[HN Gopher] The "just worrying" labelling technique [pdf]
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       The "just worrying" labelling technique [pdf]
        
       Author : jossclimb
       Score  : 128 points
       Date   : 2022-06-26 08:51 UTC (14 hours ago)
        
 (HTM) web link (www.mindmate.org.uk)
 (TXT) w3m dump (www.mindmate.org.uk)
        
       | WhitneyLand wrote:
       | For anyone wondering, this actually works, it can literally
       | change your life, and is as simple as it sounds.
       | 
       | But if this is true, why wouldn't it be some huge thing you hear
       | about everywhere?
       | 
       | And it is, as the essence of mindfulness meditation.
        
         | float4 wrote:
         | > why wouldn't it be some huge thing you hear about everywhere?
         | 
         | I feel like you hear about this all the time though. Both in
         | the context of mindfulness, and in the context of cognitive
         | behavioral therapy.
         | 
         | Also, as far as I know the actual effectiveness of CBT and
         | mindfulness is still up for debate? It certainly works very
         | well for some people, but "this actually works" might be a bit
         | much?
        
           | idleproc wrote:
           | I tend to think of the workings of the mind like those of the
           | body.
           | 
           | Some people have minds that lack even basic personal hygiene.
           | Others have minds that could run a marathon every week for a
           | year. Most people are somewhere in-between.
           | 
           | This is partly nature, partly nurture. But just as 'do
           | squats' is good advice for someone looking to improve their
           | general health, this labelling technique is good advice for
           | someone who wants to worry less often.
           | 
           | I'm not a doctor or physio, but I'd imagine that if you have
           | heart problems you'd want to get those sorted before doing
           | squats. Likewise, if you have suicidal thoughts it would be
           | best to address those before anything else, for example.
           | 
           | So yes, I believe 'this actually works'. But depending on
           | your current level of mental fitness YMMV.
        
           | WhitneyLand wrote:
           | They're both actively researched but also both have a body of
           | evidence supporting their effectiveness.
           | 
           | If your only caveat is does not work for 100% of people, I
           | think you'd have to exclude almost all therapies, drugs,
           | techniques, etc.
           | 
           | And, it's free. To learn many great books are available for
           | free.
           | 
           | Or go on a retreat to practice under an instructor. If you
           | can't afford the retreat fee, it can likely be reduced or
           | free. You will marvel at walking away at the end feeling no
           | pressure to buy or do anything.
        
       | afandian wrote:
       | The story of the Buddha 'inviting Mara to tea' stuck with me. It
       | involves more embracing of fears than "just worry", but probably
       | does take more emotional investment.
       | https://www.tarabrach.com/inviting-mara-to-tea/
        
       | Trasmatta wrote:
       | This only works to a point, especially if the excessive worry is
       | the result of past trauma.
       | 
       | > Or saying hello to the worry but don't stop to chat
       | 
       | Alternative approach: get to know the part of your brain that's
       | worried. What underlies that worry? What is that part of your
       | brain afraid will happen if it didn't bring up this anxiety? It's
       | trying to protect you from some sort of pain, even if this
       | behavior of excessive worry has now become maladaptive.
       | 
       | That's sort of the basis of Internal Family Systems therapy. The
       | idea that our brain has discrete parts (different neural nets
       | probably), and that they're all trying to protect us. Getting to
       | know these parts can let us understand why they do what they do,
       | which can give us the tools to heal them, and allow them to take
       | on new roles.
       | 
       | Sometimes this "labeling" technique can lead to negative blowback
       | if parts of your brain feel that you're now in danger because
       | you're ignoring their warning signals. The same problem happens
       | with meditation too, which is why you hear lots of stories of
       | people being destabilized at meditation retreats. I think this
       | risk is higher for people with trauma in their history.
        
         | meken wrote:
         | I never thought I had trauma, but this has been my exact
         | experience with labeling, and I've recently begun working with
         | an IFS therapist as well.
        
           | Trasmatta wrote:
           | Yeah, it's also possible that it's not the best approach even
           | for people without acute trauma. Trauma can also be complex
           | and cumulative, like with CPTSD.
           | 
           | I think it can work in the short term, but it ignores the
           | longer term fact that these anxieties are coming from
           | somewhere in our brains that can't always be reprogrammed
           | with a simple labeling technique.
        
             | spoiler wrote:
             | This is all thinking in hindsight, so maybe it's backwards
             | rationalisation, but when I started meditating it felt like
             | it helped me improve my focus at work, but around the same
             | time I've become more emotionally disregulated. So, maybe
             | there is something to what you're saying.
             | 
             | This is very anecdotal though (and I've definitely had an
             | abusive mother)
        
               | Trasmatta wrote:
               | I've read a lot of anecdotal reports just like yours. I
               | think it's way more common than people think when they
               | get into meditation. Especially for people who had any
               | trauma growing up.
               | 
               | I think the IFS model offers an interesting hypothesis
               | for why this happens. According to IFS, we have parts
               | that experienced extreme pain in childhood that hold onto
               | that pain and become "exiles". Other parts are put in
               | front of them as "protectors". Meditation seems to quiet
               | the protectors, which can unleash the pain of the exiles
               | unexpectedly, leaving us without the ability to deal with
               | it.
               | 
               | IFS takes a different approach by working with the
               | protectors, not against them. You only go to the exiles
               | (the deep pain underneath) with the permission of the
               | protectors.
        
       | riffraff wrote:
       | I struggle a bit with anxiety, and started doing some similar
       | form of labeling a few months back.
       | 
       | Whenever I notice my thoughts spiraling I just notice it ("I am
       | starting to be anxious") and take a few deep breath to put a
       | break on the automatic reflex loop.
       | 
       | I can't say it solves all problems, but it seems to be at least
       | somewhat helpful, and as the PDF says, it's really, really easy.
        
         | djbusby wrote:
         | Similar, and I add a note about the thing into a little
         | notebook to review later.
        
       | jancsika wrote:
       | The word "helpful" is doing a lot of work in that phrase "helpful
       | problem solving."
       | 
       | For starters: which phone is the most secure option for HN to
       | make a call to a therapist-- an Iphone SE or a Pixel 6 Pro
       | running Graphene OS?
        
       | hardlianotion wrote:
       | This sort of thing always reminds me of the potato sacks the
       | Silastic Armourfiends of Striterax had to punch each morning to
       | get rid of their surplus aggression.
        
       | dwighttk wrote:
       | I use this on deja vu so I don't have to spend a while trying to
       | figure out if/when I saw something before.
        
       | [deleted]
        
       | _def wrote:
       | Incredible, thanks for sharing. Seems like this whole website is
       | packed with similar good explained help around mental health:
       | https://www.mindmate.org.uk/
        
       | glenstein wrote:
       | Just this morning I listened to a radiolab podcast: "the wordless
       | place", which talks about how a word puts something in a
       | category, and that doing this can take living concepts and turn
       | them dead, like putting a firefly in a jar without air. It makes
       | reference to something named the Zeigarnik effect - for
       | remembering unfinished or interrupted tasks better than completed
       | tasks, and it analogizes this to the ability to better remember a
       | phenomenon in its detail and nuance and contextual connection
       | better when you don't have a word for it.
       | 
       | In this case, putting a word to worry is used as a good and
       | effective way to stop worry, which is an angle that had not
       | occurred to me.
        
       | meken wrote:
       | I've been doing this for months.
       | 
       | Sometimes it's helpful, but it seems more and more like I'm using
       | it as a tool to suppress my worries and control my thoughts,
       | which feels bad and leads to a lot of internal conflict.
       | 
       | I can't understand what people mean with "let your thoughts float
       | by". For me, noticing them is synonymous with interrupting them,
       | and it feels like I'm suppressing them most of the time.
        
         | jcutrell wrote:
         | I can understand that. I have to follow through with logic for
         | why the worry won't help.
         | 
         | "What is the upside for me if I continue to worry?"
        
         | rpastuszak wrote:
         | > I can't understand what people mean with "let your thoughts
         | float by". For me, noticing them is synonymous with
         | interrupting them, and it feels like I'm suppressing them most
         | of the time.
         | 
         | The way this works for me, say, when I meditate, is to
         | acknowledge a thought and put it in a box labelled "for later".
         | 
         | I'm not ignoring it, I'm just dealing with it when I _want to_,
         | not when my anxiety kicks in or when my brain tries to fill the
         | silence in my head. If it's important, I'll remember it.
         | 
         | I still suck at this, but I'm somewhat better than I used to
         | be. So, it's a bit like exercise, and one can get better with
         | time. It's also very personal (ymmv). Again, this way of
         | looking at it worked for _me_.
        
         | WhitneyLand wrote:
         | It's common to get hung up on a point like that. I think the
         | best way to get past it is have someone explain the same thing
         | in a different way that might click easier.
         | 
         | What's described here is basically mindfulness meditation. I an
         | not the mystical type _at all_ and this was a great entry point
         | for me:
         | 
         | http://ahandfulofleaves.org/documents/Mindfulness%20in%20Pla...
        
       | rpastuszak wrote:
       | This reminds me of a CBT technique known "Rumination Cues
       | Action". It was quite useful in my case.
       | 
       | The goal of the technique is to tackle the issue behaviourally,
       | spot the rumination trigger and do something else so you can
       | anchor yourself to back to reality. This should help you develop
       | a habit of stopping worrying _before_ it escalates into
       | rumination.
       | 
       | This is roughly how it works:
       | 
       | 1. Notice when you're ruminating (i.e. what are the triggers?
       | e.g. "leaving the bed", "taking a shower"). Ideally, write them
       | down somewhere. I'd use the Notes app on my phone for that.
       | 
       | 2. Once you notice the trigger happening again, _do something
       | else_!
       | 
       | Example: if I noticed that I was worrying about _<generic,
       | impossible to solve problem [1]>_, I'd leave my computer and grab
       | a glass of water, stretch, text someone. Initially, I had to do
       | this almost all the time, which felt a bit silly but after a few
       | days I had less and less to put in my Notes app and felt
       | generally more in control.
       | 
       | None of this is a replacement for therapy, of course, but it's
       | one of the CBT tools I've personally found helpful. Stretching
       | 15m per weeks is not as good as visiting the gym, but it's still
       | better than doing nothing. And this is low-hanging fruit.
       | 
       | [1] pick your poison, in my case this could've been anything
       | ranging from impostor syndrome to homelessness to cancer to war.
        
         | nonrandomstring wrote:
         | Much of this seems familiar from mindfulness and CBT style
         | approaches to rumination and catastrophising.
         | 
         | However, I do have a problem with the word "just" and its
         | possibly dangerous consequences. The opposite tendency is
         | minimisation.
         | 
         | You properly identify "impossible to solve problem" as a
         | target, but without some care the label _" just"_ might get
         | attached to: Just a final exam. Just one burger. Just a little
         | unexplained blood.
         | 
         | I was expecting a second page to the PDF dealing with how to
         | mentally process these labels and sort them into actionable and
         | inactionable.
         | 
         | Worry can be anything from a pointless, corrosive rumination to
         | a very important instinct that your subconscious or body is
         | telling you to do something about. Linking the feeling to a
         | phenomenon and possible action requires attention which cannot
         | be pushed down indefinitely.
        
           | [deleted]
        
           | ergonaught wrote:
           | This isn't about labeling the target. It's about labeling the
           | entirely unhelpful "just worrying", which they identify in
           | the very first bubble. "Just worrying" about a final exam is
           | an entirely accurate and useful label. "Just worrying" about
           | it will not accomplish anything useful or helpful.
           | 
           | Labeling it as "just an exam" may or may not be
           | useful/helpful in some circumstances, but those aren't the
           | subject of the PDF.
        
           | rpastuszak wrote:
           | I see your point, but I think this leaflet is aimed at the
           | people who have a tendency to overthink and ruminate as
           | opposed of ignoring issues, hence the approach.
           | 
           | You'll be rarely ruminating about something that is a real,
           | actionable problem. Instead, you're more likely to be
           | ruminating about something, anything that _isn 't_ the actual
           | problem at hand. So, in a sense, ruminating can be a form of
           | escapism.
           | 
           | That's why I don't worry too much about the use of "just"
           | here. At least personally, I don't think it's likely that I'd
           | follow this approach and end up _avoiding_ problems.
           | 
           | Reason: it's easier to spot either extreme when you step out
           | of your head even for a moment.
           | 
           | PS. When I worry too much about something I can't control
           | (e.g. silly office politics) I try to figure out what is the
           | thing I'm _not_ thinking about (getting the release done,
           | having a difficult workshop to run).
           | 
           | PPS. I'm not a psychologist, but I read some interesting
           | perspectives on the problem of avoidance when researching
           | Schema Therapy. Surely, there are better materials than that,
           | but I found it personally interesting and you might too.
        
             | nonrandomstring wrote:
             | > the thing I'm _not_ thinking about
             | 
             | Yes, interesting point. I think that's a good thing to
             | investigate. Thanks for the thoughts,
        
       | systom wrote:
       | This is one of the 6 key processes in ACT (Acceptance and
       | Commitment Therapy), which is based on RFT (Relational Frame
       | Theory).
       | 
       |  _Defusion involves the creation of nonliteral, nonevaluative
       | contexts that diminish the unnecessary regulatory functions of
       | cognitive events, and increase contact with the ongoing process
       | of relating as opposed merely to its products. Said in another
       | way, the focus is on mindfully noticing thinking as it occurs.
       | Some examples of defusion techniques include thanking one's mind
       | for a thought, watching thoughts go by as if they were written on
       | leaves floating down a stream, repeating words out loud until
       | only the sound remains, or giving thoughts a shape, size, and
       | texture. Clients can practice labeling the process of thinking
       | (e.g., "I am having the thought that I will never be
       | successful"), and practice behaving in ways that directly
       | contradict a thought (e.g., saying "I cannot walk" as one walks
       | across the room). The goal is greater behavioral flexibility, not
       | an immediate change in their frequency or form._
       | 
       | Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3635495/
        
       | keybored wrote:
       | I got chronically stuck in my meditation regiment when I got to
       | the point where I was supposed to briefly acknowledge
       | distractions. It turned into too much of a thing. Too much
       | thinking about thinking.
       | 
       | The best headspace for me is when I can stop identifying with my
       | thoughts. That's the best thing that I've learned from meditation
       | yet, and I would have never gotten to that place/space
       | organically by myself.
       | 
       | > This technique involves no criticism or anger at yourself,
       | 
       | Easier said than done. I blamed myself for getting distracted.
       | And then I blamed myself for blaming myself. I wasn't mindful
       | enough to get out of that cycle.
        
       | dqpb wrote:
       | > Worrying involves repetitive thinking ... without coming up
       | with any solutions
       | 
       | The problem here is not the worrying, it's the lack of solution.
       | 
       | > The 'Just Worrying' Labelling Technique
       | 
       | This is not really a technique, it's just a thought terminating
       | cliche. There are many possible thought terminating cliches.
       | 
       | In my experience, rational techniques are far superior to thought
       | terminating cliches.
        
         | dymk wrote:
         | I think the linked poster is talking about irrational
         | stressors, not ones you can talk yourself out of.
         | 
         | Worries that stem from irrational sources sometimes can't be
         | quelled with rational thought processes. We're more beholden to
         | primordial stress responses than we'd like to admit, triggered
         | by things which make no sense on paper. Social anxiety is a
         | good example. Worrying about deadlines you know you're on track
         | for. Etc.
         | 
         | It makes sense that (some) irrational stresses can be quelled
         | by sheer force of will. We have _some_ conscious control over
         | our stress responses, or at least can retrain the way our
         | brains follow up to that stress response. It doesn 't work for
         | everything, but it's a good tool to have in one's mental
         | wellbeing toolbox.
        
           | dqpb wrote:
           | > We're more beholden to primordial stress responses than
           | we'd like to admit
           | 
           | I completely agree. This is why I don't think thought
           | terminating cliches are a solution. Our stress response is a
           | policy trained over eons of evolution. We should honor it
           | with real thought and real action.
        
         | ReactiveJelly wrote:
         | I think it's okay to use thought-terminating cliches on
         | yourself if you understand what you are telling your
         | subconscious and why.
         | 
         | E.g. politics isn't going my way this year? What can I do?
         | Vote? Protest? Strike? Donate? I will certainly vote. I don't
         | feel like doing anything else. Everything else has to fall
         | under "I'm doing what I can for now." or "Yeah life just sucks
         | huh" or something.
         | 
         | Then I'm free to put that thought back down for a while.
        
       | cuser wrote:
       | Is there a good book on CBT? I've looked into Burn's collection
       | and others, but they have so much filler and anecdotes about this
       | one time they had a patient that thought they were ugly but was
       | actually stunningly beautiful, then the simple steps they
       | followed cured them etc.
       | 
       | Looking for something more practical on how to implement the
       | techniques, not something trying to sell me that it works.
        
         | kayodelycaon wrote:
         | His "Feeling Good Handbook" is actually a good course if you
         | treat it like a particularly slow textbook aimed at new
         | students.
         | 
         | Skim the exercises and anecdotes. You can stop reading after
         | chapter 6. It's just variations on the same theme from there.
         | 
         | I also have a two page "crash course" I derived from it. It's a
         | worksheet and how to use it. It assumes you have some level of
         | self-awareness and already understand the dangers of using CBT
         | improperly.
         | 
         | Word: https://kayode.co/therapy-worksheet.docx
         | 
         | PDF: https://kayode.co/therapy-worksheet.pdf
         | 
         | At some point, I need to write an article on my blog that
         | covers how to use it properly. Until then, I'm using unlisted
         | links.
        
       | darrelld wrote:
       | I keep telling myself: "He who worries, suffers twice". I can't
       | remember who the quote is attributed to, but it's a helpful
       | little phrase that reminds me that it's better to just suffer
       | once and be done, or sometimes, not suffer at all.
        
       | ad404b8a372f2b9 wrote:
       | I'm going to try it but I can't imagine why it would work.
       | 
       | After an accident two years ago I developed some tics and
       | abnormal compulsive behaviour that make me feel like a real
       | nutcase but none of the tricks I find online have done anything
       | to help.
       | 
       | I've tried inflicting light pain to myself when it happens as a
       | sort of reverse Pavlov bell, I've tried deep rationalization:
       | analyzing the feelings to their root as a way to take away the
       | associated emotions, and lately I've been trying repeating the
       | opposite of the way I feel as a way to try and cancel the
       | thoughts. It is really hard retraining the brain it seems.
       | 
       | It's given me some really interesting insights on trauma, though.
       | It's hard to empathize with things you haven't experienced, I
       | used to feel people were weak who were traumatized by life
       | experiences that I felt were not all that bad compared to some of
       | the things I and other people I know have been through. But it
       | turns out it's not about the magnitude of the harm, it's more
       | about the way your brain interprets it and the false causal
       | patterns it forms from your experience.
        
         | feanaro wrote:
         | I think techniques based on observation and acceptance might
         | have a better chance of working than trying to forcefully
         | extinguish or fight it.
        
           | ad404b8a372f2b9 wrote:
           | Bruteforce has worked for me in the past. But maybe you're
           | right, I'm going to try this one and see how it goes.
        
         | mrcartmeneses wrote:
         | PTSD? Have you considered MDMA, ketamine or Ayahuasca? Nitrous
         | Oxide is also said to work on the same "glutamate pathway" and
         | may also have some therapeutic effect. You'd need food safe
         | stuff though like you find in whipped cream, not from a car's
         | nitrous bottle.
        
           | ad404b8a372f2b9 wrote:
           | No idea what it is, I never went to a mental health
           | professional. I got Ketamine before being loaded into the
           | ambulance and I felt pretty great for about 4 to 6 months
           | after. But it's not easily available in my country outside of
           | emergency situations.
           | 
           | Hadn't heard of some of those other ones, maybe I'll them a
           | try, cheers.
        
             | yata69420 wrote:
             | If you're not aware, ketamine clinics are now trending in
             | the US. The effects do seem to last about 4-6 months from
             | what I've heard.
        
         | rpastuszak wrote:
         | > It is really hard retraining the brain it seems.
         | 
         | Have you tried seeing a therapist? A good therapist works a bit
         | like a coach (think: "sports coach", not "live coach" whatever
         | the fuck that means). We're notoriously bad at spotting
         | unproductive thought patterns, and having someone with an
         | unbiased perspective and the right expertise really helps. It
         | takes years, but so far it has been the most effective way of
         | doing so, for me.
         | 
         | Also, you can keep rationalising as much as you want, but your
         | meat sponge is not a rational, logical machine. The average HN
         | reader might make the mistake of believing otherwise (include
         | me on this list). Your amygdala doesn't give a shit, however.
         | 
         | Speaking from personal experience here, hope it didn't come
         | across as patronising. I just noticed that many of the things
         | you've said sound familiar.
        
           | ad404b8a372f2b9 wrote:
           | It'd probably be the healthy thing to do but I don't have the
           | money, the time or the ability since my physical health
           | hasn't recovered yet. Also I find the idea of talking about
           | my feelings to a complete stranger unappealing. But anyway
           | I'm not complaining, it's not too bad, I've solved the more
           | debilitating aspects through personal work and the rest I can
           | live with until I figure out a way to get rid of it.
           | 
           | I didn't take it to be patronizing, I appreciate the advice.
        
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