The Rumination Bully: Why Fighting Back Can Make It Worse and What to Do Instead

You're lying awake trying to think your way to certainty; running the same worry in circles, getting nowhere, but unable to stop. If a client's "careful thinking" has quietly become compulsive reasoning, exposure and response prevention alone won't fix it. This episode shows you what will.

Dr. Lisa Levine, Psy.D., is a licensed psychologist and owner of the OCD and Anxiety Treatment Center of Maryland. After 23 years specializing in OCD treatment, she developed non-engagement response strategies for clients whose ERP work was being quietly undermined by compulsive reasoning and rumination happening entirely in their heads; often clients who looked like they were doing everything right.

In this episode, you'll learn:
- How to tell compulsive reasoning apart from real problem-solving, intrusive thoughts, and obsessing
- The "urgency and desperation" litmus test for spotting when reasoning has become compulsive
- Why suppression and reassurance-seeking backfire — and what a non-engagement response actually sounds like
- The "rumination bully" framework and how strategic agreeing defuses it
- Why this shows up constantly in high-achieving clients who'd never be diagnosed with OCD

Timestamps:
0:00 Welcome & Meet Dr. Lisa Levine
3:03 What Makes Reasoning "Compulsive"? The Urgency & Desperation Test
9:04 Compulsive Reasoning vs. Intrusive Thoughts vs. Obsessing
12:00 Why Suppression and Reassurance Backfire
18:03 The Toddler Tantrum Analogy: Why It Gets Worse Before It Gets Better
24:07 When Deep Thinking Is Healthy — And When It's a Trap
30:00 The Rumination Bully and the Power of Strategic Agreeing
39:04 Real-World Exposure Examples: Driving, Parking, Everyday Risk
48:00 What a Non-Engagement Response Actually Sounds Like
54:00 Why This Work Takes Courage — Giving Clients (and Yourself) Credit

If you liked this episode, watch "Why OCD is Not an Adjective" next.

Resources mentioned:
- Dr. Levine's article on compulsive reasoning
- "How to Stop a Bully"- Brookes Gibbs
- Dr. Levine's mentor, Charlie Mansueto, credited with teaching her the "dead man's rule" framework

This episode covers topics relevant to CE/CEU for LCSW, LMHC, LPC, LMFT, NCC.
Free CEU available for Arizona licensure through the Board of Behavioral Health Examiners.

Subscribe for weekly clinical training you can use in your next session.

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The Self Careapist Therapist Podcast is a biweekly conversation with Lorain Moorehead, LCSW a therapist in private practice.  With guests ranging from expert psychologists, therapists, researchers and authors, each episode offers a deep dive and keeps listeners from intern to advanced supervisor  in mind while dropping gems and aha moments for everyone who loves to learn! If you love learning and want to keep track of some future learning opportunities, grab your personal curriculum here!

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Transcript

SPEAKER_01 0:00

Welcome to the Self-Cherapist Therapist. I'm Lorraine Moorhead, and this is a Therapist to Therapist podcast for mental health professionals who want practical, evidence-based skills they can actually use in session. Each week I'm joined by leading experts in the field as we talk interventions, modalities, client populations, clinical supervision, and sustainable self-care, the kind that helps you do meaningful work without burning out. If you're a therapist, counselor, social worker, psychologist, or graduate student looking for real continuing education, you're in the right place. Welcome back to Self-Care a Pist Therapist Podcast. Today we're welcoming guest Dr. Lisa Levine to talk all about compulsive reasoning. Just to get us started, how did you begin learning all about this and what has your trajectory with treating clients been like?

SPEAKER_00 0:58

Oh, sure. So I started working as an OCD specialist about 23 years ago. I was very blessed to have a wonderful mentor and teacher and boss, Charlie Mansueto, who kind of really taught me everything I needed to know and helped me along the way. I've had the privilege to treat many, many people with OCD, oftentimes pretty severe. I had noticed there was a problem happening with some clients who were doing well, external exposures, overt exposures, but were um were still stuck. One had just come back from a residential OCD treatment center. And she was saying, you know, she she achieved a lot, but no one had ever been able to help her learn how to stop compulsive reasoning or compulsive rumination. And she did. And um and around that same time I had another uh a new client who had come from um the West Coast and had had what seemed like really good treatment to me uh so far, but he really hadn't made any progress. And um as time went on with working with him, I saw that what what had happened was he did all these creative exposures with his previous therapist, but he had been compulsively reasoning or ruminating during the exposures, after the exposures, so so true response prevention was not actually happening, and he wasn't he wasn't benefiting um from the hard work that he was doing. In situations where you know there are overt um external convulsions, this is an issue, as well as for a lot of people um who don't have uh external compulsions, it's all or mostly mental compulsions um going on in in their head. We know that trying not to think about it doesn't work. Um there's mindfulness, which is which is great. My boss had for many uh years, he had always talked to us about something called dead man's rule, which is this idea that you ask someone to do something rather than asking them not to do something. Yeah. Because a dead man cannot do something better than any live person can. So I was very much used to thinking in those along those lines, and what could we do according, you know, that that could help with this? Um, and so that's really where where it came from, um, non-engagement responses, uh kind of an active uh strategic way of intervening with um compulsive reasoning and compulsive rumination. Um and uh yeah, that's kind of how it started.

SPEAKER_01 3:54

And um I uh I I you know I sometimes I I think what did I do those first uh five or six I'm so glad that you mentioned the folks that don't necessarily have an OCD diagnosis and find themselves doing this as well. I think we could call a lot of my population uh folks that fall into that category. I work a lot with high achievers, and in a lot of ways, reasoning has gotten them so far. They're, you know, they're really, they've really landed into a lot of success. And I've I I told you this, and you just mentioned the article that you wrote, but I've had several clients send that to me over the years because they've stumbled on it and really resonated. So I'll link that in the show notes for anyone listening. But I thought that was really important to hear that you can see clients who uh are on a recovery path with their OCD fall into now this type of reasoning, and you see it with people that wouldn't be diagnosed with OCD or don't identify with those symptoms also.

SPEAKER_00 5:02

Absolutely. Generalized anxiety disorder, or even not not necessarily clinical disorder, but just um, you know, a worrier, an overthinker.

SPEAKER_01 5:10

Yeah. Could you give a little more detail about what that overthinking looks like?

SPEAKER_00 5:17

It's important to differentiate, you know, between um what I would call compulsive reasoning versus uh actual problem solving. The difference um is several things. I would say the the biggest uh red flags are desperation and urgency, right? So if you have a feeling of desperation to get an answer, and there's also a feeling of urgency, like you need the answer, you need it right now, you need to know for sure you're vulnerable to potentially be compulsively reasoning. Now, that in and of itself, you know, not necessarily there are some very, you know, important, urgent types of situations where you you do need, you know, to think in that way. But uh in a situation that isn't particularly externally urgent, um uh it's a it's a good kind of rule of thumb. Um another thing to kind of look for is how much the person is thinking about it, how long they're spending thinking about it, are they coming to any answers? Um, or are they never kind of reaching a conclusion? Or if they are coming to answers, do those answers uh hold basically, or do they end up coming back to the reasoning uh when kind of doubt doubt creeps in and kind of start all over again? Uh I would say it there's a kind of a hamster wheel feeling to compulsive reasoning, um, where you're you're expending a lot of energy, but you're really not getting anywhere. Um and you you want to get off the hamster wheel oftentimes. Sometimes you can you can be desperate to get off the hamster wheel, uh, but you you can't. You you don't know how. Um so so those are kind of important distinctions. A lot of people say, but how do I know, you know, that this time I I don't need to be thinking about it right now. The truth of the matter is that when a person is feeling an intense sense of urgency and desperation, they're probably not doing their best thinking at that time anyway. So uh you kind of can't go wrong using non-engagement right now until you know I you know I'm I'm in a better place uh to deal with this, perhaps. Oftentimes what happens is uh a person never never comes back to it when the when the anxiety, the the urgency has subsided, it tells, yeah.

SPEAKER_01 8:05

Good good framework, also good little disclaimer that it could be worth a shot even if you're not seeing the degrees of urgency that you would need.

SPEAKER_00 8:16

Yes. If it's a subject matter that you where you find your you feel like you're overthinking about it, you're coming back to it again and again, you just feel kind of stuck, there doesn't necessarily have to be a high degree of urgency. Um but generally there would be some urgency, which is one of the things that's pushing the person back to revisit it again and again, again.

SPEAKER_01 8:40

Yeah, yeah. Um how do you differentiate between obsessing and maybe even intrusive thoughts? Like in your mind, how do you uh separate those three things?

SPEAKER_00 8:52

That's a really good question. So different people have different uh ways of thinking about this. Some people would consider all intrusive thoughts um the same thing as obsessing. You can look at an intrusive thought as um anything that that you you know you really don't want to be thinking about, yet you you are. It could be an image too, um, it could be um really could be anything, uh, an idea, um uh thoughts about this terrible thing's gonna happen, something that is ego dystonic, meaning it's not in line with your values, it doesn't feel like something that um you want to be doing uh or that is ultimately helpful. It's driven out of fear. You're doing it because you're afraid. While I think of an intrusive thought as more of like a one sentence or like I said, like an image or a word where an obsessing involves all of that. Um but uh I think of it as more kind of like oh no, this bad thing, you know, this is gonna what if this happens, I need to do something about this. That's the the kind of obsessing part. And then the when it comes to compulsive reasoning, the the compulsive part is the trying to figure out a reason what to do uh with the fear, what to do about it, how to resolve it, trying to get some kind of an answer. So, so within the the whole kind of process of compulsive reasoning, there there are obsessions in there, but the whole process itself, with the it's like a back and forth mental ping-pong kind of thing, really. Um, the whole process is uh undertaken to strive to to grasp for an answer, um, which is which is you can think of it as a behavior, it's a mental behavior. You're striving for something, you're trying to achieve something, and that's the compulsive part.

SPEAKER_01 11:45

Okay. Yeah, that's really helpful. So you might see pieces of all three at any given time, but the uh compulsive reasoning part is really like that next step of like, and what do I do about it? And how do I exact how do I solve for that? Okay, I loved um I the dead man's rule. I'm glad that you talked about that. In my mind, I was thinking it's also similar to like the toddler rule. Exactly. If we tell them not to do it, that's the first thing that's gonna happen. Really, and for for for the for our folks that we're talking about that are so action-oriented and really want to take an action, do something, it it makes a lot of sense that it would it would just feel more useful.

SPEAKER_00 12:32

And uh oftentimes more doable. Um like how do I just not do anything? Um it's helpful with with with that. We do know that the more important something is to a person to be able to suppress, to not think about, the harder it is to suppress that. So when it's something really, really important to you, you know, uh you some if it's driving you crazy, I don't want to think about this during my, I don't know, my daughter's birthday or whatever, um, it's gonna be even harder. You know, the more important it is to a person to be able to not think about something, the harder it is.

SPEAKER_01 13:09

I think it might be helpful here to give a few examples of like maybe the common clusters. I think um for m the ones that I see most often would be health related, needing to take a health action. Maybe we'd call it the same umbrella, but sleep related. So not being able to sleep, but for keeping ourselves then wound up and concerned about the sleep. And then I'm also thinking uh for parents or new parents, kind of safety related about keeping about the kids, and maybe post-COVID, we saw an uptick of this too, thinking about how to engage the baby, but also keeping them safe and keeping them healthy. And then I think the last one dating and predicting how to show up in a relationship, in a new relationship, or wanting to date and kind of checking how did the date go? Did I perform okay? What is are they gonna call me? Should I call them? Right of thinking.

SPEAKER_00 14:15

For all of those situations, and I would say particularly health and and dating, no matter how long you spend thinking about, you're not gonna know. You can you can think about it for hours, and well, it might be positive because of this, but no, it's probably negative because of this. Without the information, you're just not gonna know, but you you can and you are going to suffer more and get uh deeper into that pit of anxiety by trying to know. There's just in that type of situation, there's there's missing information. Same thing with um with the dating situation, you're just not gonna know at that time. Um, and so rather than trying to know, which is impossible, if you keep ruminating about it, um, you might need something else. And so one of the non-engagement responses uh it's just uh affirmation of uh uncertainty, you know, agreeing that you don't know. I I don't know right now, and I'm not gonna know right now. I'm not going to waste my time and energy continuing to think about it. Um, but it's actually even worse than wasting your time uh for for many people. It it actually makes you more anxious. So it's an acknowledgement of the reality that I am not gonna know what it's gonna be with certainty right now. That's just the fact of the matter. And so the person's response, you know, and let's say the thought is, what if this sickness really is something to worry about? And I think I do need to go to the doctor. Well, right now, like in this moment, um, I'm not gonna know for sure. That might be a situation where the person does have to make a decision, right? And um, but in a case like that where a decision is needed, the person can give themselves like a period of time. I can think about this for 10 minutes, recognizing that outside of that 10 minutes or even like that five minutes, probably not longer than that, there's not any more information that's gonna come up. There's nothing new that's gonna happen. But another situation, let's say where you're waiting for test results, you are not gonna know. You have the thoughts like, well, what if it's what if it's this? I'm not gonna know right now. I don't know right now, and I'm not gonna know for sure right now. And then, of course, you know, that usually the anxiety is not just gonna stop there, right? You know, kind of press on and be like, well, it would be terrible if it's, you know, you should think about like that family history or whatever. And then it's just like, I'm not gonna know for sure right now. You're just reaffirming that, and that's all it gets, that's all the anxiety gets. It doesn't get um justification or um defense uh or like kind of putting bringing more information into it that for the anxiety to then just use and kind of throw back at the person. And that's that's just one of the non-engagement responses. Um, but in general, that's how they're used. Um you the kind of expect actually that the anxiety is gonna try to, it's gonna persist, it's gonna try to keep pulling you in. Um, but just like uh like in a court of law where one of the attorneys says asked and answered, and then the opposing attorney tries again and asked and answered. Like that's all it gets.

SPEAKER_01 17:54

I love that too.

SPEAKER_00 17:55

Yeah.

SPEAKER_01 17:56

Yeah. Uh there's sort of like a broken record element to that asked and answered where it becomes very predictable. And once you strengthen that muscle, it's very predictable that any angle that that anxiety tries, you're being kind of apparent in the checkout line. Can I have the candy bar? No, it's gonna be dinner, and then we give that broken record kind of response that asked and answered, asked and answered, because anytime we deviate, we can kind of prolong and extend that dialogue. Yes, um, reaction or any new response.

SPEAKER_00 18:39

Right, right. You're not the toddler in the in the grocery store line. What happens first is the the kid escalates, right? So that's called an extinction burst, right? The the kid is is testing, right? Testing the parent says no, you yell louder, you know, beg more, you know, throw yourself on the floor, whatever. And then if the parent gives in at that point, well, the the kid has learned, okay, like I need to I need to scream louder, and then I'll get what I want. So oftentimes the anxiety increases, the thoughts become even more catastrophic. You can think of it kind of as it's almost like the anxiety is saying, you know, you you have to think about this now, but what about this? You basically hold your ground and you do not give it um anything other than a non-engagement type of response, uh, just like the toddler eventually will see, you know, okay, this is not not working right now. It's the same thing with the anxiety. Um, but to to speak to um that bully metaphor, oftentimes this is this is used with OCD. It does kind of operate like a bully. It's trying to intimidate you, and um, you know, your engagement with it um is really the thing that um feeds it, right? Now when I talk about a bully, I I don't mean it in a in a kind of a scary type of way where you're giving your anxiety this this like extra power as it like this it's this big, you know, scary thing. It feels that way. It definitely feels that way, and and that's how bullies, you know, feel too very intimidating. But oftentimes with bullies, uh when the bully is not getting engagement, right? Like they're not getting a reaction or you know, the attention that they wanted or whatever it is, they back off. Um and so knowing how to deal strategically with a bully, you know, not fighting with the bully, or as in that video that you're gonna link, you know, not defending yourself, not arguing back, um, but instead uh putting out there these assertive answers um that allow you to respond. So you're not um you're not in the position of kind of like a victim or or being trod upon, right? But you are but these are the types of answers that ideally leave the bully with not much to say. Um so so in that way, anxiety is is like a bully. It's kind of uh on the outside, big and bad, it feels very scary, but but what we see is if we approach it, right, rather than running from it, scrambling compulsive reasoning, rumination. You're you're running from the anxiety, you're trying to resolve it. That makes it worse. It's like being uh like being chased by a dog, right? If you run from a dog, it is definitely gonna chase you. It's the best way to get a dog to chase you, is to run from it. Uh and it's the same, it's the same, same with this. So, a metaphor that I like to use is the Wizard of Oz. Um, most people have seen that movie, and uh the part where they're in the in the room with the the big green head that is Oz, you know, he's he's very scary looking and they're shaking, and uh and he sends them away on a basically what he thinks is an impossible task. He sends them away. He does not want them to come closer. Uh and when they come back and and Toto actually runs behind the little curtain. What's revealed is that it's just a little old man behind the curtain. And they never would have seen that had they kept running from it. You have to basically facing it, approaching it, um, is the thing that shows you oftentimes what felt so scary and powerful, it crumbles when it is not fed with our uh grasping and scrambling and striving, which is intuitive, right? That's that's the problem. It's the intuitive thing to do is to try to find a way to feel better, right? So anxiety has uh an upper the upper hand in that in that the intuitive thing to do is generally the thing that feeds anxiety. Um but when it doesn't have that, uh what's revealed oftentimes is it is a little old man behind the the the curtain. Um it's it loses its power.

SPEAKER_01 23:38

Yeah. It it feels like the extra layer of like, I don't know if it's irony here, is that there have probably been rewards for continuing to comb over these issues and and folks feel like this is my superpower, that I can get to the bottom of these things, that I can see all the angles. I'm actually really skilled at that. I've I've gotten reinforcement for it in the past. And so it feels almost like letting down a part of their identity or their safety to get to the behind the curtain would feel like really a letting go of this is who I am and this is a great strength of mine.

SPEAKER_00 24:24

Right, right. Well, I and I think it's it's important to kind of clarify if a person, you know, is enjoying or you know, or or or engaging in the thinking because they want to. It it's what feels right and warranted to them, versus feeling like they're kind of trapped, right? Like trapped on a hamster wheel. That's it's a different, it's different, a different situation. You know, that there's nothing wrong with you know deep thinking as long as it's the person is the one driving that process, as opposed to the anxiety being the thing that is driving that process. Um but it is hard to let go of because it feels it can feel safer.

unknown 25:14

Yeah.

SPEAKER_00 25:14

And if you think it through a million times over, it's safer. Um, it's really not true. There's only a finite amount of you know conclusion that you can uh even even get to. Um uh so it it it it's a safety behavior, right? It feels like you're keeping yourself safe. Yeah when in reality the behavior is feeding the anxiety. It's that scrambling, it's that desperation that's feeding the anxiety.

SPEAKER_01 25:48

Yeah, I think that's a great differentiation. I think because for a lot of people it feels important, you know, and I don't know if they would say it feels good, but it's also leading to other problems that comfortable or familiar, maybe, but they re they get to a point where they realize like, wow, this is keeping me up, it's making me sick, it's leading to panic. Um and and I'm no better, you know, better for it. I don't I still don't have the answers or I still don't have that certainty.

SPEAKER_00 26:19

Exactly. A person can end up feeling like they're doing the responsible thing, right? So that's that's the reinforcement um when a person can feel like they're being irresponsible if they're not um you know agonizing over it. Yeah. Um but I would say that is a I would say that's a lie kind of put out there by the anxiety bully to you know to keep you hooked. Uh you're bad if you, you know, you know, you you know, what if uh you had just thought this through more than XYZ wouldn't have happened to, you know, it's a guilt, uh, hyper responsibility, all of these things are oftentimes involved, and recognizing those things as hallmarks of the anxiety bully uh is is important. It can be very helpful to uh rec I call it recognizing no surprise. And certain things, you have certain thoughts, and this is super common in OCD, um, but I think this happens to everyone with uh any kind of um significant anxiety. Certain thoughts are are very predictable, right? So for one person it might be that that feeling of responsibility, you know. Well, I have all these people counting on me. Um, you know, it it is appropriate to uh you know agonize over this for hours and and hours and hours. Um it's I would say uh that's kind of like the the the hook, and and it's no surprise, right? Like if for one particular person it's always what it would be irresponsible not to. Or for another person, um, it might be something like, well, you know, if you just think it through a little, like maybe you'll get to the answer. These are kind of patterns, and so if you can recognize them, right? So when that voice in your head says, you're being irresponsible if you don't, oh, no surprise, no surprise you'd go there, anxiety. Like basically that was as predictable as the sun rising. No surprise there. Um, you know, could have seen that coming a mile away. And that can be very helpful because um, with certain thoughts, right, uh, you know, oh, something terrible could happen, you're being irresponsible, you're letting people down. You know, we we we have I call the oh no reaction sometimes, like, and then we default, right, and do something about it, right? So recognizing no surprise, like, wait a minute, like this is not new. This is like I could have seen this coming a mile away. It it interrupts that um that that default into like do something. I need to do something. Yeah.

SPEAKER_01 29:13

Having this response be so familiar that it's hard, it's hard to let go of it because it feels like this is my intuition telling me this bad thing is going to happen if I don't, versus like, oh, it's really just a real well-rehearsed mechanism.

SPEAKER_00 29:28

Absolutely, absolutely. And so in that type of situation, you know, identifying patterns, right? Like familiar patterns, you know, if it's say worry about a family member's safety or something like that, right? Uh, if that's a common, you know, thing that comes up, it's easier to recognize. But uh it's also the type of situation with with that particular example that thinking it through, reasoning about it, um is not going to really uh do anything. Now, I'm I can already think of the the but um you know response to that. Well, but you know, if I if I did call my child's friend and you know found out, then maybe this would keep them safe. Um so it when it's not OCD uh or or you know um I would say like clinical uh clinical GAD or uh when it's really I think more just worrying, you have to think about um, you know, what uh what is the cost of what you're doing? Are you in the driver's seat? Um and and I mean and that can actually you can end up compulsively reasoning about that too. But then I go back to that urgency and desperation kind of rule of thumb. Um, you know, and and knowing, you know, what kind of as I was saying, like what kind of things get you, you know, that that can be that can be helpful.

SPEAKER_01 31:03

Yeah.

SPEAKER_00 31:04

Yeah.

SPEAKER_01 31:05

Could you give me the next NERS and an example?

SPEAKER_00 31:11

Yeah, yeah. So uh the first non-engagement response I usually teach people is the gentlest one. Um, I call it the gentlest one. It's hard, right? It's like it's hard to say, uh, I don't know if that's gonna happen. It's very difficult. Um uh and actually just uh before I move on from that, I I want to say too that the the tone and the attitude matters so much, right? So you're not saying, I don't, I don't know, I'm not gonna know. It's more of a it's more of like a I don't know, and I'm not gonna know. That so that's very that's very important. The tone, the you you don't want to be um kind of responding like you're like you're a victim. Uh it's the exact opposite is is the purpose. So, so back to uh affirmation of anxiety. I call it affirmation of anxiety, which is that you're you're just agreeing and acknowledging, yes, I feel anxious. Yes, that's a really anxiety-provoking idea. So instead of um, you know, if the thought is something like, uh, well, you know, what if um, you know, I don't know, what if uh I lose my job, right? Um, that's a very anxiety-provoking idea. It certainly is. You know, and then it's going to continue. Well, like maybe you should think about, maybe you should finish this project early, or you know, if you don't, like your boss could be upset with you. That's an anxiety-provoking idea, too. Um you know, well, you know, that would be terrible if you lost your job, because you know, you definitely an anxiety-provoking idea. So what you're doing is you're you're just acknowledging the anxiety that's already there, it's already there, instead of being in the position of trying to get rid of it, trying to get rid of it, trying to get rid of it. You're agreeing. And that in that way, you're you're it gives you it's something to still to strategically agree to. And that's very important with the non-engagement responses. There's an element of strategic agreement, right? So, yes, that's a really anxiety-provoking thought. It most definitely is. Or, yeah, um, I am not gonna know right now, or some of the other non-engagement responses. Yeah, maybe anything's possible, right? There's this strategic agreement that is um central to non-engagement responses, um, that uh is particularly um difficult, I guess you could say, for the anxiety bully to then come back at you with, because you're essentially agreeing in some way, right? Like, yeah, that would be really bad, you know. Um, and the bully video that you mentioned is a great um example of of the power of strategic agreeing. Not like a victim, though, not in that way at all. It's strategic, it's masterful. Uh any kind of element of agreement we can get in there. So I would, you know, tell somebody not not just a that's an anxiety-provoking idea, even better if there's, yeah, that really is like you're agreeing with it. Um, and and kind of by doing that, you're uh you're you're beating the anxiety at its own game, which is exactly what we want to do.

SPEAKER_01 34:37

Yeah. Um, I have told this story for like decades now, but in an adolescent group, there was a a kid that all the other kids really grew to love. And it was exactly for that. A different kid said, Cool shirt, do they sell men's clothes where you bought that? Instead of saying, It doesn't even look like a women's shirt. What are you talking about? And the kid responded, That's the greatest compliment I've ever received. And the whole group was howling, including the one who had lodged the critique. And every day it was something like that where he made the funnier joke out of it. And I definitely hear elements of that. Exactly.

SPEAKER_00 35:20

He found a way to kind of to go with it, right, rather than against it. Um and uh and and that that's that's such an important um thing with if with anxiety treatment and anxiety work. Um there's there's something called a Chinese finger puzzle. I don't know if you've ever heard of that. It's like a little straw, yeah, right, where you put your fingers in, and the more you try to pull them out, the tighter it gets. Really, the the way you get your fingers by pushing them together, right? So you're you're not going against it, you're not fighting it. It's doing the opposite, kind of going with it strategically. That is the thing that is setting you free. Um you mentioned humor. Yeah.

SPEAKER_01 36:05

Yeah. If anxiety is trying to warn you, then to acknowledge, like, yeah, great warning. Thanks. Yep, I can see how that would be an anxiety-provoking thought. Yeah. Sure. About humor.

SPEAKER_00 36:17

Sure. Sure, exactly. Yes, but so you know, that's a getting humor in there is a a really good way to stay in that kind of masterful strategic place, right? So one of the other non-engagement responses is affirmation of difficulty, which you know, when when people first hear this, you know, without the explanation, it can seem like, what? That is so cruel. You know, how could you say that to someone? How could you so really what it is is agreeing, like, yeah, that would really suck. Um but the reason that it's uh it's effective as opposed to super depressing and scary is because you're saying it in a way, right? Like, so well, you you could have cancer, uh, or what if you have cancer? Well, like, duh, that would suck. Like, so matter of fact, you're treating the question like it's a dumb question, right? Um, it like over the the answer is is obvious, right? Like, so what if uh, you know, what if I get fired, right? Uh that would suck. Like, what do you mean, what if you get fired? Like, that'll be terrible, like dumb question. You know, so like a little sarcastic. Uh, and it's thought it, it's that's really what the question is asking. Anxiety doesn't want it answered that way. And was, well, this would happen, and this would happen, and what if this happens? But what if I like well that would be really hard. Like that would be like dumb question. That's how how you can use it. Um, not everybody likes that non-engagement response. Some some people love it. Uh, you know, depend it you use what is what uh what's effective for you, but um, but that is a uh one where it's particularly important to use some um some humor in order to have it work for you and make it uh masterful where you know you're taking the reins by putting that out there. You're not giving you're not giving it your your energy, your time, your um, you know, the importance. You're not validating the the worry or the the what if uh with attention, right? So, you know, if we spend two hours worrying about, I don't know, um, you know, what if what if my car breaks down or you know, the you just validated that that worry. Like you're it's now gonna feel more possible and really like for your car to break down, right? Or let's say, let's say you're coming back from vacation and the worry is what if someone broke in, right? And you spend so much time thinking about did I lock every door? Did I put the alarm on? Which neighbors are home? Who is like the more time you spend, the more real of a possibility, or or I should say more probable it feels. It just feels like more of a threat because you're treating it like one, right? So uh, you know, you can think of it as you could even um induce uh a fear that way, like by by treating it. If uh somebody was made to um, you know, uh before they back out of a parking space, um, get out of their car, look, you know, um take a mirror and just this ridiculous stuff for five minutes before you back out. Backing out of your parking spot is going to feel more dangerous if if you're doing behaviors like that. The compulsive reasoning feeds anxiety, it validates the fear.

SPEAKER_01 40:06

That example hits close to home. I have a car that beeps when I back up. If anybody's within a 50 mile radius, it feels like. It's so interesting how the more layers you add on, the more protections, not only the more do you continue to want to add on, um, but also the more anxiety it adds because it's give it sending the message.

SPEAKER_00 40:30

It sends the message that it is a threat, it validates the threat. Um, and of you know, uh another another example, this happened with a client of mine. She was waiting to hear back from graduate schools, and she was checking her email so many times throughout the day, just so many times. And to the point that I mean, she it was all she could think about. And it was very difficult. We we put a limit, I think we started with three times an hour. We started with that, and then work like lower, and her anxiety improved about like, is she gonna get in to this pro? But she really had no chance, right, to not feel terribly anxious about it all day with constantly checking it like that. And so, you know, that's that's a physical behavior, but same thing with the mental behavior, right? Um, you can be you can be mentally checking, am I um I don't know, am I being careful enough? Uh, you know, was what I said um appropriate? Whatever it is, yeah uh if we if we treat it like a threat, it's going to feel more like a threat. Strategic agreement is where you're you're getting in, if you can, some kind of agreement with the threatening thought, right? So the threatening thought is um, you know, well, maybe XYZ means this is gonna happen. Yeah, yeah, maybe it does. Anything's possible. Could be. Um and I guess I'll just say this last thing, too, with non-engagement, particularly um affirmation of possibility and affirmation of uncertainty, um, which I don't know. And it's also um maybe, maybe not. It's important to just know that what you're doing there, you're not you're not trying to convince yourself that the bad thing's gonna happen. You're just acknowledging the the reality that for the most part, almost anything's possible. Your car could be on fire outside your house right now. Like it's not impossible. Um, you're not worried about it. People can acknowledge this uh with whatever it is that they're not worried about, right? Uh driving, I mean, that's a good example. Probably the most dangerous thing we do. Nobody would deny it's possible, you know, something terrible could happen. We all know it's possible. We don't worry about it for the most part because we, you know, drive safely and do the reasonable things. But I don't think, you know, someone would say, no, it's impossible. I'm 100% guaranteed safe. Um that's just not the case. So sure, sure it's possible, but it's kind of more of like, I don't need to go there though, right? Like we don't need to. So that's what maybe, maybe not is it's instead of pushing back, like, is it gonna happen? What if it means it's yeah, maybe it will. Like, you never know. Sure, it could be anything's possible in this world. That's that's kind of how you're using it. Yeah.

SPEAKER_01 43:39

I can understand how that stops the hamster wheel because um when you try and say, well, no, that's not gonna happen, your brain can produce another example or at least keeps you in that cycle of thinking. But just acknowledging, like, well, sure, of course, anything you can think of basically is possible.

SPEAKER_00 44:02

Right, right. It's just it's just affirming the reality that you know we accept all day long without thinking about it. You know, it's possible you could get food poisoning the next time you eat at a restaurant. I mean, who thinks about that? If you're if you are wanting to stay off the hamster wheel, uh, you know, then you use these strategies. I should say though, you know, there are for so many people, it's that's not even necessarily about wanting to stay off the hamster wheel. Sometimes that is exactly what it is. A person feels desperate, especially in OCD, to get off the hamster wheel. Just like they do anything to get off the hamster wheel, but can't, as you had mentioned before, there there's ambivalence, you know, I should maybe doing this. Like there's not confidence that it's excessive necessarily, right? So um, so again, like back to these kind of rules of thumb using urgency, time spent, even things like um, you know, is there even external information? Like, is there is there information that you know could come just from your mind, right? Like that you could, is that is that even the case, right? Um, you know, are you going to have you think, you know, are you are you going to, so am I going to get fired? Uh let's say that's a a common worry, or let's say someone has gotten fired from multiple jobs. So so I I have a I have a client who had a kind of bad history with that and would always worry about that. Um but that's a you know, it's a it's understandable, um, but um but frequent that that's not serving the person. And um, you know, aside from, you know, of course, like doing, you know, your job and doing just am I could what about the look on her face? Did this mean she didn't like like that's not gonna, that's not gonna tell you if you're gonna get fired or not. You're not gonna be able to figure that out. Um so uh so it's really just kind of really keeping it basic. Am I gonna, am I gonna know for sure? Am I gonna know for 100%? And if it's oftentimes if it's anything less than 100% or almost in in an OCD's case and significant anxieties, it has to be 110%. Um it's it's just impossible. Um, and so you are not going to engage, you're not gonna play this game that you know you cannot possibly win. You're not gonna do it. It doesn't make sense.

SPEAKER_01 46:44

Yeah, I think that's a great way to think about it, even when we're guiding our clients. Is any of this making it more possible to know?

SPEAKER_00 46:56

And oftentimes it is the opposite of the you know, thinking making it more clear. So much of the time it makes it less clear, right? You know, the so the more you are thinking about it, the less clear it becomes, the more confused you're, you know, sometimes I'll say, you know, it's kind of like like if you're looking at a pen, you know, if you're looking at it like this closely, you can't even see it, right?

SPEAKER_01 47:25

Um so it's the only thing you can see, yet you can't really see it.

SPEAKER_00 47:30

It's it's ineffective, right? It's not it, but not only is it ineffective, it I mean it makes it it makes it more um uh unknowable or more confused. I think what just um maybe one thing to mention about uh coping responses or supportive uh statements as opposed to non-engagement responses. Um so a lot of um a lot of kind of what's out there on social media and um you know, just in hearing about uh people are calling certain things non-engagement responses, like um uh you know, I don't need to think about that right now. I'll be able to handle that if that happens. Now, not that those are bad things at all to say. Um those can be very good things to say. And if the person is able to say to themselves something like, you know, I'll handle it if it happens, and then they can move on, excellent. So good, but if you know, something like I'll handle it if it happens, then you get caught. But how do I know I'll handle it?

SPEAKER_01 48:31

How will I know it'll happen? What are the signs it's happening? How will I react when it does happen?

SPEAKER_00 48:38

Right. And what if I don't handle it? Yeah, or another one is you know, um, this a lot of people are calling a non-engagement response is I don't need to figure this out right now. And again, that's not a bad thing to say to yourself. Um, if reminding yourself of that allows you to move on, then awesome, use it. You know, use what works for you. But if what ends up happening is, you know, to I don't need to figure this out right now, but maybe I do, you know, maybe I do need to maybe it's irresponsible not to, then it's just keeping you on the wheel. So these coping responses, like like really any coping strategy, uh, I think, you know, can be very helpful as long as um, you know, well, at least with OCD, the really the measure is can you are you moving on? Or is it is it just keeping you in the butt with anything, um, yeah, if telling yourself and it's gentler in a lot of ways, I'll handle it, or um, you know, anything if that helps you move on, fantastic. Um, but I do differentiate uh with something like that and a non-engagement response in that the non-engagement response, it really has to involve um some element of strategic agreement, right? So even though you can be strategically agreeing, yeah, like who knows, anything's possible. Of course, the anxiety can still say something back, you're not giving it more, you're not defending, you're not justifying, um, you're not uh um reassuring, like you're not giving it anything to use. Um in a lot of ways, it's it's kind of like um dealing with a narcissist, right? Where um it's best not to defend yourself, it's not it's best not to justify your behavior, right? Uh agree to disagree, noted, right? You don't want to engage. Same type of thing.

SPEAKER_01 50:40

I think those are such good reminders that sort of um transfer across different areas our clients are dealing with that can be helpful not to jump in and really engage. There are real opportunities. You know, DBT has opposite action where our instinct is to get in and really sort through it, and that might be helpful in some areas and to be able to just notice sometimes, like, wow, I'm doing this response that I've been conditioned to do. And instead, I just want to acknowledge like, yeah, it could happen. Uh-huh. I could have this experience. Yeah, but if these thoughts, no wonder I'm feeling anxious because they're anxiety-provoking.

SPEAKER_00 51:26

Exactly, exactly. And you have to remember with non-engagement responses, you know, why you are strategically agreeing, right? That's very important. So, you know, if you're saying, yeah, well, anything's possible, it could happen, you know, you throw you're you're agreeing that it's possible uh strategically, right? You're agreeing because you're not going to fight to prove something that can't be proven, right? And keep yourself it's anything is possible. So you have to remember kind of um what position you're you're in, what position you're trying to stay in, and why, yeah, why you are using this strategy in order for it to be used to empower you rather than for it to feel depressing, right? Or or like you're uh resigned.

SPEAKER_01 52:19

I I love that as just sort of a closing note that knowing what you're using, you know, do I have a response that I use that's effective? Great. Is it a non-engagement response? Not necessarily, you know, so that you know when the when the time comes up what it what those exactly look like and why a coping response that has been effective isn't effective in this other scenario, because it really isn't. You are engaging, it is an engagement response in some ways.

SPEAKER_00 52:49

And if almost like by definition, there is that element of a of agreement. Um, and that is how you are strategically not engaging, kind of like you're you're not engaging by strategically agreeing in some form.

SPEAKER_01 53:05

I like to ask everyone this as we close down with your clients or with you specifically, is there anything that you integrate or recommend for self-care or burnout prevention?

SPEAKER_00 53:18

Uh so I'm very frequently stressing giving yourself credit for doing these very hard things. Um, you know, with with OCD and anxiety treatment, exposure and response prevention is um is very effective, but it's a it's hard. Um it requires a lot of bravery. And uh, you know, even you know, outside of that, you know, telling yourself, um, yeah, well, anything's like that's hard. It is hard. It takes bravery, it takes courage. So I think um giving yourself the credit that you deserve, uh, like that that was not easy. And and also recognizing sometimes people say, well, why should I give myself credit? Like, you know, anyone can easily uh, you know, just not engage with a scary thought for, you know, why do I deserve credit for that? It's because uh how hard it is, right? Like courage is is different from fearlessness. You have to be scared in order to have courage, right? Um it means that you're you're scared, but you're you're doing it anyway, right? Um, so it doesn't matter what it what what you're scared about, right? It doesn't matter if it's something that everyone can relate to. Like it's scary to run into a burning building to save someone, you you know, deserve a lot of credit, or it's scary um acknowledging that you're not gonna know and like keeping that up. So they're both scary, and and the more scary something is, you know, uh the more credit you deserve, right? So and with some for someone uh with OCD or or or even without, you know, if it's some a really big worry, like not going there can be legitimately extremely scary. Um so though giving yourself credit, I think, is is so important because it's deserved and also because it will help you next time um do it again. It's a bit you're associating, you know, um something good uh associated with it as well.

SPEAKER_01 55:33

Such a great point. Uh well, Lisa, thank you so much for uh being here today and talking through this. I think this is gonna be so helpful for folks to know more about. Thank you for listening to the Self-Cherapist Therapist. I hope today's conversation gave you insight, clarity, or a tool you can take straight into your clinical work. If you found this episode helpful, be sure to subscribe to the show on YouTube and leave a review on Apple Podcasts or Spotify. It helps other therapists find the show and keeps these conversations going. Until next time, keep learning, stay curious, and take care of yourself too.