Podcast: Turning the Page on Anxiety With Dr. Jill Stoddard

Jenn talks to Dr. Jill Stoddard about anxiety and acceptance and commitment therapy (ACT). Jill shares simple ways to address anxiety, identifies self-reflection questions to ask ourselves, and talks about how we can all be better at accepting anxiety and being mighty in our own way.

Jill Stoddard, PhD, is an award-winning teacher, peer-reviewed acceptance and commitment therapy (ACT) trainer, author of two books, and co-host of the popular Psychologists Off the Clock podcast. Dr. Stoddard is director of the Center for Stress & Anxiety Management in San Diego, as well as a co-founder and vice president of the nonprofit San Diego Cognitive Behavioral Therapy Consortium.

Relevant Content

Episode Transcript

Jenn: Welcome to Mindful Things.

The Mindful Things podcast is brought to you by the Deconstructing Stigma team at McLean Hospital. You can help us change attitudes about mental health by visiting deconstructingstigma.org. Now on to the show.

Hi folks, good morning, good afternoon or good evening and thank you so much for joining us wherever you are joining us from, for McLean Hospital’s, inaugural episode of Turning the Page, where we are featuring authors in the mental health world sharing their vast knowledge and expertise with us.

I’d like to introduce myself, I’m Jenn Kearney and I’m a digital communications manager for McLean Hospital. And as I was excitedly talking about before I clicked the record button, I am beyond thrilled to have the first guest on the series be Dr. Jill Stoddard and it’s not just because her book, which I am holding up right now, has a semi-permanent home on my nightstand when I’m not lending it out to friends or family.

So her book is titled “Be Mighty: A Woman’s Guide to Liberation From Anxiety, Worry and Stress Using Mindfulness and Acceptance.” And it is a hybrid educational guide and personal development map, for those who are feeling stuck in the cycle of anxiety and paralyzed by the circumstances that they’ve found themselves in.

In my personal experience, it’s a book that’s geared toward those who identify as women, but for all genders, it has so much solid content in it, that can help anybody live their best life. Where they’re unafraid of their thoughts and they’re unbound by the constraints and boundaries that their minds have once set on them.

So throughout this book, Jill prompts action and change through tactics used in acceptance and commitment therapy, which throughout the session we’ll actually be referring to as ACT, so, if you hear that acronym, that’s what it is. If you are unfamiliar with the fabulous Jill Stoddard, you are in for a huge treat.

Jill Stoddard PhD is the director of the Center for Stress and Anxiety Management in San Diego. She’s also co-founder and vice-president of the nonprofit, San Diego Cognitive Behavioral Therapy Consortium. And she’s also the co-host of the podcast Psychologists Off the Clock, and she’s the author of “Be Mighty,” as if she doesn’t do enough in a day.

So, Jill, I’m like, I’m so giddy over here, this is like the highlight of my year so far, I, thank you so much for joining. I want to get started by asking you what is the value in applying ACT to our daily lives? And do we have to have anxiety in order for the components of ACT to actually be effective?

Jill: Great questions, first of all, thank you for having me, I’m so excited to be here and I’m truly honored that I get to be the first guest in this book series, I think it’s such a cool initiative.

And actually, well, I’m going to correct one thing which, ‘cause otherwise we’ll get slapped on the wrist in that we call it ACT and not A-C-T and I think the reason for that, I’m not sure is because A-C-T is the Academy of Cognitive Therapy.

Jenn: Ah, thank you so much.

Jill: So acceptance and commitment.

Jenn: I’ve been calling it A-C-T for a year and a half, so-

Jill: So now you know, now you know, so acceptance and commitment therapy is ACT and typically not A-C-T, so, you said, what is the benefit to using ACT in our lives? And then the second part was do you have to have anxiety to benefit?

Okay, got it. Let me take the second question first, which is, no, you absolutely don’t have to have anxiety to benefit from ACT but I don’t know anyone who doesn’t have anxiety, now that doesn’t mean every human on the planet has an anxiety disorder but we certainly all experience anxiety at some point or another.

And typically, when we’re doing the things that are the most important to us is actually when we have the most anxiety.

So like, if you think about, you know, the last time you were up at night and the wheels were spinning and what you were worrying about like you’re probably not stressing about like whether Bridgerton is going to have another season even if it’s like your all-time favorite show, right?

Like this is not what we get anxious about, we get super anxious about the things that like really, really matter. So, our loved ones, our work, you know, those kinds of things.

And so I just want to say that as a way to like really normalize anxiety or worry or stress, my daughter had her last day of school today and was sobbing because she had to say goodbye to a friend who she’s not going to see again.

And we were talking about how, like the reason your heart hurts so much is because you love each other so much, and that they are two sides of the same coin. So I want to start by normalizing pain and we have this tendency to run away from it.

And in some ways that makes sense like sometimes fear is telling you you’re in danger and the instinct is to run, but sometimes it’s a false alarm and really it’s telling you, this is something you care about and therefore you should move toward it rather than away from it.

And so that is one of the ways that ACT can really benefit people in their lives is, you know, we don’t focus on trying to change or control the way that we’re thinking or feeling, we change our relationship to our thoughts and feelings so that we can make space and let them be present like become an observer of those experiences.

And then really get clear on our values, like what we want to stand for, who we want to be, what we want our lives to be about and be willing to move in the direction of those things, even when anxiety is present or some self story or something like that.

And you know, for me, I’ve been practicing this in my own life for over 20 years, in addition to in my practice. And I tell people like the bad news is that you probably don’t want to hear is like, I’m actually more anxious today than I’ve ever been in my life, is that because ACT doesn’t work?

No, it’s because what ACT has emboldened me to do is be brave and take risks and even when my mind is saying, you have nothing of value to say, you’re not important, you know, whatever the self story is, because I make space for that and don’t listen, I take big risks, you know, like I’m willing to put myself out there but it makes me anxious, ‘cause I care about it, right? It makes sense, but-

Jenn: That’s such a fascinating cycle too, because what you all, what we always want to do is avoid feeling anxious, so that tends to make us go back into our shells, we retreat away from the things that we care about but we’re, we might be afraid to pursue, ‘cause we don’t want to get that feeling of caring, you know.

Jill: That’s exactly right and you know, what I like to talk about is the comfort zone, the comfort zone is cozy, but it is never where growth happens, it’s not where the magic happens.

And I interviewed a woman on the podcast called Majo Molfino and she talks about if you picture the comfort zone as a circle, she talks about the outline as the vulnerability edge.

So like, if you’re willing to just go to that edge you know, to do things that are uncomfortable to get out of that comfort zone, it doesn’t have to be a mile outside the comfort zone, it can be just stretching past that edge, that’s where growth happens.

Jenn: Oh, that’s, I’ve never heard that before, I’ve heard the one where it’s like, this is your comfort zone and over here is where life is happening and that’s always, that one I always try to bring to mind when I feel like I’m starting to retreat into that like, oh God, it’s happening, it’s that feeling.

Jill: Right, that’s right.

Jenn: So I wanted to ask in, so in the book, the second chapter is titled “Shedding the Shackles of Anxious Avoidance” and first of all, I’m a sucker for an alliteration, so like A plus that was I read that and I was like, oh, this is amazing, but it... So it discusses methods of avoidance to prevent outcomes.

So this question based on everything in the chapter is two parter. So first and foremost, what does consistent avoidance do to our anxiety and stress levels? And then I’ll ask the second part after.

Jill: Okay, yeah, that’s good ‘cause my memory isn’t great these days, so, one question at a time is probably going to, you know, not challenge me too, too much. So here’s the thing about avoidance, it works or we wouldn’t do it, right?

So like, let’s take the example of procrastination. That’s a form of avoidance and everybody’s done it. So I like it as an example.

And if you think about like the feelings you have before you procrastinate maybe it’s dread about some task, anxiety, whatever the case may be, in the moment that you give yourself permission to put it off, what do you feel, relief.

Right, you feel better, you’re like, oh, sweet. I don’t have to do that, so, avoidance works. Like if you think about any avoidance behavior, whether it’s drinking, whether it’s avoiding social situations, whether it’s overworking, you know, the opposite of procrastination.

I, you know, my husband will sometimes sit on the sofa and buzz at me because one of my avoidance strategies is go, go, go, do, do, go, go, go, do, do, do, right?

So no matter what it is like in the moments that you’re giving yourself permission to engage in those behaviors, you feel better, but it’s short term. And then in the long run, there’s always a cost, right?

So with procrastination, now you have the same amount of work to do, but less time to do it. So the anxiety or dread or whatever it was that you were feeling that led to the procrastination, that the procrastination temporarily fixed is now worse. And you teach yourself that the only way I get to feel relief is if I avoid.

So, it can become this cycle where now whenever I feel uncomfortable, like if I’m worried about going to a party, like we’re all doing this re-entry thing now with the pandemic and I feel worried like I don’t remember how to talk to people anymore and you know, and if you don’t go to the party, you’ll feel relief, like, oh good, I get to stay here in my cozy comfort zone.

But now you’re teaching yourself each time, the way to feel better is to avoid things. And so the world can tend to get smaller if you start relying on anxiety over and over, because it works, because you feel better in the short term but in the long term, it usually amplifies those feelings and then you also never get the opportunity to like test out.

Maybe the party would have been awesome, maybe once you reenter and you have three conversations it’s going to be just like it was, you know, back in the before times. But avoidance prevents us from engaging in that new learning.

Jenn: So this is not my second question, but out of curiosity you know, there is a healthy amount of fear and anxiety around re-entry around social situations and a lot of that anxiety is because we care and we care about our own health, but how do we know what the difference is between that good anxiety that’s our like fight or flight response and when it becomes an avoidance tactic how do we know where that line is?

Jill: That’s a really good question and I think right now, under these current circumstances it’s maybe harder than ever to know where that line is.

You know, what I’ve been advising people around the whole pandemic essentially is just pay attention to science, like whatever we know based on science right now.

You know, it requires a level of trust, like a leap of faith because, hey, the science could be wrong, you know, they’re always learning new things, but it comes down to this kind of cost benefit analysis that, you know, when I think about my values, what’s important to me the life I want to live, the kind of person that I want to be, the qualities I want to embody, am I making choices that are consistent with those values?

And if right now, continuing to limit exposure, wear masks especially depending where you live, some places the numbers are smaller than others if that feels values consistent and it’s not like a hundred percent based on fear, then that’s probably okay.

But if you live in a place where the numbers are low, the government, the health department, whomever is saying, you know, it’s now safe for fully vaccinated adults to that’s a good example, right?

Fauci the CDC said, it’s now safe for fully vaccinated adults to hang out, inside. You know, if you’re still not willing to be with your friends outside sitting six feet apart without a mask on after that, then that’s probably a good indicator that there’s more fear here than, you know, that it’s I forget how you phrase the question but it’s not like the healthy fear, it’s the kind of false alarm type fear.

Jenn: So one, I just want to get back track onto my second question before I forget it, so if we are addressing our avoidance tactics like we find ourselves procrastinating and instead of openly acknowledging it saying, oh shoot I was doing it again, let me get back to the task at hand.

If we just beat ourselves up mentally and give in to the procrastination, how do we keep ourselves from just falling privy to those mind traps?

Jill: Yeah, well, first of all, that’s going to happen, right? Like that’s not an, if it happens, that’s a, when it happens because no one is perfect, we all choose to avoid sometimes.

And I think there are two important things here, you know, one is to try as often as you can to make your choices, choices. So if you’re procrastinating it’s not just this like autopilot reactive thing you do to feel better without even thinking about it.

But it’s something that like you really stop and think about and maybe you say to yourself, you know what, I know it’s a good idea for me to start working on this project today. And I’ve had a really tough day and I’m exhausted, and I think that practicing some self-care in the form of taking a shower and going to bed early instead of continuing to work is a better choice for me.

So like you’re procrastinating, but you’re doing it in a way that is a conscious deliberate choice, it’s basically being mindful about something. So I think that’s part of it, the other part is even when you do it on autopilot and you forget to choose because we do that too, right.

We’re talking about long standing habits that are challenging to break. I cannot overemphasize the importance of self-compassion.

So, you know there’s something called the abstinence violation effect which is that thing, when you are trying to quit smoking or you’re on a diet or you’re giving up drinking and let’s go with the diet example you think you end up eating like a big huge piece of cheesecake and you say, oh, I blew it, screw it, I might as well eat the whole entire cheesecake, and I’ll just start again next Monday.

And then in that period of time from eating the cheesecake to Monday, you eat, you know, two weeks’ worth of food, right? It’s called the abstinence violation effect, it happens with behavior change all the time, research shows that when you beat yourself up you’re much more likely to eat two weeks’ worth of food and not start till Monday.

But if you practice self-compassion, so self-compassion has three parts. One is mindfulness of your own suffering, so you’re aware of your thoughts, your feelings, you know, what’s going on internally.

The second is common humanity which is recognizing I’m not alone, you know, this is hard and everybody struggles with behavior change. And the third is self-kindness and it’s just being nice to yourself instead of beating yourself up and saying, you know what? I made a mistake, you know, I didn’t do what I had really wanted to do but I’m working on it, I’m doing my best.

And you know, people have lapses sometimes there’s always going to be setbacks but I can do this and I’m going to get back on track. When you have that self-compassionate mindset, you’re much less likely... You are more likely to get back on track much more quickly.

And you know, it’s, it can be, we’re very, it’s easy for us to be easy on other people but really hard for us to be nice to ourselves. So I like two ways to practice this.

One is like if you’ve got kids or nieces or nephews, like, you know, an innocent little person in your life, if this person came to you and said, I blew it, what would you say to them?

‘Cause it’s easy for us to say kind things to cute, little innocent, you don’t, if you don’t have any cute innocent humans maybe an animal, but you get the idea.

So that’s one way, the other way is to think about someone you really respect or admire and who you know is of, you know, of, this can be someone you know, a celebrity, a fictional character, it doesn’t matter but who you imagine would be compassionate.

And what would that person say to you? And then it’s a little easier to come up with some of that self-kindness.

Jenn: It’s always so hard to picture ourselves the way that other people picture us, but we have so much respect and compassion for people that like when we’re looking past a mirror, that it’s so hard so often to try and like turn that back on ourselves.

Jill: Absolutely yeah.

Jenn: So I’m curious about how, what you’ve just addressed. How can these concepts be applied when there’s an urge to avoid social situations, if you’re afraid of what others are thinking or saying about you?

Jill: Well, it comes back to that same values piece is, you know, this is so, some people have social anxiety disorder, that’s kind of the nature of the of the anxiety is this, you know, being terrified of having a performance failure, like I won’t be able to carry on a conversation I’ll say something boring or stupid and then incurring negative evaluation.

But even aside from social anxiety, you know, we live in an age of constant comparison, social media is putting us in a position where, you know, we’re comparing our full lives to the highlight reel of other people’s lives who have filters on and don’t actually even look the way they look and you know, comparing ourselves to that, it’s really become a problem.

And we can either listen to the voice that says you’re not enough and let the anxiety drive us to stay in our comfort zone, or we can determine like is connecting with other humans something that matters to me?

Is that something I want to have in my life? And if it is then can I be willing to travel past that vulnerability edge, in the service of connecting with other people?

Now that doesn’t mean you have to go to a huge party where you don’t know anybody, I mean, I’m pretty extroverted and I have no desire to do that but it might mean just getting together and I think that the pandemic has taught many of us, I’ve learned about myself like I used to think, I was very extroverted now I’m like, I think I maybe just kind of an extroverted introvert.

Like I did well just being with small groups, you know, not being out and social all the time, but you know, being really choosy about like, I don’t have to engage in social situations because I should, because society thinks it’s better to be a party animal or you know, whatever it is, like whether it’s your culture, whether it’s your parents, values are meant to be yours, freely chosen, personal and freely chosen.

And if your values are consistent with your culture, your religion, et cetera, great. But if not, you know, it’s that idea of like deciding you know, it’s okay for me to say no to social events that don’t fill my gas tank, but if it’s important to me to be connected, then how can I find ways to have that in my life that work for me?

I’m sorry, if you guys can hear my dogs barking I was telling Jenn at the beginning of this that I’ve got kids home and nobody watching them and they’re probably riling up my dogs making all sorts of noise.

Jenn: That’s okay, we’re going to get a bunch of questions about what type of dogs you have? So you should probably answer that right now.

Jill: I have two French Bulldogs and they are little clowns so I can hear them playing and barking right now.

Jenn: Alright, so the fifth chapter in the book and I’m trying, I know some folks who are joining us or tuning in have read the book and some folks haven’t, so, just trying to provide a little bit of an overview without giving away the secret sauce.

So one of your title, one of the chapters is titled, “Declaring Victory Through Values” and throughout it, you provide tactics and tools for us to charge into the lives that we desire which I think is just exceptional.

So a lot of it is that you’re encouraging folks to dig deeply into and to learn what our own personal and consciously chosen values are. And I know that you’ve alluded to this already by saying with social media and rejoining society and feeling a lot of the pressure to do some of everything.

It can be really hard for when we’re trying to discover our own values. It can be hard to number one, not fall into a comparison trap, which like, hello social media and number two, not really let others around us muddy the personal waters by projecting what they value on to us.

So the long and short for my question is how can we discover and communicate our own values while keeping any feelings of shame, embarrassment, or self-consciousness out of the picture while we’re on this journey?

Jill: Well, the short answer is we can’t. So, you know, the whole premise of ACT is, we don’t get to control, I don’t remember what all the feelings where you just said but shame, embarrassment, you know, the little list that you just gave.

Those things show up, like thoughts show up, feelings show up, they get triggered by all sorts of different things, our learning history, you know, past experience all sorts of different things.

And we don’t get to control that they just show up, but those things aren’t the problem, it’s how we respond to it, that can be the problem. So if we’re responding to, you know, if we’re acting in ways to try to prevent feeling shame or embarrassment or whatever, we’re going to be staying in our comfort zone and that may or may not be values consistent.

Or if we go to that vulnerability edge and embarrassment shows up and we retreat back into our comfort zone, you know, that’s where the problem lies. So it’s not the pain, that’s the problem, like pain is just, you know, part of the deal of being human, right?

We like literally come out of the womb screaming and if we’re not, it’s a problem. So pain is just part of the deal, and we don’t have a choice in that, but it’s our unwillingness to experience those feelings, that is what really creates suffering and that’s good news because we don’t control the feelings but we do control how we respond to them.

So, if we can learn how to, you know, get rid of that resistance, then we reduce suffering. So we’re left with pain, but not suffering, but I feel like there was a different part to that question that maybe I’m not answering with that, no, okay.

Jenn: No, you nailed that one, so, you know, there’s the pain, there’s the suffering and we can at times separate the two of them. So what do we do if we’re anxious about getting together with folks that make us anxious?

Jill: Well, this, I mean, this is, I think the same thing that I said before is like, if they’re making you anxious because you admire them, like they’re rock stars and you learn a ton from them and at the end of the day, your gas tank is filled up after you spend time with them.

But let me tell, I’ll give you an example. When I wrote my first book, I was invited to a dinner with all the other authors, with my publisher New Harbinger and when I opened up the e-invite and I saw all the names, I burst out crying, like sobbing crying and I was so anxious.

I was like completely overwhelmed, because all I thought was like, I can’t do this, I can’t hang out with these people because like, they’re up here and I don’t belong with them, right?

So that’s an example of like, people who make you anxious, but not because they’re jerks because they’re giants, right? And so in that case-

Jenn: That’s basically how I feel every time, I host one of these sessions, like I, for folks tuning in who didn’t hear me at the beginning I was basically fangirling about getting to talk to Jill and it’s anxiety ‘cause I care, but it’s also anxiety because you’ve got decades of experience and I’ve got a year and a half under my belt.

So for me, it’s like, you’re basically hoisting me up a flight of stairs to put me on the same level conversationally.

Jill: So, I mean, that’s exactly it, it’s the exact same thing and at the time that this happened, I had just had this one book come out and these people had all this other, all these other just accolades and experience.

And so in that case, it was about, you know, like what kind of opportunities might I be sacrificing, if I let my anxiety win in this case? And, you know, to tell the truth, I did have a couple glasses of wine to facilitate my ability to go be with these people.

And you know, every dinner since I still feel anxious but it’s a little bit better than it was in the beginning. And now many of these people have gone from, you know, these strangers on a pedestal to my friends, you know, Lisa Coyne, who is part of this, would be an example of one of those.

And, you know, so I think it’s really thinking about is this important to me? Is this going to fill my tank even though it makes me feel really scared? Are there opportunities of connection or, you know I don’t just mean networking in a professional sense, but like, might I meet new friends? Might I connect in important ways?

And then you go, but if you’re feeling really anxious because every time you hang out with these people somehow you are made to feel, I shouldn’t say made to feel, but you feel really small or they’re gossiping and talking about people behind their backs and like, that’s just not how you roll or right?

Or like they all lean one way politically and it’s different from you and that makes you really uncomfortable or they have very different values from you, you know, then that may be a case where you choose not to go like it’s okay to avoid sometimes, you know, the question is, so avoidance isn’t bad, avoidance is only bad if it has a cost.

So for example, like if I have a headache like let’s say I had a headache before this conversation and I decided to take Advil, well, avoidance is anything you do to feel better basically or prevent some feared outcome.

Well, Advil would take my headache away, it’s technically avoidance, but, it doesn’t have a cost like Advil at small doses, isn’t going to give me an ulcer, it doesn’t cost a lot of money and in fact, if it makes me feel more clear headed it’s actually going to allow me to engage better with you, with our audience, right? So that’s technically avoidance, but it’s not bad, it doesn’t have a cost.

Jenn: I truly hope that, that wasn’t a true experience that you just had to go through taking Advil, before talking to me-

Jill: I did not, I did not, no.

Jenn: It’s like she’s speaking so clearly, like eloquently about this, I really hope this didn’t happen.

Jill: It did not, no. Now, but I’ll take that example and keep going, it’s like, if I’m so unwilling to feel any kind of pain in my body and you know, like as a middle-aged woman I’ve got a little bit of pain, at least every day and I start taking four Advil every two hours.

Well, now I am going to have an ulcer and it might get expensive and I’ll probably start having like rebound headaches, which are the thing I was trying to cure in the first place is now back.

And so in that case, then avoidance that now, the avoidance comes at a cost and so, you know, now it’s problematic.

And so I think going back to that social situation question, the potential cost of all avoidance is, if I hang out too much in my comfort zone, I get too cozy in my comfort zone, and I don’t stretch ever, right? But you know, it’s like this question of does this fill your gas tank or not? Is this values driven or not?

Jenn: So would that same concept be applicable to public speaking ‘cause we’ve had folks ask about how to address your anxiety around speaking publicly.

Jill: Yeah, the same principle applies to all things and honestly, that is one of the most beautiful things about ACT like as a therapist.

If I have someone come to me who has panic attacks or is getting divorced or bites their nails, I mean three completely different issues, ACT is appropriate for all of those things, because in every case, you’re learning to identify your internal experiences, right?

What’s the pain that shows up in your life? What do you do when it shows up? That’s the strategy that might be experiential avoidance, What does that get you? It works or we wouldn’t do it, but what’s the cost?

And if there’s a cost and especially if that cost is that it’s pulling you further away from your values, then what the work we want to do is okay what’s an alternative.

Can you change your relationship to this pain? Can you have the anxiety? Can you have the fear that people are going to think you’re boring or incompetent if you stand up and speak? And can you choose to do it anyway if it’s something that matters to you?

If you don’t care about public speaking, like if it’s not holding you back at work or you don’t have to like decline to be the maid of honor for your best friend, then maybe it’s okay to have some public speaking anxiety.

But if it’s and to not do anything about it but if it’s getting in the way of you living the life, you truly want to live, then maybe it’s worth feeling some anxiety. And then of course, as you face your fear, the more you do something, the easier it gets.

I mean, believe me, I used to be an absolute mess, doing this kind of thing, way back in the day and then I started teaching, and then once I was doing that all the time, you know, now it’s easy.

And the reason for that is all this bad stuff you think is going to happen. If you get up and talk to people, it usually doesn’t happen. And even if it does, it’s not as bad as you think it’s going to be and you can handle it. And so you build up the ability to do it more comfortably.

Jenn: Exactly, the reason why I do these webinars, is my boss came to me and said, how do you want to grow in your role? And I said, I am absolutely terrified of public speaking, give me public speaking opportunities and-

Jill: Good for you.

Jenn: And granted, COVID ended all of our public speaking opportunities for 2020 but we started a webinar series as a result, so it’s been like 80 something sessions and now I feel infinitely better than I did, a year and a half ago running these.

Jill: That’s awesome, I love that, that’s such a good example, that’s great.

Jenn: So, I know in the book you talked about the anxiety triumvirate but I wanted you to talk a little bit about it to folks who are tuning in, who might not be familiar with it, just a little bit about what it is and if we find ourselves being stricken with it, how can we lighten the weight of it on our minds and our feelings?

Jill: Okay sure, let me, before I do that, I just thought of one other thing with what we were just talking about, the public speaking thing, is if you think of that comfort zone and that vulnerability edge, the more you dip a toe out, the further it expands, right?

So like your comfort zone actually gets bigger and your vulnerability edge gets further out, the more you do, so it ends up being rewarding in and of itself. So I just, I liked that image, I wanted to share that, so-

Jenn: Very good point to add.

Jill: Yeah, so the anxiety triumvirate is, so there are three things that we know really trigger or worsen, exacerbate anxiety and they are uncertainty like having difficulty with uncertainty, which most humans have difficulty with uncertainty, a lack of perceived control.

So it’s not how much control you actually have, sorry, hold on. It’s your perception of control so even if you don’t have it but you think you do, you’re good to go. So your perception of control and then an overinflated sense of responsibility.

So when all three of these things are present anxiety is going to be higher. And I mean, I think never, I wrote this book well before the pandemic, but through this whole experience I thought, wow, if those three things aren’t present for so many people all the time, I mean none of us had any control, none of us had any idea what the hell was going to happen.

And many of us, I think had a high sense of responsibility, if you know, we’ve lost jobs and can’t pay bills, if we have to educate our children at home, I mean, you know, so many things that triggered that.

So, if ever there was a time for that anxiety was normal, it was certainly during this time. So those are the three, they trigger anxiety, what to do about it is counter-intuitive. So I’ll give you an example to illustrate because what we normally do is the wrong thing.

What we normally do is we try to get more certainty and more control and, probably double down on the responsibility. But I’ll give you an example that at least shows the first two, think about like when you have kind of a maybe like some kind of medical symptom, right?

Like maybe I’ve like started having headaches and I didn’t used to have, I keep using headache examples or like I’ve been much more tired and I don’t really understand why. And what, that makes, there’s uncertainty I’m having symptoms and I don’t know what it is, there’s a lack of control, right?

Like, gosh, what if something’s really wrong with me? And then that responsibility piece might come up, like, what if I can’t work if something’s really wrong? What if I have to leave my children? And so what do we do when the anxiety gets triggered by that, we go to the Google machine, right?

We go to WebMD and remember I said that’s avoidance and it works or we wouldn’t do it. So in the moment that you go to your WebMD you’re like, yes, I’m going to figure this out, I’m going to reduce the uncertainty, I’m going to get my answers, I have a sense of control, am taking control by getting on the computer and figuring this thing out, I’m being responsible.

And then, you know, you put in your symptoms and now being tired is you have leukemia and you need to see a doctor stat, right? Or a brain tumor with the headache example. So now your anxiety’s higher, you have less certainty, less sense of control, more fear about your responsibility.

So just like all these examples, what we do in the moment works in the short term but it typically makes things worse in the long term, and so what’s the alternative? Learning how to accept uncertainty, knowing that there’s lots of stuff in this life that we don’t get to control and that’s okay.

It’s not dangerous, we can let go of that need to control, we can let go of that overinflated sense of responsibility, we can still be responsible, without it being over inflated sense of responsibility.

And we know that we are all capable of doing this and here’s how we know, for people who drive a car, take the bus, every time you get on the road, you might get in a car accident and die, and yet you do it and why do you do it?

Because it’s important to you to be able to move freely about your life. When you watch a TV show or you read a book, most people don’t fast forward to the end and watch the last scene first or go to the last page of the book and read the last page of the book.

In fact, it’s the uncertainty that actually makes those experiences enjoyable. So, we do this all the time and we can do it, what has happened is because of technology, we’ve had fewer opportunities to practice.

So if right now you thought, oh, I wonder who won the Oscar for best picture this year? Like I can just ask, you know, who A L E X A in the corner, I’m not going to say her name cause she’ll respond and I can have that answer instantly, any question you want, instant answers.

If you need a new curling iron, just go on Amazon and read the reviews, you never have to buy anything without knowing whether it’s probably going to be good or not, Yelp reviews-

Jenn: We’ll all get ads for curling irons after this session-

Jill: We will that’s, right? Yes, you’re totally right we will, I should make sure I use examples of things that I actually want ads for. So we don’t have a lot of practice anymore, you don’t just go try a restaurant and maybe you like it maybe you don’t, but if it sucks, you learn like, well that’s a bummer, but it’s no big deal, right?

Like we just, we have so much information that it’s like our ability to tolerate uncertainty has atrophied with all this technology and so what we need to do is really be aware of that and look for opportunities to practice making space for uncertainty and lack of control and learning understanding like this is fine, I can tolerate this.

Jenn: Can you provide a little more clarification on having an overinflated sense of responsibility, for some folks it’s like paying bills is a normal part of being an adult, how could that be an overinflated sense of responsibility?

Jill: So it would be like, let’s say you’re in a two person household, and you’re thinking like, it’s all on me, it’s all my responsibility.

Or let’s say you’re a parent and you’re in a two person household, you know, if you’re taking on 100% of the kid responsibilities or the, you know, the cooking, the cleaning, whatever it is that needs to be done you know, domestically and yet you have a partner who theoretically should be able to split that 50/50.

That’s an overinflated sense of responsibility or if you feel it, some people feel a sense of responsibility like for climate change, which is fine, we should all feel some responsibility to like treat the world well.

But our ability as individuals to fix that problem is limited there’s stuff, we can get solar, we can get drive electric cars, we can be vegan you know, there’s all sorts of things we can do but to have an overinflated sense of responsibility would be like, I’m struggling with the words, but that like it’s on me, like it’s on us, like, we must do something to a degree that’s like, maybe not realistic.

Jenn: If the ice caps melt, it’s a hundred percent my fault.

Jill: Yes, right, right, yeah, I have to save the polar bears and this and this and this, yeah.

Jenn: And pay my bills on time.

Jill: Right, exactly.

Jenn: So, alright, so fundamentally, is there a difference between mindfulness and willingness and if so, what are those differences?

Jill: So I would say mindfulness is part of willingness, I’m not sure that willingness is part of mindfulness. So mindfulness very simply is just non-judgmental present focused attention and flexible attention.

So like you’re paying attention on purpose which might mean using your senses, like, what am I seeing and what am I hearing and tasting, et cetera. And so I am paying attention I’m aware and its present and then I’m not judging it.

So it’s what I’m experiencing not what my mind is saying about what I’m experiencing. So one of my favorite examples of that is, I was riding the bus in the winter in Massachusetts.

Actually I did my PhD at BU and so I would take the 57 bus and the colder it was the more crowded it would get and I would just sit there and be like, stupid Boston weather, you know, lots of judgment, right?

And it was miserable, I was suffering. So I decided to try to ride the bus mindfully kind of test out this mindfulness thing.

And that meant, you know, feeling the my nose freezing as I was breathing in and then once I got on the bus and it was 87 degrees feeling, the bead of sweat go down my cheek and I’m short, so, I can’t reach the handle.

So, like I’m having to just sort of surf and hope I don’t fall and feeling myself, make contact with the people near me and feeling my leg muscles contract and just having the experience like normally it would be lots of judgment.

And what I found from doing that is not that I suddenly loved riding the bus, it didn’t make it a pleasant experience but it made it less unpleasant, because it just was what it was without all the stupid winter crowded bus, right?

That like creates more suffering, so mindfulness is just that, like non-judgmental present focused attention and awareness of what’s what. Willingness requires you to be mindful because to be willing, you have to be present to what’s happening.

But willingness also called acceptance, that’s what the acceptance in acceptance and commitment therapy is means that you are opening and allowing those experiences without doing anything to try to change or alter or shove them down or push them away.

So there’s it’s an active addition to mindfulness, which is where you’re changing your relationship to your internal experiences. Does that make sense? Is that-

Jenn: Yeah, definitely, so you, I want to talk a little bit about the suit of armor that you allude to in several chapters in the book. So one of the chapters is titled, “Understanding Your Suit of Armor” and there’s a ton of really helpful workshopping in it.

And I’ll break it out really quickly for folks tuning in without again, giving away the secret sauce, so it’s broken into the following, which are reflecting on lingering messages and actions of your childhood and the impact that they’ve had on you, identifying how you react when pre-existing beliefs show up, breaking down how what’s called a safety behavior may not serve you well now.

And then reflecting and writing on how these behaviors recreate, what you refer to as early hurts that they were created to protect you from which I love the phrasing early hurts, I think it’s incredibly helpful.

So when trying to shed the suit of armor, you suggest some of these, obviously not all of them like including but not limited to, connecting back to values, observing ourselves, defusing thoughts from values and self-worth and selecting our responses consciously to our thoughts.

I’m curious from the science point of view of it how do exercises like this change our mental pathways and our patterns of thinking over time?

Jill: Well, Rick Hanson, who’s a like neuropsych guy, he does a lot of work on this and talks about I don’t know why, but I always get this bizarre image in my brain where I think about like the old school wagons.

You know, like Oregon Trail wagons, with the big wooden tires like getting stuck in a rut, like if you’re in the mud and the mud dries, like it’s hard to get those wheels out of that rut, you know.

You’re just going to keep going in that same direction ‘cause the wheels are stuck in the rut and what these different strategies that you just mentioned, like what they do is they get you out of the rut and then as you practice them, consistently, you make new ruts and that’s what happens.

This is a very crude metaphor for this but that’s essentially what happens in your brain is that you sort of rewire your neural pathways, you know, for some of this. New ruts for your wheels.

Jenn: It’s like, if you’re driving down a street and you know if you’re driving the same two miles every day and there’s a pothole three quarters of the way down on your left, you know, to avoid that pothole, but if you go two and a half miles you don’t know what that other half mile is going to include.

Jill: Right, and then if you keep doing that half mile you’ll get to know that too and you’re sort of yeah, like rewiring, yeah.

Jenn: Just trying to go into the Boston metaphor of terrible roads.

Jill: Ooh, terrible roads and all the one ways and the cow paths, right? No grid.

Jenn: So, for many of us that are tuning in who have either worked with patients or have been a patient ourselves, we all know this to be true, whether or not we want to admit it, progress isn’t linear.

But in fact it looks like a big tangled ball of string more often than not, so, do you have any advice that’s rooted in ACT for what we should do if we find ourselves in a backslide and effectively putting this suit of armor back on, do you have any key exercises that you would recommend practicing over some others?

Jill: Not exercises per say, let me real quick, what were you just talking about before I was blanking on the word, but it’s neuroplasticity is the word for that like changing in the brain.

So, if people are interested in learning more about that if you just Google neuroplasticity or Rick Hanson, you can get like really cool stuff around that.

Yeah, so, I think of progress, not so much like a ball of string, a little less chaotic than that but like, if you picture, you know, picture a regular graph I never know which way to draw it with people looking at me.

But if you picture a regular graph, if we think of progress as we wish it was a straight line like over time, progress gets better, I think it looks like this, right? So it’s a bumpy line but the slope is still going in the right direction, right?

And so if you’re like this and you are at a setback so the line has started going down, away from the progress side, that would be a setback or a lapse. And so what’s important is what tends to happen in that moment is we’re just zeroing in on that piece.

I’m here in my lapse looking at how I fell from up there and focusing on that, but what I need to do is zoom out and look at the whole graph, Because even if I’m in a lapse right here, I started here, right?

So this whole area, hopefully people can visualize whatever I’m doing with my hands, but this whole area is really important. Like a relapse is way back here not just this bump right here-

Jenn: It’s like looking only at like looking down from a mountain only when you’ve reached the top, like you’re not seeing anywhere between the base and the top of the mountain.

Jill: Yes, exactly, that’s perfect, so when you’re in that lapse, the way to make it not turn into a relapse is to think about like what is it that might have contributed to this? And again, this is an if not when, I mean a when not if, right?

Like they happen for sure and sometimes they happen because of things totally out of your control, like, you know, you get the flu and you’re in bed for several days. Or, you know, there are several stressors that have just depleted your gas tank or you’ve had a traumatic event occur or they can be caused by things that are within your control.

Things like, oh, I’ve been hanging out in my comfort zone a lot, I’ve started avoiding again, I turned down every one of those social invitations and, you know, skipped the work meetings where I knew I’d have to speak up on the call and so if you’ve gone back to those old patterns, then that’s what’s going to cause those lapses.

And you know, so then the question is, well what do I need to do to get myself moving back in the other direction? And you know what are the ACT skills that I find to be the most helpful? Well, I need to practice acceptance, I have to make space for my discomfort.

We haven’t talked so much about defusion but defusion is the way you relate to your thoughts, so, instead of being hooked and seeing the world from your thoughts, it’s like taking your thoughts out here and looking at them, being an observer, like a dispassionate curious observer and then you choose if I listen to this thought, is it going to move me in the direction of my values?

Now, if the thought is, oh shoot, my mortgage is due tomorrow, that seems like a good thought to listen to if I care about keeping a roof over my head, but if the thought is, you know, you have nothing of value to share with the people coming to the webinar and I listened to that, I’m going to back out of this commitment I made, that’s really important to me and my mission in life is to share ACT with other people, right?

So can I observe that thought, and then choose to do something different? Can we do like a quick little exercise with that?

Jenn: Yeah, absolutely.

Jill: So what I want everyone to do, is say you can say it out loud, if you’re in a place you’re comfortable doing that or willing to do that, or just say it in your head.

I cannot raise my hand and now do this, look at that, who knew, you can have a thought, think one way and act another and you know, if we kept our hands up long enough it starts, it’s going to start to get tired and you could think, gosh, I can’t possibly keep my hand in the air for another single second longer...

But probably you can do one more second or one more second after that and of course, this isn’t important, whether we have our hand raised, it’s just an example. But if your values are saying this is something that’s important to me can I have all those doubting thoughts?

Observe them, notice them dispassionately from a distance and choose to act differently. What else, you were saying? I just lost my train of thought of where we started with, oh if you’re having a setback, how to get back on track, got it, I’m back.

You know, so connecting with values, willingness for the internal feelings, emotions, physiological sensations, defusion, so that new relationship to thoughts and then you take the committed action which is the values driven action irrespective of how you’re thinking and feeling.

Jenn: I want to be cognizant of your time, I have like a hundred thousand questions for you but do you have time for two more?

Jill: Totally, yeah.

Jenn: Fantastic, we had somebody write in, sharing that they are a crisis counselor for a crisis text line where a lot of people write in with anxiety and they’re curious when folks write in about a high level of anxiety, what do you or what should you advise for them to do in the present moment?

They want us to clarify too not for folks who would be suicidal, just air quote just for those with high anxiety or are in panic mode.

Jill: Okay, well, so this is sort of counter-intuitive but when people are in panic mode, the thing about anxiety is as long as you’re unwilling to have it you’re going to have it, right?

If I hook you up to a machine and say just don’t get anxious and you’ll be fine, but if you get anxious, this machine is going to give a lethal shock and you’ll be dead.

You’re going to be anxious, because what you’re saying to yourself is, oh my God, I can’t be anxious, it’s dangerous, it’s deadly, it’s going to kill me, I have to get rid of it.

And so now you’re anxious about anxiety, so that’s what often happens with people who are panicky, they’ve now gotten anxious about their anxiety and so you’re anxious. And so one of the best ways to tackle that, so, the opposite of that is willingness which is bring it on.

So, if I’m panicky, the best thing I can do is spin around in a chair, I can do it right now, I have a spiny chair, spin around in a chair to make myself dizzy, run in place to make my heartbeat and for me to get sweaty, do jumping jacks what those things are doing they’re called interoceptive exposures, is there, you’re saying, you know what?

I can handle sweat, I can handle dizziness and lightheadedness, I can be nauseous, bring it on and now you’re willing to have it, so, you’re no longer anxious about anxiety. Now you can’t do that as a trick, like, okay, if I do jumping jacks, then I won’t be anxious anymore, ‘cause that’s still, I’m not willing to be anxious, right?

But it’s like, okay, this is super uncomfortable, this is what I, the mantra I give people, this is super uncomfortable, but it’s not dangerous, it’s temporary and I can handle it and how do you know that’s true? Because you’ve done it before, right?

And so if I know all those things are true and I’ve done it before then I know like, these are just feelings even though they’re really intense and painful and so if I know I can handle that, I’m going to run, I’m going to jumping jack and now you’re willing to have it and then it typically decreases the intensity and duration of those episodes.

Jenn: So I promised I have two questions, I really have two at this point, so, first and foremost, so, when working through all of the exercises that you have throughout “Be Mighty” for folks who have not cracked open the book, please do, the exercises are incredibly helpful.

Do you advise that these exercises are done alone? Or can you enlist your partner or friends in them or is this self-discovery for your own mental health best done solo? And then you enroll the people that you care about later on?

Jill: I would say yes, yes and yes, to all of those options, I say like you do you like, you know yourself, do whatever you think would be the most helpful, you know, if you know that you work better with a buddy, then do it with a buddy, if you’d prefer to try it solo, do that.

You know, we know that we retain 90% of what we teach others and only like 10% of what we learn from others. So, if you want to really get this down, then teach it to somebody else after you’ve done it yourself, like there are no rules, there are no boundaries.

Like you do it, be creative, like just go with it and then let me know, reach out and tell me how it goes.

Jenn: That tees me up beautifully for my last question, where can we find you? If folks want to reach out and learn more?

Jill: You can find, you know what, I keep having this thought intruding here. I want to go back to the question about the anxiety on the caller, the crisis line.

For people who aren’t having panic attacks and are just having really heightened anxiety, breathing is always helpful. So to do like inhale and count to say four, five, six and then exhale longer than your inhale, so, if you inhale four, exhale, six, it immediately quiets down the central nervous system so that’s always good too.

I hesitate to recommend like typical relaxation stuff because people can start using that as an avoidance strategy where it increases their anxiety about anxiety, like I got to do my breathing because I don’t want to be anxious, so, you just have to be careful about that, but I did want to suggest that too.

You can find me at jillstoddard.com. And my name is spelled J I L L S T O D D A R D. I have a monthly newsletter, I don’t spam people, but all this content we talked about tonight, like I do a snippet, my last newsletter was about the comfort zone, I talk a lot about imposter syndrome.

So I encourage you guys to sign up, I promise I won’t spam you, you’ll just get a short little newsletter once a month. And all my social media buttons are there too.

I’m on Instagram sharing this kind of stuff, little bit on Facebook, Twitter, LinkedIn I think, although I never post there and I would love to connect with everybody, so, definitely that would be great.

Jenn: Well, Jill I think it goes without saying that, I could talk to you for hours, but this concludes our hour together and I have to say from the bottom of my heart, thank you so much for making our inaugural session for Turning the Page, such a success.

I, you have given so much valuable information that I have a hundred thousand notes and I can’t wait to share them with everyone I know, for everybody tuning in this actually concludes the session.

This is the book, “Be Mighty” by Jill Stoddard, PhD and Jill, thank you again. This has been phenomenal and thanks.

Jill: You’re so welcome.

Jenn: Thanks to you for tuning in this ends the session and until next time, be nice to one another but most importantly, be nice to yourself, thanks folks.

Jill: Thanks Jenn, thanks everybody.

Jenn: Thanks for tuning in to Mindful Things! Please subscribe to us and rate us on iTunes, Spotify, or wherever you listen to podcasts.

Don’t forget, mental health is everyone’s responsibility. If you or a loved one are in crisis, the Samaritans are available 24 hours a day at 877.870.4673. Again, that’s 877.870.4673.

- - -

The McLean Hospital podcast Mindful Things is intended to provide general information and to help listeners learn about mental health, educational opportunities, and research initiatives. This podcast is not an attempt to practice medicine or to provide specific medical advice.

© 2021 McLean Hospital. All Rights Reserved.