– [Ryan] Welcome to Redeem the Commute Stress and Anxiety course. I’m Ryan, your host. I hope that you enjoy the course today and get a chance to think about or discuss the question at the end with honors. Just as a general reminder, the course includes general tips and you should absolutely see a medical health professional to understand your specific situation. Courses offered by Dr. Kate Witheridge and here she is now.

– [Dr. Kate] But we have to unlearn our thinking. So if you want to think of it kind of like if your toothbrush is on the right hand side of your sink, this applies for everything I’m about to talk about as well, and it’s sort of learned process, right? I walk up to my sink and my toothbrush is on the right hand side. I don’t really think about brushing my teeth, I just reach. And then one day I move to the left hand side. I came in, I was like I’m moving it to left hand side. For a while I’d walk up, same situation. I would have the same thought process but I’d have to learn a new thought process, a new behavior. And for a while I’d still reach to the right. Why? ‘Cause it’s learned but as I learn a new way of approaching it, a new way of thinking, a new way of behaving, I learn that new way to respond to situation. So I like to say this about thoughts as well is when I start talking about behaviors that we’re trying to unlearn things. Learn new adaptive ways so that we can actually turn those into habits. Clear is mind, all right.

– [Woman]

– [Dr. Kate] The more, this is what I always say to my students. The more you practice, the faster you’ll do it, right? So if you go to the gym once a week, you’re not gonna get as fit as if you go three times a week. So the more you practice it, the more you bring awareness to it. Even if it’s just oop, I can tell I’m in my bunny trail or my negative thinking. The more you catch yourself, the more you remind yourself of it, putting balanced thoughts in your phone or reminding yourself of this stuff, once again, helpful reasons why you write it down ’cause none of us will remember what we said three weeks ago. But if I have a piece of paper that’s like this is what I said last time I was worried about somebody not texting me back or when I had a presentation or when I had a job interview, I can remind myself of that. It makes sense to people. If you want more information on this stuff so this is a great book. I would say ignore the cheesy picture on the cover. It reminds me of a Zoloft commercial. But Mind Over Mood is a really great workbook that talks about challenging thoughts and challenging behaviors so it’s good for anxiety, depression, there’s some anger in there and some other, I think perfectionism as well. So it’s designed to be a workbook, you can find it at Chapters, you can find it on Amazon. There’s an older version too so if it happens to show up in used book stores it’s just green and white. But Greenberger and Padesky are the authors and it’s on the reference list that’s on the table so if you want more information feel free to look that up. You can also Google it ’cause there’s lots on thought records on the internet. One other thing I’m just gonna quickly talk about is that those what if thoughts. Like what do I do with them? So this is an overly simplified version of how to challenge what if thoughts. But I like these questions. So often what happens with worry is there’s sort of the current worry which is I need to make sure this presentation is done to send to Mike today, versus what if people don’t like me. And the idea is to say current worries are things I can problem solve. Like I need to make sure I get these Power Point slides done so Mike has them ready for my presentation. Unproductive worries are the what ifs, the I can’t do anything about this because it’s out of my control. What if I get fired from my job? I can’t do anything about that ’cause right now I think my boss likes me. So I feel these questions are just helpful to figure out do I need to problem solve or do I need to use maybe a thought record? So is it plausible or reasonable? Could it happen, right? Could I actually maybe be late to this presentation? Yeah, what am I gonna problem solve and do? I’m gonna make sure I leave work on time. Can I take action immediately? Can I do something, yes or no? If my rent’s due on Friday and I don’t have enough money, that’s probably something I need to problem solve, ’cause I can figure out how to get enough money. Can I carry any options to lead to a solution? Where is my worry set? So is it current or kind of distant future? Have I gotten ahead of myself? So commonly what happens is I’ve already predicted something bad’s gonna happen and I’m preparing for that. And it’s like, but it’s like 4:15 at work and I’m already predicting what am I gonna do if I’m late to this presentation? But it’s not something I can actually do anything about and I’m not actually in that situation yet. And like I said, does it exist now? Can I describe it in concrete terms? So like I need to speak at seven o’clock. I need to be to church by 6:15 and it’s currently 4:15. All right, let me problem solve. How late can I stay at work and still get to this presentation on time. Would others see this in the same way? So I don’t know if there are any worriers in the room but I treat a lot of people with worry and often their partners, their friends are like why are you thinking about that? What is going on? Why are you like 27 steps ahead and two years from now? And someone else would say here’s how you problem solve. Or why are you worrying about where you’re gonna be two years from now, if you’re gonna get a job and you’re graduating when it’s the third week of your masters degree? So I just really like these questions and it’s kind of helpful like I often say, is it productive or unproductive worry? Is it current or future-oriented? And like I said, if it’s sort of future-oriented, thought records are great for that of the what can I do, where am I now? The other side is problem solving which I’ll talk a little bit about in a second in terms of shifting behavior. So like I said we want to look at what else can we do, right? So the behavioral portion of anxiety and worry. So what are the behaviors we actually want to target? So we want to think about how do we reduce avoidance and procrastination. I don’t want to approach it, it might be bad or I’m gonna fail. A lot of people with anxiety over plan. Like I need a routine. If I know what’s gonna happen, good. If something happens that I was not prepared for, bad. But the problem is when you over plan then something doesn’t’ happen, sometimes we feel more anxious ’cause it’s like I had a plan, I had a conversation. I knew what I was gonna say and then they were gonna say this and now they asked me a question I wasn’t prepared for. Maybe we leave situations. I feel overwhelmed, I’m getting out of here. Sleeping is sort of like the almighty avoidance. Like bed is comfortable. I don’t have to deal with life. I wake up from my nap and life is still there, I go back to bed, right? I used to joke in grad school that whenever I’ll be wide awake and then I had to study for conference of exams and suddenly I got really tired. Like oh, I want to take a nap. I’m pretty sure if I was doing something fun I’d have lots of energy, but all of a sudden anxiety pops up and it’s like nap time is good. All people relate to that, like oh, I if I were hanging out with my friends, good. Studying ethics, ah, nap time. Checking or seeking reassurance, right? That uncertainty piece. Maybe I need to check my door lock. Maybe I need to check with other people. Maybe I need to make sure I didn’t say something, right? And there’s something called safety behaviors which is the idea of like we have subtle avoidance techniques so things like avoiding eye contact. A lot of my students, they tend to do things like play with their phones, fidget with things. Email instead of call people. And the problem with this is not necessarily that they’re bad, we all do this, right? I email and text people all the time but it’s sort of when I become reliant on it and then I have to do something. All right, what happens if I’m walking down the street and make eye contact. I’m not used to it, it can trigger more anxiety. So we want to think about how do we change some of these ’cause while they might be helpful in the short term, like avoidance means I don’t have to deal with it. It might actually make me feel more anxious or stressed in the long term. So this is going to be like a 27 second version of what we do entire group therapy. But how do we actually approach the things we fear? So as I said about anxiety, it’s all about predicting bad things happening. Fear, we run away from bears. But the problem is we have to think about if I need to approach something, how do I do that? So we also have to think about it systematically. So the silly example I give of this is that if you’ve ever seen on t.v. someone says they’re afraid of a snake. And then while they’re talking some unhelpful t.v. host brings out the 15 foot python from behind the screen. They’re like, here you go, right? Not so helpful, right? All of a sudden, now that thing that I’m afraid of actually turns into a traumatic experience. So instead we want to think about how do I approach something in a systematic way if I do need to do something? So whether that’s something like social situations or leaving the house or approaching worry. Sometimes people don’t wanna look at the news, they don’t wanna look at things out of fear. I don’t wanna know what’s going on with car accidents but then I have difficulties if I hear on the radio, oh yeah, avoid this area ’cause there’s a crash on the 401. So we want to think about when we’re doing this we call it exposures, which is basically I need to approach a situation and then forgot how to do it. We want to do it in small steps. So most people know that I’m a runner. If not, I’m a runner And I always say to people if we all looked and said, all right, so the Toronto Waterfront Marathon is in two Sundays from now. And for those people who don’t know how long a marathon is it’s 42.2 kilometers if you run in straight line. So if I said okay look, this is what we’re gonna do as a group. We’re all just gonna get up next Sunday morning and we’re gonna run a marathon. What do you think would happen?

– [Woman] Nothing.

– [Dr. Kate] What, nothing. Yeah. No one would be there to join me, right? It probably wouldn’t go so well, right? It would probably be a painful experience, right? We wouldn’t meet our goal, we’d fail. Like, okay I was in a marathon and some of us might make it further than others. But we probably wouldn’t all make it. And if we did, we’d probably hate it so much we’d never wanna do it again. So we think about approaching situations. Once again, we want to do it in small steps. So if I have a fear of talking to strangers, thankfully I don’t, but I probably did at one point in my life. So my ultimate goal is I need to go to a wedding. I’m going to some event where I have to talk to people I don’t know well. How do I work up to that if I have difficulty talking to people? So we want to think about could I break it down? So usually we put numbers on this ’cause like I said we like numbers, we do ratings. But we might think about how do I take that thing that I’m afraid of and break it down into smaller things that I can practice that don’t seem so overwhelming. So the ultimate goal is I need to be able to talk to maybe five people I don’t know at this event. I’m gonna be at a wedding, I’m sitting at a table. That’s what I want to prepare for. Then I might say okay, well the next most difficult thing that I want to work on is introducing myself to three people I don’t know at a smaller social event. So maybe my friend’s having a party or there’s a work gathering. I’m like all right, that seems pretty manageable. And what else can I try? Well, I can talk to the cashier at No Frills for two minutes while they’re ringing up my groceries. It helps me practice introducing myself, talking, but low risk and once my groceries are done, I don’t have to talk to them anymore. And then I might say well I could also practice things, saying hi to the barista at Starbucks and ask how their day is going. So I’m working like all right, what can I do in a small chunk? Say hi, make eye contact, how are you doing. And then kind of a low end of that, I might say well, what do you think would be the easiest thing to start with? I could talk to my co-worker in the lunch room for five minutes. I know them, it’s not too stressful. We can talk about work and if I tell myself I only have to do five minutes while my food’s heating up, not so bad. So we all start with the bottom thing and then work up towards if I practice that enough and do the next thing and do the next thing and the next thing then I’ll be prepared. So like I said, this is a very simplistic version and if we were to do this, we would figure out all kinds of fun stuff and probably more than five things we have to do depending on how avoidant I am. But I think it’s a great way to think about what do I want to work on and what little elements can I think about. So like I said, I at this point don’t have to bad of a fear of public speaking ’cause I talk a lot but thinking about what has helped me to work on that is things like I worked in customer service and I had to talk people and make small talk and make eye contact. And I had to answer the phone and I did presentations for grad school. And now I colleague coping skills workshops twice a week and I keep volunteering for presentations that always make me anxious but I keep doing them. But the idea is the more I do it, the easier it is. My first ever presentation, I was eight and really anxious. But over time I’ve gotten used to it and now I’m standing here and making silly jokes. So this is kind of our ultimate goal. Break it down into small chunks. So what I would say is thinking about if I have this wedding tomorrow, how do I break down this bigger event into smaller chunks? Like in the first half hour, can I try to introduce myself to three people? Just say hi or ask them their name. You can think about what it is. And then you might say all right, in the next hour let me see if I can have a conversation with three people for two minute maybe about how they know the bride or groom. So if it’s something where it’s gonna be a long event and you have pressure, sometimes I think about break it down into small manageable tasks that help you do little bits of it over a long period of time rather than I get to do little things over a long period of time to spread it out. The other thing I like to talk about, and this was part of this, how do we break things down into manageable chunks? So I think a lot of avoidance is that things seems daunting. Whatever that goal is, whether that’s sort of I need to talk to people at a wedding or I hate washing dishes so that’s why this picture’s up there. But if I said to myself I need to wash dishes, if I saw that many dishes and that was my goal, my agenda for the night after this is to go home and wash dishes I would just be like ah. Right? Seems overwhelming. But if I said to myself, okay, I want these dishes done by the end of the weekend. I would think about how do I break that down into things that seem manageable, smaller kind of chunks? So the first thing is to think about in this goal or this thing I need to approach, what are the specific tasks involved? So rather than saying washing dishes, I might say something like wash plates, bowls, cups, cutlery, dry and put away dishes. So all of a sudden my list got longer but now I have a better sense of what that bigger goal is. If I’m working on my taxes what does that mean? Cleaning my apartment, like, all right. That seems daunting until I’m like oh, I’m gonna sweep the floors, vacuum my rugs, scrub my toilets, I don’t know. Put my shoes back where they belong rather than the pile. Okay, now it makes sense what I’m doing. The second thing is how do I make this goal measurable? So sometimes we set goals like how do I know if I’m done with this? How long is it gonna take? So once again, I might say well, I’m gonna wash 10 plates, or I’m gonna spend 15 minutes washing dishes. We often talk about in psychology this thing of the 15 minute rule, which is whenever I’m avoiding something, can I and commit to working on it for 15 minutes? If 15 minutes seems like too much, choose a number you want or if you need to be more than 15, totally fine. But the general idea is to say, all right, I think I can commit to this thing even if I don’t really want to do it for this amount of time. The first thing that it will actually do is help you get started. And the second thing is even if I only wash dishes for 15 minutes, at least I’m 15 minutes closer to being done. So whatever that measurement is, that can be really helpful. ‘Cause sometimes it’s like well, when am I done cleaning? I clean my apartment, I clean my house, but if I said, I’m going to pick five things up off the floor when I walk in. Every time I walk in my bedroom, I’m gonna hang up five pieces of clothing. Or five shoes away. I have a better sense of oop, I’m making progress towards my goal. Then we want to make sure our goal’s attainable. So this is where we often set ourselves up for failure. I am totally going to clean my entire apartment today. I did most of that on Monday and let me tell you, at some point I was like this is kind of a big goal. But if I said I’m gonna wash all these dishes tonight, I’m probably not gonna do that but I could say I think I could wash 10 of everything every night when I come home at seven, I can just do 10 of everything and my dishes will be done by Sunday. Just making sure you’re setting yourself up for success. Ours realistic relevant or sometimes we talk about resource, which is just making sure you have everything you need. So if I were to say I’m gonna wash dishes and then I don’t have enough dish soap, I’m not gonna be successful so I might need to add a goal around that of go to No Frills and buy extra soap. I had relevant because sometimes we break things down and we feel like we have to do the hardest stuff first. So for some reason, maybe I think to myself I have to wash all the dishes and I’m not allowed to dry anything and put it away until everything’s washed but I might say actually I’m kind of sick of washing them. I could dry them and put them away. That’s still relevant to my bigger goal of getting all my dishes washed. And then the final step is to say it’s time-limited. So the idea of just check-in points so this isn’t like pressure. Like I have to get this done but often the big tasks require check-ins to make sure I’m making progress. So if I realize I want all my dishes done by Sunday night, I would say what do I have done by tonight at 10? It might be 10 of everything. And tomorrow at 10 I’m gonna check to make sure I have 10 of everything done and I know I can check off, yep, I did my 10 tonight, 10 tomorrow. And if I continue to make those steps by 10 p.m. on Sunday, my dishes will be washed. Does that make sense to people? I will say this is one of those logical things like sitting here, you’re like, yeah, that makes sense. You have a PHD and you’re telling me this? But it’s really helpful when you think about why am I avoiding things? How do I break it down? Is my goal this nebulous poorly defined cloud that’s hanging over my head? What does that mean? What does that look like? So when in doubt, kind of think about yeah, what are specific tasks and 15 minute rule. So if you remember anything from that, make sure it’s specific and when in doubt, 15 minute rule. And like I said, if 15 minutes seems like too much, do five minutes or say to yourself, I’m gonna pick five things off the floor. When I’m washing dishes I do it based on my coffeepot. So I’m like, all right, coffee’s brewing. I’ll wash dishes as long as my coffee’s brewing and then usually halfway through I’m like I might as well keep going. I’m on a role and since I hate it so much I might as well keep going. So the other thing that I like to talk about is planning in pleasant activities. So this is also one of those things you’re like yeah, that makes sense. But I think what happens is when we feel stressed out, when we experience anxiety or life got busy, we stop doing things that help us feel better. So this applies to anxiety and this also applies to depression. Knowing that they kind of go together. But we need downtime. So I think we often feel guilty about doing things that we don’t feel like are productive or are not part of bigger goals. So I shouldn’t be watching t.v. ’cause that’s not productive. Or I need to multitask while watching t.v. But we want to think about how can I do pleasant activities. The other thing is to think about how can I actually add activities in my life that give me a sense of accomplishment that maybe aren’t unpleasant tasks? So clearly I work in academic setting so I always say to people don’t have your sense of accomplishment based on your assignments alone. You want to have a sense of accomplishment of I also did my laundry today. Or I painted or I learned a language for fun. And when we notice that we actually plan in breaks. If I know I get to watch my favorite t.v. show or I’m having dinner with my family or my friends, or I’m gonna go for a walk, we’re actually more motivated to do the things that we don’t necessarily always want to do. So if I know, I’m trying to think of a good example. So often I know, I have planned runs and the runs that I actually really enjoy are the ones that I get to have brunch with my friends afterwards. And it’s like I’m gonna do that thing that I don’t necessarily want to do but I’m gonna brunch later. When I was marathon training, I would bribe myself with coffee. It’s like well you must go on your 37k run because there’s coffee at the end. I was like, all right, keep going, right? But if I said to myself, all right, I’m just gonna run and then I have to go home and I’m not gonna do anything pleasant, I’m probably not as motivated. So planning it does increase motivation and another thing is that if it’s planned into our lives, it decreases guilt. So giving yourself permission to do something that might not be productive but that’s planned in. So when I was in undergrad, I never worked after six on Friday nights. I was just like, I don’t do any work anymore. I can do whatever I want. Now I have a little more freedom but same thing. Or it’s like I plan in dinner with my friends and I get to have dinner with my friends tomorrow night and that’ll motivate me to get through all the chart notes I have to write tomorrow. And all the things I have to do. Why? ‘Cause I know I’m having pizza with my friends at 6:30. And that actually leads to increased productivity. So I think it’s helpful to remember that we tend to burn ourselves out. It’s like I must do lots of work and then we crash and then it’s really hard to recover. But if we plan in breaks, it actually helps us to keep going. I will say this is a little bit like a car that you can only put so much gas into it. But the problem is if we said to ourselves, well, it’s a waste of time to stop at that Esso station, I should keep driving. Eventually you’re gonna run out of gas on the 401 and then you’re really gonna be in trouble and you lose way more time than if you’d spend 15 minutes getting gas. So think of down time as those little fuel breaks to keep you going. I think the other thing and clearly I work in academic setting, so this can tie into it but I think this applies to everybody is that we often have all these great coping mechanisms. Like when I have all the time in the world, I see my friends, I watch t.v., I exercise, I have hobbies. And all of a sudden life gets busy and we start chucking those out the window. It’s like I don’t have time to exercise. I don’t have time to see my friends. I don’t have time to take a break. And then it’s like why do I feel so bad? It’s like, oh, ’cause I had more stress and I threw all the good stuff out ’cause I said I didn’t have time for it. So making sure we continue those things. You know, if you say I have a hobby that I really enjoy. How do you plan it in so you can actually maintain and manage those stressors? So like I said, I like to use running as an example, but even when my life is busy, I try to make sure I exercise ’cause I know it’s really easy for me to get busy and want to go home and sit and I end up actually feeling worse than if I’d just gone home and went running for a half an hour. That actually helps me feel better. So plan in pleasant activities.

– [Ryan] Well, thanks for joining us on day five of the stress and anxiety course. Today we talked about shifting what we do, shifting our actions. And the question for you to think about today or discuss with others, is what goal would you like to work towards? What are the specific measurable attainable realistic and time-limited steps that you can take? And do think about it through those dimensions too before you just jump on something that seems like a good idea. Pause and think if it is specific, measurable, attainable, realistic and time-limited. Well, this would be a good one to discuss with friends as well because it’s so specific about things that you’re gonna try. And maybe your friend would be able to help you follow through on those things ’cause that’s the new thing about forming habits. That’s what’s hard is trying to actually follow through. So please do share this course if you can and can’t wait to hear about how things go. Please do reach out to me through the app website.

Question: What goal would you like to work towards? What are the specific, measurable, attainable, realistic and time limited steps you can take?