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I think it's safe to say when we talk about prayer and pray without ceasing in the context of the altar, the same concepts, I don't think it necessarily means that you are to pray in the sense of, you know, I'm going to lock myself in a room and for, for ten hours I'm just going to not stop praying. If you want to do that that's your business, but the idea is that it is perpetual, it's continual. That means whatever I might have prayed for yesterday, I may come back again tomorrow and do the same thing and likewise and so on. And I think that's where people get a little bit nutty. They think taking it literally, which is I will, I will pray without ceasing, I will pray at all times. No one can pray at all times, okay. Just get, get that idea out of your head. ♪ ♪ So we've been studying the tabernacle in the wilderness, its particular; its dimensions, its material, colors, the structure itself, and the furniture therein. And today I want us to turn our attention to the table of showbread, the showbread, and if times permits, we will move onto the golden altar.
But here is what's important. So this table, which you'll find in a diversity of places, but in Exodus, specifically the mention for the building of the table, which is sometimes called “the table of showbread,” sometimes called “the pure table,” when eventually when we get to Solomon's temple it will be called the temple of; “the table of gold,” but again, made of acacia wood. If you remember I said to you there's a translation from the Septuagint, which is the Greek version of the Old Testament, and if you read the Septuagint version of these verses and passages, they call the translation of the acacia wood is “incorruptible wood.” And I think that's really pretty cool.
Always overlaid with pure gold; and the dimensions of the table, two cubits in length, and if you heard me explain the cubit, from the elbow approximately to the length of the, we'll call it the middle finger would have been a cubit, so two cubits in length and one cubit in breadth and one-and-a-half cubits in height. And as I've said, the numbers always mean something. And I've done enough on the numbers that you could probably go back into the other messages and see what those, if you don't know them, what the numbers symbolize. I've already explained the gold, referring to Christ's divinity and the acacia wood referring to His humanity, which He was both all at once. So I love that these pieces of furniture, except for the candlestick, which we saw, which was pure gold, I like that everything in here points to a description. Which, by the way, think about this: God could have just said, “Make everything out of gold.” They had enough, by the way. Don't think they didn't have enough; they had enough. Remember, at some point God says, “Tell them to stop bringing; we have too much.” Remember that? So it's not as though they couldn't have done it some other way.
This was God's design and this is why you read in the New Testament, “See to it that you build it exactly according to the pattern.” Why, because there was built into that pattern, we'll call them the shadows and types that reveal and point to Christ. So this table had two, what are referred to as crowns, separated by a border and four golden rings, one at each corner through which poles or “staves” would be put through in order to carry that table when it was time to move. I also want you to keep in mind; obviously they wandered in the wilderness for forty years, so I want you to keep in mind that everything that God did here, pretty interesting that God saw this is going to be a moving event, perpetually. So the fact that everything is incorporated into the design is, is pretty interesting, because you know, if you think about it, we humans would go, “Okay, let's build a table,” but we wouldn't think maybe of putting the rings on for the staves, because we don't; it would be an afterthought. God included all this in the design.
So what I like about this is if you're reading about the table itself, when it says it has two crowns, there are three pieces of furniture mentioned with crowns, and I think this is not an accident either. The ark of the covenant has what's referred to as “crowns” on it, the table of showbread, and the golden altar. And I need to say something here, because I hope I haven't confused people, who don't maybe have this down pat. The brasen altar, which is outside versus the golden altar of incense, which is what we're talking about; I'm moving towards that, which would have been on the, in the same realm, if you will, of the candlestick, in that same area. So three pieces of furniture that had crowns on them, and what's interesting about this is these three pieces of furniture at some point we might take a bird's-eye view, but having these crowns, I thought it interesting that the table, in fact, has what I would call a double crown on it. And I don't think it's an accident.
Obviously crowns in this case, at this point in time, can only have two references. One would be to the miter that the high priest would wear, which was referred to as a “holy crown,” and that obviously of a king. And if you think about it, Jesus fulfilled both the high priest and kingly role, so when you read about, for example, two crowns on one piece of furniture, it, to me, fulfills both of those roles. This is a lot of, as I said, type. We're looking at types, but you know, if you look at all the furniture it is not a mistake.
As I said, the numbers, for example, we're talking about four corners in this case of the table, which I've already said in numbers, four corners of the earth, like we have four seasons or four quarters. These numbers are incredibly important. The same thing, this table is described as having four feet. Luckily it has four and not two. You'll get that one later. Again, balance, representing what will be presented to the whole earth or what's available to the whole earth. So I love all of these examples in type. But the table itself would have twelve loaves of bread weekly, basically. So these twelve loaves would be baked and placed on the table every week, and at a certain set time during the week these loaves would be replaced. And we know from different parts of the Bible there's an explanation that once this bread basically has been replaced, the old bread can be consumed by the priests.
So it's almost as though everything in the tabernacle has a purpose. There's really no waste. And as I said, kind of interesting, if you go to the book of Leviticus; Leviticus, for example, explains in just a few verses about the showbread. Leviticus 24 says, “Thou shalt take the fine flour, bake twelve cakes thereof: two tenths deals shall be in one cake.” And you see, even that you might think, “Well, why is that important: 'two tenths deals shall be in one cake'?” I'll tell you in a minute. “Thou shalt set them in two rows, six on a row, upon the pure table before the LORD,” there it is. It's not called “the table of showbread,” but “the pure table,” right there. “Thou shalt put pure frankincense upon each row, that it may be on the bread for a memorial, even an offering made by fire unto the LORD. And every sabbath he shall set in order before the LORD continually, being taken from the children of Israel by an everlasting covenant. And it shall be Aaron's and his sons'; and they shall eat it in the holy place: for it is most holy unto him of the offerings of the LORD made by fire by a perpetual statute.” So it's kind of interesting this bread, baked every week, but the two tenths deal kind of got my attention, and why is that? Because if you read some of the other places where you find this “two tenth deal” for, for example the meal offering in the feast day of the sheaf of the firstfruits was to be two tenths deal of fine flour.
The wave offering, for example in the feast of Pentecost, the same thing: two tenths deal of flour. But the manna that was to be gathered on the sixth day of the week, you would actually end up with a double portion, because you had to gather twice as much, because you were not allowed to gather on a set day that was set aside where no gathering could occur. So I want you to think about this. It's equally interesting that the twelve loaves, inside each loaf basically would contain a double portion.
And that might not hit you right away, because the loaves are a little bit tricky to explain in their type, in their meaning, but I'll, hopefully I'll get to it. And then you come back to the understanding of the manna. And the manna has, I think, kind of baffled a lot of people. And I say that because, think it, think of it this way. God rains down this light bread, which the people, after they murmured that they were hungry, right, God rains down this light bread, the “what-cha-ma-call-it,” right, gives them instruction on how to gather, what basically what to do with it, and so forth. And one of the stranger things is when the instructions are given to gather up manna and put it in a pot that will be placed inside the ark, along with Aaron's rod that budded and the unbroken tables of stone, but what's strange is those, that manna that's placed inside the ark is, it's called something, we'll call it continuous or perpetually contained in the ark. And we'll say once the lid or the mercy seat was placed upon the ark, covered and not seen anymore.
And I've said this for many weeks now, with people asking, “Where's the ark?” When you read in the book of Revelation, and I believe it's in the second chapter, it talks about “To him that overcomes I will give to; to him I will give to eat of the hidden manna.” That's why I said to you be very careful to not exclude Scriptures that tell you that God had a purpose in taking away the ark. So think about that. While all of these mystery hunters out there think they're going to solve the problem and it will be an “Aha moment,” uh, okay. Knock yourselves out. So with that being said, I also read here about this frankincense that would be placed upon the loaves. And then of course, these loaves would be replenished weekly. Now, frankincense, there's kind of this shades of meaning. It can be representing holiness, righteousness, truth, even deity.
But if you recall of the gifts that were brought to the Christ child, it was gold, frankincense, and myrrh. And we know that there in those offerings we see a type again. The gold obviously was representing His divinity or His deity, the myrrh in preparation for His death, and the frankincense we can kind of ambiguously say either sweet savor, sweet aroma to God, but also His righteousness. There's a whole━there's kind of that. So applied to the bread it becomes, well, what would be the purpose if the bread, by the way, is going to be consumed by the priests? But it's, it is consecrated bread, in some places called “consecrated bread,” other places called “hallowed bread.” So why would God have them put this frankincense on there? And I think a lot of times there's, there's all these little nifty things we can read about, but the frankincense could also serve as a form of preservative.
So imagine, you know what happens when you leave something out, especially bread. What happens after a week of it being exposed? It's nice and hard, right. So I'm assuming that the frankincense actually had a preservative-type action with the bread. There's something else that's equally interesting about the bread. We read that the bread was pierced. And I think that's interesting, because the bread had to be pierced in order for it to rise.
Do I need to explain that one? That's pretty━okay, but I'm going to do it for the sake of the people that say, “Okay, well what? What the hell did she just say?” So if the bread, remember this I said it's tricky, because the bread is actually an offering out of God's provision from, basically from God, the people take it, and then the people bring it back as an offering to God, right. But so it has multiple, we'll call it, it could have at least two or three meanings or two or three interpretations.
So the bread being pieced, as I said, if we call Christ, as He referred to Himself as “the bread from heaven,” or “the bread of life”" that Bread of life also had to be pierced so it could rise. I love these little━they're very simple, but they're very clear. It's almost like God's saying, “Can you hear Me now?” right. All right, the measurements of the table, as I've already said, the height is one-and-a-half cubits tall, the same as the ark of the covenant. And this is important because the table being the same height as the ark, where the bread would be placed, puts it on the same level, if you will, as the mercy seat.
So the redemptive act where the blood would be sprinkled and applied would carry the same value in height as the bread placed upon the table. And this kind of is important to understand, because the bread may also be considered representing communion or fellowship with God. So if you think about it, the redemptive work of Christ and communion with Christ kind of go on the same level as the measurements depict. It's one of those things that if you're moving around you see that every detail here points to something. God didn't waste a crumb; pardon the pun. All right, there is I said, I mentioned a crown around the table; two crowns, in fact. And I love this, but be very careful about how you interpret what I'm about to say, because I know a lot of people will go far with this one. The crown around the table may have had a practical purpose, and that practical purpose may have been from keeping the bread from slipping off the table. Now if you go back to what I said about our two crowns and the full fulfillment of high priest and king being fulfilled in Christ, then Christ does help us, but unlike the bread that doesn't have free will, we do.
So we can slip and fall, if you will, off of God's table. All right, don't make the mistake. This is, again, one of those things denominationally speaking that some believe “once saved, always saved.” I do not preach that and do not believe that. I have seen more people in my lifetime, some very impressive, brilliant minds for the Lord, they were incredible, they made incredible contributions in ministry that fell away.
And then the people that believe in the doctrine of eternal salvation, “once saved, always saved” will say, “Well, they were never saved in the first place.” That's pretty hard to actually remedy when you look at some of the writings of some of these people who spent thirty and forty years of their life studying the book, preaching the word, and for whatever the events that happened fell away. So I, I don't think that this crown around the table, we can't go too far, as I said, because I don't believe in “once saved, always saved,” but it did have a purpose. And I'd say if you want to take this and make it something that could be applied, looking to the crowns, the high priest and king, can help you.
It doesn't mean it's going to stop you from slipping, but it can help you, and I, I'm just going to leave that there. The bread, sometimes called “the bread of faces,” the bread that would be placed before God, bread, lechem, and pânîym, so it's interesting. The bread of faces, if you translate the word “showbread,” just the word “show” from our English going back into the Hebrew is “to say,” or “to declare.” So it's, it's kind of a strange thing.
I'm not even sure why or how that came to be, but that's what it is. Sometimes also, as I said, referred to as “the continual bread,” and I like that. Remember that each one of these in proper context, the continual bread, which would mean the bread never ceases, even though the manna stopped the bread never ceased. If the bread for us is Christ, He is everlasting and ever liveth, so you can take that how you want. If you remember, there is a passage where David is fleeing for his live and runs in. He finds the priest and he's asking for two things: food and weapons.
Do you remember that? Okay, when he asks the priest, the priest says, “I only have hallowed bread here; not common bread.” And I like the fact that just in that one distinction it lets us know this is no ordinary bread. The priest did not see it as ordinary. Even though it was bread, it was not considered common or ordinary. And again, if you're going to keep going back to these references of Christ, who is the bread of life, no ordinary situation here in Christ either. So all of these, as I said, have great meaning if you're going to comb through the furniture here. The bread, as I said, represents both an offering; and this is where it get complicated and I'm going to try and do this as clearly as I can, but it's difficult, because the bread is, yes, an offering from the people to God, but let me take a little pause right here.
There are too many places specifically in the first five books of the Bible that talk about offerings and giving that explain something that if we all just kind of took a minute to process this, there would be no confusion here. Even that offering from the people to God came out of God's provision to the people, and if you think about it, every single offering that God along the way asked, whether; it didn't matter, it all came out of the provisions that God provided. This is what is frustrating to me as, as a preacher, but also as a person of God. I don't understand this.
And maybe someday, someone will come and argue and enlighten me on this, but I don't understand. If it's as clear as day here that God multiple times over gave to the people, in order that they could give back and participate in worship. What does that tell you about our response? I don't care what you've been taught; what does that tell you about our responsibility, first in recognizing who the Provider is, where the provisions come from, and why we need to be givers? It really kind of; you know, think about this. Have you ever given something to somebody, and we're just human flesh pots, but have you ever given something to somebody and they don't even say, “Thank you.” They don't even━it's like someone who's entitled.
They don't even recognize the gift that was just given to them. And you don't do it because you're expecting “Thank you” or recognition. Now put that on steroids. God, who has given us our faculties, our abilities, the breath in our lung, and yet; lungs, and yet people will still make this an argument. And I think probably this year for me has been the most crystal clear on this subject. It's not discussable. It never was discussable. For all the people out there, for all of you out there who still play this game of “Well, I don't think it's necessary,” or whatever it is, you're just deceiving yourself, because if I'm showing you the patterns that God put down here, not just the patterns of Christ and everything that points to Christ, but also how we are to relate to God. And even, remember I told you a couple of weeks ago, the approach to the tabernacle, those white curtains, right; think about this. Before you came into the church you might have been thinking, you might have been, you know, wondering about God, but then if you're like me, I stayed away from the church.
And I stayed away from the church, A) because I left the church long ago and out of, from a myriad number of reasons. But I also in my mind thought I couldn't possibly be accepted into the mix. So those white curtains still exist today. They're for any person who hasn't come to know the door that you must go through or the sacrifice that was made or the laver of cleansing; all of these things help us, including the structure in which God organized it. See, too many people focus on this idea of the tithe, and not enough focus is given here on who gave to be able to make you a giver. Think about that. Cain and Abel; who, who provided the offering for them? Who? And you keep going and you recognize all the way through it, every juncture it's the same thing. So what happens when we come before God? And I'm just going to say it like this, because the Bible talks about coming before God empty-handed.
What does it say? It says, “I completely deny that You ever provided for me in the first place.” Sorry, but if you can't see that you may not have the Spirit of God in you, because that's exactly, without telling somebody how much you need to give, but rather what's underneath it all. What is in the person's heart? Failure to recognize that, you can't━it doesn't matter what you take out of your pockets afterwards, it's all going to be works of the flesh, an endeavor to check a box and not see how God has laid this out crystal clear. So just put a little period right there, because that tells you my take.
Again, every week I'm going to maybe hammer on this. My take on giving is not some optional ideology or let's describe a percentage. Let's start with the right first place here. Every place here we're looking at, so the, the bread placed on the table, as I said, the oil in the lamps. And yes, there are two distinct types of oil; it doesn't matter. Again, the people had to gather it and bring it and produce it. So you've got enough there, all of the material that was required to build the tabernacle: all the threads, all the gold, all the silver; all of it, where did it come from? You could say, “Well, they came out of Egypt and they basically looted the Egyptians as God told them to do.” That's a good obedience right there. I mean, you know, we, we got people thinking they're coming out of Egypt in San Francisco and Sacramento all day long. That might; you'll get that one later.
No. All right, I was meaning in the looting part there, okay. So don't say, “Oh, well, it's biblical! I just went into whatever place to rip it off because it's biblical.” No, this is━but I'm, what I'm trying to show you is even there God made a provision and said, “Go get it from these people,” and there was a reason for them. Obviously, God didn't━think about this. God said, “Go get it from these people and take it from them as you go.” Why? If God wasn't planning to have this, all of what they took be a part of a pattern to build, then they'd just be a bunch of rich, heavy laden wanderers in the desert and with no point.
So again, this kind━I, I hope I've killed that one and it's clear. So I said the bread is complicated, because the bread, as I said, as an offering the bread can also be a representation, as I said, of Christ as I described that the bread being pierced in order for it to rise. So there, there could be multiple ways to interpret this, and I'm not going to get dogmatic over which one to go with.
They both embody the concept that I'm trying to convey. Twelve: the number of loaves that would be placed there every week, and replaced weekly; this number, as I've pointed out reoccurs over and over again. You've got the twelve tribes, you've got the, the twelve disciples. So twelve in this case, the number of divine government, which kind of is the pattern we're going to see spread throughout. Some people have labeled twelve as apostolic fulfill-ness or fullness, if you will. I, I'm just going to say I prefer to say divine government. It, it takes care of everything here. The number twelve also is carried into the heavenly city with its gates, if you think about it, twelve is everywhere in the Bible; twelve foundations, twelve precious stones, so not an accident in terms of the number.
I love the fact, by the way, that if you look at some of the references of twelve, like the twelve stones that Joshua took where the waters were basically arrested so that they could cross over, or the twelve stones of Elijah. Again, probably more of a mystery to me, the twelve stones of Elijah, because we're dealing with 1 Kings 17 or 18, where we're just starting to see the fracture that is beginning to occur within the kingdoms, and yet God didn't say, “Pick up two and ten.” He said, “Twelve”" there were twelve stones.
So again, with all of the separation we know that will occur, God's language is always going to be united; multiple parts, but united within. And I like that too. There's a mention in the table that might not make sense, and it says that there was a “border of a handbreadth between.” So I want you to think about this. Think about the table itself, and then almost a table within a table, so that you can understand what the border might be. And that border of a handbreadth, this is a tricky one, because no one is quite sure. And trust me; I went to some of my Hebrew sources. No one is quite sure what to make of the proper interpretation of this word, because it's so ambiguous. But I'm going to go for how I understand it, almost as the word connotes “fortress, safe place, enclosure,” a “handbreadth.” So I'm going to say that that concept basically separates. In other words, there is a ledge that is probably designed for the placing of utensils.
The table came with spoons and bowls and other things, so probably that area might have been to put some of those items on. That would have been enough space for it. But I'd like to say that the interior, what we'd call the interior border or that interior walled-off section was a way of separating. And I like this because it, it reminds me of a very strange, it's a very strange analogy I'm going to tell you right away. But if you remember, in the book of Ezekiel, God's describing the city, and He's taking Ezekiel through every part, and He says once He's finished in one area He takes him outside, and He mentions, in the Hebrew━you won't see it in English, but it's the same concept of a hand, hand's breadth to denote separation from other things coming in contact with other things.
So I think that's interesting that God put that there on the table. And whether that is to suggest the bread, if that is possible, being separated out, which it was, it wasn't common bread, or whether that is to represent those people who could approach the table, who were separated out, the high priests. But in any case, it denotes a form of separation, which I think it's like saying this bread is specific and not everyone is invited to partake and to touch, okay. And you might say, “Well, that's kind of unfair.” Well, whoever said it was fair? All right, I think I've probably covered enough on that to talk about, so why I say the separation of the bread is because within all of these pieces of furniture you're also going to find different concepts theologically that we talk about in the New Testament.
So I believe that part of the design of the table, you know, I just used the word “separation” or to keep out would represent what we would call in the New Testament “sanctification,” a separating apart. So kind of just put that as an important thing. And then I love this. In the realm of the tabernacle God basically says, I read it to you that Aaron and his sons, they shall eat it in the holy place. So God made a provision for the people who would be serving and doing the work of basically everything that was contained within that holy place.
Now we don't have a designated place anymore, but I love the fact that right there it basically says God provided. You know, bread is always interpreted as “the staff of life.” God provided for those serving Him the ability to partake. Now take yourselves right into the New Testament. We are a royal priesthood. There is no priests; Jesus is our high priest. But again, this comes back to provision.
And I believe this wholeheartedly. Someone who serves the Lord; and don't just say, “Oh, are you talking about being a pastor?” No, I'm talking about anyone who serves the Lord; you are a servant in your own home. You are a servant unto the Lord when you come here and you do whatever you do, if you do it in the name of the Lord that the Lord provides. And this is another one of these built-in messages that says to me when it says, “And Aaron and his sons, they shall eat it in the holy place,” as if to explain to us that anyone who's going to be committed. You know, there's another Scripture that says, “I have never seen his righteous ones begging bread.” Well, I've seen people begging for bread, hungry, okay. And that doesn't mean, no, they didn't serve. But I'm talking about I have yet to see God abandon the hand or the mouth of someone who is committed to serving, why, because God knows what's in your heart.
That's not to say that God's going to put out fillet mignon for you every night, but it's simply along the same lines of the Lord knows exactly what we need. And if bread is the staff of life, I'm going to go beyond the provisions of food to talk about the provisions of the total person, which come to us in the form of Christ. Again, everywhere you turn it's like mirrors that keep reflecting Christ throughout this whole tabernacle.
It's inescapable. And that's what I love about these studies. You cannot, if you're reading the same Bible I'm reading you cannot escape these types. And they tell me something. They over and over and even deeply or deeper every single week tell me God did not make━there were no accidents here like, “Oops, you know, I just, I decided I wanted this.” No, they're very deliberate. When I talk about these things, and I just mentioned the vessels that would be used in accompaniment with the table, the vessels were set apart for a specific purpose. You'd never see the flagons or the covers or the spoons being used for something else. They were specifically used for service at that table and nowhere else. And that tells me just like each and every one of us as vessels, we have a unique purpose.
That doesn't mean that we can't do multiple things or multitask, but we have a unique purpose in God's plan. And again, I, I think the concept, the question that's asked, you know, “Could God set a table in the wilderness?” Well, of course He did. And this paints the picture rather clearly, not only was this a table of fellowship and communion, but if you think about it, from the very beginning where they would have to go and gather the manna, I want you to imagine what that must have been like, all right, because God gives a specific command for how much they can gather and when they can gather and how they can gather it. So from start to finish God provided opportunities for the people of God to participate. Now I'm going to stop right there and ask you a question. Why is it that, fast forward into the New Testament church world and people think, “There's nothing for me to do”? I'm not talking about works.
I'm just saying that if you look even at the pattern of how everybody participated, each had their own. I said this last week. Some people were responsible for gathering the olives to make the oil, some people were charged with gathering the manna, some people were charged with the craftsmanship, but everybody did something that brought the whole camp to be involved. So think about these things, because I think it's pretty important. Now, when it came time to move the table, like other pieces of furniture, God provided the covering. And it's the same covering that I described, more or less. You've got the table that would be covered with a blue cloth that would be underneath it all. And of course, I've already blue, the color of eternity. The dishes, spoons, and bowls had a scarlet covering on them or red covering on them.
And the final covering would be badger skin. And I always like this because even the last time I mentioned this, people were like, “What the hell is that?” But think of it as the ugliest nondescript covering that you could have; nothing to look at. And this is what I love. To the natural eye, to the person in the flesh, if they saw the badger skin it, it would almost probably be repulsive. They would say, “What? What? How could that be holy?” because, you think about it, look at the complete opposite here. The complete opposite when people think of “holy” they think of opulence and they think of grandiose.
They think of the Catholic Church with its pomp and splendor and all the ornate-ness, right? You don't think badger skin. Badger skin is like, “Yuck, that's repulsive” to the natural man, to the natural eye. But someone who can look at this and really understand the meanings of these coverings, you're seeing what we'd call the, the, what the Bible refers to in Isaiah, speaking of Christ: there was no beauty in Him. So one has to look at the covering, and if it is with the eyes of the Spirit, you can see beyond the badger skin down to the blue and see the eternal purpose. But someone who doesn't have the Spirit is going to look at this and say, “What is this? This is like a junkyard with all kinds of stuff being transported, covered up with all kinds of”━it's like going to Grandma's house with all these different coverings on everything, right? What the heck? All right, so I think I've, I've given you enough of the picture of this table and its, its purpose.
I'm going to move on to the golden altar of incense, which was also in the holy place, as I realize if I keep going at this speed we will never get out of the tabernacle. So this piece once more, acacia wood overlaid with pure gold, sometimes called “the altar of gold before the throne.” There is that reference, by the way, in Revelation 8:3. I want you to ask yourself the question, why are there references to articles of furniture or concepts that were in the Pentateuch that appear in the book of Revelation if it's not because God is saying, “That was a shadow; I'm showing you what the actual substance, the tangible substance is now”? That's what will be revealed, the real thing.
So as I said, the altar before the Lord, also called “the altar of sweet incense,” it's dimensions, one cubit square and two cubits high. And I think this is pretty interesting myself, because that right there, one cubit square, means it was a square. It was square square. And I don't, again, I don't think this is an accident. If this golden altar, being probably the tallest or greatest in height of the table, of the ark of the covenant, or whatnot, the interesting thing here is that you have the shape. The shape brings me back to something pretty important, the, the city that is described as foursquare, the city that's yet to be, the heavenly city of Jerusalem described as foursquare. And again, the interesting relationship to the other pieces of furniture, what this particular altar, we call it the altar of incense; incense would be burned upon it, if you will. That altar represents for us what we would call another form of communion, prayers ascending to God, in the New Testament form if you will.
This golden altar had horns on each corner, a crown molding of sorts, gold around the edges with two rings of gold underneath what I'm calling the “crown molding,” which would kind of be a decorative something that goes around the exterior square. This altar would be found just before the veil. And I want to make sure that I make this really, really clear, because I know there'll be people that will be confused about this. So the difference between the brasen altar, which is further back, go back towards the entrance, all right. And sometimes I think people confuse the brasen altar with the golden altar. So the brasen altar is where the sacrifice for the sinner was offered. We call that judgment, we'd call that everything that you want to look at in terms of the act required to redeem or to forgive the sins of the sinner.
And you cannot, you would not be able to approach the altar of incense without having made or seen the sacrifice. So in translation for us, you come through the door to see the sacrificial and finished work of Christ, and when you are able to see, understand, recognize, no, and it doesn't have to be perfectly, but with that focus, then you approach and the incense of prayers can ascend. You know, people say, “Well, can I just pray?” Well, who are you praying to? So there, there is a pattern with purpose here. It's not just simply, “Okay, I'm going to go through the motions and check the box.” There was actually a method to this. Also, once a year on the great Day of Atonement, Yom Kippur, they'd also apply blood onto this altar as well. In fact, I think everything got blood-covered. The blood obviously being a picture of this sacrifice accomplished, and so the foundation of worship therefore and praise was going back behind what was already done, the shed blood that was already shed.
So again, none of this would have━do you realize if I wasn't giving you the other side, which is showing you Christ, it just kind of sounds like, “Well, what's the purpose?” because you'd have to repeat this every year, and some of this you'd have to repeat every day or every week. What's the point? So again, that's why I said to you, you cannot read this without seeing that God actually had a vision to carry out the fullness of His Son, but these all point in that direction. The incense, this is another interesting one, made of four sweet spices in equal amounts would be blended and burned, produced fragrant odors or perfume.
One of these spices, the Hebrew word nâtâph, “to drop,” or “to distill,” a balm, which suggests fragrant outpouring of a life yielded. It's kind of interesting if you look up that word. The second one is a little bit more strange, because the second ingredient would be, would come from a shell or a scale that would be ground down into a fine powder. They'd find this shell around the Red Sea. It sounds a little bit weird to grind down a shell, but when finely ground it would produce a very fragrant perfume. Some scholars have equated the, this kind of incense, the full compound of the incense with a complete dedication or devotion. I'm not sure that I want to go that far, but it all has meaning. The next ingredient was a sap-like substance called, “galbanum,” which is purported to have medicinal properties. And finally frankincense, which you can see frankincense would have a place almost, almost throughout the whole tabernacle.
Our English word refers to its fast and free-burning qualities. Frankincense as a medicine or antidote to poison in some cases, equally like that, it's kind of interesting, but it could also be used if you remember I talked about it being put on the bread as preservative. It could also be used in the context of purity. So remember that this consecration would also be like the memorial of the meat offering. So all of these ingredients, they are, it's not just one time that they appear. They appear in different places and I believe they all have a part, an important in; we'll call it the recipe and the formulation that God put together. So you put all these ingredients together; they're blended for one singular purpose to be put on the altar of incense, and then obviously it is something that ascends.
Now we are not burning incense, but that altar does represent our place of prayer, the prayers going up. And Christ, who is our high priest, would pass into the holiest place of all to obtain that eternal redemption for us. So it's, again, nothing can be done, it's weird, like everything is connected. You can't even start understanding all of the furniture, unless you come through the door; sorry, okay. And once you come through the door, that one singular door that brings you in from, from being outside of those white curtains, once you come through the door and you begin to see this furniture there must be an understanding of the purpose of the why.
And for example, if one was just going to stand at the laver of cleansing, we'd say, “Well,” as I pointed this out, we're washed and cleansed by the word of God. Each one of these has a connection. And the more you look at this━I'm just giving you a very generic picture. You want to knock yourself out, if you can read Hebrew or you have access to a Hebrew Old Testament, look up some of these that words I've talked about just in reference and you see, wow, there, there are deeper meanings to these words.
I'm trying to keep this generic, because I realize that I'm describing furniture, which you might say, “Well, a message on furniture; okay, interesting.” As I mentioned earlier, I believe the coals that came off of the altar of burnt offering were used on the golden altar as well. And God was very particular about this. If you remember the episode that happened with Aaron's sons Nadab and Abihu, remember where they took false fire, right. God basically warned them, by the way, it wasn't like they just stumbled upon and said, “Oh, let's try this.” God said, “Do not use strange fire,” meaning if there was a fire that was perpetually burning, that is from where you get the coals or whatever for whatever you need; you don't go and get it elsewhere. So I like the fact that God's very specific, even right done to the fire, when He says, “This is what I want you to do and this is how I want you to do it.” Of course, their disobedience and their blatant disregard for God's instructions and God's ways obviously cost them their life.
You have a similar scenario that plays out with Korah and the rebellion of Korah; not so much over fire, but the idea is still there, direct denial of God's chosen way, direct denial of God's way of approach. And of course, the same thing with Korah and Korah's band, it cost them their life. And my only lament is why God is not opening the earth up nowadays and swallowing people up, I don't know, but 250 men that followed Korah were consumed, completely consumed. So I think it's safe to say with God obedience is better than sacrifice. Let's leave that one alone. But what's unmistakable here about this altar is if, as I said, if the brasen altar was where satisfaction was made to the holiness of God for the sake of the sinner, then the prayers being offered by the saint are what are seen essentially in the golden altar of incense, accepted, by the way, because of the sacrifice that was already done. So I like to put it this way. If the first altar, the brasen altar flesh is sacrificed, here at the golden altar of incense you have basically the soul; if the flesh has been sacrificed the soul is communing with God.
So those are the two pictures that I like to use as a New Testament appropriation. I have one final thought here on, on the altar, on the golden altar, which is Aaron was instructed to offer a perpetual incense upon it. In the New Testament we are told by Paul to “pray without ceasing.” And this becomes a stumbling block for a lot of people, because the idea I think a lot of people think is, “What does that mean? Should I lock myself in a room and I, I pray and I pray and I pray and I pray and I pray, and I keep praying? Or I pray redundantly? Or I pray from a card? Or”━no, it doesn't mean that. The picture that has been depicted here, and I want you to think about this, if the offeror, in this case Aaron, was told to offer perpetual incense, then think about this.
What he brought, whatever those four ingredients were, had to be basically consumed before he would bring and replenish more. So I think it's safe to say when we talk about prayer and pray without ceasing in the context of the altar, the same concepts, I don't think it necessarily means that you are to pray in the sense of, you know, I'm going to lock myself in a room and for, for ten hours I'm just going to not stop praying. If you want to do that that's your business, but the idea is that is perpetual, it's continual. That means whatever I might have prayed for yesterday, I may come back again tomorrow and do the same thing and likewise and so on. And I think that's where people get a little bit nutty.
They think taking it literally, which is I will, I will pray without ceasing, I will pray at all times. No one can pray at all times, okay. Just get, get that idea out of your head. Not even the people who profess to pray all the time pray all the time. At some point you've got stop for some bodily functions here, okay, and I don't think that while you stop for that you're equally praying at the same time. Just save it for somebody who might believe you. All right, so I just want to say this about everything, because I've kind of done a very more generic approach here.
But these concepts, the table of showbread and the golden altar of incense, they do represent something to me that I think is desperately needed in this particular time, and that's called communion with God. And this got me to thinking a little bit, especially with Easter coming up, and I'll just tell you straightway in advance, because I was having a conversation with somebody last week, and I said, “You know, we have enough Resurrection, proofs of the Resurrection, different approaches to the Resurrection, many, many years of, of these messages.” But the application, it dawned on me; I think a lot of people don't actually know how to apply the resurrected life into their lives.
And that actually requires communion and fellowship with God to understand that. So when we look at these items you don't look at the table of showbread and the altar of incense without, as I just finished mentioning without all that came before. And recognizing just even how you came into the tabernacle, how the way of approach explains that without recognizing and understanding; you don't have to be a mathematician and understand formulas, but you do have to look at the big picture to recognize your standing of who you are before God, which as a sinner. We're all sinners, there's not one person in the sound of my voice who isn't.
We are sinners being basically washed and cleansed by the final and finished sacrifice of Christ, washed and cleansed by the word as He described in John 15. But all of this kind of comes down to a bigger picture, which is how do we understand this in fellowship and communion? Because it is in the fellowship and communion that the relationship is developed or built, it is a relationship. And you can't have the relationship just simply built on what I just described, the table and the altar of incense without recognizing the sacrifice, the way of approach, the way in, what walled you out, what kept you away.
And that that wall of partition has been broken down. But all of that is to say that when I do get around to, I believe next week is Easter, it may not be a traditional proofs of the Resurrection, because it dawned on me in all the years, my 18 going on 19 and probably 30 years of Dr. Scott's ministry here, I don't think I've heard a message on why it matters to understand about that resurrected life and how to apply it, because there begins the concept. See, I think a lot of people come in and it becomes it's an obligation for one day, “Okay, I've got to go because I know this is kind of a commemorative thing.
I go because, and here's all the reasons.” But there all the wrong reasons, because if you come to understand the proofs, and the proofs properly applied to your life bring something incredible to the believer that without that you may just say, “Well, it's enough for me to know, because Christ resurrected sits at the center.” But the lack of understanding, in my opinion, brings about a lack of communion, a lack of fellowship, and a lack of worship. And those things that are lacking keep the distance, in my opinion, between the believer and God. So hopefully we will, I'll get to that next week and I'll talk to you about that next week, but what I want to say in wrapping up; I'm not done in the tabernacle by any means. But I wanted to keep this simple because, as I said, showing each measurement or each color or each dimension is it, it's there, so you can go back and read the descriptions of the table and read it for yourself or the descriptions of the altar of incense and read it for yourself.
And understand now with the understanding of what is, what is a cubit and what the numbers mean or that the materials mean. But go back and read it, as I've said for many weeks now, looking at through the eyes of God in Christ, looking at how amazing God is to paint this picture. And the picture as I said, wasn't painted for a few people. That's why, again the numbers matter.
This four corners of the earth, to all ends of the earth; it wasn't designed for a singular people. This is the mistake that people get into when they say, “Well, this was given,” and I've heard people say this, “This, this was given to the Jewish people.” No, the Jewish people didn't exist at this time. I've already gone through that, and please, if you haven't listened to my message do not argue with me, do not post on my social media page. If you have not listened that means you are still ignorant as to what this book; not me, not my opinions; what this book says about what I just said. This was given as a pattern of what God would do for the whole earth. And when you come to see that it just makes God and His plan of salvation all the more amazing, because He said, “I don't need for people to keep coming to the door perpetually and slaughtering an animal anymore. I chose My only begotten Son,” and He gave His life that you and I may have life eternal.
And that life eternal is something so powerful in, especially in this day and age where people are vacillating in fear and confusion and everything else. This resurrected life says, “No matter what's going on, God has a plan.” He had it here, He had it here, He had it here, He has it here at the end of the book, and He's got it here and He's got it there. And if you just look it will bring something else to your life: peace. And without that I don't know how you're going to get along in this world, in this crazy lunatic world right now. So with all that being said, I hope that you can take what I've said today and without it being too detailed, very generic, to say there is definitely reason to go back, reread and study, and see the beauty of Christ in the Old Testament. That's my message. You have been watching me, Pastor Melissa Scott, live from Glendale, California at Faith Center. If you would like to attend the service with us, Sunday morning at 11am, simply call 1-800-338-3030 to receive your pass.
If you'd like more teaching and you would like to go straight to our website, the address is www.PastorMelissaScott.com.
Hello everyone Today we will discuss how to stop palpitation immediately without any medicine , and equipment Now first of all what is Palpitation unpleasant sensation of own heart beat In some types arrhythmia neck vein pulsations also seen clearly with palpitations There are many causes for palpitation Most of cause are simple Like anemia or low hemoglobin Anxiety, stress, these conditions released adrenaline Which causes palpitation Or overactive thyroid and pregnancy If you take heavy caffeine, coffee, alcohol and smoking Or taking some drugs like cocaine and marijuana all increased palpitations Some palpitations have serious causes Like Heart related factors which increased palpitations Heart failure, valvular heart disease, mitral valve prolapse and cardiomyopathy palpitation is serious 4 easy ways/methods to stop palpitation immediately anywhere, anytime First is valsalva Maneuver It stimulates vagus nerve Vagus nerve is connected to heart and brain And as soon as vagus nerve stimulates it decreased heart rate and palpitation finger and thumb Then close your mouth also Then forcefully exhale outside, means breath out while your nose and mouth both closed This Maneuver you do for 10-30 second This valsalva Maneuver increased your intrathoracic pressure Which stimulates the vagus nerve and your heart rate will come down Second method is coughing You do forcefully coughing, As you do forcefully coughing it increased your intrathoracic pressure And bring down your heart rate and palpitation Third method is Deep breathing Deep breathing is simple method to break or stop heart palpitation It also decreased your anxiety and panic attacks And increased oxygen supply to brain To perform Deep breathing you sit comfortably at one place Then take deep and shallow breathing through your nose Then exhale slowly slowly through mouth This procedure do continue for some couple of minutes till your heart rate become normal Fourth method is cold water When you feel palpitations wash your face with cold water Or splash cold water on your face Or take shower or bath in cold water Very simple is to keep ice cubes in towel and Apply on your face, it stimulates your vagus nerve and decreased your heart rate and palpitation So these four are very simple method by which you can break your palpitations In these maneuvers no need any medicine or equipment Thanks
As found on YouTube
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this episode was pre-recorded
as part of a live continuing education webinar on-demand CEUs are
still available for this presentation through all CEUs registered at all
CEUs comm slash counselor toolbox I’d like to welcome everybody to today’s
presentation on common co-occurring issues exploring the interaction between mental health
physical health and addiction so we’re kind of putting together the stuff that we’ve been
talking about for a couple of sessions now we’re going to start by talking about some
questions and then reviewing what a healthy person needs and then going through and talking
about how different addictions may cause or be caused by mood disorders and physical health
issues and we’re going to talk about things that you may see in private practice or the
a facility that you’re working in just real quickly for those of you who are here how many people if
you would just type in the chat window if you’re a mental health counselor type mhm if you are a
addictions counselor type SI or whatever so just kind of so and know who I’m talking to you okay
so mostly mental health ok cool so what we’re going to look at is what you may
see in private practice or a mental health setting because these clients a lot of clients
that have substance abuse or addiction issues and I use the term addiction because we’re
talking about behavioral addictions too many times they don’t meet the criteria for admission
for substance abuse because they don’t meet that threshold of a substance use disorder tolerance
withdrawal yay yay so substance abuse agencies can’t get funding to provide the treatment so
they end up in a mental health facility or a mental health counselor’s office and they may
be dealing with some of these addiction issues and wanting to address them or they may not be
but those issues are out there and exist so we want to know how they interact so told you
we’re gonna have a couple of questions to think about and I’m just asking you to ponder these for
right now and you can add throughout the class if you want but we’re gonna talk about it more at
the end how can we and why is it important to address chronic illness and disabilities
that result from or that cause mood disorders or addictions so thinking about you know like
HIV or hepatitis are two of the big one’s cirrhosis of the liver chronic obstructive
pulmonary disease from smoking so these are things that can result from addiction why or how
is it important for us as clinicians mental health clinicians mainly to think about addressing these
how can we address depression and/or anxiety kind of our mood disorder genre and hopelessness that
results from or causes depression and anxiety so we know that thinking back affects acceptance
and commitment therapy there’s clean discomfort which is what he calls your initial emotion
when you feel something if you feel depressed if you feel anxious that’s how you feel and
it’s uncomfortable but it’s clean it is it is what it is and then he calls dirty discomfort
the feelings that we have about those feelings so we can get angry that we are depressed we can
get depressed that we’re still depressed and he calls that dirty discomfort because we’re kind of
layering on and piling in think about just kind of throwing somebody into a hole and piling more
dirt on top of them so we want to think about how can we address these issues that result from
depression or anxiety or sleeping eating or energy changes so if you’ve got somebody who is dealing
with a chronic illness or something else has happened or they’re they’ve got some sort of
an addiction and they are not eating well not sleeping well it could trigger depression or
anxiety so we’re going to talk about that how can we address sleeping eating and energy changes
seems like we’re getting repetitive we’re looking at how each one interface and how can we address
these things that are caused by or cause mood disorders or addictions because we know when we
look at the diagnostic criteria for depression for example sleeping eating and energy changes
primary in there and how can we address guilt and regret which may accompany addiction recovery
or the diagnosis of the disease as the result of addiction such as lung cancer or HIV or cirrhosis
of the liver and people who have liver disorders cirrhosis of the liver and hepatitis are at a
greater risk of liver cancer so that can they can have some additional anxiety that is related
to that so they may look back and go I wish I hadn’t well you have so how can we help you deal
with that and come to some level of acceptance so my little editorialized soapbox when we’re talking
about addictions I mean sometimes we don’t want to think that they exist we want to pretend that our
clients are coming in their mental health clients otherwise their perfectly healthy things are
going great well that may not be the trick the case a lot of people begin to use and I mean
think about ourselves when we’re when we were in high school and college or you know even later
some people use it for recreation you know they want to go out have a few beers do whatever cool you
know that’s fine some people drink or use it for relaxation my son has a love of we will use that
word videogames and he will get on his videogames and we’ll kind of get lost in it it helps him
escape from you know life as we know it for a little bit of time some people use
because of peer pressure you know it’s everybody’s doing it or you know you’re at a football party
or something and everybody’s having a beer and somebody offers you one and you don’t want to be
rude things like that can happen and some people begin to use straight up for self-medication
they’re like I feel crappy I need something to help me feel better or numb the pain so there’s
a lot of reasons people begin to use so then you might say well why don’t they just say no because
it’s easy to say no well it’s not some people start to use it because they’re bored and
they want something to bring some excitement some euphoria to their life and we’re talking about
everything from sex addiction to internet addiction to cocaine use I mean we’re running the gamut here
they may lack the awareness of the dangers or how quickly you can become addicted I know when I was
working in the facility in Florida there was the sort of knowledge if you will and knowledge is not
the right word rule I guess that with crack cocaine for some people, it was a one-hit wonder
you did it once and you were hooked and several drugs can be highly addicting
quickly especially if they’re taken either through injection or inhalation but we’ve talked
before about the fact that our bodies can start developing tolerance to opiates within 3 to 5
days so you know people may not a lot of people don’t realize when they go in and their doctor
writes him a script for two weeks of opiates and they take it as prescribed that they’re actually
becoming somewhat addicted to those opiates if they take the whole prescription so they may not
understand that some people don’t say no because they have low self-esteem so they’re looking for
comfort to help them relax to help them loosen up so they can be more fun at the party and or
to peer pressure somebody tells them why don’t use or why don’t come out and go drinking
with us or whatever the case may be so to fit in they may try to use it to fit in to feel
part of a crowd and part of it can also be you know with that peer pressure just generally the
culture promoting this kind of behavior going it’s ok I think I’ve shared with you before at
At the beginning of some of the original Beverly Hillbillies episodes they still advertised Winston
cigarettes, like they are the greatest thing and cool people, have them and that’s the thing to
do so if that message gets out people may start believing it and not do their research so to
speak on what the true problems or risks may be and then again self-medication some people may
be struggling just to get by from day to day and this helps them survive the best they can with the
tools they have until we give them some new tools so just saying you know I had I grown up
during the era of Nancy Reagan and you know God loves her she was trying to help and for a certain
small percentage she probably did but for a larger percentage just saying no is not that easy we need
to give people the tools so they can say no so they don’t so they aren’t relying on these drugs
for some reason because when people start using it for recreation and relaxation some people may not
have a big big issue with it other people may start throwing their neurotransmitters kind of out
of whack depending on how much how often they use what combinations if they’re on any medication so
people may inadvertently start messing with their neurotransmitters and creating and we’ll talk
about this creating depression or anxiety that they end up trying to self-medicate so that
that is my soapbox for it is not that easy to just say no we as a culture not just as clinicians
have some work to do so what do we need to do to help people be able to just say no
they need to have access to healthy nutrition and knowledge of what that means my son and it’s
still like drawing fingernails on a blackboard to me today this week, I told his sister that you
no, he didn’t understand why she was so concerned with the nutrition he’s a guy he doesn’t need to pay
attention to nutrition it’s just whatever and I was just like oh my gosh you know everything I’ve
said has fallen on deaf ears but okay we’ll back up and figure out a way they need access to
it and then they also need to eat it you know if we have healthy foods available but people are
still eating peanut butter and jelly sandwiches for every single meal it’s not going to help so we
need to make sure people understand what a healthy diet looks like and how to do it in a way that’s not
painful you know we’re not asking you to just eat rabbit food as my daddy used to say but so what
does it look like to eat a diet or nutrition that makes you feel good that’s happy that makes you
feel happily fulfilled you like it tastes good whatever you want to say but that’s also
healthy you know it’s not just pizza or just peanut butter we need to educate people and a
lot of adults that I work with have no clue about sleep hygiene you know they know they’re supposed
to try to go to sleep but they don’t know anything about turning off the blue turning on blue light
filters so the blue lights are not keeping them up so we need to do some education here ideally in
elementary schools but if we can get it out to the community so they can pass it on to their little
minions we’ll be on a good path to pain control we need people to start having pain control but
we need to also have them have alternatives to pain control besides opiates and there are a lot
of them out there again people don’t know about so we must educate and we’re not
prescribing pain control that’s not our job but if we have a client who’s in chronic pain we can
suggest that they work with their doctor that they look into options for pain control you can google
it and find a lot of different alternatives now if they don’t want to go to the doctor but you
know there are a lot of different things from acupressure it attends units to things that are
nonpharmacological that can help people manage their pain so they can sleep which will help
the rest and rebalance to deal with fatigue and be able to deal with life kind of on life’s terms
because they won’t be in this constant state of stress people need access to regular medical care
to prevent problems so you know we want to prevent this thing on your face from becoming skin cancer
we want to prevent anything else that that might trigger problems and early intervention so like
with Lyme disease, if people get early intervention mentioned they don’t end up with the chronic
problems with HIV the earlier the intervention the better same thing with hepatitis you know
the list goes on so we want to make sure that if people have some sort of issue that’s disrupting
their ability to get enough sleep process nutrition go to work do any of these things that
they have access to some method whatever method they need to address it so sometimes it’s medical
sometimes it’s mental health it’s social services they need safe housing so we’re on to
social services now and that includes a roof over their head that they’re not worried when
they go to sleep at night but also being safe from domestic violence and things like that safety
and this kind of goes with safe housing and I put internal and external because you know the first
part is external safety we want to be able to know that our patients can relax wherever they’re at
they have enough money to keep a roof over their head in a safe place and you know typically that’s
not something that we think about as mental health counselors we think about helping them deal with
their anxiety but if they can’t get enough sleep and they never feel safe when they’re at home
they’re not going to be able to rest and they’re at best their recovery is going to be impeded at
worst you know it’s going to contribute to the issue that they’re seeing us for so safe housing
is important we’re not going to get it for them but we can point them in the right direction your
local United Way which is 2-1-1 and most places generally has a listing of different resources
for accessing safe housing if you don’t work in a facility that’s used to dealing with that
and then internal safety that’s shutting up that internal critic that’s being able to go through
a day without being derogatory to yourself and that’s something that we definitely can
help with we can help people shut down that internal critic or that internal person that
is always calling gloom and doom and you know waiting for the other shoe to drop or whatever
the case maybe we can help clients change their cognitions so it’s safe inside their head
and then people need love and acceptance and this should sound pretty familiar are you
know Maslow’s hierarchy here kind of in Reverse but people need love and acceptance but in order
for love to have love and acceptance in many cases they also need to love and accept themselves so
we’re gonna work on self-esteem we’re gonna help people develop relationship skills hopefully there
are some people in their life that have provided some level of love and acceptance maybe not the
unconditional positive regard we’ve hoped for but they’re there so these are things that the healthy
happy person needs and these are things in large part we can do through education referral and direct
services help people get so why do we care about co-occurring issues as mental health counselors
well 35 percent of people with anxiety disorders have according to one of these studies abused
opiates so that’s a lot if you’ve got somebody with an anxiety disorder this isn’t just panic
this isn’t just something you know severe this is you know any of your anxiety disorders
one in three roughly have abused opiates they’ve used some sort of opiate drug to help them kind of
chill out of opiate or alcohol dependent patients 20% have major depressive disorder so of that
35% you know there’s going to be a percentage of them who may be opiate or alcohol dependent
and there are a lot of our clients that we see in mental health treatment who are not willing to be
truthful about how much they really drink or how often they drink because they might be
suspecting it’s a little bit of a problem but they’re not wanting to go there yet they’re in
what we call pre-contemplation okay so let’s just go with this in mind that there may be some
underlying other stuff that they haven’t told us about opiate or alcohol-dependent patients 20%
have major depressive disorder so you know we’re taking them and we may be seeing them in the clinic
for depression and we do want to be suspect of whether there’s either some opiate or alcohol
issues there depression and opioid-dependent patients including pain management patients so
those who are opiate-dependent by prescription have been associated with poorer physical health
decreased quality of life increased risk-taking behaviors and suicidality am I saying that pain
management clinics are bad no but what I’m saying is those who are in pain management clinics for a
variety of reasons are at a high in a higher risk category I mean think about it if your pain is
bad enough that you need to be going to a pain management clinic think about how much that must
hurt think about how much that must impair your daily life think about the impact of the drugs
that you’re taking on your mood your energy levels and the stigma in some cases associated with it
some people here suboxone and they’re like yeah whatever my neighbor takes that other person here
suboxone and they’re like ah you can’t be taking that so there is still a lot of social stigmas that
goes along with medication-assisted therapies so there are a lot of things that may contribute
to depression in opioid-dependent patients the prevalence and severity of depression tend to
decline within the first few weeks after treatment initiation so if they are trying to get off of
you know ideally their detox and they’re trying to you know remain sober the prevalence
and the severity of depression tends to decline so we need to get them off of it first and get them through
that acute withdrawal from a depressant including alcohol and I know this slide is boring
but we’re gonna be through in a second withdrawal from depressants including alcohol opioids and
even stimulants invariably include potent anxiety symptoms so it’s important to pay attention and
withdrawal from stimulants can also include potent depressive symptoms if they’ve been on a crack
binge for you know five days that won’t sleep for a while many people with substance use disorders
may exhibit symptoms of depression that fade over time and are related to acute with drawl well we
talk about acute withdrawal we’re talking about the first three months we’re not talking about
the detox period which is generally three days so encourage people who’ve gone through detox and
maybe they’re seeing you on an outpatient basis encourage people to you know be patient and work with
the treatment team if they need to but the first three months is always the hardest so chicken or
the egg you know did the person start using and become depressed or was the person depressed so they self
medicated does it matter depression and anxiety are associated with addiction because because
if you have stimulant withdrawal or recovery that period after you quit using that’s maybe
a week maybe two weeks where your body is going whew that was a run people may feel depressed
fatigued have difficulty concentrating which can impact how well they eat it’ll impact
their sleep they’re gonna sleep a lot more but the quality of sleep may be poor so they can mess
up their circadian rhythms and you know they may not have access to the social support that
they wanted they may but really with stimulant withdrawal we’re looking at nutrition
and sleep so we want to educate patients if they decide to stop taking stimulants what they need
to look at stimulant use can also be associated with depression and anxiety because many people
not you know the majority but a lot of people out there will self-medicate depression with
stimulants from anything from caffeine which you know maybe like mild dysthymia but if you
abuse enough caffeine you know it starts getting into your system you become dependent on it but if
you start combining caffeine and nicotine plus oh let’s add in some workout supplements or you know
the occasional Ritalin or something not suggesting it then it’s these things can wear the body down
which can lead to additional depression but people may use these things to try to feel better because
think depression is related for some people they may not feel like they can wake up they’re
fatigued they’re lethargic all the time and they’re feeling blue so if they take stimulants
they get that dopamine rush they’re starting to feel good and they’re awake stimulant
use can cause anxiety well the so if you’ve got somebody who already has maybe they are depressed
but they’ve also got some anxiety and they start using stimulants which may make the anxiety way worse
alcohol or opiate use some people use these things to numb or to forget and that’s just your
the standard used the depressant some people will use either one of these but especially opiates to
deal with physical pain to medicate depression or anxiety remember there are a lot of trials not
several trials right now that are looking at using opiates to treat intractable depression
but a lot of people also use opiates off-label illegally to address anxiety so if you’ve got a
client with depression or anxiety just kind of be alert for how they’re behaving if they’ve
got pinpoint pupils or if they’re itching and picking all the time I mean not the occasional
are winter and the heat just turned on I’ve got dry skin itch but constantly itching and picking
and you know where you’re like please just settle down detox from opiates can all often produce
depression produces a lot of flu-like symptoms which can make people feel crappy and the
flu-like symptoms I won’t get graphic impaired nutrient absorption impaired sleep you know
they’re sleeping a lot because they feel like crap but they’re also having to get up every
10 minutes to go to the bathroom sometimes so this first week or so during the initial if they
go cold turkey so to speak can be rough detox from alcohol as I’ve talked about before
can produce anxiety symptoms so understanding that when people are going through detox whether
they are alcohol dependent and have been drinking a whole lot which needs to be medically monitored
I can’t say this enough and I’ll say it a lot more tomorrow when we talk about where Nikki Korsakoff
syndrome but people who are detoxing from alcohol will have anxiety symptoms and a period of high
blood pressure and sometimes depression and anxiety are associated with addiction just because they
sober up one morning and they look at their life and they’re like what the hell have I done so
you know and you’re looking at them going yeah I don’t blame you for feeling that way now let’s
see what we can do to improve the next moment so make sure that we understand that these
things are going to go hand in hand and to be on the lookout because like I said a lot of people
aren’t forthcoming even about alcohol use which is legal but if they’re using something illegally
or using maybe their kid’s Ritalin or something they’re pretty much almost guaranteed not to tell
you so we want to be on the lookout for signs and symptoms bipolar disorder can be triggered by drug
use so we just know that we can the person could get worn down mess with the neurotransmitters
enough they’re not exactly sure how it happens but we have seen the initial acute episode of
bipolar disorder-triggered mania triggered by drug use it is more common for people with bipolar
to use stimulants when they’re depressed and just about anything when they’re manic now if you’re
working with somebody with bipolar you know you’re probably already having these discussions
about how you stay safe when you’re in a manic episode people with ADHD may use to self-medicate
and we’re talking cannabis is a big one for ADHD to help people feel like they’ve got more focus
and not feel like they’ve got so much coming in and so much stimulation all the time which can be
exhausting and after the use of any of the substances of abuse the disruption and neurotransmitters
can make people feel like they’ve got ADHD-type symptoms faculty concentrating difficulty
following through with things etc so understanding that even if things don’t meet the threshold for
DSM-5 diagnosis we want to look at what symptoms are there and how can we help people manage them
so they’re getting adequate sleep nutrition pain control social support and safety borderline and
antisocial personality just kind of threw those in there because we see those a lot when we’re
working in dual diagnosis facilities more people are more likely to use addictions to cope with a
lack of sense of self and their emotional lability if they’re borderline so I mean their world is so
chaotic many people with borderline personality disorder are likely to use to try to get some calm
in the storm now I will put out my other soapbox here with both of these personality disorders
when you see somebody in active addiction or early recovery they probably have symptoms that
would meet diagnosis you know their symptoms are pervasive in multiple areas of life their
symptoms would meet the diagnosis for one of these two personality disorders during this period
but it resolves as recovery becomes the norm as the neurotransmitter stabilizes they develop
interpersonal skills so you know giving people a little bit of time before we say it’s borderline
personality disorder versus borderline personality characteristics if you will be helpful because
both of these diagnoses can block people from getting into certain treatment centers and getting
some of the services they need okay so we’re going to move on to some of our more common addictions
alcoholism is associated with eating disorders there’s a really strong Association and it usually
flip-flops between bulimia and alcoholism so if somebody’s symptomatic for bulimia they may not
be drinking a lot of alcohol but they may during periods of remission from the bulimia drink a lot
more alcohol become alcohol dependent so there’s a lot of research out there that shows there’s
a strong correlation between these two things and it’s also associated with binge eating disorder
but especially bulimia nutritional deficiencies from alcoholism can cause mood disorders so
even if somebody is not and I use the term I should have put alcohol instead of alcoholism
because even the term heavy use without physical dependence can cause nutritional deficiencies that
can cause ulcers it can cause physical problems physical exhaustion which can disrupt sleep
alcohol impairs sleep quality alcohol makes apnea worse so if you’ve got a client who has
sleep apnea they’re drinking they’re probably gonna sleep even worse than they normally do
depression is the result of using well alcohol as a depressant so what do people expect well most
people expect to relax they don’t think about the rest of the stuff that’s going on in neurochemical
imbalances because the alcohol exits our system a lot faster than our brain can catch up and go okay
it’s not in there anymore so I need to adjust the temperature and in sleep disruption anxiety can
also, be triggered as a result of use I’ve said before say it again after that initial period
where people feel the depressant or relaxing effects of alcohol there is an upsurge in anxiety
so a lot of people have another drink to kind of quell that anxiety feeling but you know people
with anxiety disorders are gonna feel it more prominently and the neurochemical imbalances
that alcohol use causes can worsen pre-existing anxiety conditions or trigger anxiety conditions
nicotine is another one that we see a lot even in just straight-up mental health clinics not
co-occurring so what effect does nicotine have well anxiety and depression are 70% more likely in
smokers so that’s one of those statistics we want to look at nicotine triggers dopamine release okay
so nicotine is one of the most addictive drugs on the planet and you’re thinking I thought that was
opiates well opiates are in there but nicotine not only is nicotine legal but it’s also one of
the most addictive drugs on the planet so that’s another important point to think about people are
using their trigger and dopamine release their brain gets used to being flooded with dopamine so
their receptors on the other end start sensitizing so we’re creating an artificial environment
basically when people are smoking blood vessel changes when people smoke it causes blood vessel
changes that can cause high blood pressure as well as depression and fatigue and confusion in the blood
vessels narrow and get stiffer so the oxygenated blood has a harder time getting to where it needs
to be so people start feeling blah and that can cause them to think that they’re starting to feel
depressed can also cause those cause loss of energy people with severe and persistent mental
illnesses are two to three times more likely than the general population to use nicotine so that’s
just an interesting little fact to have out there if you work with people with SP MI and people
with ADHD may smoke because it increases their concentration and attention for about five minutes
literally, for about five minutes but during that five minutes they’re like oh my gosh it’s a relief
I can like focus for half a second so we want to look at what else is going on whether the
a person has adult ADHD for example physical health mental nicotine is linked with COPD and emphysema
and lung cancer so you know all kinds of lung and cardiopulmonary stuff well when that happens
you know we have less oxygenated blood efficient efficiently getting through the system we’re going
to have increased fatigue increased confusion some grief that may go along with that especially if
people are starting to have to carry an oxygen tank around with them or something you know we may
have to help them deal with disability acceptance and depression and stroke because smoking like
I said increases blood pressure and reduces circulation so cutting off or greatly reducing
circulation to the brain they have shown that people who smoke especially heavy smokers are at a
much greater risk of stroke and addiction nicotine is strongly correlated with other addictions a
a lot of people when they’re in the bar well not so much anymore since smoking is not allowed in
public places but used to be when they were in the bar they would also be smoking but a lot of
people associate alcohol and nicotine or nicotine and other drugs so if somebody is using other
drugs likely they’re smoking now it doesn’t work the other way around just because they’re smoking
doesn’t mean they’re likely using other drugs the reason this is more important is that people
who continue to smoke after they have gone into recovery for their drug of choice have a relapse
rates as high as 68 percent higher than for people who quit smoking so we start thinking about that
and we say well why is that well because nicotine is a mood-altering substance you know we don’t
think of it as such because it’s not a woohoo it’s Marva hey okay it’s not as prominent
of interaction as maybe cocaine or something but it does change the balance and people still
do use smoking to cope with life when things get stressful they smoke well if things get stressful
and you know they’re too stressed for smoking to handle then they may start going back to what
else can I take use or do that will make this feeling go away right now we know also that was
smoking and that repeated release of dopamine they’re messing with the neurochemical balances
in their brain, so it makes sense that eventually just like tolerance to other drugs happens it may
not be enough at a certain point and they may fall back into other habits nicotine has been known to
suppress appetite and but whether it keeps weight off or not they haven’t shown alcohol
and nicotine both are appetite suppressants which is another reason people with bulimia tend to
drink and one of the reasons why people quit smoking they tend to be hungrier so helping
them get through that period now whether it helps them keep weight off the party that deals with
the reason that they eat it’s not really that it’s suppressing their or increasing their metabolism
so much its nicotine suppresses the anxiety and sometimes the desire the hunger but if people
are still eating out of anxiety if they’re still eating under stress eating then you know when they stop
smoking and they don’t have a cigarette to put in their mouth when they’re stressed they tend to
go for other things and so we need to help people figure out when they stop smoking are you
eating because you’re hungry or are you eating because you’re stressed if they’re eating
because they’re hungry and they’re getting heavier than they want to be they need to talk with their
doctor about you know thyroid tests and also let their doctor educate them on biological setpoint
theory of you know not everybody’s going to be a zero so you know that may be something we can
help them deal with body acceptance issues if you know maybe they’re programmed genetically to
be you know a size X whatever that is and they’re not happy because they want to be a zero which our
culture does tell us to do as clinicians we can help them look at you know the costs and
benefits of continuing to smoke and what being you know a size zero means for them to opiate
abuse there’s a lot of physical stuff and we’re just gonna run through it real quick because
you’re not as concerned with it the physical stuff the doctors are gonna see but we need to be
aware of from a clinical point because it can keep people from getting their basic needs met blood
and injection site infections you know that’s probably going to lay them up for a while but if
they have repeated infections and are repeatedly out of work they can lose their job they can lose
their housing they can you know get some sort of MRSA or something else which can be really
expensive it can be life-threatening ya-ya collapsed veins and this is more common obviously
this is only for injection drug users but collapsed veins just as you would expect keep the
oxygenated blood from getting where it needs to be so people are more likely to experience strokes
and may have certain forms of vascular dementia because of the strokes dementia we’re familiar
with endocarditis is the inflammation around the heart so again this is only for needle
drug users but if you’ve got a client who is using needles to inject any kind of drug be aware
of that and what they get and what they inject is rarely pure so knowing what else they’re injecting
into their system if they’re you know crushing pills from the pharmacy you’re a little bit more
sure about what they’re getting as opposed to if it’s from the corner dealer and sometimes
they’re cut with really nasty things like you know comic bathroom cleaner and stuff HIV if
people get HIV from injection or some other risky behavior they’re probably going to experience
some depression and a lot of times HIV from opiate abuse they’re gonna experience depression
remorse regret all that kind of stuff anxiety about how long they’re going to live what’s
going to happen and oh those medication side effects those the antiretroviral medications that
they have to take are doozies I’ve seen people go through the induction weeks on their medications
and it is a rough time so helping people get through it so they are medication compliance
so they can continue to live we need to help them maintain hope and self-efficacy and all that kind
of stuff to maintain that forward movement to get through the induction period liver damage from
acetaminophen can set people up for you know physical pain among other things and it decreased
pain tolerance now this generally the decreased pain tolerance goes away after the
the body starts producing its endorphins and natural painkillers again but that initial period
if somebody quits using and maybe you know you are seeing them as a mental health client and
they had an accident or had surgery or something they started using pills they got a couple of
refills then the doctor said no I’m cutting you off and now they’re going through a detox period
detox from opiates is unpleasant but it is rarely life-threatening unless somebody becomes their
electrolytes get imbalanced because of the flu symptoms but we still may see this in private
practice in mental health practice because of the scenario I just told you people can start
taking painkillers as prescribed for something they may get addicted you know take them for
a month or so then when they get off of them not only do they feel like you know really bad
but their pain is also back and it may be they had their wisdom teeth out that pain may be gone
but other aches and pains and everything you feel is probably going to be intensified until the
body kicks back in so educating clients about this is what happens you know it’s not uncommon
if you think it’s too bad go see your doctor helping them make sure they’re getting
good nutrition you know it’s hard if you’ve got flu symptoms to feel like you want to eat or
hold anything down so what can you do to make sure your body has the building blocks to make the
stuff that it needs to help you feel better what can you do to improve your sleep and a lot of our
clients and you know where I used to work we had a methadone clinic and we also had a mother
baby unit and as soon as the mothers would give birth then the doctor would start them on
their detox from methadone and he didn’t believe in the kinder gentler taper he was just like okay
baby’s gone threats gone because you can’t detox from somebody from opiates when they are pregnant
because it can cause the baby to die anyway so as soon as they would stop or as soon as
they weren’t pregnant anymore he would just D see them and they would feel really bad I mean
not only did they just push an 8-pound something out of their body but they also are experiencing
a decreased pain tolerance because they’re not on the opiates anymore and all they want to do is
sleep it’s just like please so understanding that is important in helping people get through
that period even though they may want to sleep all the time helping them understand that it’s
important to maintain their circadian rhythms if they have to take two or three ten-minute
power naps throughout the day to get through the day you know more power to them but if they
can practice good sleep hygiene they’re gonna be way better off in the long run OPD opiate
abuse is also or opiate use is also associated with the treatment of depression but it can cause
depressive symptoms due to its pharmacological properties I mean it slows everything down from
you’re gastrointestinal to your heart rate to your respiration you’re not breathing as much you’re
not getting as much oxygen in you’re gonna have more fatigue you’re gonna have more confusion
you’re going to have more of those symptoms of depression for some people they find it is and
certain opiates they find it is a powerful way to reduce anxiety it makes them feel like they’ve
got a ton of energy because they’re not stressed out anymore and this last one is one of the
The main reason that I find people don’t want to give up opiates is that they finally feel better when
they’re on the eating disorders commonly a coat co-occur with depression and anxiety which can
be caused by nutritional deficiencies you know you’re not giving your body the building blocks
so it can’t make the neurotransmitters it needs and it also probably disrupts your sleep some
and depression anxiety can cause or trigger or whatever you want to say eating disorders because
people with eating disorders may fear becoming fat have low self-esteem have a sense of lack of
self-control or have body dysmorphic disorder so we also want to be aware that there are mental
health stuff that can trigger dysfunctional eating patterns there’s about a 24% prevalence of PTSD
among people with eating disorders so if you’ve got a client with eating disorders especially
bulimia be on the lookout for depression anxiety body dysmorphic disorder alcoholism and PTSD they
maybe smoking too but of the things, I just listed that’s probably the least of their worries it’s
all eating disorders are also associated with alcoholism and smoking I said physical health
issues now you’re seeing somebody with an eating disorder it’s a mild eating disorder you’re seeing
them once a week outpatient so you’re not and you have you know you have training and
working with eating disorders or maybe it’s mild enough that you’re just getting supervision
on treating this issue whatever being aware that people with eating disorders anorexia or bulimia
can have irregular heartbeats and cardiac arrest due to potassium imbalances and electrolyte
imbalances so if they’re not eating or if they are binging and purging in some way shape or
form and that includes excessive exercise which can trigger a lot of heart problems they may have
loss of bone mass and osteoporosis so they may break bones a little bit easier going back up to
the heartbeat not to belabor the point but again heart problems mean a lack of available oxygen
mean confusion fatigue potential difficulty sleeping depressive symptoms and you know cardiac
arrest in and of itself is bad kidney damage from Doretta caboose and low potassium can also
potentially drain damaged the adrenals which are on the kidneys and so it’s important to be
aware of what people are using a lot of people with eating disorders are going to creatively
use stimulants to suppress their appetite think about any of your diet drugs your enter mean I
think it’s one of them the ones they give to help people lose weight they’re stimulants
they’re intense stimulants so people who are struggling with eating disorders are likely to go
towards abusing stimulants or at least using them which can drain the adrenals it can in some
cases have been linked to the development of Addison’s disease liver damage from not eating
or binging and purging causing toxin buildup and possibly pain we can help people deal with it
as much as we can anemia which can cause symptoms of depression in and of itself so goes back to
that nutrition making sure they’re getting enough infertility which in and of itself can be
devastating for young women if they can’t have children anymore or can’t have children
ever that may be a grief issue that we need to help them deal with cathartic: and this is
an important one to be aware of because you don’t have to have somebody who uses laxatives
all the time but people who regularly use or abuse laxatives can become dependent on them so
when they don’t use them they have a feeling of bloating feeling full and abdominal pain which
especially in people with eating disorders or body morphic disorders surrounding just general
body fit bad back body fat can greatly increase anxiety depression hopelessness and in some
cases of suicidality so again educating people is the first step to helping them understand what’s
going on and how dangerous laxatives can be but also if somebody is trying to cut back on their
use of laxatives or just recently stopped using laxatives like when people stopped using
opiates it takes the body a while to get back online but for most people it eventually does
people with eating disorders also have chronic ulcers which are painful and can keep you up at night
As you know gastric reflux and pancreatitis which can flare up at a moment’s notice will is
extraordinarily painful and can cause people to lose time from school or work social activities
feel bad about themselves and also pancreatitis causes a lot of bloating
which in eating disorders is a huge trigger for anxiety and depression pathological gambling
is associated with stimulant abuse especially cocaine methamphetamine and Ritalin to stay
focused disrupted sleep and rebound depression when they quit taking that stuff they wake up and
they’re like oh wow what did I just do alcoholism is also associated with pathological gambling
some people drink to calm their nerves some people drink because it’s the culture if you go
to any of the casinos you know their hand-and-out drinks, they’re trying to get you drunk so you
keep gambling more and there’s as we spoke about earlier rebound depression or anxiety smoking
may help people increase their focus or make them think they can increase their focus so if
you can’t smoke in public places this is more of an issue if you have somebody who does a lot of
online gambling or they gamble at their friend’s house or somebody’s house where there’s poker
games and stuff smoking has some anti-anxiety anti-anxiety properties and may be part of the
the culture I know when my daddy used to have his poker games everybody would smoke cigars and even
the one woman who went there would be smoking a cigar with everybody else and it was just the
culture of being there so there are a lot of different reasons that people may use substances
in addition to gambling mental health issues from gambling anxiety from the stimulant use or from
the tension and release of am I going to you know I’m down $20,000 am I going to make it back ADHD
is also strongly associated with pathological gambling bipolar disorder, especially during manic
phases are associated with pathological gambling generally you see them co-occurring it’s not
like gambling causes it it’s you will see co-occur depression can occur due to losses and
gambling can start because somebody’s depressed because of their financial situation and their
trying to figure out a way to you know borrow from Peter to pay Paul and get ahead you also see
pathological gambling is more strongly associated with people who have obsessive-compulsive
disorder if you’ve got clients with these diagnoses just kind of you know be attentive to
the fact that they are more likely to engage in pathological gambling or if they start gambling
it’s more likely to become a problem than for people who don’t have these issues internet
an addiction that is diagnoseable so you know I’m not just making something up
depending on your resource affects eight point two percent to thirty-eight percent of the
general population now obviously we were looking at you know like games versus you know games plus
Facebook plus shopping or something so depending on the study you looked at their parameters
were a little bit different but either way up to 38 percent of the population has sacrificed
significant personal recreational activities to engage in some sort of internet
behavior Internet addiction can cause anxiety or depression due to eyestrain and chronic headaches
you know if you’re hurting all the time it can make you feel wonky it can also interrupt your
sleep can cause circadian rhythm disorder which can trigger depression fatigue reduced stress
tolerance this is a condition when your body doesn’t know whether it’s supposed to be awake
or asleep because a lot of people who engage in internet-addictive behaviors do so in the dark or
you know they don’t pay attention to whether the lights are on or not they may just sit there kind of
in their cave carpal tunnel contributes to pain and sleep disruption because carpal tunnel does
wake you up at night back ache again may disrupt your sleep and can cause chronic pain during the
a day which can interrupt your daily activities poor nutrition I know a lot of gamers that will sit
there for an entire weekend and not get up to go eat so if it’s not brought to them they don’t eat
they’ll even wear adult diapers so they don’t have to get up to go to the bathroom reduced immunity
due to exhaustion from not sleeping and job or relationship problems I know uh several people
whose marriages ended over a world of warcraft’ so internet addiction is a real thing and it’s
something that we need to be cognizant of because it does cause a lot of problems and a lot of
relationships and it may be one of many problems but it’s something to look at sex addiction
can cause hepatitis and a variety of different STDs which if not treated can cause systemic problems
it’s related to anxiety and depression because sex addiction may begin in order because somebody
wants to feel loved or connected maybe after a breakup or because they never felt loved you’re
connected and then they feel that rush and they’re like oh I like that I want to do that again part
of it could be engaging in that behavior which is so thrilling you know depends on the person
psychological withdrawal from sex addiction people who have been engaging in sex addiction
type behaviors and I include pornography addiction in it for this presentation if they’re not able to
access that may start feeling anxious or depressed they can’t get to that they can’t get to the
the thing that’s gonna cause the dopamine rush and reflection on behaviors that they’ve engaged in
as a part of their sex addiction can also prompt anxiety about a spouse finding out you know am I
going to develop an STD and am I you know how I feel about what I’ve been doing so as clinicians
if we’re working with somebody who has compulsive sexual behaviors even if you know anywhere about that
the spectrum we need to be aware that these things may exist and figure out or help them figure out
how they feel about it and what they need to do to make sure that they’re getting good sleep
that they’re dealing with their depression and their anxiety so that they can have a safe internal
and external environment so back to that global perspective how can we and why is it important
to address chronic illness and disabilities that result from or cause mood disorders or
addictions how can we address depression anxiety and hopelessness that results from or causes
depression anxiety or physical problems how can we address physical problems that are caused
by mood or addictions and how can we address guilt or regret which may accompany addiction
recovery or the realization of a diagnosis of a disease caused by the addiction so while you kind
of ponder those there was a question that came in so question what about robbing Peter to
pay Paul in association with trauma specifically childhood trauma so if you could clarify that
for me a little bit I had mentioned robbing Peter to pay Paul in terms of gambling so I’m just so
mental health issues can be caused by or trigger addictions or physical health issues addictions
can cause or trigger mental health issues or physical health issues that can
be caused by addictions or mental health issues so again chicken-or-egg we don’t necessarily know
which one came first when you have any one of these it’s probably going to or likely impact
each other person or each other area common issues are seen in all three changes in sleeping
changes in nutrition fatigue and grief effective treatment requires addressing the underlying
causes as well as the ripple effects you know so yes after childhood trauma or trauma
of any sort, some people may spend a lot of time feeding the addiction as you put it or
engaging in addictive behaviors to avoid some of the PTSD symptoms to avoid thinking about it
to deal with the grief to deal with the shame so they may engage in something that makes them
feel better or helps them forget to cope with the trauma that happened until they
have other tools so they can come to some sort of terms with it and you know as I
say close that chapter in their book already if there are no other questions tomorrow’s
the presentation I learned a lot creating is on alcohol-related dementia and vascular dementia
and fetal alcohol spectrum disorders all three of which are issues that are caused by substance
use and specifically alcoholism and then I’ll give you a hint about where an acute Korsakoff a
a lot of clients who abuse alcohol but they’re not alcohol dependent who decide to stop drinking can
trigger where Nikki Korsakoff syndrome and causes alcohol-related dementia-type symptoms
so again in mental health, we need to be on the lookout for it if we hear that our clients
are trying to cut down on their alcohol use alrighty everybody and so tomorrow is that
presentation and then Thursday we’re going to look at different models of new bottles of
treatment if you enjoy this podcast please like and subscribe either in your podcast player
or on YouTube, you can attend and participate in our live webinars with doctor Snipes by
subscribing at all CEUs com VirtualBox this episode has been brought to you in part by all
CEUs calmly provide 24/7 multimedia continuing education and pre-certification training to
counselors therapists and nurses since 2006 used coupon code consular toolbox to get
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– Hey, Psych2Goers. Do you have trouble paying attention? For example, zoning out
while watching this video? Do you think you have
ADHD because of this? Oftentimes, people mistake
symptoms of anxiety for ADHD because of some of the
similar traits they share. According to the Centers
for Disease Control and Prevention data, about 3 in 10 children
with ADHD have anxiety. So to help you get a better understanding of the difference
between ADHD and anxiety, here are six signs to look out for. Number one, you have poor focus because of worrying thoughts.
Are you always distracted by your worries, so much so that you’re unable to focus on the things you’re doing? When fear and apprehension
dominate your thoughts, it may cause you to become restless, and have trouble sitting
still, paying attention, or staying focused in class. According to John Waldrop, MD from Weill Cornell Medical College, when you experience anxiety, your prefrontal cortex, the part of the brain which is essential for thinking, learning, and
remembering, is shut down. Your brain is concentrated
on staying safe.
In contrast with ADHD, you aren’t consumed by worrying thoughts. Instead, it has more
to do with an imbalance in your hormones: dopamine
and norepinephrine, which causes you to be distracted. Number two, you don’t tend to have as many problems with impulsivity. Do you often find yourself
speaking out loud in class without raising your hand? Perhaps you were even labeled
as the troublemaker in school because of the way you
can never sit still. According to Dr. John, a
person with ADHD may feel as if there are dozens of controllers trying to control their
brains at the same time without checking in with each other first. So if you find that you
don’t appear to have as many problems with impulsivity but just struggle to speak up or stand up because of your nerves, then you may have anxiety rather than ADHD. Number three, you have trouble
completing your schoolwork because of perfectionism. Do you have trouble
completing your schoolwork? Perhaps you find yourself procrastinating even if you only have just
one assignment to you.
This struggle could be because
you have so many points you wanna make in so many
ways to phrase the words that leave you wanting
to throw up your hands and ignore them. You’re avoiding starting your assignments because you can’t have
it is less than perfect. If you can relate to this, then it’s more likely you’re struggling with anxiety and not ADHD. Dr. John stated that
while people with ADHD may experience difficulty
completing their schoolwork or performing tasks, it’s often due to trouble
with concentration rather than perfectionism.
Number four, you are
generally more sensitive to social cues. Are you very sensitive to how you come across to other people? Do you find yourself often uncomfortable with your social environment? Perhaps you find it challenging to eat in front of other people, or tend to avoid speaking in public because of an overwhelming fear that people will judge you negatively. According to Dr. John,
if your answers are yes to the above questions, it’s more likely that you
have anxiety rather than ADHD. This is because people
with ADHD usually struggle with understanding or missing social cues rather than being hypersensitive to them. Number five, you experience
a racing heart, clamminess, tense muscles, headaches,
nausea, or dizziness. Do you often experience
headaches, nausea, or dizziness? These are just some of
the symptoms of anxiety. Dr. John stated that anxiety comes from a tiny almond-shaped part at the back of your brain
called the amygdala.
As a watchman for your brain, it is constantly watching out for danger. And whenever it detects danger, it triggers a fight or flight response. However, for anxious people, the amygdala is large and hypersensitive. Because of this, it ends up sending out
a lot of false alarms. You can think of it as a watchman
who cries wolf too often. As a result, your brain may sense threats even in non-threatening situations. And number six, you are unlikely
to show problem behaviors when you’re feeling calm, safe,
and doing things you enjoy.
How do you act when you’re having fun? Whether it’s listening
to your favorite music or playing video games, you
may find yourself feeling calm and safe while doing the things
that you genuinely enjoy. You are neither restless nor feel like you need
to catch your breath. According to Dr. John, anxious
individuals are unlikely to display any problem behaviors
when feeling calm and safe and doing something they enjoy. On the contrary, people with ADHD will experience problem behaviors even when they engage in a particular fun or exciting activity. For example, a person with ADHD may become so engrossed
with painting a picture that they tune out or completely
ignore everything else. This behavior is known as hyperfocus. Did you relate to any of
the signs we’ve mentioned? Let us know in the comments below. If you found this video helpful, be sure to like, subscribe,
and share this video with those who might benefit from it. And don’t forget to hit
the notification bell icon to get notified whenever
Psych2Go posts a new video. As always, the references and
studies used in this video are added in the description below.
Thanks so much for watching
and see you in our next video. (light music).
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– Hey Psych2Goers, welcome back. Think you've never
experienced anxiety before? Well, you might not have realized it because people experience
anxiety in different ways. Your idea of anxiety might not align with
how you experience it. And you may not notice anxiety in someone who grapples with it privately. So, it's important to
remember to always be kind because you can never know
what others are struggling with when they're alone. If you're dealing with anxiety, know that you're not alone
in facing these challenges. Anxiety is a normal part of life.
It alerts us to dangers
and helps us prepare for a wide variety of situations. But according to the Diagnostic and Statistical
Manual of Mental Disorders, DSM, anxiety becomes a disorder
when it starts to impact daily functioning and
different aspects of life. With that said, here are five things people with anxiety secretly do alone. Number one, overthink,
overthink, and overthink. Anxiety disorders are
characterized by excessive or disproportionate worry and fear that gets in the way of daily activities. It may not be as obvious to other people, but those who struggle with
anxiety tend to overthink while in the presence of
others and when alone. Many people who struggle with anxiety tend to dwell on negative thoughts about themselves and their past. They may replay these
past events in their head over and over, trying to think of what they
could have done differently.
And may also imagine
possible future events to try and anticipate
things that might go wrong. Two, confine themselves
to their comfort zone. Everyone feels anxious now and then, but those struggling
with an anxiety disorder constantly adjust their
lives to cater to it. They may stick to activities that calm their racing thoughts, or engage in pursuits that
allow them to avoid the things that make them feel anxious instead of choosing activities
purely for fun or interest. Like re-watching the
same shows over and over because they don't have to
feel anxious anticipating what might happen next. Some people may not even
be able to leave the house out of fear of being in
places and situations where escape may be difficult.
Or they may struggle to leave the house without a certain person
they're scared to lose. Three, withdraw from social interaction. Some people with anxiety may
have a limited social life and turn down invites, not
out of a lack of interest, but to stay home to calm
certain worries and fears. In some cases, the person
may seem uninterested in spending time with others due to a crippling fear of
feeling humiliated, rejected, or looked down on in social interactions. People with anxiety may withdraw socially to cope with their fears
and might avoid their phones or ignore or turn off their notifications to manage their feelings of anxiety, and then feel overwhelmed
and anxious later when they see the backlog of messages. Number four, procrastinate
or struggle to finish tasks. People with anxiety, especially
high functioning anxiety, may seem like completely
put together achievers, but they may also grapple
with getting their work done when they're alone, because anxious thoughts may
force them to procrastinate.
Anxiety also affects working memory, which makes it difficult
to focus long enough to complete tasks. And so, they may then have to rush to get things done on
time, adding extra stress. Then number five, tossing
and turning in bed. Having anxiety doesn't
immediately translate to nervous, jittery energy that
others can easily detect. Someone with anxiety can
seem calm and rested, when in reality, they might be
tossing and turning at night, unable to fall asleep because
of their anxious thoughts. If they do manage to get some sleep, they might be restless or
riddled with nightmares about their anxieties. For example, those with
separation anxiety disorder may have nightmares about being separated from their loved ones. Anxiety disorders are complex and varied, but remember that a certain
level of anxiety is normal and anxiety disorders are those that cause significant distress or impairment in different areas of life.
If you or anyone you know, are struggling with an anxiety disorder, please don't hesitate to
reach out to a qualified mental health care provider. Can you relate to any of these signs? Share with us in the comments and remember to like and share this video with someone who might benefit too. As always the references and studies used are listed in the description below. Until next time, take care friends..
Light music Narrator, Hey Psych2go ers. Before we begin, we would like to thank you all so much for your love and support for our channel Psycho2go.’s mission is to make psychology and mental health knowledge more accessible to everyone, and we hope we’ve helped you along the way.
Now let’s begin As a child.
I loved to be the center of attention.
I wasn’t afraid to introduce myself or speak up, but now there are days when I find it difficult just to look someone in the eye.
It was frustrating to watch my peers build relationships with ease.
While I struggled just to make a connection at all For years, I blamed shyness and lack of self-esteem for these changes, But it wasn’t until college that I truly learned about social anxiety, Just as with any mental illness.
Social anxiety affects everyone differently.
For me, it even changes from moment to moment.
Sometimes my nervousness reveals itself in stuttering or repetitive speech.
Other times I freeze, I’ve learned a myriad of coping mechanisms, some more helpful than others, and techniques to understand the root of my anxiety, but none have been more beneficial than therapy Finding communities such as Psych2go, where I have a voice, as well as the Support system to reach out and relate to, also help me practicing using my voice with confidence, Even when I feel so fragile that I could shatter It’s. Okay, if you don’t, feel ready to join a community or speak up about your experiences, but the team at Psych2go wants you to know that we are here.
Here are seven things: people with social anxiety will understand, Number one being social can be draining, While not everyone with social anxiety is an introvert.
Many people can feel exhausted after a social event.
Worrying can be tiring and trying hard to keep your anxiety under control while interacting with others can be enough for you to require time to recharge for the rest of the day.
It’s, okay, to push yourself to be social but be sure to know your limits and respect them.
Pushing yourself too far may end in more anxiety and exhaustion than you began with, And it’s important to take care of yourself and your needs.
First, Two: you prefer texting over calling.
Do you relate to the dread that comes when you receive a phone call For? They fear that calling someone will bother the other person For others.
They may not know who is calling or know what to say when they pick up.
Phone Calls can be sudden, disruptive, and unpredictable. So you may worry about what the other person is going to tell you Number three.
You feel anxious without direct interaction.
Sometimes you might feel anxious without directly talking or interacting with someone Just being aware that someone is watching.
You can be difficult For some that occurs when they’re eating or doing other simple tasks.
The fear can stem from judgment for doing something wrong or differently, but more often than not people don’t pay attention as closely as you think, Number four.
When it comes to friends, quality is greater than quantity, Not everyone.’s idea of fun includes hanging out with a huge group of people or going to a party.
It can be intimidating to be around a lot of people.
You don’t know, And you’d – much rather prefer to spend time with a few close friends.
The beauty of life is that no two experiences are the same, So there’s a friend out there for everyone, Even if you may be socially anxious.
Five, it’s, not all in your head. Social anxiety can manifest as physical sensations for a lot of people.
These symptoms are similar to feeling embarrassed, sweaty, hands, blushing hyperventilating, but can feel more intense and last longer.
Facing social situations can potentially lead to panic attacks for some people, while others feel physically ill or faint.
These physical symptoms may be scary, but they rarely are threatening to one’s immediate health Number.
Six, you feel, like everyone is judging you When you’re socially anxious it can feel like you’re under a magnifying glass all the time.
You feel overly conscious about yourself and project those worries onto other people about their perceptions of you, but just because you’re monitoring every detail about yourself, doesn’t mean everyone else is too In reality.
People aren’t as focused on you, as you think, and they likely have their worries too And number seven.
You are your harshest judge.
When you’re socially anxious, you might find yourself comparing how you think act, or look to others.
This self-criticism can seriously hurt your mental and emotional health and it’s important to treat yourself more kindly While it might feel like others, make connections more easily or have it so. Well, it’s important to remember that everyone is going through their things and they have worries and concerns.
Just like you do.
When it comes to social anxiety, it can be hard to interact with people or make friends when you’re overly worried.
The truth is, though, there is no normal when it comes to being social.
Everyone has their way of socializing with others, And you’ll find someone who you connect with on the same level.
There’s nothing wrong with leaving early or spending another night at home with your dog.
We hope you enjoyed this and found some comfort.
What have your experiences been with social anxiety? Leave a comment down below to share your thoughts.
If you enjoyed our video, please give it a like and subscribe to our channel for more content like this.
Thanks for watching – and we’ll see you at the next one.
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[Music] high functioning anxiety isn't actually considered a mental health diagnosis instead it's a term many people can relate to when they have anxiety and can still carry out everyday tasks at a functional level it could be the valedictorian in your class your co-worker who has an exceptionally polished resume or it might even be you it's no surprise that this has become widely relevant when roughly 40 million adults struggle with anxiety when someone tells you you're fine or always has a smile plastered on their face they might actually need your help here are 10 signs of high functioning anxiety 1.
You're an overachiever do you consider yourself a perfectionist type a and a planner people with anxiety always feel like they need control in order to feel at ease whether it means making big to-do lists showing up at a meeting early or staying up late studying for a test they already memorized by heart the individual stays busy in order to feel productive one research study shows that it's only when you feel in control that you can deal with stress two no is rarely used in your vocabulary getting things done becomes more important than your health if you sacrifice eating meals on time or cancel plans with friends to do someone else a favor you might have high functioning anxiety you'd rather suck it up and get the work done instead of saying no fearing that it might pile up otherwise you may also be afraid to reject others afraid that you'll hurt them so you bite the bullet and you hurt yourself instead 3.
What is sleep apparently never enough for people with anxiety how can it be when you're constantly tossing and turning in bed consumed by your worries anxiety doesn't need a reason to keep you up you have everything checked off your to-do list and still worry about a million other things 4. you crack cynical jokes for fun are you sarcastic or make jokes about dying chances are you aren't as happy as you seem when you tell the punchline if you're laughing and putting on a show when you're actually suffering this is anxiety it forces you to entertain and mask your intensities behind your witty combat remember you don't have to put up a front lower your guard and tell people what's going on 5. negative self-talk is common and it's so common that you don't even consider it negative just your usual way of thinking people with anxiety are the hardest on themselves they can stand in front of the mirror and pick out flaws at a snap of a finger or beat themselves up if they make one minor mistake they don't give themselves a break always seeking to be a better worker student citizen the list goes on six your coworkers consider you a mystery you might be the helpful reliable worker everyone loves so it's no surprise that you'll get asked to go out once it's time to clock out but you'll usually decline remaining an enigma other people will find it hard to read you not because you want to seem cold or detached but letting loose and socializing without preparing ahead of time actually terrifies you 7.
You're easily startled it's normal to get jumpy during a horror movie but are you startled even during the slightest disturbance afraid that others might find you spineless therapist and right says you may resort to unhealthy habits such as drinking drugs or endless social media scrolling as a distraction eight bad days are normal for you excessive ruminating panic attacks and an inability to relax have all become ingrained in your daily routines that good days become once in a blue moon but instead of outwardly complaining or calling up a friend to talk about it you might just bottle it up since it happens every week you worry that others will find you annoying or a burden nine you constantly seek validation anxiety makes rationality hard to achieve that's why the individual often seeks logic from others they fear their judgment isn't enough so they rely on the support and guidance of friends family and co-workers they don't mean to lean on people 24 7 but it significantly quiets down their loud thoughts on the flip side however some may worry about being a burden so they choose to suffer silently instead of reaching out to others 10.
You're afraid of letting people down you don't know how to break the news to your loved ones if you're not happy with your so-called dream career or don't want the same things as them you often succumb to other people's expectations working hard to be a role model and no matter how tired you are of being you your anxiety will push you to continue performing as if your whole life counts on it did you enjoy this video jaiden animations also covers her own personal struggles with anxiety we think her content holds value and will be helpful for you be sure to check out her videos and show some love thanks for watching you
Drew Linsalata: on episode 217
of the anxious truth, we’re gonna do 10 More of the most
frequently asked questions about anxiety and anxiety recovery. So
let’s get to it Hello, everybody, and welcome back
to the anxious truth. This is podcast episode number 217 to
one seven were recorded at the end of July 2022. Welcome, I am
Drew Linsalata, creator and host of the anxious truth. This is
the podcast that focuses on all things anxiety, anxiety
disorders, and recovery. So welcome. If you’re new here,
welcome aboard. If you’re a returning listener, welcome
back. Today we’re going to do part two of our frequently asked
questions. These are 20 of the most frequently asked questions
about anxiety and anxiety recovery that I encounter in my
many years in this community and doing this work that I do.
Last
week in Episode 216, we did the first 10. So go back and listen
to that if you have not. And today in 217, we’re going to do
the second 10. The show notes for these two episodes are quite
detailed. So you can find the show notes for this episode at
anxious truth.com/ 217. And I have included in there all the
links to all the other resources and podcast episodes that I’ll
talk about here. So go to the anxious truth.com/ 217. And
check that out. And while you’re on my website, I would like to
remind you that the anxious truth is more than just this
podcast episode. There are 200, and somewhat other podcast
episodes as a ton of free social media content.
There’s my free
morning newsletter called The anxious mourning. And there is
three excellent books and anxiety and anxiety recovery
that I have written that are helping 10s of 1000s of people
around the world. So while you’re on the anxious truth.com,
check out all of those resources, they’re good, and most of
them are free, so go ahead and avail yourself of them. And if
you are enjoying my work, and it’s helping you in some way,
and you would like to help me keep it free of sponsorships and
advertising.
All the ways to do that can be found at the anxious
truth.com/support. So check that out. Never required, always
appreciated. So let’s get into part two of our frequently asked
questions. And we’ll get right into it. We’re going to do 10
today. So question one this week is whether recovery is possible, even if
you’ve suffered for many years. And the answer to that is
sure is this is a short answer. Many, many members of our
community can turn things around even after years of dealing with
disordered anxiety. For me, it was over 2025 years of my life
on and off and three or four major episodes. So yeah, the
amount of time that you have suffered with this. I’m not
gonna say it doesn’t matter completely, but it is certainly
not a reason why you could not get better you can do that. Yes,
you may build some habits, but at some point, the hole can only
get so deep. And I think that’s what people worry about, like,
oh, I keep digging a deeper and deeper hole.
I’ve been digging
for 20 years. So how am I ever going to crawl out of this hole?
That’s not the right way to visualize it. I like to say the
hole can only get so deep once you are to the point where
you’re avoiding everything your housebound or stuck in one room
or you’ve got yourself down to eating only three foods because
you’re afraid or you know, you’re super restricted there’s,
there’s only so much restriction you can impose on yourself. So
assume that the hole has gotten as deep as it is ever going
to get. You just start decorating and get comfortable
in that hole. you personalize it, hang artwork like you
put in a stereo system, and listen to your favorite music
while you’re there.
So if the hole doesn’t get deeper, you
just get more comfortable in it. That doesn’t matter. You can
turn this around, it doesn’t matter how long you have
suffered, I promise you can get better. I was 20-plus years, 25
plus years. I know people even longer than that, that have
dealt with this, and one woman over 40 years. And she has
turned things around. She’s well on the way to recovery. So yes.
In terms of resources, Episode 124 of the anxious truth talks
about that. So you can go check that out. So question number two
today? What if I don’t have panic attacks, and I just feel
anxious all day? So there are two things that I
want to address in this question. First of all, there’s
a misconception that people that have panic attacks are somehow
calm or not anxious between attacks. And that is 100% not
true. Like people with panic disorder, I had panic disorder,
I was anxious all day long, too. So if you’re in that boat, and
you don’t have panic attacks, the first thing I want you to be
aware of is that that’s not necessarily a special condition.
And it’s not like people that do have panic attacks, have attacks, and then are calm the rest of the day.
It doesn’t work that
way. So don’t feel bad about that. Now, being anxious
all day can be the result of the same mechanism that drives
things like panic disorder, you can start to learn to be anxious
just because you’re anxious. And the longer this goes on that
becomes part of the puzzle for a lot of people. Like I’m anxious
all day long. I can’t figure out why. So now I start to become
anxious about being anxious.
That’s one of those things or
another reason why you might be anxious all day long. And this
starts to get into the realm of generalized anxiety or
generalized anxiety. disorder. A lot of people that have gad are
anxious all day long, but not everybody that’s continually
anxious has gad. So really God is defined by excessive worry
and focus on external things to the health of your family, your
health, doing good at work, not letting people down taking care
of everything being perfect being a people pleaser, like
those are things where we are trying to control the world to
an excessive degree. And that’s sort of the hallmark of
generalized anxiety disorder, it’s based on that sort of
stuff. And then it gets off the rails and gets carried away. So
people with gad can have a general background anxiety that
lasts all day long too. So there could be that and then you could
also begin to just be anxious about being anxious because you
can’t solve the anxiety problem. So it’s not that this is a
special thing or it can’t be fixed.
Sometimes if you’re
the in that gad camp, get a look at some of the underlying things
that go with that. Things like excessive worry, overthinking
over planning, perfectionism, and people-pleasing, are things that can
drive anxiety state, but that you think could be good
things about your personality. Gotta look at that. So I talked
about this in Episode 119. I had Dave Carbonell on and we talked
about generalized anxiety disorder, and episode 148 of the
podcast covers this. But if you’re anxious all day long, you
don’t have panic attacks. It’s okay, you can still get better I
promised. So Question three, how can I drive during a panic
attack or anxiety spike, it’s not safe. So this one, I did two
podcast episodes that specifically talked about this
Podcast, episode number 55. podcast episode number 105.
We’re specifically about driving and driving anxiety. So there’s
an assertion here that people will make that when you are in a
high anxiety state or a state of panic, that you
lose control and have no agency anymore.
Like some
external force rolls in and possesses you and makes you do
things or prevents you from doing things. This is a thing
that you have to start to challenge has that ever been
True? Now, you are most certainly afraid you’re very
uncomfortable. But the choices that we make in those moments in
an attempt to alleviate that fear and escape from the
discomfort are not involuntary.
So, when talking about whether is it
safe to drive during a panic attack, you have to realize
that, yes, a rapid heartbeat during panic is involuntary, you
can’t control that, and yes, maybe feeling a little short of breath
is involuntary. Yes, feeling nauseous is involuntary. Feeling
a little depersonalized is involuntary. That’s all true.
But the things that we do to add fuel to that fear, fire, omg
omg, calling for help trying desperately to get to a safe
place trying to run away from it. Those are voluntary. Those
are choices that we make.
So you can’t control how you’re going
to feel. But we do have some agency in what we do about that.
And you have to realize that the uncontrollable feeling or the
idea that you will completely lose control of your
mind and your body or that you do lose control of your mind and
body is you know what you’re doing, and you know what
that activity looks like, and you’re calling that
uncontrollable. But really, we do have choices, we are making
choices to do those things. So it’s important to consider that
because that sort of challenges the narrative that says it’s not
safe to drive because I lose control. Well, no, you choose to
help to fuel a frantic state in your frantic effort to try and
get away from the fear. But there is a choice there. And
there’s an agency that’s important when you’re talking
about driving. And I would urge you to consider another thing.
And that is all the times that you have been anxious behind the
wheel or experienced full-blown panic behind the wheel, and you
have run home with that car or pulled over immediately or got
off the highway or the motorway.
In all of those situations, you
are surprisingly adept at maneuvering your vehicle, even
though you’re insisting that you can’t and you must stop
maneuvering the vehicle. So sometimes we have to insert a
little bit of objectivity here, take two steps backward
from that emotional reaction of oh my god, I’m out of control.
It’s horrible. And look at the facts like, Am I out of
control? Or am I just worried that I will be and have I ever
even shown any sign of being unable to control my vehicle?
Now, I’m not saying that driving with a panic attack is
comfortable or easy in any way, shape, or form and it’s okay to
pull over and let it pass.
It’s okay. But you got to
start to challenge that narrative. But in the end,
you’re the only ones that get you’re the only one that gets to
decide whether you should drive or not. I can’t tell you Yes, go
ahead and drive. I can tell you to start to really try and think
objectively about the way you’re evaluating that. And let reality
be a bit of a guide.
But I cannot tell you now, go ahead
and drive you only you can determine that. Again, take a
listen to podcast episodes, 55 and 105. And maybe those
will help. So let’s go on to our next question. Question five.
What if you have a real medical condition? Okay. This is
unfortunately, common human beings have medical conditions
all the time. More than one thing can be true at a time. So
when this happens, you have to remember that you have an actual
medical or health issue and can also be caught in the
grips caught in the grips of disorder and anxiety, those two
things will get glued together, and you will stick them together
and think that they are one big giant ball of fear. But really,
they are not. So there are two things in the face of a health
challenge or a medical condition, that medical
the condition can cause actual restrictions, lifestyle
restrictions, but it can also cause fear, uncertainty,
vulnerability, anxiety, worry, and normal things like human beings
that are having health problems will normally experience those
states.
But then there’s the extra state on top of that. So
that’s the medical condition itself and the normal human
reaction to that. And then there’s the disordered part that
comes on top of that, which is now I am going to excessively
worry beyond what is helpful about my health
condition. I’m going to try to make predictions, I’m going to
write giant horror stories and screenplays in my head about
what might happen even though it’s not happening.
Now. I’m
going to ruminate and worry and ruminate, and worry and research
and Google, and I’m going to try to solve this problem in my
head. But you can’t, that’s the part that you don’t have to do
that part is not required, that part is not helping you
in any way. It’s kind of hurting you in terms of
mental health. Right? So you have to recognize there are two
things, oh, I’m worried right now, I’m concerned, I’m afraid I
feel uncertain and vulnerable because of this medical
condition. Okay, that’s okay. And that sucks. And my heart
goes out to you. But that’s part of being human. But the part
where you latch on to it and spend 24 hours a day, every
waking moment trying to solve this problem and writing stories
about it in your head that’s not needed, then in many cases, your
anxiety level goes up, because you’re doing that, and then
you’re anxious because you’re anxious.
So it’s important to
step back again, try to insert a little objectivity, and say, Oh,
I see what’s going on here. I don’t have to say, Well, I have
a health condition, and it sends my anxiety through the roof. No,
I have a health condition. And that makes me feel certain
things. And then I am adding on top of that with some of the
habits that I think are safety or protection for me. And I can
recognize that and begin to tease that apart and start to
work on those other habits. So that’s my answer to what if I
have a real medical condition, people will often say like,
well, I have a real medical condition. So all bets are off
to bed like I’m going to have to be an anxious mess. No,
that’s not true. Now I did an episode of the podcast with my
friend Jessica Seidner. Jessica doesn’t have anxiety disorders,
like, as we are aware. But we did a great episode together,
where she talked about having to deal with the increased anxiety
of breast cancer diagnosis, which came right on the heels of
losing her husband.
So she had a lot going on with her medical condition
and a huge life loss. And her anxiety went up because it
normally did. And we talked about how she had to work
through that which might be helpful. I also did an Instagram
live on this topic, probably a year and a half or two years
ago. So again, if you go to the show notes for this episode, the
anxious truth.com/ 217.
Under this question, you’ll see that
link to Instagram. So next question, we are on to question
number 6789 10. Okay, so the question, I think five or six,
how do you accept anxiety or surrender to it? So this is a
question I get every day. And this question is really like
other statements in code? This question is really, it’s
super scary to surrender. So please tell me how to do it
without being afraid or uncomfortable. Right? So there
is no way to do this without being afraid or uncomfortable.
And I know that’s a glib answer, a brutal answer. It’s it sounds
like a cold answer. But we need to confront these things. It
doesn’t help us to try desperately to make it easier or
fluffy, or it doesn’t work that way.
So you also have to
recognize that when you ask the question, but how am I supposed
to accept this or surrender to it? What you’re doing is
insisting that you must continue to resist it. But why? Why do
you think you have to continue to resist it? So if you are in
this camp right now, where you want to keep asking, but I don’t
understand how I’m supposed to surrender, or how I’m supposed
to accept it. What you’re telling me is number one, I
don’t want to be afraid, which I understand I’m not picking on
you for that nobody wants to be afraid. And number two, no, no,
no, I How am I supposed to I can’t if I drop all this
resistance, then it’s going to come and get me? And my answer
is yes. Correct. So how can I accept or surrender is an
insistence that you’re not supposed to accept or surrender
because you have to continue to fight it and resist it? Because
if you don’t, you won’t be safe.
And if you want one big step
that you can take toward acceptance and surrender, is to
face the harsh, brutal, cold reality that all the things
that you are doing to resist it, stop it, make it go away. All
your rituals and safety behaviors and escape behaviors
are doing nothing. Don’t leave a big pregnant
pause. They’re lit doing nothing, no amount of tapping
your cheeks sniffing oils, drinking cold water popping
men’s calling for help snapping rubber bands, chanting, counting
backward from 100. None of those things is doing
anything because that danger has never actually existed. So in
terms of how can I accept and surrender, I will say if I
walked up to you and said, I am so tired from having to hold up
the moon all the time, but I can’t stop holding up the moon
or it will fall to the ground, you would look at me and say,
no, no, you can stop holding up the moon, because you’ve never
been holding up the moon, it doesn’t fall to the
ground, it’s okay, you can let go.
The same thing applies here. So
the thought that you can’t possibly accept anxiety or
surrender it and by the way, acceptance doesn’t mean liking
it, do not get confused, you can still hate it, and you can still
want it to not happen. That’s all normal and you can’t control
that’s human, you’re allowed to be human. Accepting doesn’t mean
liking it. But accepting and surrendering means you will drop
all of those safety behaviors, all of those resisting
behaviors, because you must face the realization that they are
doing nothing, they have no impact on your safety at
all.
They’re just designed to make you feel different. But
feeling different isn’t safer at all, because you’re never in
actual danger from feeling anxious. Right? So you’re gonna
have to confront the reality behind that question. But how am
Did I suppose to surrender or accept? Well, look what those
questions mean. So next question is, what exposures can
I do get ready for dot dot dot, pick an event, a wedding, a
concert, a family vacation, something. And so in the end,
this is a simpler answer. You have to remember what exposures
are therefore, people think, or they get confused. And they
think, Well, I’m learning to drive on the highway. Again, I’m
learning to go shopping, I’m learning to stay home alone.
Again, you’re not learning to do anything. The
only thing that you’re learning to do, which is portable across
situations and challenges, and context is learning how to
get better at experiencing anxiety and fear.
So we only do
exposures, do specific things like drive go for a walk or
stay home alone or eat food that you’re afraid of. So that
it will trigger that anxiety, we were intentionally triggering
anxiety, fear, uncomfort, discomfort, uncertainty, all of
those things were intentionally triggering them so that you can
practice feeling them and moving through them in a new way, a
the more productive way that ultimately teaches you that you
don’t have to save yourself from them. So if the exposure is not
to the event, the task, or the place where the food or
whatever the exposure is to the feelings, then every exposure is
an exposure that works for other things.
Right? So if you’re
getting ready to go to, for instance, you’re going to a
concert all you got tickets to a concert, how can I expose myself
to that? I mean, yes, can you do things that sort of mimic a
concert? Yeah, that doesn’t hurt in any way. But remember, you’re
only you’re not afraid of the concert, you’re afraid of how
you will feel at the concert. So if you want to take a cruise
around the world get better at staying home alone for two
hours. That’s what I tell people all the time. If you want to go
back to work, then get better at walking around your block.
Because you’re really in the end, you’re learning a new way
to relate to anxiety across all contexts. And if you can
adopt this, then you don’t have to worry about specific
exposures for every single thing you might have to do in your
life, life gets a lot simpler that way.
And your recovery
starts to become a little wider and more durable. So it’s really
important, like think about that. I’m only doing these
things because they trigger my anxiety, the anxiety, fear,
that’s the exposure, not the task or the place. So let’s move on to the question.
You know, in 10. I know which one I want to take, we’re on
seven right now. This question is what does this method work if
I have trauma too. So first of all, I always have to say this
is not a method like I’m not teaching them. This isn’t the
drew method. It’s not my method. I didn’t invent any
of this. These are just the principles of a cognitive
behavioral approach to anxiety disorders. So there are
parallels between anxiety disorder, recovery, and trauma
resolution, that’s 100% True, a lot of things will look the
same.
If you’re working with a trauma resolution specialist,
some of the things that you would hear would sound a lot
like the things that I talked about, but they’re not
the same. And the issue here is, let’s assume that you do have a
traumatic background and you’ve experienced some traumatic
events in your life. And maybe that that trauma did spawn your
anxiety disorder that can happen. But then what I always
say is that one problem, the trauma has now become two
problems. You have trauma and an anxiety disorder. Right? So you
have to realize that it doesn’t mean that the anxiety disorder
doesn’t count because it’s only the trauma if you had one
problem now you have to That’s okay though, don’t freak out.
You can successfully deal with both of those issues. A lot of
people do, right? A lot of people do that work on both
fronts. But traumatic experiences do not mean that the
anxiety disorder doesn’t count, so some people are under
the assumption that like, well, this all sounds good, but
I have trauma.
So what you’re saying doesn’t apply to me.
Okay, you may have trauma, and I’m very sorry for the things
that you’ve lived through. That’s possible. But in the end,
if you will have learned to be afraid of your heartbeat, or
your breath or you have learned to be afraid of, you
know, depersonalization or jelly legs, and you refuse to go out
of the house, or you are convinced that you have some
sort of health problem, and you will only eat foods as a
result. Maybe some trauma spawned that, but
But knowing about that trauma doesn’t help you become less
afraid of your heartbeat.
Now you’re afraid of multiple
things. So maybe you are having, you know, you’re afraid of the
experience. But now you’re also afraid of yourself. So you
have to do both things. But of them, if two
problems, you can solve them both. So traumatic experience
can be a roadblock 100% to executing the recovery plan that
we’re always talking about here. It’s 100% true if you have
lived experiences that teach you that you are always unsafe, the
world is dangerous, you are weak, you’re not capable, you’re
stupid, and you’re not worthy of being better. trauma can do that
to you. And if you have those beliefs about yourself, because
of your past experiences, that can 100% present a roadblock to
doing the work that I was talking about, have to
acknowledge that and I always will always well never going to
invalidate that.
So in that situation, you’re going to have
to work on that too, right? You’ll have to work on that.
It’s kind of hard. And this is different for everybody, right?
There’s no set answer to this on the other side. So in that
situation, you may find you have to do a little bit of work on
yourself before you can effectively do this recovery
work that I’m talking about.
Some other people find
that their anxiety disorder is so bad, that they’re so wracked
with panic and irrational fear that they can’t do the
trauma work until they put out this fire. So some people have
to do this first and then go back to the past and do that
work. Some people can do it at the same time. It’s individual,
it depends. So there’s no set answer to this. But I can
tell you that you can recover from both trauma and
anxiety.
And the things that I’m writing about which are
geared toward anxiety recovery can be effective while
you do that. It’s just a very individual situation. But please
don’t feel that since you have lived the traumatic background,
you can’t get better. That’s not true. That’s not fair. And I
understand why you might think that but it’s not true. You
can get better. It’s not easy. But there’s hope for you
too, I promise. So last few questions. This is a really
common one I’m accepting, why am I still anxious? So I might
argue that if you are asking why you’re still anxious, then
you’re not accepting. We can’t qualify for our acceptance.
I’m accepting. I’m accepting this, but I also want it gone.
Well, you can’t have both of those things. Think about that
for a second. I know it sounds a little bit glib and a little
silly.
But think about it. There’s truth in there. I’m
accepting this, but I also don’t want to accept it, and I’m not
accepting it. I know you want your anxiety to go away,
but accepting and doing all the things we talked about. It’s not
a recipe for banishing it, right? If that’s why you’re
doing this like you are hoping that if you do the Claire weeks
acceptance or the Dru surrender, or the Josh Fletcher willful
tolerance, if I do this, then it will stop. You’re trying to skip
the part where you have to experience the anxiety and use
it as a classroom.
It’s super important. So if you’re trying
to skip that, and you’re just hoping that okay, I except, wait
a minute, how come it hasn’t gone away? You’re missing the
whole process. And you’re going to wind up disappointed,
frustrated, and do and ask this question I don’t
understand. I’m accepting why isn’t gone away. So
expectations are important. Understanding the concepts of
recovery. Why are you accepting that is that the whole thing? Or is
it just part of it? That’s important, aiming at the right
target is important. So in this situation, I did episode 192 of
the podcast, which is linked in the show notes here, go listen
to that, that will probably help you. And this is related to
question number nine, which is, I’m doing my exposures.
But it’s
not working. This is what you think you’re doing. I’m doing
all the things I’m doing exposures but not working. Why?
And there are a couple of common explanations for this. Number
one would be we’ll ask you a couple of questions. And this is
right at the show notes. Are you trying to do exposures without
being too afraid? Are you trying to do your exposures without
triggering high anxiety or panic? Are you only doing
exposures now and then when you’re forced to or when you’re
having a good day? Are you doing exposures while also using all
of your soothing and coping tools to calm you down if it
gets uncomfortable? These are all red flags as to why exposure
might not be working.
So remember what I said a couple of
questions before the point of exposure are not doing the
task. The point of the exposure is experiencing the fear the
anxiety, the discomfort you want that you need that if you’re
trying to find ways to do your exposure tasks without feeling
that or minimizing it or soothing or calming it or making
it’s easier Don’t do the exposure, there’s no point in it. Because
you’re not, you’re not learning to drive again, you’re learning
how to get better at experiencing anxiety. So this is one of the
main reasons why people will say my exposures aren’t working
well, okay, but you’re not doing exposure, in some
cases, for a common mistake. The other thing would be that you
know, that you’re supposed to experience that experience,
panic, but you are still hanging on to those who escape
behaviors and those rituals.
So some people get close to like
real exposure, I would say real exposure, but most effective
exposure, but they still hang on to like, well, there’s a line
that I just can’t cross with anxiety and panic. And when I
get close to that line, I will break out all of my copings
skills. And I will break out my, safety skills and my make it
go away skills. And that’s the response prevention part. So
we’ve talked about exposure and response prevention, ERP, which
is very commonly used in the OCD community, you hear ERP in that
community all the time, but even for all of the
anxiety disorders. Exposure is always ERP. So doing the things,
you’re doing the things, you’re intentionally triggering this
comfort, and you’re doing that without using your old
responses, your safety responses, and soothing responses, you’re
preventing those responses.
So one of the reasons why
another key reason why exposure might not be working air quotes
for you is first of all, what does working mean? It doesn’t
mean to make it go away. Remember, it means teaching you how to get
better at being anxious. But why do you think it’s not working?
Well, one of the reasons is doing the exposure without doing
the response prevention. I’m out there driving on the highway,
but I’ve got my mints and my cold water and I got my radio
on, I’m calling and I’m talking to my friend or I bring my
husband or my girlfriend with me that that’s one good reason why
it might not be working. Right. So if you go to
anxious truth.com and just search for the word exposure,
you’ll see quite a few podcast episodes where we talked about
this in more detail. And then question 10 Final question for
the day. This is a big one. How do I deal with a setback? So
this is a such question I hear every single day and I the
word setback, I almost want to be stricken from the vocabulary.
Many times when people are in the recovery process, they
feel like they’re doing great because they’re not experiencing
anxiety or panic.
Like they’re feeling good. That’s, that’s
awesome. We want everybody to feel good. I want you to feel
good to write, I want you to have good days. We all want to
have good days. Everybody deserves a good day. So when you
start to string good days together, and you’re feeling
pretty good. And it’s been a while since you had a panic
attack, or it’s been a while since you had those scary
thoughts or it’s been a while since you’ve had an
anxious day and then you have an anxious day or the thoughts come
back or you have a big panic attack one night. A lot of
people will say up, it’s a setback. That’s not a setback.
That’s not a setback, right? If the core principle of
recovery, is to learn that anxiety and panic are not
emergencies, then how is feeling that a setback, it’s no longer
an emergency, you are trying to learn that it’s not an
emergency, we do not declare it a special event.
We don’t
retreat from it. So setback is usually a red flag word and it
indicates that you’re still insisting that the only
successful recovery is one year where you will never feel
anxious or panicky ever again. And if you’re trying to recover
to that degree, where you never you can guarantee that you never
panic or ever have another scary thought in your life.
You’re going to be disappointed and frustrated. So
setback is not feeling things. If you haven’t felt anxious for
two weeks, and then today you feel anxious. Well, your job
today is to move through those feelings and practice being
better at being anxious. That’s not a setback. That’s just life
happening. And that’s an opportunity to get even better.
Like we want it we get to the end of the road to recovery
when we don’t care if we’re anxious or not. And I know that
if you’re in the thick of it right now you are thinking that
is an insane statement.
But that is truly where you are headed
with this. That is when the war is over. So if every time you
experience anxiety, you yell setback and want to know what to do
I do with a setback? You’re kind of missing the point and you’re
not being fair to yourself. Okay, so the only true thing
that I might call setback is setback is also really what
happens when we say up all bets are off and I’m going to return
to my old rituals.
I’m gonna go back to my figuring it out
trying to fight it trying to resist it hiding from it. Going
back to my compulsive. My compulsions, like that, might be
setbacks. Yes, if you start to revert to those old habits, I’ll
call that a setback with you. But how you feel and what you
think is not the setback. But even if you do start to revert
to those old habits as soon as you waive the setback flag and
one piece of advice just remember, oh wait, I have to start doing what I was
doing before. No problem that happens to everybody move
forward again. So if anxiety returns after some time, right
at the show notes here your job is not to wring your hands
and try to figure out why and how to stop it and declare
a disaster.
Your job is to surf through it, move through it
like you presumably did as part of the progress that you said
you had made. So I did do an episode on this early on in 2015
of the podcast, episode 14 talks about the nonlinear nature
of recovery and goes over setbacks. But I know setback is
a thing that we talk about all the time in this community.
Hopefully, this helps. And that is it. Those are our second 10
frequently asked questions about anxiety and anxiety recovery. We
are done with episode 217. If you have not heard to 16 go
ahead and listen, because those are the first 10 questions you
know, we’re done because he told me that music. Anyway, I will
pay you out as usual. Afterglow by Ben Drake, you can
find Ben and his music ed Ben Drake music.com Go check them
out and tell him I said hi, I will ask you a favor. If you’re
listening to the podcast on iTunes on Apple podcasts or
Spotify or some platform that lets you rate and review.
Please
leave a five-star rating and maybe take a second to write a
review because it helps other people find the podcast. If
you’re listening on YouTube. Sorry, there’s no video this
week. But if you’re listening on YouTube, Like the video,
subscribe to the channel, and leave a comment. You know the deal. I
appreciate you guys coming by all the time spending time with
me giving me your attention. Hopefully, I’m able to help you.
I’m doing the best I can. I’m hoping it’s working out for you.
I’ll be back next week. We’re gonna do it again. I don’t know
what I’m gonna be talking about. But I will be here. And as
always remember, this is the way Unknown: this is where your
story begins. You got the feeling that you go yeah, you’re
doing fine. Now in the city, you live fast. No looking back on
the past. Never get another chance.
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Number four, you are
generally more sensitive to social cues. Are you very sensitive to how you come across to other people? Do you find yourself often uncomfortable with your social environment? Perhaps you find it challenging to eat in front of other people, or tend to avoid speaking in public because of an overwhelming fear that people will judge you negatively. According to Dr. John,
if your answers are yes to the above questions, it’s more likely that you
have anxiety rather than ADHD. This is because people
with ADHD usually struggle with understanding or missing social cues rather than being hypersensitive to them. Number five, you experience
a racing heart, clamminess, tense muscles, headaches,
nausea, or dizziness. Do you often experience
headaches, nausea, or dizziness? These are just some of
the symptoms of anxiety. Dr. John stated that anxiety comes from a tiny almond-shaped part at the back of your brain
called the amygdala.
As a watchman for your brain, it is constantly watching out for danger. And whenever it detects danger, it triggers a fight or flight response. However, for anxious people, the amygdala is large and hypersensitive. Because of this, it ends up sending out
a lot of false alarms. You can think of it as a watchman
who cries wolf too often. As a result, your brain may sense threats even in non-threatening situations. And number six, you are unlikely
to show problem behaviors when you’re feeling calm, safe,
and doing things you enjoy.
How do you act when you’re having fun? Whether it’s listening
to your favorite music or playing video games, you
may find yourself feeling calm and safe while doing the things
that you genuinely enjoy. You are neither restless nor feel like you need
to catch your breath. According to Dr. John, anxious
individuals are unlikely to display any problem behaviors
when feeling calm and safe and doing something they enjoy. On the contrary, people with ADHD will experience problem behaviors even when they engage in a particular fun or exciting activity. For example, a person with ADHD may become so engrossed
with painting a picture that they tune out or completely
ignore everything else. This behavior is known as hyperfocus. Did you relate to any of
the signs we’ve mentioned? Let us know in the comments below. If you found this video helpful, be sure to like, subscribe,
and share this video with those who might benefit from it. And don’t forget to hit
the notification bell icon to get notified whenever
Psych2Go posts a new video. As always, the references and
studies used in this video are added in the description below.
Thanks so much for watching
and see you in our next video. (light music).
When it comes to friends, quality is greater than quantity, Not everyone.’s idea of fun includes hanging out with a huge group of people or going to a party.
It can be intimidating to be around a lot of people.
You don’t know, And you’d – much rather prefer to spend time with a few close friends.
The beauty of life is that no two experiences are the same, So there’s a friend out there for everyone, Even if you may be socially anxious.
Five, it’s, not all in your head. Social anxiety can manifest as physical sensations for a lot of people.
These symptoms are similar to feeling embarrassed, sweaty, hands, blushing hyperventilating, but can feel more intense and last longer.
Facing social situations can potentially lead to panic attacks for some people, while others feel physically ill or faint.
These physical symptoms may be scary, but they rarely are threatening to one’s immediate health Number.
Six, you feel, like everyone is judging you When you’re socially anxious it can feel like you’re under a magnifying glass all the time.
You feel overly conscious about yourself and project those worries onto other people about their perceptions of you, but just because you’re monitoring every detail about yourself, doesn’t mean everyone else is too In reality.
People aren’t as focused on you, as you think, and they likely have their worries too And number seven.
You are your harshest judge.
When you’re socially anxious, you might find yourself comparing how you think act, or look to others.
This self-criticism can seriously hurt your mental and emotional health and it’s important to treat yourself more kindly While it might feel like others, make connections more easily or have it so. Well, it’s important to remember that everyone is going through their things and they have worries and concerns.
Just like you do.
When it comes to social anxiety, it can be hard to interact with people or make friends when you’re overly worried.
The truth is, though, there is no normal when it comes to being social.
Everyone has their way of socializing with others, And you’ll find someone who you connect with on the same level.
There’s nothing wrong with leaving early or spending another night at home with your dog.
We hope you enjoyed this and found some comfort.
What have your experiences been with social anxiety? Leave a comment down below to share your thoughts.
If you enjoyed our video, please give it a like and subscribe to our channel for more content like this.
Thanks for watching – and we’ll see you at the next one.
They’re just designed to make you feel different. But
feeling different isn’t safer at all, because you’re never in
actual danger from feeling anxious. Right? So you’re gonna
have to confront the reality behind that question. But how am
Did I suppose to surrender or accept? Well, look what those
questions mean. So next question is, what exposures can
I do get ready for dot dot dot, pick an event, a wedding, a
concert, a family vacation, something. And so in the end,
this is a simpler answer. You have to remember what exposures
are therefore, people think, or they get confused. And they
think, Well, I’m learning to drive on the highway. Again, I’m
learning to go shopping, I’m learning to stay home alone.
Again, you’re not learning to do anything. The
only thing that you’re learning to do, which is portable across
situations and challenges, and context is learning how to
get better at experiencing anxiety and fear.
So we only do
exposures, do specific things like drive go for a walk or
stay home alone or eat food that you’re afraid of. So that
it will trigger that anxiety, we were intentionally triggering
anxiety, fear, uncomfort, discomfort, uncertainty, all of
those things were intentionally triggering them so that you can
practice feeling them and moving through them in a new way, a
the more productive way that ultimately teaches you that you
don’t have to save yourself from them. So if the exposure is not
to the event, the task, or the place where the food or
whatever the exposure is to the feelings, then every exposure is
an exposure that works for other things.
Right? So if you’re
getting ready to go to, for instance, you’re going to a
concert all you got tickets to a concert, how can I expose myself
to that? I mean, yes, can you do things that sort of mimic a
concert? Yeah, that doesn’t hurt in any way. But remember, you’re
only you’re not afraid of the concert, you’re afraid of how
you will feel at the concert. So if you want to take a cruise
around the world get better at staying home alone for two
hours. That’s what I tell people all the time. If you want to go
back to work, then get better at walking around your block.
Because you’re really in the end, you’re learning a new way
to relate to anxiety across all contexts. And if you can
adopt this, then you don’t have to worry about specific
exposures for every single thing you might have to do in your
life, life gets a lot simpler that way.
And your recovery
starts to become a little wider and more durable. So it’s really
important, like think about that. I’m only doing these
things because they trigger my anxiety, the anxiety, fear,
that’s the exposure, not the task or the place. So let’s move on to the question.
You know, in 10. I know which one I want to take, we’re on
seven right now. This question is what does this method work if
I have trauma too. So first of all, I always have to say this
is not a method like I’m not teaching them. This isn’t the
drew method. It’s not my method. I didn’t invent any
of this. These are just the principles of a cognitive
behavioral approach to anxiety disorders. So there are
parallels between anxiety disorder, recovery, and trauma
resolution, that’s 100% True, a lot of things will look the
same.
If you’re working with a trauma resolution specialist,
some of the things that you would hear would sound a lot
like the things that I talked about, but they’re not
the same. And the issue here is, let’s assume that you do have a
traumatic background and you’ve experienced some traumatic
events in your life. And maybe that that trauma did spawn your
anxiety disorder that can happen. But then what I always
say is that one problem, the trauma has now become two
problems. You have trauma and an anxiety disorder. Right? So you
have to realize that it doesn’t mean that the anxiety disorder
doesn’t count because it’s only the trauma if you had one
problem now you have to That’s okay though, don’t freak out.
You can successfully deal with both of those issues. A lot of
people do, right? A lot of people do that work on both
fronts. But traumatic experiences do not mean that the
anxiety disorder doesn’t count, so some people are under
the assumption that like, well, this all sounds good, but
I have trauma.
So what you’re saying doesn’t apply to me.
Okay, you may have trauma, and I’m very sorry for the things
that you’ve lived through. That’s possible. But in the end,
if you will have learned to be afraid of your heartbeat, or
your breath or you have learned to be afraid of, you
know, depersonalization or jelly legs, and you refuse to go out
of the house, or you are convinced that you have some
sort of health problem, and you will only eat foods as a
result. Maybe some trauma spawned that, but
But knowing about that trauma doesn’t help you become less
afraid of your heartbeat.
Now you’re afraid of multiple
things. So maybe you are having, you know, you’re afraid of the
experience. But now you’re also afraid of yourself. So you
have to do both things. But of them, if two
problems, you can solve them both. So traumatic experience
can be a roadblock 100% to executing the recovery plan that
we’re always talking about here. It’s 100% true if you have
lived experiences that teach you that you are always unsafe, the
world is dangerous, you are weak, you’re not capable, you’re
stupid, and you’re not worthy of being better. trauma can do that
to you. And if you have those beliefs about yourself, because
of your past experiences, that can 100% present a roadblock to
doing the work that I was talking about, have to
acknowledge that and I always will always well never going to
invalidate that.
So in that situation, you’re going to have
to work on that too, right? You’ll have to work on that.
It’s kind of hard. And this is different for everybody, right?
There’s no set answer to this on the other side. So in that
situation, you may find you have to do a little bit of work on
yourself before you can effectively do this recovery
work that I’m talking about.
Some other people find
that their anxiety disorder is so bad, that they’re so wracked
with panic and irrational fear that they can’t do the
trauma work until they put out this fire. So some people have
to do this first and then go back to the past and do that
work. Some people can do it at the same time. It’s individual,
it depends. So there’s no set answer to this. But I can
tell you that you can recover from both trauma and
anxiety.
And the things that I’m writing about which are
geared toward anxiety recovery can be effective while
you do that. It’s just a very individual situation. But please
don’t feel that since you have lived the traumatic background,
you can’t get better. That’s not true. That’s not fair. And I
understand why you might think that but it’s not true. You
can get better. It’s not easy. But there’s hope for you
too, I promise. So last few questions. This is a really
common one I’m accepting, why am I still anxious? So I might
argue that if you are asking why you’re still anxious, then
you’re not accepting. We can’t qualify for our acceptance.
I’m accepting. I’m accepting this, but I also want it gone.
Well, you can’t have both of those things. Think about that
for a second. I know it sounds a little bit glib and a little
silly.
But think about it. There’s truth in there. I’m
accepting this, but I also don’t want to accept it, and I’m not
accepting it. I know you want your anxiety to go away,
but accepting and doing all the things we talked about. It’s not
a recipe for banishing it, right? If that’s why you’re
doing this like you are hoping that if you do the Claire weeks
acceptance or the Dru surrender, or the Josh Fletcher willful
tolerance, if I do this, then it will stop. You’re trying to skip
the part where you have to experience the anxiety and use
it as a classroom.
It’s super important. So if you’re trying
to skip that, and you’re just hoping that okay, I except, wait
a minute, how come it hasn’t gone away? You’re missing the
whole process. And you’re going to wind up disappointed,
frustrated, and do and ask this question I don’t
understand. I’m accepting why isn’t gone away. So
expectations are important. Understanding the concepts of
recovery. Why are you accepting that is that the whole thing? Or is
it just part of it? That’s important, aiming at the right
target is important. So in this situation, I did episode 192 of
the podcast, which is linked in the show notes here, go listen
to that, that will probably help you. And this is related to
question number nine, which is, I’m doing my exposures.
But it’s
not working. This is what you think you’re doing. I’m doing
all the things I’m doing exposures but not working. Why?
And there are a couple of common explanations for this. Number
one would be we’ll ask you a couple of questions. And this is
right at the show notes. Are you trying to do exposures without
being too afraid? Are you trying to do your exposures without
triggering high anxiety or panic? Are you only doing
exposures now and then when you’re forced to or when you’re
having a good day? Are you doing exposures while also using all
of your soothing and coping tools to calm you down if it
gets uncomfortable? These are all red flags as to why exposure
might not be working.
So remember what I said a couple of
questions before the point of exposure are not doing the
task. The point of the exposure is experiencing the fear the
anxiety, the discomfort you want that you need that if you’re
trying to find ways to do your exposure tasks without feeling
that or minimizing it or soothing or calming it or making
it’s easier Don’t do the exposure, there’s no point in it. Because
you’re not, you’re not learning to drive again, you’re learning
how to get better at experiencing anxiety. So this is one of the
main reasons why people will say my exposures aren’t working
well, okay, but you’re not doing exposure, in some
cases, for a common mistake. The other thing would be that you
know, that you’re supposed to experience that experience,
panic, but you are still hanging on to those who escape
behaviors and those rituals.
So some people get close to like
real exposure, I would say real exposure, but most effective
exposure, but they still hang on to like, well, there’s a line
that I just can’t cross with anxiety and panic. And when I
get close to that line, I will break out all of my copings
skills. And I will break out my, safety skills and my make it
go away skills. And that’s the response prevention part. So
we’ve talked about exposure and response prevention, ERP, which
is very commonly used in the OCD community, you hear ERP in that
community all the time, but even for all of the
anxiety disorders. Exposure is always ERP. So doing the things,
you’re doing the things, you’re intentionally triggering this
comfort, and you’re doing that without using your old
responses, your safety responses, and soothing responses, you’re
preventing those responses.
So one of the reasons why
another key reason why exposure might not be working air quotes
for you is first of all, what does working mean? It doesn’t
mean to make it go away. Remember, it means teaching you how to get
better at being anxious. But why do you think it’s not working?
Well, one of the reasons is doing the exposure without doing
the response prevention. I’m out there driving on the highway,
but I’ve got my mints and my cold water and I got my radio
on, I’m calling and I’m talking to my friend or I bring my
husband or my girlfriend with me that that’s one good reason why
it might not be working. Right. So if you go to
anxious truth.com and just search for the word exposure,
you’ll see quite a few podcast episodes where we talked about
this in more detail. And then question 10 Final question for
the day. This is a big one. How do I deal with a setback? So
this is a such question I hear every single day and I the
word setback, I almost want to be stricken from the vocabulary.
Many times when people are in the recovery process, they
feel like they’re doing great because they’re not experiencing
anxiety or panic.
Like they’re feeling good. That’s, that’s
awesome. We want everybody to feel good. I want you to feel
good to write, I want you to have good days. We all want to
have good days. Everybody deserves a good day. So when you
start to string good days together, and you’re feeling
pretty good. And it’s been a while since you had a panic
attack, or it’s been a while since you had those scary
thoughts or it’s been a while since you’ve had an
anxious day and then you have an anxious day or the thoughts come
back or you have a big panic attack one night. A lot of
people will say up, it’s a setback. That’s not a setback.
That’s not a setback, right? If the core principle of
recovery, is to learn that anxiety and panic are not
emergencies, then how is feeling that a setback, it’s no longer
an emergency, you are trying to learn that it’s not an
emergency, we do not declare it a special event.
We don’t
retreat from it. So setback is usually a red flag word and it
indicates that you’re still insisting that the only
successful recovery is one year where you will never feel
anxious or panicky ever again. And if you’re trying to recover
to that degree, where you never you can guarantee that you never
panic or ever have another scary thought in your life.
You’re going to be disappointed and frustrated. So
setback is not feeling things. If you haven’t felt anxious for
two weeks, and then today you feel anxious. Well, your job
today is to move through those feelings and practice being
better at being anxious. That’s not a setback. That’s just life
happening. And that’s an opportunity to get even better.
Like we want it we get to the end of the road to recovery
when we don’t care if we’re anxious or not. And I know that
if you’re in the thick of it right now you are thinking that
is an insane statement.
But that is truly where you are headed
with this. That is when the war is over. So if every time you
experience anxiety, you yell setback and want to know what to do
I do with a setback? You’re kind of missing the point and you’re
not being fair to yourself. Okay, so the only true thing
that I might call setback is setback is also really what
happens when we say up all bets are off and I’m going to return
to my old rituals.
I’m gonna go back to my figuring it out
trying to fight it trying to resist it hiding from it. Going
back to my compulsive. My compulsions, like that, might be
setbacks. Yes, if you start to revert to those old habits, I’ll
call that a setback with you. But how you feel and what you
think is not the setback. But even if you do start to revert
to those old habits as soon as you waive the setback flag and
one piece of advice just remember, oh wait, I have to start doing what I was
doing before. No problem that happens to everybody move
forward again. So if anxiety returns after some time, right
at the show notes here your job is not to wring your hands
and try to figure out why and how to stop it and declare
a disaster.
Your job is to surf through it, move through it
like you presumably did as part of the progress that you said
you had made. So I did do an episode on this early on in 2015
of the podcast, episode 14 talks about the nonlinear nature
of recovery and goes over setbacks. But I know setback is
a thing that we talk about all the time in this community.
Hopefully, this helps. And that is it. Those are our second 10
frequently asked questions about anxiety and anxiety recovery. We
are done with episode 217. If you have not heard to 16 go
ahead and listen, because those are the first 10 questions you
know, we’re done because he told me that music. Anyway, I will
pay you out as usual. Afterglow by Ben Drake, you can
find Ben and his music ed Ben Drake music.com Go check them
out and tell him I said hi, I will ask you a favor. If you’re
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Please
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subscribe to the channel, and leave a comment. You know the deal. I
appreciate you guys coming by all the time spending time with
me giving me your attention. Hopefully, I’m able to help you.
I’m doing the best I can. I’m hoping it’s working out for you.
I’ll be back next week. We’re gonna do it again. I don’t know
what I’m gonna be talking about. But I will be here. And as
always remember, this is the way Unknown: this is where your
story begins. You got the feeling that you go yeah, you’re
doing fine. Now in the city, you live fast. No looking back on
the past. Never get another chance.