts of stabbing or bludgeoning loved ones or family pets. The thoughts may be sexual in nature, especially thoughts of acts that run counter to the individual’s morals or values. Part of the anxiety associated with these “bad thoughts” is the accompanying idea that they might represent secret urges or desires and the individual’s fear that they may act on them. ([Location 822](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=822)) It’s impossible to have a thought about not doing something that doesn’t include a thought about the thing you don’t want to do. ([Location 828](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=828)) As you begin to slice the tomato, if you pay close attention, you’ll notice the idea or image coming to mind of slicing through one of your fingers. You respond to this thought by carefully positioning your fingers outside the path of the slicing knife. These thoughts are simply your brain doing its job of protecting you. ([Location 833](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=833)) Needing to Be Certain ([Location 847](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=847)) Another common pattern of obsessive thinking has to do with our response to ambiguity or uncertainty. In nature, ambiguity represents a threat. If we don’t know what’s coming toward us through the bushes, we’re less likely to be prepared for it. ([Location 847](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=847)) The need to be certain is also at work when we feel the need to reread a paragraph just in case we missed an important sentence or word, or to ask someone to repeat what they said earlier, in case we misunderstood or forgot something important. ([Location 852](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=852)) The only thing harder than knowing exactly how we feel right now is predicting exactly how we will feel in an imagined future. ([Location 863](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=863)) Cognitive fusion comes into play when the brain attempts to reduce our uncertainty. Since “sitting with” the ambiguity of not knowing what’s coming through the bushes can lead to being devoured, the anxious brain gives us the illusion of certainty. ([Location 864](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=864)) “Relationship OCD” and “Sexual Orientation OCD” ([Location 874](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=874)) The ambiguity inherent in our feelings for others, as well as a similar fuzziness surrounding feelings of physical attraction, contributes to two types of OCD that have received increased attention in recent years. While not official diagnoses, “relationship OCD” and “sexual orientation OCD” are well documented and much discussed in online forums. ([Location 875](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=875)) Relationship OCD can also include obsessions about a partner’s sexual history or about their fidelity or future fidelity. ([Location 884](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=884)) Fans of the sitcom classic Seinfeld will likely remember the episode in which George, anxious about receiving a massage from a male masseur, subsequently obsesses about whether or not “it moved” during the massage, adding, “It was imperceptible, but I felt it!.” Individuals with sexual orientation OCD, or what has also been called “gay OCD,” obsess about their sexual orientation. ([Location 893](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=893)) Incidentally, while it’s less common, a similar dilemma can occur for the person who identifies as gay or lesbian but has obsessive concerns that they may actually be straight. After coming out to family members and friends, and perhaps building a long-term relationship with a same-sex partner, discovering that you are in fact straight could indeed be inconvenient in a number of ways. ([Location 901](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=901)) Maximizing or FOMO ([Location 915](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=915)) Given a choice between something good and something better, most of us would choose the something better. Because we have an aversion to losing things, we can even have something good and experience the lack of something better as a loss. ([Location 916](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=916)) Psychologist Barry Schwartz, who has done extensive research on this phenomenon and its implications for mental health and economics, refers to the impulse to have the best possible thing as “maximizing” (B. Schwartz et al. 2002). ([Location 919](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=919)) But how do we know that we have the best possible thing? What if there is something better out there? These questions naturally arise when considering our choice of romantic partner, a job or career, which school to attend or send our children to, where to go or where to stay on a vacation, where to live, which restaurant to try, or even what to order from the menu. Notably, this is a predicament more often faced in affluent societies where a multitude of options are available in all of these areas. The anxiety that accompanies this abundance of choice has come to be known as FOMO: Fear Of Missing Out. For many people, it is also a fear of regret. We imagine our future selves discovering a better option than the one we chose. The indecision and struggle produced by maximizing and FOMO has its own trendy name: analysis paralysis. ([Location 922](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=922)) In his research on maximizing, Dr. Schwartz has found that people who tend to be the greatest maximizers not only take the longest time to decide, but also are less satisfied with their choices, less happy, and less optimistic than people with low maximization scores. He goes on to suggest that, while initially having increased choices makes us feel better, at some point, increased choice actually decreases our happiness. ([Location 928](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=928)) From Cognitive Fusion to Defusion— A Look Ahead ([Location 936](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=936)) Social anxiety and feelings of being “not good enough” offer good examples of how sticky narratives can “feel true” even in the absence of any supporting evidence. ([Location 939](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=939)) In other words, it’s not the content of the thought, but our relationship to that thought, and our response to it, that causes us to suffer. ([Location 943](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=943)) To the extent that cognitive fusion plays a central role in all the problems outlined here, cognitive defusion can offer a path to decreased struggling and suffering in all of these areas. As used here, the word “defusion” is not about directly reducing danger or tension, as in “defusing the situation,” but rather about de-fusing, or separating a thought from the reality that it refers to. ([Location 945](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=945)) Chapter 3 As Above, So Below ([Location 955](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=955)) Magic…we have all wanted it at some point. Whether it’s crossing our fingers, wishing upon a star, or searching for that four-leaf clover, most of us have yearned for the power and protection of magic. And no, not just as children. Even in our most adult moments, we have wanted to just make it happen, to make it okay…with the power of thinking it so. ([Location 956](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=956)) Ritualized actions performed on one level to control outcomes on another level, in the absence of a clear causal connection between the two, are also associated with certain mystical rites and magic. Sympathetic magic, also known as “imitative magic” or “contagious magic,” refers to this correspondence between two seemingly unrelated things. This implied correspondence between one realm and another is also captured neatly in the words “as above, so below,” a phrase attributed to early mystical writers and associated with alchemy. ([Location 1015](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1015)) This understanding of the connection between uncertainty, anxiety, and rituals is based largely on the research and writing of the cultural anthropologist Bronislaw Malinowski (Homans 1941). An expert on rituals of all kinds, he lived with and studied the cultural life of the Trobriand Islanders in New Guinea during the 1920s. Based on his observations there and elsewhere, he concluded that the performance of rituals increases in response to perceived uncertainty. The less control we feel we have, the more likely we are to engage in some sort of ritual. ([Location 1029](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1029)) Obsessive thoughts are to OCD what the stars are to astrology. The experience that controlling this (thoughts) will control that (reality) is an expression of cognitive fusion. The thoughts, and the reality they refer to, are fused in our experience. We may not believe they are the same thing, but we respond as if they are. ([Location 1049](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1049)) - [I] Note: The fusion doesn't mean you believe the compulsion will work, but it feels like it Avoiding cracks is a way of avoiding that dangerous thought. I once saw a young man in my practice who was convinced that exerting control over his thoughts was imperative not only to his mother’s back, but to the safety and well-being of all of his loved ones, and even that of complete strangers. ([Location 1055](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1055)) Dualism and Idealism ([Location 1070](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1070)) The Cave ([Location 1075](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1075)) The notion that ideas are more real or more important than the physical objects they refer to has been called idealism, as in “The Platonic Ideal.” If this sounds like the opposite of how we usually think about reality, it is. Contrary to the idealism that may have prevailed early on, materialism is the dominant paradigm of day-to-day thinking for most people in the modern world. Materialism asserts that matter precedes ideas. ([Location 1084](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1084)) Cognitive Fusion and Idealism ([Location 1091](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1091)) Still, most of the time we know that we cannot milk the “inside goat” of our thoughts. If we’re hungry, we have to find an “outside goat.” At other times, though, this separation of inside and outside can become murkier. On another night, lying in bed, when we think about our favorite goat, sleeping in the meadow, we might also think about the wolves we have heard howling in the forest. Our ancient, anxious brain knows all about wolves and goats, so it sends us a warning image, an “inside wolf,” in the meadow, stalking our favorite goat. If we’re a bit keyed up, and maybe already having some trouble falling asleep, the inside wolf and the outside wolf can become one and the same. Fused. In response, our heart rate and blood pressure rise, and our muscles tighten. Our body is preparing to save our favorite goat! ([Location 1100](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1100)) Idealism as a Cultural Movement ([Location 1111](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1111)) Religious Beliefs and OCD ([Location 1132](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1132)) Many traditional religions have also emphasized the importance of thinking “good thoughts.” Prayer often takes the form of thoughts, and most religions view rituals as significant and powerful. ([Location 1134](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1134)) For individuals struggling with OCD who also happen to be religious, it can be difficult to know where to draw the line between their religious beliefs and their OCD. Is it possible to practice cognitive defusion and maintain one’s religious belief and devotions? ([Location 1135](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1135)) In my experience, this confusion often shows up in two common patterns of OCD. In the first, intrusive thoughts are seen as blasphemous or otherwise going against an individual’s morals or religious beliefs. ([Location 1137](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1137)) Struggling to eliminate or control those thoughts can be seen as an act of religious obligation. The other form is when a religious practice, like saying a prayer or making the sign of the cross, has become an OCD ritual. In both cases, I have found it helpful to ask patients about how they distinguish between religious beliefs and superstition, and whether superstition can sometimes show up in the guise of religious beliefs. ([Location 1138](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1138)) Malinowski made a distinction between magical and religious rituals. In his view, a magical rite had a clear and definite practical purpose: a good crop yield, the catching of many fish, and so on. He maintained that this was not true of most religious rituals, which were intended to show devotion or elicit more general well-being or protection. ([Location 1142](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1142)) In OCD, individuals are usually focused on controlling specific outcomes through their own behavior, while in religious rituals and prayer, they are appealing to a higher power to intervene on their behalf. Belief in the necessity of OCD rituals varies depending on a person’s level of anxiety, while spiritual and religious beliefs tend to be much more constant. ([Location 1146](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1146)) Understanding and Noticing Fusion ([Location 1156](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1156)) Whatever our religious or spiritual beliefs, and in spite of evidence from the field of quantum physics for as-yet-unidentified connections between consciousness and matter, most of us think and operate in a materialistic, nonmagical way most of the time. In my experience, most people with OCD maintain that they do not actually believe in magic as the best way to influence things like test performance, health and safety, or the future of their relationships. In my practice, I have found that labeling compulsive actions like rituals, checking, reassurance seeking, and even avoidance as “rain dances,” “spells,” and “magic” can increase an individual’s awareness of what they are doing or attempting to do. Becoming more aware that we are operating solely on a symbolic level is itself a form of defusion. ([Location 1159](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1159)) When I identified and labeled this practice as “casting a spell” on the door to assure that it stayed locked, it was suddenly easier for me to abandon at least the “locked” part of this ritual. ([Location 1166](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1166)) Chapter 4 The Arrow of Time ([Location 1178](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1178)) We have heard that we must live with the past. This is true, and we must live with the future as well. We live with both past and future as they exist in our minds, entirely in the present. Only the present moment is available to us as a direct experience. We experience both the past and the future exclusively as thoughts. Like all thoughts, both memories of the past and images of the future are susceptible to cognitive fusion. When we find ourselves struggling to alter events that occurred in the past or dreading a possible future as fixed and inevitable, we are experiencing what I like to call “time fusion.” This extremely cool-sounding subtype of cognitive fusion plays a key role in the obsessive indecision of analysis paralysis and in obsessive regret. ([Location 1179](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1179)) Analysis Paralysis: Stuck in the Hallway ([Location 1228](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1228)) With a girlfriend he loves, and two attractive job offers, Miguel seems to have acquired the basic ingredients of a good life. However, he is having trouble putting those ingredients together to make something substantial for himself. ([Location 1229](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1229)) Like a swimmer treading water, he is struggling and putting a great deal of effort into staying in one place. ([Location 1232](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1232)) Miguel avoids making choices because he can imagine a future self who regrets the decision he is about to make. To avoid becoming this future self, he puts off making a decision. The problem with not choosing is that not choosing is also a choice. ([Location 1236](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1236)) - [I] Note: Maybe this is me and fitness? Whatever Miguel chooses, whether or not it turns out to be the “right” choice will depend largely on his ability to embrace that choice and take subsequent action to make it the right choice. ([Location 1260](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1260)) Keeping his options open, on the other hand, could be the very thing that spells the end of an otherwise happy relationship. ([Location 1265](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1265)) When the goal is maximizing, or making the best choice possible, it’s not enough to know that a choice is ([Location 1271](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1271)) likely to work out well for you. We want to know that there is not a better choice out there. ([Location 1272](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1272)) Obsessive Regret ([Location 1278](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1278)) The stickiness of anxious thinking can play another trick as well, this time after we have made a choice and left the hallway. Having chosen, followed through, and arrived at an outcome, it is still impossible to say for certain whether the choice we made was in fact the best choice to make. Even ([Location 1279](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1279)) We are struggling to make a different choice, to undo what has been done, to change what is unchangeable. In these moments, the past, which we usually experience as frozen and fixed, a story that has already been written, appears to us as something subject to our influence and efforts. Our thoughts about the past, which are here, now, are fused with the reality they refer to. Our body struggles to act on the past the same way it would act on the present. This is another form of time fusion. ([Location 1285](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1285)) Our Experience of Time ([Location 1289](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1289)) Time, like music, is constructed by the mind, from our memories and anticipations. In other words, time, as we experience it, is made of thoughts. ([Location 1296](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1296)) We tend to think of and speak about time using space as a metaphor. “Measuring” the “passing” of time with the movement of a second hand around the face of a clock is an example of this spatial metaphor. ([Location 1298](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1298)) ### New imports from [[Readwise]] on [[2024-06-09]] at 4:36 PM Time fusion in the opposite direction causes us to experience the past as somehow changeable or fixable. When we experience obsessive, ruminative regret, the memory of a past event and the actual event are fused in our experience. Since we can usually act on actual events (as opposed to remembered events), when this happens, we respond to the memory with fight-or-flight arousal and the drive to take action, literally struggling to prevent or change the event. ([Location 1323](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1323)) Unled Lives ([Location 1330](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1330)) I once worked with a patient who, in spite of his many personal and professional successes, was obsessed with thoughts of how much better his life might have been if he had attended a different university. ([Location 1333](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1333)) Literary scholar Andrew Miller (2020) offers an extended meditation on the idea of the alternate self in his poetic book On Not Being Someone Else: Tales of Our Unled Lives. ([Location 1365](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1365)) While growth realizes, it narrows: plural possibilities simmer down into one reality, haloed by evaporating, airborne unrealities. There’s loss to be found, if you look, in the bare fact that you’ve had only one past and arrived at only one present. Life is exclusive… Growth excludes and hardens. (7–8 ) He goes on to caution that our unled lives are part of this world as shadows are part of things, as memories are part of perceptions, as dreams are part of day…my imagined life makes this one seem like less. Instead of adding to the world, my unled life subtracts from it. (49) ([Location 1369](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1369)) Being Present with the Past and the Future ([Location 1376](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1376)) When it comes to making choices, it can help to recognize the diminishing return of trying to maximize. The costs of lost time and increased distress that come with postponing choosing are often greater than those of making a sub-optimal choice. Barry Schwartz (2004) found that “satisficers,” who use “good enough” as the guiding criterion when making choices, were happiest with their choices and least prone to regret. ([Location 1383](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1383)) It’s not just unled lives and the story you tell about your actual life that are constructions. Even the main character of your story, what you usually think of as your self, is a construction of your mind. If that’s so, then who is the author and the audience of all these stories in your head? This is the question we will turn to in the next chapter…when…and if…you choose to read it! ([Location 1395](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1395)) Chapter 5 Song of My Self ([Location 1400](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1400)) ### New imports from [[Readwise]] on [[2024-06-21]] at 10:09 AM the response I get is often some version of the following: “I get the concept, and it makes a lot of sense to me, intellectually. The only problem is, I can’t stand to be that anxious.” With patients struggling with Pure O, I hear something similar: “I know these are just thoughts, but I’m afraid that if I let them be there, they’ll just take over.” I’ve learned to listen closely to these concerns and to ask patients a lot of questions about what exactly they mean. ([Location 1403](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1403)) In most cases, patients are concerned that feeling certain feelings or sitting with certain thoughts will harm, damage, or change them in some fundamental way. ([Location 1411](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1411)) Do you remember those nutrition posters that proclaimed “You Are What You Eat”? Well, at times, anxiety can lead to the perception that “You Are What You Think.” ([Location 1413](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1413)) When he heard reports about a celebrity assaulting numerous women after spiking their drinks, it occurred to him that he had probably been in a position to spike a woman’s drink in the past. He had no idea what he would put in a woman’s drink, or where he would have gotten it. Yet, he knew that he would have had opportunities to do so. Was it possible that he could do such a thing and then forget that he had done it? How could he know for sure that this had not happened at some point? The idea made him very anxious, and kept coming up. ([Location 1432](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1432)) - [I] Note: Example of intrusive thoughts or obsession Protecting the Self ([Location 1447](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1447)) The anxiety that Carl feels about possibly violating or not respecting a woman’s boundaries is a reflection of deeply held values. This is who Carl is, and, based on his history, who he always has been. The same self that responds with concern and alarm to these thoughts is the self that has been guiding Carl in his respectful interactions with women since his earliest interactions with them. ([Location 1450](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1450)) The problem for Carl is that cognitive fusion leads him to mistake his imaginary, thought-based “self” for his real self. The thought of spiking a woman’s drink feels like actually doing it. ([Location 1456](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1456)) It’s not just thoughts of harming others. We often feel the need to protect the self from a variety of uncomfortable thoughts, and from intense emotions as well. This is not so surprising. The idea that the self can be harmed or injured by our experiences is ubiquitous in our culture. Western religious traditions, in particular, which identify the self with the spirit or soul, have historically described it as subject to damage or contamination, emphasizing the need for “cleansing” the spirit or otherwise repairing the soul. ([Location 1459](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1459)) Over time, there has been a shift in the field away from this structural thinking to a more functional model of the self. Instead of damaging us or leaving psychic scars, early experiences are seen as influencing what we think or believe about ourselves, others, or the world. Increasingly, this process is described as one of learning, rather than being shaped and formed. ([Location 1465](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1465)) Unlike injuries and scars, which are part of us, as part of our experience, thoughts and beliefs can shift and change over time. Who we are is different from what we think, feel, or even believe. Still, the idea of a self that must be protected persists in the culture. ([Location 1468](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1468)) Both the cultural idea and the individual experience that thoughts, feelings, and beliefs are us can be understood as a type of cognitive fusion. The thoughts and what they refer to (us) are experienced as the same thing. ([Location 1470](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1470)) Consciousness and the Conceptual Self ([Location 1478](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1478)) The researcher and teacher Julian Jaynes, whose career focused on describing and understanding human consciousness, compared the search for the self to looking for darkness with a flashlight. ([Location 1481](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1481)) The Origin of Consciousness in the Breakdown of the… ([Location 1482](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1482)) - [I] Note: #toRead Jaynes (1976) begins his search with a description of consciousness as “an operation rather than a thing…” As an “operation,” consciousness is like mathematics. Math takes things from one realm (the physical world) and maps them to another (the numerical). Consciousness operates in a similar way, constructing an internal “space” that is an analog for the real world. Jaynes points out that “space” in the mind, while a metaphor, is a universal experience. “We are always assuming a space behind our companion’s eyes into which we are talking, similar to the space we imagine inside our own heads where we are talking from” (45). He calls this function of consciousness creating metaphorical space where none exists anatomically spatialization. He goes on to point out that even “things that in the physical-behavioral world do not have a spatial quality are made to have such in consciousness. Otherwise, we cannot be conscious of them” (60). One example of this is the spatial representation of time that we discussed in the last chapter. Jaynes maintains that this creation of spatial metaphors, even for abstract things, is required for any type of thought… ([Location 1483](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1483)) - [I] Note: I wonder what the connection is here to conceptual metaphor theory (CMT) Most importantly, consciousness produces an analog experience of us, what Jaynes calls the analog “I,” that inhabits and observes this constructed space and everything in it. This is the you that is reading these words right now, transforming them into spatialized concepts in the analog realm of your mind, and arranging them there as you would organize cereal boxes in the pantry, or cards in an index. This is not, however, the end of our search for the self. Among the spatialized ideas of consciousness encountered by the analog “I” is a representation of ourselves that we can observe. Jaynes calls this the metaphor “me.” This is the self that we tend to think of when we think of ourselves.… ([Location 1494](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1494)) - [I] Note: Is there anything to be learned about [[I-YOU-WE]] here? In ACT, this metaphor “me” is referred to as the conceptual self. It is a concept, an idea, a construction, that we tend to think of as us. This is the self that we are protecting when we avoid… ([Location 1501](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1501)) For example, consider the thought of not killing someone. It’s impossible to have the thought I would never actually kill someone without encountering… ([Location 1504](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1504)) Fusion and the… ([Location 1509](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1509)) The conceptual self is made up of thoughts. We can experience this sense of self as an image or as a story or narrative about who we are that… ([Location 1509](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1509)) We begin to work on this conceptual, verbal model of the self as soon as we learn to think and speak in words. It starts when people ask us questions like “Do you like… ([Location 1511](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1511)) We use the answers that we come up with to construct an internal model of who we are. We add in things we hear about ourselves, like “She’s so smart!” or “… ([Location 1512](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1512)) This construction of the conceptual self reaches the level of high art in pre- and early adolescence, when we decide what kind of music we like, which clothes we want to… ([Location 1514](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1514)) By adulthood, we have usually added things like political leanings, a particular sense of humor, and our… ([Location 1515](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1515)) By then, the conceptual self also includes pretty firm beliefs about our abilities and vulnerabilities, our capacity to love and be… ([Location 1516](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1516)) Since the conceptual self is a verbal model, essentially made up of thoughts, it too, is subject to cognitive fusion. In this case, the reality that the thoughts refer to is us. This leads us to experience this constructed model or narrative as us…the actual self. ([Location 1522](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1522)) When Anthony experiences his obsessive thoughts and anxiety about the jacket as himself, he can easily find himself saying things like “I don’t want to wear the jacket” even though he loves the way it fits, and it’s cold out. It’s as though the anxious mind or the OCD is saying, “I am you. What I want is what you want.” ([Location 1526](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1526)) The conceptual self and the OCD are protected, but Anthony is left out shivering in the cold. ([Location 1531](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1531)) When we start to look at practical choices related to how to behave, knowing the difference between a conceptual you that includes OCD’s judgments and rules, and the larger you that may have values other than just avoiding anxiety, becomes much more than just a philosophical question. ([Location 1532](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1532)) - [I] Note: #important The Self vs. Experience ([Location 1537](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1537)) If you are observing something, it is part of your experience. In ACT we would call this the content of your experience. Now look at the object again, and consider this question: Is this chair, tree, or lamp me? ([Location 1542](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1542)) So, while you tend to think of your hand as you, and while you may be, quite literally, attached to this hand…it is not, in fact, you. It is part of your body, and while your body has changed a lot over the years, you are still the same person. There is a sense of continuity that you experience as you, independent of your continuously changing hand, face, and body. In ACT, we would say that this constant, continuously abiding part of you is the context for the shifting, growing, changing, temporary content of your hand. ([Location 1559](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1559)) If you were following the directions, and picturing yourself, then it would seem the answer here is yes, this is you. However, please consider this… Who, exactly, was observing this image of you? Who chose the image? Who decided what you would be wearing, and what you would be doing? ([Location 1571](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1571)) In ACT, this patient, unobtrusive, quietly observant, hand-watching, self-imagining, thought-thinking, feeling-feeling, continuously continuing you that hardly ever gets noticed at all is called the contextual self. It corresponds roughly with Julian Jaynes’s analog “I.” It is the larger, more enduring self that looks out at the world from behind your eyes and looks inward at your thoughts. It’s the you that experiences thoughts, memories, judgments, rules, and feelings like sadness, joy, and fear. This self is separate from these things, which are not you, but are all part of your experience. The you that you think about when you think about you, the conceptual self, is also a part of your experience, held and observed by the larger, more enduring, less visualizable, less trunkable, largely untouchable YOU that is the contextual self. ([Location 1576](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1576)) The Contextual… ([Location 1584](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1584)) This is sort of a ruling-out approach to the contextual self. You can think of it as what’s left when we subtract all the content of consciousness. Because the contextual self is so fundamental and behind the scenes, it’s very hard to describe or discuss it in a straightforward,… ([Location 1585](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1585)) Steven Hayes offers a more experience-based definition when he refers to the contextual self as “you-as-perspective” (Hayes, Strosahl, and Wilson 1999), emphasizing that we contact this sense of self not as a being who can be observed but as “a locus from which observations are made.” He goes on to posit that this fundamental distinction between transient, observable things (content) and this sense of an enduring locus from which things are observed (context) “… ([Location 1588](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1588)) The contextual self, also referred to as “self-as-context,” is very much like the traditional concept of “spirit” in that it is ever-present, is enduring, and cannot be observed. Buddhism refers to it as “the… ([Location 1593](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1593)) The psychologist and spiritual teacher Ram Dass (1971) compares this quietly abiding self to the blue sky. When we look up, we tend to focus on what is in the sky. If there are clouds there, this is what we see. The clouds are our thoughts, feelings, experiences... content. Usually, the clouds get all of the attention. What we tend to miss is the patch of blue that indicates a larger, enveloping sky, the ever-present context that surrounds and contains the clouds. This blue sky is the contextual self. If you are the sky and not the clouds, it is not so important to be in control of the clouds. The sky does not require protection from the clouds. It’s big enough to contain all of them, without injury. Observing the clouds of our thoughts and feelings from… ([Location 1595](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1595)) Learning to Be with the Contextual Self ([Location 1622](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1622)) One very straightforward way to create space between your self-as-context and the anxious thoughts, judgments, and rules that are often folded into the conceptual self is to take a breath, notice the anxious thoughts, and say to yourself, That’s not me. ([Location 1623](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1623)) “That” may be part of your experience, and perhaps even part of your experience of “self.” But the you that is observing all of that is, by definition, not that. ([Location 1625](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1625)) In his groundbreaking book Brain Lock, psychiatrist Jeffrey Schwartz (1997) formulated this idea in the helpful phrase “It’s not me; it’s my OCD.” There is an image on the back of that book that I also find immensely helpful. It’s a picture of a brain made with a functional MRI, which produces images of brain activity. It shows OCD at work, as elevated activation in the anxious parts of the brain. ([Location 1626](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1626)) If you are able to observe OCD operating in your mind, in the form of anxious thoughts, there must be more to you than those thoughts. ([Location 1631](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1631)) When we observe our experience from the perspective of self-as-context, we begin to look at our thoughts and feelings, rather than through them. A very basic way to do this is by labeling our thoughts and feelings. ([Location 1635](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1635)) The increased space between you and your thoughts adds a contextual, or relational, dimension to your experience. It is this awareness of the relationship between you and your thoughts that offers the opportunity for change. ([Location 1644](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1644)) Our instinct to struggle and protect ourselves from certain thoughts starts and ends with cognitive fusion. This can be the fusion of self with experience, as when we say “I am anxious” or “I am sad,” equating ourselves with our experience in a fixed way. ([Location 1651](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1651)) Part Two: Making Thoughts Less Sticky ([Location 1668](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1668)) ### New imports from [[Readwise]] on [[2024-10-07]] at 11:31 AM If cognitive fusion is when our thoughts become stuck to the reality that they refer to, cognitive defusion is when those thoughts become less sticky. Still, at this point, you may be thinking something like This is all very interesting, but when I’m struggling with obsessive thoughts, what exactly should I do? ([Location 1674](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1674)) Label: Observe and identify what is happening using labels that create defusion. Let Go: Relax your struggle with your thoughts and lean in and feel your feelings. Accept: Use defusion to accept thoughts as thoughts and narrative as narrative. Mindfulness: Ground yourself in the present by noticing more of your experience. Proceed with Purpose: Connect with your immediate purpose and act on your values. ([Location 1686](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1686)) Labeling ([Location 1706](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1706)) Unless you’re able to notice and identify fusion when it’s happening, you’re unlikely to apply any of the other four skills. ([Location 1708](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1708)) Labeling troubling thoughts and feelings has two benefits. First, it reminds you that certain thoughts and feelings are not what they appear to be. Second, the very act of labeling your experience creates space between you, the labeler (context), and your experience (content), making it clearer that these thoughts and feelings are not you. ([Location 1711](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1711)) This tiny space between the thought and what it refers to and between you and the thought is the beginning of cognitive defusion. ([Location 1713](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1713)) More often, the labels are not physical objects, but classifications you hold in your mind. Your labels for the people you encounter probably includes designations like “boss,” “lover,” “friend,” “acquaintance,” and “stranger.” ([Location 1719](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1719)) Labeling Feelings ([Location 1724](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1724)) Labeling strong emotions can help us shift our perspective away from looking at the world through those emotions to looking at the emotions themselves. ([Location 1725](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1725)) Labeling and looking at emotions also helps us move from the fused experience of “I am sad” or “I am afraid” to the more defused awareness that “I’m feeling sadness” or “I’m experiencing some fear.” ([Location 1727](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1727)) anxiety often presents itself as something other than what it really is. Anxiety is basically an alarm that goes off both in our body and in our mind to alert us to a possible danger or threat. ([Location 1730](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1730)) But what happens if you mistake the alarm for the fire? What if, in your experience, the alarm and the fire are essentially the same thing? Cognitive fusion can lead us to respond to the alarm as though it were the fire itself. ([Location 1737](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1737)) - [I] Note: This is very close to the ideas in Cruel Optimism! Observing our physical feelings of anxiety and labeling them as “sensations,” for example, can help us make room for them and experience them as separate from the story they are trying to tell. Other useful labels for the experience of anxiety might be “alarm bells ringing” or “my engine revving.” These labels can remind us that anxiety itself, while unpleasant (like those piercing beeps), is not actually dangerous. It can make it easier for us to let go of our struggle to control or get rid of the anxiety, giving us more options for what we choose to do next. ([Location 1741](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1741)) Over the years, I’ve noticed that my most anxious patients tend to have very colorful and impressionistic ways of thinking and talking about their experience of anxiety. For example, they may describe anxiety with phrases like “I’m crawling out of my skin,” “My head is going to explode,” or “I’m going to die.” These thoughts are all referring to sensations they are experiencing. A more accurate labeling of these sensations might be “I feel my skin tingling,” “There’s a pressure in my head,” and “My heart is racing.” These labels highlight and describe the alarm that is going off in your body, rather than telling a story about a nonexistent fire. The problem with the more colorful, fire-like thoughts is that they tend to set off more alarms. ([Location 1746](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1746)) - [I] Note: Grounding in the physical helps stop new stories. Labeling Thoughts ([Location 1752](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1752)) Not all of our thoughts are equally helpful, however. If we’ve gone over a thought countless times, if the thought refers to events beyond our control, or if it is distorted and biased, it is often of little use to us. Labeling an obsessive, anxious thought as “not helpful,” “not realistic,” or “too much” can put us on alert to treat this thought differently from other, more helpful thoughts. ([Location 1755](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1755)) One way to remind ourselves that anxious thoughts are not exactly what they appear to be is to label them in a way that highlights their inherent bias. You might remember our discussion of threat bias in chapter one. ([Location 1761](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1761)) It can be helpful to keep in mind that the anxious part of the brain is highly specialized. Being anxious is its job. It’s the only thing it knows how to do. ([Location 1763](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1763)) Having a Thought vs. Buying a Thought ([Location 1788](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1788)) It’s important to notice that labeling a thought is not the same as changing or getting rid of the thought. We still have the thought. The label just prompts us to interact with it in a different way. In ACT, this is often referred to as the difference between having a thought and buying the thought. ([Location 1789](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1789)) Sushi Boats ([Location 1792](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1792)) All day long, thoughts float by. Most are unremarkable, some are helpful and appealing, and some are suspect or downright disturbing. Having our thoughts is like having the boats of sushi float past. ([Location 1797](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1797)) Buying a thought is more like taking a piece of sushi, putting it on our plate, and eating it. The important thing to keep in mind at one of these sushi bars is that you don’t have to eat every piece of sushi that comes by. ([Location 1798](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1798)) Labeling thoughts as “not helpful,” “too much,” or “questionable” can make it easier to let them just float by. This is not the same as changing or not having the thought. It’s there, right in front of us, like it or not. We’re just deciding not to put it on our plate and eat it. ([Location 1800](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1800)) Junk Mail ([Location 1806](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1806)) Obsessive thoughts in particular can be a lot like junk mail or spam originating from the anxious part of your brain. ([Location 1807](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1807)) While I’m sure that most thoughts you have are very important, and at times even profound, is it possible that some of your thoughts are just…well…junk? This is not intended as an insult, and it certainly isn’t personal. Remember that anxiety is a blunt instrument, and the anxious part of the brain is not exactly the smart part of the brain. ([Location 1813](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1813)) Notice, this is not about stopping the junk mail from coming to your mailbox. It’s about what you do with it once it’s there. You can’t unsubscribe from your anxious mind. It’s impossible to stop yourself from having a thought. But maybe you don’t have to buy it. ([Location 1818](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1818)) “Extra” Anxiety ([Location 1821](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1821)) Suppose you want to cross a busy street. Having some anxiety about this proposition keeps you from running out into the path of a speeding vehicle. ([Location 1827](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1827)) You want to have enough anxiety about crossing the street to prompt you to cross at the light, wait for traffic to stop, and look both ([Location 1828](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1828)) ways. This much anxiety actually helps you to cross the street. If you have so much anxiety about crossing the street that you wait through multiple cycles of the light, step off the curb only to leap back onto it in terror, and eventually decide that you really don’t want to cross the street at all, you probably have more anxiety than you need. ([Location 1829](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1829)) One more note about extra anxiety. Most of us really don’t want it. That’s understandable. However, struggling to stop your brain and your body from giving you extra anxiety is not likely to work. It’s important to remember that all of this largesse is coming from the part of your brain whose mission is to protect you at all costs. ([Location 1862](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1862)) Inside vs. Outside ([Location 1868](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1868)) A similar distinction helped Lou to feel less triggered by thoughts of his son growing distant from him. When he allowed himself to pay attention to these thoughts, one of the first things he noticed was that the inside Adam was anywhere from fourteen to twenty years old, depending on the day and the specific thoughts he was having. Outside Adam was consistently eight years old. Similarly, while inside Adam wasn’t very interested in hanging out, outside Adam usually wanted nothing more than to spend time with his dad. Formulating his experience in this way made it possible for Lou to make a clearer distinction between the imagined Adam and the real one. This in turn begged the question: Which Adam was more important to Lou? ([Location 1878](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1878)) “Not Me” ([Location 1884](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1884)) Finally, labeling can also help to decrease the fusion of your self with your experience. A relatively direct way to create space between yourself and sticky thoughts… ([Location 1885](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1885)) This label can be useful with any sort of anxious thoughts, even if they don’t involve a specific reference to the self. First, allow yourself to focus on and… ([Location 1887](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1887)) Closing your eyes can help you to get a clear sense of the ideas, images, emotions, and physical sensations that you’re struggling with. You might also notice judgments you have about your experience. Then, observing all of this, gently remind yourself that “this is not me.” You have been here all along, and will continue to be here. This is your experience at the moment, and it is subject to change. The space this label creates between you as context and everything else as content can make it easier to let go of the struggle to change or control your experience, which you… ([Location 1889](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1889)) The Opposite of… ([Location 1896](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1896)) When you experience your thoughts and feelings and yourself as the same thing, change is very difficult. It’s like living in one-dimensional space. You and your experience are all contained in one continuous, straight line. Here, change means changing your experience. One way we try to do this is through… ([Location 1897](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1897)) This adds a second dimension. In this two-dimensional way of living, the horizon is the continuous line of self-fused-with-experience, and our behavior is an up-or-down attempt to escape from that line. However, because compulsive behavior is driven by the very thoughts and feelings that we are trying to escape, any change it offers is only temporary. Checking, rechecking, straightening,… ([Location 1899](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1899)) Adopting them as your agenda reinforces the notion that you and your anxiety are the same thing. Whether movement is up or down, it’s still defined in terms of the continuous line of experience. When you’re… ([Location 1903](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1903)) Letting… ([Location 1906](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1906)) Learning to notice yourself as separate from your experience introduces a third dimension: relationship. It is in this relational dimension that a… ([Location 1907](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1907)) How do you, as the context, relate to your experience, the content? How do you encounter, hold, and interact… ([Location 1908](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1908)) The flatness of the two-dimensional world opens up to a more expansive, three-dimensional space, offering more… ([Location 1912](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1912)) When your body is tense and you are focused on controlling or changing your thoughts or feelings, your relationship to that content is one of struggling. This chapter is all about tilting… ([Location 1913](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1913)) First, imagining your anxious thoughts and feelings as a gorilla can help you recognize that, like you and the gorilla, you and your anxiety are two distinct entities. Second, it can help you notice that you’re struggling to control or get rid of your anxiety. Third, this metaphor can prompt you to consider how this relationship could be different: Is there another way to be in a room with a gorilla? Finally, it suggests a specific way to accomplish this change in the relationship. The opposite of holding onto a gorilla is letting go. ([Location 1922](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1922)) Letting Go with Your Body ([Location 1927](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1927)) - [I] Note: #revisit Because anxiety is a very physical response, one way of noticing how you are relating to your experience is to pay attention to how your body is responding to your thoughts and feelings. ([Location 1928](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1928)) When you focus on your anxious thoughts and feelings, are you aware of tension in your body? This tension is part of the relationship between you and the thoughts and feelings. It’s the observable part of you holding onto or struggling with the gorilla. Noticing this tension can help you to recognize and then shift this relationship from one of struggling to the opposite of that. ([Location 1929](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1929)) This shift can happen even if the tension doesn’t change. It’s not necessarily about relaxing your muscles, though that can help. It’s more about acknowledging your ongoing struggle against or resistance to your experience, and tilting your intent away from that struggle. This is letting go. ([Location 1932](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1932)) Try It Now… ([Location 1940](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1940)) Rather than thinking about it too much, it might help to just try letting go now. Think of a recurring obsessive thought, or anything in your life that’s unsettled or uncertain. It can be something small or something large, but should be something you’re at least a little concerned about. After you read this paragraph, close your eyes and focus on this obsession or unsettled thing. Notice how it appears in your awareness, both the thoughts and the emotions related to it. The thoughts may include images or a sort of unfolding story. The emotions may register more in specific parts of your body, or they may be more diffuse. Sit with this for a moment, then see if you can notice any resistance or tension between yourself and these thoughts and feelings. Pick a spot in your body where you are most aware of this resistance or tension. Take a deep breath and hold it. As you hold your breath, focus on that spot, feeling the tension between you and your experience. As you slowly exhale, imagine relaxing that tension slightly. Just as letting go of an object does not require completely opening your hands, just relaxing your grip a little, letting go of an obsessive or unsettling thought requires just a gentle release. Sit for a bit and notice what it feels like to be less resistant and to struggle less against these thoughts and feelings. If you notice that you are still struggling, take another deep breath, focusing on the spot where you feel the struggle, and once again exhale slowly while thinking, Let go. You may need to do this several times before you sense a shift. Try it now. ([Location 1940](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1940)) - [I] Note: #exercise But It’s Still There ([Location 1974](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1974)) The thing about letting go is that, while it changes your relationship with the gorilla, it doesn’t make the gorilla go away. Once you let go of the gorilla, it will still be there…and you will still not like having the gorilla in the room. Letting go does not change our experience any more or any less than struggling does. It only changes our relationship to that experience. ([Location 1975](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1975)) Anxiety is not pleasant. Fear pushes for a response. The gorilla will continue to look, act, and smell like a gorilla. It may knock over some of the furniture. It might even make a smelly mess on the rug. Being in the room with a gorilla isn’t fun; however, it’s not as bad as wrestling with one. Nobody is suggesting that you’ll like the anxiety just because you’re not struggling to get rid of it. What has changed is your relationship to it. What has left the room is the struggle. ([Location 1978](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1978)) The Mechanics of Letting Go ([Location 1983](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1983)) Thinking about and visualizing letting go is important because it reminds us that we’re not trying to change the thing that we’re holding on to, only our relationship to it. The body, however, has a long history of holding on. The tension you feel when you notice your resistance and struggle against certain thoughts and feelings is the fight-or-flight response. ([Location 1984](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1984)) Our body has another nervous system, however, that runs parallel to the sympathetic nervous system and counteracts it in many ways. This is the parasympathetic nervous system. It governs the body’s relaxation response, which allows us to recover from the fight-or-flight response. Learning to trigger the parasympathetic nervous system and encourage your body’s relaxation response can help with this second step of letting go of your struggle to control thoughts and feelings. Like fight-or-flight, the body’s relaxation response is largely automatic. You cannot consciously lower your heart rate or reduce your blood pressure. This is not about directly controlling or shutting down your body’s automatic responses. There are small things you can do, however, to tilt your body’s response gently in the direction of relaxation and letting go. ([Location 1991](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1991)) Breathing and the Vagus Nerve ([Location 1998](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1998)) Our body comes equipped with a sort of “on switch” for the relaxation response. The vagus nerve has wide-ranging parasympathetic functions. “Vagus” is Latin for “wandering,” reflecting the nerve’s far-reaching influence within the body. It originates near the base of the brain, connecting to the esophagus, the cardiac and pulmonary networks of nerves, and the smooth muscles and glands in the abdomen. ([Location 1999](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=1999)) The long exhale of the sigh helps keep you from getting hyperventilated from all the extra breathing you were doing while looking for your keys. Something similar happens at the end of a long day when we start to yawn. In a way, a yawn is just a long, gentle stretch of the diaphragm and a holding of that stretch, followed by an open-mouthed exhale. The holding part of the yawn stimulates the vagus nerve, making us more relaxed. One yawn usually leads to more yawning as the body prepares itself for sleep. One of the best ways to learn diaphragmatic breathing is to start by sighing or yawning and observing what happens to your diaphragm. The breathing parts of most relaxation techniques are really just stylized versions of a sigh or a yawn. ([Location 2013](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2013)) The Calming Breath ([Location 2019](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2019)) When we’re engaged in aerobic activity like jogging, biking, or running from a predator, it’s natural to breathe primarily by using our chest muscles. This “shallow” breathing results in the chest rising and falling. It causes more oxygen to enter the blood stream, feeding the large muscles of the arms and legs so we can fight and fly harder and faster. If we breathe this way when we’re not engaged in strenuous activity, the extra oxygen can build up in the blood, causing us to eventually become “hyperventilated.” There’s a tipping point at which too much oxygen in the blood can itself be a trigger for a fight-or-flight response. This feedback loop is often what causes panic attacks. ([Location 2030](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2030)) In contrast, “normal,” non-aerobic breathing is mostly governed by the use of the diaphragm, which is below the chest. This is the way most children breathe. Somewhere along the way, a subset of people begin to breathe with their chests much of the time. ([Location 2035](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2035)) Leaning In ([Location 2062](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2062)) Letting go can be tentative. It can feel like you’re just waiting to grab hold again. To shift more fully out of struggling, it can help to actively lean in to your experience, focusing on the thoughts and opening yourself up to feeling what is there to be felt. I think of “leaning in” as taking letting go to the next level. Once you have relaxed your struggle to control or get rid of anxious thoughts and feelings, see if you can go a little further and allow yourself to settle gently into those thoughts and feelings. ([Location 2063](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2063)) Letting go and leaning into feelings of anxiety can feel like the wrong thing to do. Letting go of control and feeling what is there to be felt, however, can allow us to make choices that work for us in the long run. ([Location 2074](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2074)) Another metaphor I like for leaning in has to do with downhill skiing. If you have ever skied down a mountain with any success, you have likely learned that the way to keep from falling down is to lean in to the slope of the mountain. This is counterintuitive, since our instinct is to lean away from the direction our feet are sliding in. However, if we can let go of that impulse and lean forward, we are more likely to remain upright. ([Location 2076](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2076)) Chapter 8 Tilting Toward Acceptance ([Location 2101](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2101)) If resistance and struggle are ways of saying no to your feelings, letting go and leaning in are the beginnings of saying yes to them. This openness to feeling your feelings without judgment, and without trying to change them, creates space for the next step, which involves more fully accepting your thoughts. Saying yes to your thoughts can be a little different from saying yes to your feelings. Feelings are fairly straightforward. The thing to do with feelings is to feel them. Thoughts, on the other hand, can appear to be one thing when they are really something else. Because of cognitive fusion, the alarm appears to be the fire; the map is confused with the territory. This leads to the struggle to control and avoid thoughts that we’ve identified as “Pure O” OCD. The opposite of that struggle, which starts with letting go and leaning in, continues with the acceptance of the thought. ([Location 2103](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2103)) Acceptance Through Cognitive Defusion ([Location 2109](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2109)) This is defusion as it occurs naturally. Allowing ourselves to think about, and even talk about, a trauma helps us to process the actual event into the memory or narrative that it will be going forward. This transformation of reality into language, and the repetition or stylizing of that language into a narrative, is how breaking news slowly becomes history. It’s through this process that the events of our lives become the stories of our lives, composed and organized into a form that we can live comfortably with. We compile these stories into chapters or volumes, then place them on a shelf for future reference. The tools presented in this chapter all tap into this natural process of transformation. ([Location 2128](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2128)) Observing and Reporting ([Location 2141](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2141)) The most basic defusion methods involve capturing our thoughts as words and gaining some distance from them. This usually involves condensing or summarizing what we’re thinking into a short phrase, or even a single word. ([Location 2142](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2142)) I’m Having the Thought… ([Location 2145](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2145)) A very straightforward way to highlight that what we are experiencing is just a thought is by prefacing the thought with words that emphasize its thought-like nature. ([Location 2145](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2145)) Pick a disturbing, obsessive, or worrisome thought. First, state it as a fact: “I’m going to fail.” Then try stating it with the thinking qualifier: “I’m having the thought that I am going to fail.” Notice how the more qualified reporting of your thoughts makes them easier to accept as thoughts. ([Location 2152](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2152)) Looking at Thoughts ([Location 2155](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2155)) Another way to get this distance from your thoughts is to write them down. We’re not talking about journaling here. ([Location 2156](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2156)) Instead, try to capture the gist of your obsessive thoughts in a single sentence, or better yet, a phrase. Write that down and look at it. Try writing it again, larger or smaller. Write it in a different color ink, or using your nondominant hand. All of these are ways to help you begin to look at these thoughts instead of through them. ([Location 2158](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2158)) Pick up the paper that the words are written on. Notice that no matter what you write on the paper, no matter how painful or harsh the words, the paper still has the same weight in your hands. Words, thoughts, judgments, and stories are all as weightless as they are transitory. The power we associate with them lies elsewhere. ([Location 2160](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2160)) Hearing Thoughts ([Location 2167](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2167)) Another group of defusion methods involves speaking or singing your obsessive thoughts out loud until the words begin to separate from the reality they are stuck to. Use the same obsessive or troubling thought, distilled into a phrase or a word. ([Location 2168](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2168)) A variety of defusion methods involve saying upsetting or obsessive thoughts out loud in different ways until this defusion occurs, to a greater or lesser degree. ([Location 2173](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2173)) Don’t Touch That Dial! ([Location 2201](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2201)) Doom Radio ([Location 2210](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2210)) Lou worked with this exercise extensively, noting that the program’s theme song was the sentimental folk ballad “Cat’s in the Cradle.” The show’s only sponsor was Hallmark, and all the commercials had to do with the “empty nest” of Lou’s future. Imagining these thoughts as coming from a very biased, one-note source helped Lou to experience them as a worst-case expression of his fears and not representative of his real relationship with Adam. ([Location 2231](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2231)) Muzak ([Location 2240](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2240)) Another way to defuse from obsessive thoughts, particularly when they have a repetitive quality, is to imagine them as background noise or music. The term I like to use for this is “Muzak,” a registered trademark for an American brand of background music dating back to the 1930s. I think it’s a wonderful word for something that is not exactly noise, but not exactly music, either. ([Location 2241](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2241)) If we let them, obsessive thoughts can be a lot like Muzak. They are what we experience, in the background, when we are doing something else. ([Location 2245](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2245)) Defusion means adding repetitive, obsessive thoughts to this category. We choose to treat certain parts of our experience as meaningless background noise all the time. ([Location 2248](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2248)) Are you saying that you neither love nor hate these sounds, and don’t make any particular effort to stop them? This is hearing without listening, and we do it all the time. Refrigerator sounds are a form of Muzak. Now try imagining what it would be like if your refrigerator happened to make sounds that sounded exactly like your obsessive thoughts. For ([Location 2253](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2253)) idea. You might not particularly like what you’re hearing, but since it’s just Muzak, whether made by your refrigerator or your mind, how big of a problem does it have to be? ([Location 2257](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2257)) The TV Across the Room ([Location 2259](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2259)) When our obsessive thoughts are images, it can help to imagine watching them on a television screen. ([Location 2259](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2259)) Can you let these images play, without struggling to change the channel, and go on with the business of living your life? Does it really matter what’s on that little screen on the other side of the room? In fact, does it even matter if it’s a bigger screen? ([Location 2263](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2263)) As the context for your thoughts, you are the room itself. The images on the TV are merely part of the ever-changing content of the room. ([Location 2265](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2265)) The amazing thing about consciousness is that it can expand indefinitely. No matter how big your thoughts or your anxiety, you always have the option of being bigger than they are. It’s only the struggle to limit or control what you are aware of that makes things feel crowded. ([Location 2268](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2268)) Going Over the Top ([Location 2273](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2273)) Choosing to be playful with thoughts demonstrates to the anxious brain that these thoughts are not actually dangerous. Humor allows us to view even the most “unacceptable” thoughts from a slightly different angle, making room for them as just thoughts. ([Location 2306](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2306)) Exposure as Defusion ([Location 2309](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2309)) Exposure is an opportunity to observe your anxious thoughts and feelings in a defused way. ([Location 2317](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2317)) The idea of the event is almost always worse than the actual experience. We covered the reasons for this in chapter one. Your anxious brain wants to prepare you for the worst possible outcome, so it offers you thoughts that are biased in that direction. ([Location 2321](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2321)) Because of this focus on defusion, the ACT version of exposure tends to be a little more lighthearted and playful than the traditional behavioral therapy version. ([Location 2326](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2326)) The Silliness Factor ([Location 2346](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2346)) As powerful and helpful as these tools are, one obstacle to using them that I have encountered repeatedly over the years is that many of them can seem a little awkward or silly. No matter how clear patients may be about the theory behind their use, some are hesitant to practice or even to try defusion methods for this reason. ([Location 2347](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2347)) On the surface, these methods can appear rather gimmicky or too simple to be effective. To overcome this hesitancy, I’ve learned to start by emphasizing that, at its best, defusion is something that happens naturally all the time. ([Location 2349](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2349)) Tilting… ([Location 2358](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2358)) “Acceptance,” as it is used here, the A of our LLAMP, is not so much a state or goal as a “move” that you can make right now—a shift or tilt that involves looking at and making room for your obsessive thoughts. This becomes more possible when we experience thoughts as what they are, rather than as what they say they are. Defusion creates space in which to make the move of saying yes to your experience. ([Location 2364](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2364)) You can think of acceptance as the fulcrum on which this see-saw pivots. I’ve borrowed this idea of “pivoting” directly from Steve Hayes. He uses it very effectively as the central metaphor for change in his rich and accessible book A Liberated Mind: How to Pivot Toward What Matters (Hayes 2019). In it, he points out that “pivot” originally referred to the pin in a hinge. Pivots in hinges take the energy that is headed in one direction and immediately redirect it in another. When we pivot, we take the energy inside an inflexible process and channel it toward a flexible one. (23) ([Location 2369](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2369)) All of the LLAMP skills facilitate this shift of energy. Labeling and Letting go tilt us away from struggling. Acceptance of our thoughts swings that energy toward a Mindfulness of the present and connection with our values and P ([Location 2377](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2377)) Making Your Own Acceptance Move ([Location 2388](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2388)) As you experiment with the defusion methods described here, allow yourself to be creative and adapt them to your own circumstances. ([Location 2389](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2389)) Defusion methods lend themselves to creativity and novelty. Keep in mind that this is all about getting to the point of saying yes to your thoughts. Not Yes, I agree with you, but more like Yes, you said that, and Yes, you’ve said that before, and Yes, thank you for sharing. Remember, it’s just a tilt. If “yes” is too far, try just a nod and an Okaaaay... Don’t worry about being silly. Silly actually helps a lot here. Start by just reporting your experience: I’m having the thought that . Then try writing the thoughts down. Carry them in your pocket or stick them to the wall. You can even put them in your shoe and walk around on them. Try saying the thoughts out loud, over and over again, for a minute or two. Try doing them in different voices. Sing them, loudly. If you have trouble finding privacy, do it in the shower or in your car, but do it. You can’t really know if something is likely to help until you’ve actually tried it, maybe even several times. ([Location 2390](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2390)) Put your obsessive, anxious thoughts into the mouth of another, imaginary person. Or a lizard. Since many anxious thoughts come from our more primal “lizard brain,” try imagining a little lizard saying these things to you. I keep a tiny plastic lizard in my office to help patients imagine this. See if you can hear your obsessions as Muzak, piped in through some invisible speakers, just faintly, but constantly, in the background. Imagine hearing your obsessions humming out from the back of your fridge. Lean into these thoughts with humor and playfulness. It might feel like false bravado at first, but eventually the bravery will be more real. ([Location 2400](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2400)) Look for opportunities to take real-life behavioral steps toward things you avoid because of your obsessions. Notice the thoughts that fly up like little flares warning you away from this exposure. Thank your mind for the warning, and lean in further. Play with the thoughts that arise to show your mind that thoughts really aren’t that dangerous. Make room for this energy coming from the struggling, avoidant part of your mind and tilt it in a whole new direction. ([Location 2404](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2404)) Chapter 9 Bringing in the World ([Location 2409](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2409)) Living in your head comes at the cost of experiencing fully the rich sensations, lived experiences, and intimate connections of life in the actual world. ([Location 2422](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2422)) - [I] Note: #revisit Mindfulness ([Location 2425](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2425)) Anxious people in particular sometimes want to skip over mindfulness. The response I get most often is some version of “Oh yes, I’ve heard this before. I agree, being in the moment is very important. Now what’s the next step?” ([Location 2428](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2428)) For many people, the idea of practicing and developing mindfulness sounds time-consuming and tedious. If ([Location 2430](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2430)) When thoughts become obsessions, our relationship to them is characterized by struggle. We struggle with these thoughts because we perceive them as a threat, but it’s also true that we perceive them as a threat because we are struggling with them. ([Location 2435](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2435)) In the midst of the struggle, obsessive thoughts can carry more weight and seem more real than other aspects of our experience. When you are “in your head” in this way, you are more aware of the narratives and images that make up the obsessive thoughts than of the wind on your face, the ground beneath your feet, or the food in your mouth. ([Location 2436](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2436)) Stepping back from your thoughts enough to notice all of your experience in a given moment is the essence of mindfulness. It is the opposite of being “in your head.” ([Location 2440](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2440)) The word “mindfulness” has enjoyed a surge of popularity over the past two decades. Like any word subjected to heavy use, it has taken on a broad spectrum of meaning. For some, it refers to a specific practice or discipline that often centers around meditation. For others, it’s more of a general state of awareness cultivated in daily life. Most would agree that it involves being more fully “in the moment” and meeting your experience of now without attachment or judgment. ([Location 2445](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2445)) From an ACT perspective, this means observing your experience with the awareness that none of this is you, and experiencing thoughts as thoughts, separate from what they refer to. ([Location 2449](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2449)) Mindfulness helps us to shift from struggling with obsessive thoughts and anxiety to experiencing them with more openness and acceptance. In this way, mindfulness happens from the perspective of the self-as-context and is very much about our relationship to the content of our experience. ([Location 2450](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2450)) The Refuge of Now ([Location 2454](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2454)) For most people, most of the time, the present moment is not a bad place to be. If you’re not extremely warm or terribly cold, if you’re not very hungry or thirsty, and if you’re not in a great deal of pain, right now can be a refuge, even as difficulties and challenges continue to be a part of your life. ([Location 2454](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2454)) When it comes to thoughts and feelings, suffering is usually focused on events that happened before the present moment or things that we expect will happen sometime in the future. In the present, we are not really experiencing these past or future events. ([Location 2457](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2457)) Mindfulness means accepting the mind’s stories about the past and narratives about the future the same way we accept our breathing, the beating of our hearts, and the warmth of the sun on our skin as an experience of the moment. ([Location 2461](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2461)) This absorption or engagement with an ongoing process is what many people refer to as being “in the zone” of an activity. The refuge it provides is an important part of what many people value about participating in certain sports that require their full attention, or playing a musical instrument. It’s part of the appeal of many crafting activities, like knitting or woodwork. It’s also what many people find soothing about listening to music, hiking, or interacting with a beloved dog or cat. ([Location 2469](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2469)) All of these activities offer a richness of experience in the present moment that is separate from stories or narratives about the past or the future. They invite us to pay more attention to what is happening now, which helps us to experience the stories and narratives as not happening now. ([Location 2473](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2473)) Mindfulness and LLAMP ([Location 2476](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2476)) Labeling brings with it an increased focus on and attention to the thing that we are labeling, settling us more fully into the moment. In fact, a common meditation from the Buddhist tradition consists of sitting quietly, observing your experience, and labeling it. ([Location 2479](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2479)) Letting go and leaning in also involve a degree of mindfulness. The openness to experience that comes with letting go of struggle and control is part of adopting a mindful stance. Leaning into our experience involves attending and focusing in a mindful way. ([Location 2482](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2482)) It looks something like this: Using LLAMP as a guide, you notice and label “anxious feelings” and “obsessive thoughts.” You take a breath and let go of the struggle to control those feelings and thoughts, instead leaning into your experience of them. You might say to yourself, I am having the thought that…or use some other defusion method to unstick the thought from what it refers to, tilting you toward accepting the thought. Now, using mindfulness, notice what else you are aware of. What sensations are you aware of in your body? Where are you? What do you see? What do you hear? Bringing more of the world into your awareness makes the anxious feelings and obsessive thoughts part of a larger whole. In the current moment, narratives that refer to past or future exist only as thoughts. In this way, mindfulness supports further defusion of these thoughts from the reality they refer to. ([Location 2492](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2492)) Wading into Mindfulness ([Location 2500](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2500)) For both the uninitiated and the veteran, equating mindfulness with the practice of meditation can be somewhat problematic. ([Location 2505](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2505)) Running off to meditate as a response to anxiety can quickly start to look like avoidance, or even a compulsive ritual. ([Location 2509](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2509)) Meditation is a way to work out and develop our mindfulness “muscles” so that we can use them effectively as we live our lives outside of our meditation practice. ([Location 2512](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2512)) Listen, Look, Smell, Feel, Taste… ([Location 2521](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2521)) The problem with obsessive thinking is that it constantly pulls us away from our senses. Even when our senses are involved in our obsessions, like Anthony’s heightened awareness of the look or smell of poo, the focus of the obsession is on our memories, judgments, and narratives about these sensory experiences. In other words, our thoughts. ([Location 2523](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2523)) Start by listening. When you get to the end of this paragraph, take a few minutes to sit and really listen. Close your eyes and focus on all that you’re able to hear. If you’re indoors, start by listening to the sounds you can hear in the room you’re in. Is there a clock ticking? A fan running? What about you? Can you hear yourself running? Can you hear your breath as it comes and goes? Perhaps a gurgling from your belly? There may be a hum or a ringing sound, which is the way many of us hear silence. Now listen for sounds coming from other rooms and from outdoors. When you notice yourself thinking about what made the noise, or why it sounds that way, notice these thoughts, then bring your attention back to the sound itself, staying with it. Notice the separation of yourself as listener, or context, and the sounds you are hearing, which are all content. Try it now. ([Location 2542](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2542)) Looking is something that we do all day long, as long as our eyes are open. Seeing is something that happens less often. When it does, it is often a means to an end. We see where we are going, what we are doing, or what others are doing. We are focused, not on what we see, but on the meaning of what we see. You’re doing it right now as you see these words. Mindful seeing is seeing as an end in itself. I think of this kind of seeing as experientially absorbing what we see. This concept helps me to stay more closely attuned to what I am seeing, allowing myself to steep in the experience. Seeing color is a good place to begin. Start with the color yellow, since it’s a little less common and tends to jump out at us. Wherever you are right now, take a couple of minutes to carefully look around and really see everything in your field of vision that is yellow. Imagine that you are soaking up as much of the color yellow as you can get. Notice any variations in shade or saturation. Notice any thoughts, associations, or emotions that arise, then gently bring your focus back to the yellowness itself. Try it now. When you’re done, try the same thing with the color blue. Notice what a different experience it is to see blue. Yellow is one thing, and blue is another thing entirely. Try it now. Now do it again, but this time try to see and sit with the shape and texture of everything you see that is yellow, and then everything that is blue. Notice that you can see the texture and contours of things as well as their color, “touching” them with your eyes. This is mindful seeing. This is a wonderful way to see the world when you take a walk. ([Location 2549](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2549)) For most mammals, the sense of smell is primary. My little cat is constantly sniffing things. Whether it’s a package that has just been delivered, a jacket hung over the back of a chair, or the hand that’s petting her, she uses her nose to make sense of things and where they fit into her world. Humans tend to ignore or avoid smells, often covering them up with grooming and cleaning products, cutting ourselves off from a rich source of information about people and places. Food is one exception. We rely on smells when preparing food and to tell us when to eat something or throw it out. Smells can bring us into the present moment, but they can also transport us, bringing up powerful memories of the past. Being mindful of smells means noticing these memories and reactions as part of our experience, even as we allow our awareness to rest more fully in the smell itself. Closing your eyes, try smelling your fingertips, then the palm of your hand. Now smell the back of your hand. Notice the subtle differences. Smell your clothing.… ([Location 2561](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2561)) Your skin is covered with touch receptors. These sensors quickly habituate to constant pressure so that you’re less aware of things like the clothes on your back, the shoes on your feet, or the seat of a chair pressing against your butt. Your fingertips, however, are jam-packed with sensors and offer you a constant feast of intense, rich, nuanced sensations. You lead with your fingertips to discover whether the water coming from the tap is hot or cold, whether the counter is wet or dry, and whether or not it’s a good idea to take that seat on the subway. A big part of the experience of eating has to do with the texture of foods. We touch the food with our tongue as we taste it. We note the change in texture as we chew, and we use this information to determine when to swallow. With your eyes closed, notice the vast variety of what you can feel where you are sitting right now. Start with your fingertips, feeling the crisp pages of this book, or the coolness of the device you’re reading it on. Touch the chair you’re sitting in. Let your fingertips explore your own clothing, your skin, your hair. Now notice what you can feel with the rest of your body. Can you feel where your skin makes contact with your… ([Location 2571](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2571)) The best way to explore the sense of taste is by eating or drinking slowly and luxuriantly. To isolate the experience of taste, it helps to stop chewing, allowing food to sit on your tongue and melt in your mouth. The taste buds are highly specialized. Some are more sensitive to sweetness, others to bitterness. Still others are specifically attuned to saltiness or sourness. We experience these tastes more or less with different areas of the tongue. Try moving food from one area of the tongue to another. One of my favorite things to eat mindfully is dry cereal. I like it for the texture as much as for the taste. Some cereals are light and flaky, others are hard and rough. If you hold cereal in your mouth without chewing, some cereals will soften up right away, while others take a long time to turn to mush. Often, one side of a piece of cereal will feel and taste different from the other side. When you bite into it, cereal tends to make a satisfying crunching sound that you can hear inside of your head. It goes down easy and leaves an aftertaste of grains and sugars. Notice that there’s more going on here than taste. Eating involves all of the senses, from the way the food looks and smells to the texture, the taste, and even the sounds that it makes. ([Location 2582](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2582)) A Symphony of Senses ([Location 2591](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2591)) Going for a Walk ([Location 2603](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2603)) There’s no ideal place to practice mindful walking. Don’t worry so much about finding a quiet place. Mindfulness is about meeting your experience and attending to it. Some people actually find this easier to do when there is more activity to focus on. ([Location 2609](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2609)) Remember, mindfulness is about cultivating a special relationship with your experience. This doesn’t mean finding the “right” experience. ([Location 2612](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2612)) At first, try being mindful for about twenty minutes during your walk. You can walk a bit before and for a while after this twenty minutes, just for the exercise, but bring your intention and focus to mindful walking for a set period. ([Location 2639](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2639)) Watching Your Body, Breath, and Mind ([Location 2646](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2646)) The Body Scan ([Location 2651](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2651)) Close your eyes, and notice what your body feels like. Start by doing a slow scan of your body, starting with your toes and working your way up. Just notice your toes. Start with the left foot, if you like. Notice what your toes feel like. It’s okay to move them a little. Now the other foot. Then notice the balls of your feet. You can notice both feet at once or take on one at a time. There’s no one correct way to do this. Now notice the arches and the heels of your feet. Notice your ankles, your lower legs, your upper legs. Notice where your butt makes contact with the chair. Notice your back, lower, middle, and upper. Observe the positions of your arms. Notice your hands; what are they touching? Now be aware of your neck, and then your head. Notice your scalp, and the muscles of your face. When you’re done with this, notice your body as a whole. See if you can experience your body as a physical object, with mass and weight. Notice your body at rest, supported by the chair you are sitting in. ([Location 2651](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2651)) that you have about it, and then continue with your scan. When you first try the body scan, take your time. Start by giving yourself a good fifteen or twenty minutes to move from your toes up to your head. As you get more practiced, you’ll be able to complete the scan more quickly. When you’re able to do it in about five minutes, you can use it as step one of a three-step process. Once you are more fully in your body, the second step is to notice and attend to your breathing. ([Location 2662](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2662)) Watching Your Breathing ([Location 2666](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2666)) After completing the body scan, with your eyes still closed, watch yourself breathing in and out. Notice that your body knows just how to do this. Don’t worry about whether you’re breathing the right or wrong way for this. Remember, you’ve been breathing practically your whole life; just notice it. Notice the movement of air past your nostrils as you breathe in. See if you can feel the air moving past the back of your eyes, through your sinuses, and past the back of your throat with each breath. You may feel your chest expanding as you breathe, or feel the breath all the way down in your belly. Watch this ongoing, complex process the way you might watch a machine operating. Notice that breathing is a process that continues, on and on, whether you’re watching it or not. ([Location 2667](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2667)) Watching Your Thoughts ([Location 2682](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2682)) Watching your thoughts in a mindful way means observing the thoughts without being carried off by them. Watching your breathing for a bit first is a good way to get a sense of what this is like. ([Location 2683](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2683)) Practicing Mindfulness ([Location 2729](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2729)) Whether you practice mindfulness by sitting and watching your thoughts, by doing the occasional body scan, or by walking, know that what you are doing in these moments is just that…practicing. You are developing mindfulness as a skill. You’re practicing mindfulness to get better at it so that you can apply this skill when you think it might help you to live a better life. Aside from these more formal ways to practice mindfulness, there are countless moments for developing mindfulness as you go about your day. Eating a meal or snack, washing dishes, and brushing and flossing your teeth are all excellent opportunities for focusing and being in the moment. Exercising, listening to music, spending time with pets, and engaging in hobbies like knitting or gardening all invite us to be more present, developing and strengthening our “mindfulness muscles.” ([Location 2730](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2730)) Chapter 10 The Compass and the Barometer ([Location 2745](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2745)) Anxiety and Purpose ([Location 2784](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2784)) Plotting Your Course ([Location 2808](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2808)) On a boat, the instrument that points us in any direction is a compass. The compass is a reliable guide because of its stability. North is always north, East is east, South is south, West is west. The compass lets us know when we are on or off course. Our values are like a compass for our lives. An awareness of the things, people, and experiences that make life more valuable to us can guide us in our choices, moving us in a particular direction, toward a life of increasing value. ([Location 2811](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2811)) Values are unique to each individual. What I value may not be what you value. Within a given individual, however, values are quite stable. They may change gradually over the course of a lifetime, but from day to day, they remain largely the same. North is north, East is east. ([Location 2814](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2814)) The other instrument on board our ship is a barometer. The barometer lets us know what the weather is like wherever we happen to be. It can forecast things like choppy waters and headwinds. It can help us to avoid stormy seas and find smooth sailing. ([Location 2817](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2817)) What it doesn’t tell us is where we’re going. Our feelings, especially feelings like anxiety, are like a barometer. Anxiety suggests to us that the waters ahead may be difficult. Choosing to move forward through choppy waters means being willing to feel discomfort, or even pain. ([Location 2818](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2818)) Sometimes, based on what the barometer tells us, we change course. We steer to the right or to the left, avoiding the worst of the storm. We point our ship toward calmer waters. Sometimes this works. As long as we use the compass to correct our course, it’s not always necessary to sail through the worst part of the storm. The problem comes when we begin to steer our ship mostly by the barometer. When we consistently avoid rough weather and plot a course based on where the waters are quietest, we find ourselves without direction, and we end up in no place in particular. Feelings are important. They often give us useful information. But, like the barometer, they aren’t so useful as guides for our direction in life. ([Location 2820](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2820)) Values and the Contextual Self ([Location 2829](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2829)) ### New imports from [[Readwise]] on [[2024-11-01]] at 8:12 AM Our thoughts and feelings, like all the content of our experience, tend to flow and change constantly. Our sense of what is valuable, on the other hand, is more enduring and stable. Our values offer a perspective from which to view our experiences, a fixed frame for our shifting thoughts and feelings. ([Location 2830](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2830)) Getting in touch with our values can remind us of who we really are. It puts us in touch with the enduring, larger self for whom fear and anxious thoughts are fleeting experiential content. ([Location 2833](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2833)) If your choices have been guided by your values rather than reactions to your thoughts and feelings, don’t you think you’ll be more likely to see a pattern that more accurately reflects who you really are? ([Location 2836](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2836)) While he enjoyed meeting new people and had a personality that others were drawn to, Anthony’s anxiety could make it hard for him to develop and maintain deeper friendships. He refused many invitations because his fear of stepping on something gross or dirty made it difficult for him to navigate city sidewalks while having a conversation. ([Location 2855](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2855)) - [I] Note: I relate to this except it is myself that I feel is fat gross old unlovable etc. Fears Disguised as Values ([Location 2861](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2861)) Sometimes it can be difficult to tell what is a value and… ([Location 2862](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2862)) When Anthony and I talked about what prevented him from having people over, he sometimes described it as a value-driven choice. He said things like “I value my privacy” and “I enjoy spending time alone.” Both of these statements were true, but these values were not what was driving his choice to not let friends cross his threshold.… ([Location 2862](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2862)) - [I] Note: I have never thought about this before but it makes so much sense. Sometimes our fear and our values both suggest a move in the same direction, but fear tends to point us more strongly toward absolutes, sending us due north, when a value-guided course would be more northeast. For example, Anthony valued fitness and exercise, which led him to run most days. His need to maintain a consistent, orderly schedule made him inflexible when social opportunities conflicted with his running schedule. Instead of running a bit earlier or later in the day (northeast), he passed on activities that he might otherwise have enjoyed in order to stick to his running schedule (due north). Similarly, his obsession with finding the “right” running shoes and keeping them clean… ([Location 2867](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2867)) The Values… ([Location 2874](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2874)) - [I] Note: #revisit #bpa3545 One reason that it’s easy to confuse fears with values is that they both reside inside of us. When they are pulling us in clearly opposing directions, it can… ([Location 2874](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2874)) Sit quietly with your eyes closed. Just watch your breathing for a moment and get settled into your body, noticing and getting in touch with your physical self. When you’re ready, think of something you’re afraid of. It can be big or small, but bring to mind something that makes you anxious or uncomfortable or that you worry about. Try to open yourself up to feeling the anxiety in your body. When you feel it, try to notice exactly… ([Location 2879](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2879)) Next, think about something or someone you value and care about. It can be anything about the world or about life that you value, a relationship with a specific person or group of people, a favorite activity or an intellectual pursuit. Don’t be distracted by fears you may have related to this value. Just try to focus on the valuing, caring, or loving itself. Feel the value this thing, person, or activity holds for you. When you are in touch with that, notice where… ([Location 2883](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2883)) What did you notice about the two parts of this exercise? Did you experience anxiety and valuing in different ways? When it came to localizing and drawing a line around the experience, was this easier to do with the anxiety or with your sense of valuing? Did you experience them in the same part of your body or in different locations? I’ve walked patients through this exercise hundreds of times over the years, and most of them report a similar experience. Almost without exception, they report that, compared to valuing, anxiety is easier to locate in a specific, discrete part of their body. It has clearer limits and boundaries. It’s easier to draw a clear circle around the anxiety. When it comes to the second part of the exercise, their experience of valuing and caring is more diffuse and harder to locate physically. Many people say that they experience valuing as being everywhere. Others say that it’s lower down in their body than the anxiety, or deeper within them. In any case, almost everyone is able to tell the difference, when they pay… ([Location 2888](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2888)) What Values… ([Location 2898](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2898)) tend to tread carefully when discussing values with patients. In fact, I often avoid using the actual word “values” at first, instead talking with patients about “purpose,” what they “care about,” and what qualities and experiences “add value” to their life. I’ve learned to do this because the word “values” has been used many different ways and picked up a number of confusing connotations. From an ACT perspective, your values are simply… ([Location 2899](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2899)) We’ve already talked about mistaking fear for values, but there is often a more general confusion between our feelings about people and things and our values related to them. A helpful distinction to make is that feelings tend to come and go, while values persist. For example, you may value and want to keep your job. How you feel about your job, however, likely varies from day to day. Do you only show up for work on the days when you feel enthusiastic about it? Showing up for work… ([Location 2904](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2904)) - [I] Note: #revisit What if you only made an effort to interact with and be nice to this person when you were feeling… ([Location 2912](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2912)) Commitment to a relationship means that we work on it even as our feelings toward the person shift from love to annoyance to anger, and back to love again. Commitment is about acting on our values, proceeding consistently in a valued direction, independent of day-to-day shifts in how we are feeling. In this way, our values help us to coordinate and direct our choices over the long term. This is how we develop… ([Location 2913](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2913)) - [I] Note: #revisit Morals or… ([Location 2917](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2917)) People sometimes use the word “values” as another word for morals or rules for living a good life. ([Location 2918](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2918)) As it’s used here and in ACT, the word “values” does not refer to any set of rules or code of conduct imposed from the outside. Rather, it refers to your own unique and internal sense of what makes life good. ([Location 2920](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2920)) While values give your life direction and can point you toward specific choices, they are not fixed rules about how to behave. Holding a particular value guides us, but it does not direct or control us. While we may set verbal rules for ourselves based on our values, the rule and the value behind it are two different things. Living our values sometimes requires a flexibility that is inconsistent with rigid rules. ([Location 2921](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2921)) Goals ([Location 2927](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2927)) There is sometimes a similar disconnect between our values and the goals that we set related to those values. Setting goals that move us in a valued direction can be extremely helpful, but it’s important to remember that values and goals are not the same thing. Values point us in a particular direction, while goals are specific destinations that lie in that direction. Often, making real progress in a valued direction requires being flexible about our goals. ([Location 2928](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2928)) People who pursue the same goal often do so because of different values. Think of the politician again. Have you known people to run for office because of values other than serving others and making the world a better place? Likewise, even a goal as simple as playing golf can be an expression of a range of different values for different people. For some, the value is taking their golfing skills to the highest level possible. For others, golfing is an opportunity to be outdoors or to focus on something in a mindful way. While some people may value golfing as a way to network professionally, others value it as a way to maintain connections with family or close friends. How you approach the goal of playing golf will vary depending on the values that move you to set that goal. ([Location 2935](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2935)) Whereas a goal is often something that you do or do not obtain, a value is something that you already have. The goal lies outside, in the world, and the value resides in you. ([Location 2941](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2941)) Suppose you are a single person with the goal of getting married. You’re drawn toward that goal because you value shared experiences, intimacy, and love. As you pursue your goal, it’s important to keep sight of the values behind it. Otherwise, it’s possible you might obtain your goal of marriage, but… ([Location 2942](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2942)) Correct or… ([Location 2947](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2947)) While knowing what your values are is very helpful, it doesn’t make sense to say that your… ([Location 2948](https://readwise.io/to_kindle?action=open&asin=B09RMTH2N3&location=2948))