Hardcore Self Help- Fuck Anxiety

by Robert Duff

  Ch. 9 Get Your Head Shrunk

  I’m not sure why you picked up this book. I am so thankful that you did and I owe you a mega sized hug for it, but I don’t know your particular reasons. However, I do bet that there are quite a few of you out there who bought this book because you wanted to see what you could figure out on your own without the help of the therapist. Well, good on you. You’re a badass and I hope that this totally works out for you. I want to at least mention psychotherapy, though. After all, it is my full-time real person job. People have a lot of different expectations and impressions of therapy, so I want to just talk a bit about what it looks like and how it can help you.

  First of all. Therapy is not a club. You don’t have to be an A-lister with co-existing OCD and PTSD to get in. Therapy is for everyone. There are also different types of therapy. The most common model in the United States is talk therapy. Depending on who you see, this could be as frequent as once per week or as infrequent as a monthly check-in.

  Therapists vary quite a bit in their approaches as well. A more behaviorally oriented therapist will look into the circumstances surrounding your anxiety. What situation provokes the symptoms and where did you first learn to respond that way? They will then work to help you “unlearn” those responses. A cognitively oriented therapist will really dig deep into your thought patterns (we did a little of this earlier). You will be collaborative scientists together and test your thoughts to get to the bottom of whether it makes any sense for you to feel this way. Psychodynamic or insight oriented therapists will take things a bit further and look deep for the origins of your anxiety. They will view anxiety as a symptom of some deeper underlying issues and work to help you achieve insight into how those issues are playing out in your life.

  That is a small sampling of the different types of therapeutic approaches that are utilized currently in the field. There are many more. The other thing to consider is that not all therapists are created equal. I mean it when I say that there are some shrinks that really just suck at their job. It’s okay, we are people too. Some people are not good at their job. Maybe they are burnt out from years of clinical work and they know it, or maybe they think they are the best ever and can’t see that they are just too awkward to ever help you open up. Don’t feel bad if you have a bad experience with therapy. You are allowed to shop around. Don’t forget that you are a consumer. No one wants you to be wasting time and money on something that isn’t going to work for you.

  Don’t let a single awkward or negative experience prevent you from trying other therapy in the future. The first time I tried Thai food, I thought I hated it. I thought that it was just something that other people could like but it wasn’t for me. I realized later on, after shopping around a bit and sampling some other restaurants, that it was just a bad chef that gave me that impression. Thai food kicks ass. So hungry right now.

  The length of treatment can vary quite a bit. Some issues can be resolved in just a few weeks and others might take a lifetime to unearth. In my opinion, a good shrink will start with the immediate stuff, help you find some solid ground to put under your feet, and then when you are a bit more stable, they will work to dig a little deeper to find out where all of this shit really came from. You might also engage in different forms of treatment like group therapy. Groups can be a lot of fun. Typically, they involve some educational component where someone much more eloquent but probably less funny than me will explain the topic of the day, such as “managing worries” or “how to know when you are panicking,” and then the group will discuss together about the topic. Groups are made up of people. Some people are awesome and some people suck. The quality of the group depends on the quality of the people. Again, don’t be afraid to shop around.

  How do you shop around for therapists? Well it depends on your particular situation. If you are a college student at a university, chances are you’re already hooked up with free access to psychotherapy with students in the training program at your school. Don’t worry, they won’t make things awkward if you see them elsewhere on campus. There are a lot of really strict rules in place about confidentiality. If they were to not respect your privacy, they’d basically be screwed anyway. I worked as a therapist during my doctoral training and some of my regular clients were able to make serious changes in their life. It feels pretty damn great. Often times at these “training clinics” you don’t have to be a student to get services, but you would just end up paying for sessions at a much lower rate than you are likely to find out in the community. If you don’t have insurance, start there.

  Do you have mental health coverage? If so, groovy. These days, you can often go to the insurance provider’s website and use their own search engine to find covered providers near you. If they don’t have one, you can just use something like Psychology Today’s “Find a Therapist” tool and look for therapists that accept your insurance. The neat thing about searching for a therapist online is that you can filter by specialty or type of therapy. You can also check to see if they have their own website, which for someone like me speaks to the character of the therapist.

  Don’t have insurance? It sucks, I know… been there. There are still options. Look up therapists that have what’s called a “sliding scale.” This means that the therapist will charge a rate consistent with the client’s income. If have no income, you could be looking at mega cheap, or in some cases, free sessions. You typically have to provide some sort of proof of income (or lack thereof) so that they know you aren’t just trying to work the system. Don’t let the discounted price scare you. It doesn’t mean that you are going to get budget quality therapy… it just means that some people are awesome and legitimately want to help you. Finally, if you are strapped for cash and without insurance you could also look into community resources. Many counties have non-profit organizations that offer free services to those who are really in need. I should reiterate that my experience is in the United States. I’m not entirely sure how similar therapy and mental health services are in other countries.

  I’m going to cut the funny shit for a second here. If you are in need of help that is probably above and beyond what you can do on your own right now, please seek professional help. Family and friends are great, but there will always be a limit to what they can help you out with. From me to you, there is absolutely nothing to be ashamed about. We all fall down sometimes and we are all allowed to have periods of recovery. The help is out there and if you aren’t able to find the strength to do this for yourself, that’s okay too. Let someone who loves you know and they will be able to help you out. It’s not worth it to keep suffering, friend. Let’s get you better.

  The last thing that I want to mention in this chapter is medication. Now this is something that I initially left out of the first edition of this book. I did that because I wanted to cover my own ass. My role is as a therapist, and while I have a doctorate in psychology, I am not a medical doctor and it is beyond my scope to advise you on which medications to take. Many of you wanted to hear more about medication, though, so I am going to give you some of my thoughts about it. At the time of writing this, I am currently working at a large healthcare organization as a therapist. At the end of every intake session with a new patient, I ask them how they would like to follow up. The main buffet of options includes psychotherapy, educational or support groups, and consultation with a psychiatrist to talk about medication.

  People fall on many different sides of the fence when it comes to medicine. There are a lot of misconceptions out there about medication. People think about movies that they have seen where it zombifies you and makes you unable to feel. There are certainly some medications that have a bit of a sedating effect, but in general this is not what happens. They also aren’t a miracle drug. Many medications take a few weeks to alter your brain chemistry and begin working their magic. Some medications are for emergencies only such as when you are actively panicking. As for which are right for you, that is definitely something that you should talk to a
psychiatrist about. Psychiatrists are medical doctors that specialize in psychiatric medication. Your primary care can certainly write you a prescription for some anti-anxiety medication, but these particular types of medications can be a bit tricky to dial in. If you have access to a psychiatrist, I would definitely suggest talking to one.

  My opinion about medication is that it doesn’t solve any problems for you. A pill will not make the issues that create anxiety for you disappear. That said, I think that medication can be invaluable in its ability to help you cope with the crushing pressure of anxiety that sometimes makes it so damn difficult to find solutions on your own. Basically, the long term medications (non-emergency) help to bring your baseline level of anxiety and reactivity down to a point that you can focus on learning good coping skills in therapy or through your own problem solving. On that note, I also want to say that I definitely suggest taking advantage of both therapy and psychopharmaceutical (drug) treatment if you decide to try out medication. With few exceptions, nobody wants you to be on medication for anxiety for the rest of your life. The point is to help raise you up while you build your own emotional scaffolding underneath. That way, if at some point, you feel like you have made progress and want to try this shit out on your own, that scaffolding that you built in the form of skills, knowledge, and perspective will hold you up when that medication support is taken out from underneath you.

  Ch. 10 Get Pumped. Do Work.

  This chapter doesn’t have a particular therapeutic basis or massive research backing it up. This is the freestyle section where I get to geek out and tell you how freaking amped I am for you to get out there and do this damn thing. No, seriously. I wish you could see how fast my fingers are typing right now. You are all coming from different backgrounds with different attitudes and different levels of readiness for change. When you picked up this book, you might already have been amped like me. Maybe you were curious but skeptical. Maybe you were doubtful, but thought you’d give at least one more shot at feeling better. In all of those situations, you still picked up the damn book. You’re ready for this.

  You are in a period of progress. Whether it’s a little tweaking that you want to do or a radical overhaul, allow this period of your life to be one that you work on yourself. There’s no timeline on healing, but there’s also no time like the present to start making some changes. The anxious brain is likely to take that statement and feel like that is a lot of pressure. You might think, “Do I HAVE to get better now?” or, “Should I be better by now?” No way! It’s all good. These things can take time, but you’re already closer to the version of you that you want to be. In fact, if the prospect of changing everything all at once is daunting or scary to you, then break it up into smaller pieces.

  Get out a sheet of paper and write down the things that stuck with you from this book. Write down the things that you don’t have to go back and re-read to remember. Even if you can’t remember the full details, write down a few general concepts. Now, think about the aspects of your anxiety that are causing you the most grief. Which pieces are really screwing with you? Boom. You just found a place to start.

  Is there one of those issues that seems to line up well with the concepts you learned in this book? You bet your ass there is! Set yourself up with a plan for success. What is one small thing that you can do to get started on your quest? Maybe it’s forcing yourself to take 3 short breaks during your week to reinvest your energy. Maybe you want to start keeping a little notebook with you to use as a thought log through your day. Maybe you even want to finally use that gym membership you’ve had for half a year and listen to that catchy ass new T-Swift song on the elliptical.

  The point I’m trying to make is this: you can start now and be super stoked about taking these first steps toward really creating some enduring change in your life. You may even find that you have now given yourself permission to change and you will begin to naturally improve on your own. I promise you that there will be days when you feel crazy motivated and resilient and others where you feel like you are losing the uphill battle. These are normal things. The graph of improvement over time is never a perfect line. There will be ups and downs, but you will be trending upward. My best advice to you is to try to be enthusiastic about the journey in a way that makes sense to you.

  I’ll tell you how I stay motivated. I named my anxiety. No seriously. His name is Fred and he’s a fucking pain in the ass. I hate him. He’s annoying, mean, pushy, rude, and he constantly smells like cabbage. Now, I’m not one for real interpersonal violence (unless it’s in the octagon), but when I wake up and I’m in one of my periods of progress, I say to myself, “You’re goin’ down, Fred.” I also love video games, so I make a game out of it. Exposure is like gaining experience, leveling up my character. Getting better at deep breathing is like improving my fireball skill. Learning a new coping skill is similar to stumbling upon some epic imbued weapon. You should see my character at this point… much more badass than my actual outward appearance.

  There are a zillion ways to get the work done. Maybe for you, you can conceptualize it as building yourself this swaggarific castle. Sometimes, you have to first build the foundation and some scaffolding; then you can hire more hands, upgrade your tools, and eventually build the crap out of that thing. From then on, it’s just occasional maintenance from stray catapult shots or dragon fire throughout the years.

  Find something that works for you. This is your deal. You can go it alone or bring some friends along for the ride. You can pack it all in at once or take it slow and gradual. Whatever the case may be, you are ready to get started now. I’m getting chills thinking about how fucking awesome you are. Get pumped, my friend. Do work.

  Thank You

  You did not have to purchase this book, but you did. For that I thank you. If you enjoyed what you read, please consider leaving an honest review on Amazon. This will help the book reach a broader audience. If you have particular feedback about the book that you would like to share, please email duffthepsych@gmail.com with the subject “feedback”.

  It was my absolute pleasure to write this book and I am more than a little excited to continue the series. I encourage you to continue to keep up with the series by joining the Email list at hardcoreselfhelp.com, following on twitter @duffthepsych, or liking the Duff the Psych Facebook page.

  Finally, if you want to connect with other people who are on the same journey of self-improvement, check out the private Hardcore Self Help subreddit at reddit.com/r/hardcoreselfhelp. Here you can share your triumphs, give advice, ask questions, and keep yourself accountable. I hope to see you there.

  -Robert

  Appendix

  Guided Muscle Relaxation - Approximately 10 minutes

  Before you begin this exercise, get into a comfortable position. You can sit or lie down. Bring your hands to rest by your sides or in your lap. In this guided relaxation, I will be asking you to tense various muscle groups in your body and then release the tension. If you have injuries or pain that would make any part of this uncomfortable, feel free to skip over them. If you would like a longer experience, simply tense each muscle group two times for a more complete relaxation.

  Take a moment to notice your breathing. Feel the rise and fall of your chest. You have a unique rhythm to your breath that belongs to you alone. Take some time to just be mindful and appreciative of this rhythm. Take in the awareness of how your body feels as it is supported by the furniture that you rest on. In your mind, scan your body from bottom to top and notice any areas of tension or pain.

  You are first going to relax your feet. Take a deep breath in and as you do, curl your toes downward to tense up the muscles in your feet. Hold that tension for a moment and then exhale, releasing both your breath and the tension in your feet. Allow your foot to fall limp and relaxed.

  Next, you will focus on the calf muscles in your lower legs. You can tense these muscles by pointing your toes downward. Do this now while breathing in a deep cleansing breath. Hold
the tension. Now release. Exhale and allow your calf muscles to relax completely.

  Move to the muscles in your upper legs now. You put much strain on this part of your body from walking around all day and when you exercise. You can tense these muscles by pushing your feet into the ground while sitting or by stretching your legs out straight while lying down. Take a nice deep breath and tense the muscles in your thighs. Hold it for just a moment and then release everything. Notice the flow of blood into your muscles, which are now more soft and relaxed. It might feel tingly and warm. Enjoy this feeling for a moment before moving on.

  Now you will tighten your glute muscles on your back side. These take much abuse from sitting for long periods. Take in a deep breath and clench these muscles tightly. You should feel your body rise a little. Keep that tension for as long as you are comfortable, then release it as you exhale away your stress and worry.

  Take in another slow breath and tense all of the muscles in your legs. Do this in any way that feels natural and comfortable for you. Hold it… now release all of these strong muscles and let the tensions melt away with your outbreath. Notice that you are feeling more and more deeply relaxed.

  Now, bring your awareness to your stomach. Draw in a long breath and tense your abdominal muscles in a way that feels comfortable for you. Keep that tension for a moment and then release it as you exhale.