430: Mindfulness & Cognitive Behavioral Therapy

Dr. Seth Gillihan and Ashley James


  • How CBT is different from other therapy
  • What the Think Act Be approach is
  • Mindfulness-centered CBT
  • How to get rid of worrying
  • Focus on what’s real
  • Service is a crucial part of self-care

During this time of uncertainty, many people are always worrying. Constant worrying leads to anxiety and stress and doesn’t help us and our situation. Ph.D. Seth Gillihan joins us in this episode to talk about what mindfulness-centered CBT is and how it is different from traditional CBT as well as other forms of therapy. He tells us that we need to worry less and instead focus on what we have. He also gives some tips on how we can reduce stress in our lives.


Hello, true health seeker, and welcome to another episode of the Learn True Health podcast. Today's guest is Ph.D. Seth Gillihan. He specializes in mindfulness and cognitive-behavioral therapy. He has some wonderful things to share today, and I'd love to make sure that you know the best link to go to to get access to all of his stuff including his online courses, which I just love, learntruehealth.com/calm. That's learntruehealth.com/calm. If you find yourself in a bit of anxiety, panic, or worry these days, you're going to love his training and his system because it's going to bring you back to center, bring you back to a place of being grounded, peaceful, and focused, and give you a lot of clarity. Enjoy today's episode, and please, share it with those you care about who also would love to master their brain, their heart, and their mind and increase their mindfulness. Have a wonderful rest of your day and enjoy today's interview.

Photo by Gift Habeshaw on Unsplash

[00:01:06] Ashley James: Welcome to the Learn True Health podcast. I’m your host, Ashley James. This is episode 430. I am so excited for today's guest. We have with us Ph.D. Seth Gillihan I. You are a licensed psychologist, and you're the host of the weekly podcast Think Act Be. I'm really excited to have you here because you specialize in cognitive-behavioral therapy, and that's something that is so cool. To me, it's one of the coolest things in the world. I know we were talking about how it might be really dry and boring, I don't think it's working at all.

I think it's so cool that you can help someone to shift their mind, their behavior, and their results in life. That we can reprogram ourselves and that cognitive-behavioral therapy is not painful. It's not like Freudian where you sit and have to relive your childhood over and over again and cry. No, no. It's actually just really quick. You get to the root of it and you shift your behavior, which shifts your results and you can shift your whole approach to life. 

It's really exciting that people can break free from phobias, anxiety, and issues that have plagued them their whole life. I love that you're an expert in it, you've written several books in it, you have a wonderful online class so people can, right now in the comfort of their own home, start to shift their life. This is the perfect time to do it. I'm just so excited, Seth, to have you here today. Welcome to the show.

[00:02:45] Seth Gillihan: Thanks a lot, Ashley. Thanks for that warm introduction. Yeah, I think that is right about CBT. It does tend to have that reputation of being somewhat dry and maybe a kind of formulaic approach, but hopefully, by the end of our talk today, we'll show that that doesn't have to be the case. There really is a lot more to it, and the techniques can be very quick and effective, but can also be quite deep.

[00:03:13] Ashley James: I love it. I love it. Before we dive into learning from you today and learning tools for shifting our life, I want to learn a bit more about you. What happened in your life that had led you to want to become a psychologist that led you to want to help people in this way?

[00:03:33] Seth Gillihan: It's an interesting question because the answer really has changed over the past couple of years. I've been doing cognitive-behavioral therapy and mindfulness related approaches for the past, gosh, I don't know, 10, 15 years. Mindfulness really is in the past 10 years and CBT longer than that. I wasn't prone to a lot of anxiety or depression growing up, so I wasn't quite sure what drew me to it initially. In hindsight, some of it might have been seeing family members struggle with those things. Unconsciously, on my part, wanting to offer some kind of help and not really knowing what to do. 

I was inspired by my grandfather's life of service. He was a physician for over 50 years in rural Eastern Kentucky. I knew I wanted to do something some way of being of direct service to people, and I wanted to do it as effectively as possible, which got me into CBT and later into mindfulness. But it was only really through my own prolonged sickness that I'm actually still recovering from that. I really found what to me feels like a really holistic integration of mindfulness and CBT that I've started calling mindfulness-centered cognitive-behavioral therapy because it's not about tacking on this third technique. 

We can do cognitive stuff and behavioral stuff and here's some mindfulness stuff if you need it, but viewing our spirits as central to who we are and to everything else that we experience. Putting mindfulness in that place really of priority within the approach and letting it lay the groundwork for everything else that we do. As we'll talk more about it, it's much more effective to address our thoughts and our actions when we're coming from a place of really being centered within ourselves rather than being off-kilter and then that kind of frenzied chaos we often find ourselves from. It’s hard to make really positive changes from that place.

[00:06:14] Ashley James: What was the first aha moment that you had, your first experience with cognitive-behavioral therapy? What was the first oh my gosh, this is amazing—like body tingles amazing shift for you?

[00:06:30] Seth Gillihan: I still remember the first time reading about what cognitive therapy was. I was reading an interview with Dr. Aaron Beck, one of the founders of the CBT approach. This was probably around 1999 or so. I was in a master's program at George Washington University. I was in the library late at night, I was reading this interview, and I thought wow, this just makes so much sense this idea that our thoughts—the things we tell ourselves—have so much to do with the way we experience the world, the emotions we experience, and how we interact with other people. I carried that with me and it was probably a few days later I was in the kitchen in our little apartment in Washington DC where my wife and I were living at the time. We hadn't been married that long, and we're probably arguing fairly often at that point. There was a good bit of tension in our relationship at times.

For some reason, it stands out in my memory. I was in the kitchen and I was getting ready to bake a frozen pizza. I don't remember what the specific thought was but some thought about my wife went through my mind. It was some kind of interpretation of like she thinks such and such or she's treating me in some way, and I caught it at that moment. I was like oh wow, that's an interpretation. The way that I am seeing my wife at this moment where the story that my mind is crafting about who my wife is or what her actions mean has everything to do with the way that I'm seeing her and the way that I feel about her because I recognize such a close link between that story—the kind of negative view of my wife—and this kind of feeling I had toward her of probably just feeling she wasn't being very nice or wasn't very generous.

I realized, at that moment, wow, this really can revolutionize relationships, which obviously is such an important part of our experience and our well-being in life. From that moment, I think that’s when it really hooked me and I realized the power and the potential of it.

[00:08:59] Ashley James: How has this type of therapy helped you in your health?

[00:09:12] Seth Gillihan: I guess this goes back at least a couple of years now, maybe coming on three years when I realized. It turned out to be toxic mold poisoning my now former office, or my old office, or my mold office. I only got out of there a few months ago. So thankfully, since then, it's been slow and uneven recovery, but the world's better than it was two or three years ago. This has been going on probably at least for five years, really when the umbrella of this really began. Just the stress, the uncertainty, and all the unknowns and the questions about what is going on with my health? Why can no one figure out why I have no energy? I can't sleep, my brain is fuzzy. All this wide range of nonspecific symptoms that wasn't clear why they all should hang together.

I ended up getting quite depressed through that. Actually, I had a podcast guest on. We talked about treating depression and the power of shaping our behavior in a way that boosts our mood. I looked at my life and I realized wow, my activities really have shrunk down to almost nothing. I mean, I spend a ton of time in the kitchen preparing food for these specialized diets that I was on. I wasn't seeing anyone because the illness had led to a lot of vocal problems including growth. My vocal cords, I had to have surgery for it to have removed. My world has gotten quite small as it often does when we're going through a chronic illness, and that tends to lead to depression.

As I was reading this book in preparation for my interview with this guest who's also a psychologist, I thought, you know what, I'm going to put this into action. I'm going to do CBT on myself. So that led me to really think about what are the life-giving activities that I can build back into my life that I'm actually able to do now even with the physical limitations that I have. That included building a pretty extensive garden in our backyard. In hindsight, I didn't realize it at the time, Ashley, but it was kind of rebuilding me as much as I was building it. I felt just compelled almost not against my will, but more than I was willing myself to just throw myself into the work of building this garden. At a time when I had very little energy and I was in a building these eight raised garden beds and doing all this learning to figure out how and what to plant and figuring out the watering schedule and all that, that really was a big part I think of the process of beginning my healing. I still experience those benefits now as the crops are coming in again. It feels like there's that resonance in the life in the garden and in the life within me.

[00:13:38] Ashley James: I love it. I love it. I love it. There are so many ways that nature or gardens metaphorically represent our life and our health. I think that's so beautiful and healing that as you built that garden you also built that inner garden as well.

[00:14:05] Seth Gillihan: I remember the day. It was one of the first really warm days last year and the whole garden had grown. The way I'd built it was there were four beds on the outside part of the garden, and the inside was for triangular beds arranged in a way with the long edges facing in so it formed a kind of diamond on the inside. There's an opening in the middle. I was working on that opening and I knelt down on both my knees to pull something out of the ground or something. It just hit me at that moment. It felt like an act of reference, it felt like an act of worship. I used it as exactly that to just say thank you, I can't believe here I am, I'm feeling well. I'm surrounded by all this green and this energy. This is not Seth Gillihan who went to graduate school to become a psychologist and learn CBT, this was something different. It had a much more overtly spiritual feel to it then. I think I would have a little wigged out by me ten years earlier, but that's what happened.

[00:15:26] Ashley James: I love it. We grow so much so we look back to ourselves 20 years ago. I've been thinking a lot about 1999 transitioning into the 2000s and that was 20 years ago. It just feels like yesterday but it also feels like a whole lifetime. I've had these thought exercises of what kind of conversations I'd have with my 19-year-old self back in 1999. What kind of conversations would I have, how different am I, and what's the same? That thinking then in 20 years, what's my life going to be like when I'm 60? Who am I going to be when I'm 60, and who's still going to be me? What's still going to be me and what's going to be different? Because we are growing, and that's good. That's a good thing. 

We want to grow and change. We want to shed what's no longer serving us. We want to shed the anxiety or the habits that are no longer helping us whether it's something obvious like alcoholism or smoking, or if it's something less obvious like maybe quick to interpreting things in a way that sets you up to feel like a victim, or not allowing you to quickly resolve issues and instead go to anger or other negative emotions. This is part of the wiring of the brain, and we can shift it. If we can look at our life like what’s no longer serving me and what can I shift? Maybe it would help if you could explain what cognitive-behavioral therapy is because a lot ­­of people who have not been to a therapist, we all think therapy is basically what Hollywood has portrayed for us. 

There's a stigma that only sick people go to therapy, and I don't think that that's the stigma for the millennials. I've seen more and more that in the millennial, in the younger generation, that therapy is seen as something that we go to to become even better or at least like for preventive medicine. I have a friend and I've told her story on the podcast before but I have a friend who is in her late 30s, she has a 5-year-old daughter, she has a wonderful boyfriend who's the father of their child, and she is a personal chef for people—wealthy families in Seattle. She's constantly traveling to these different houses and cooking for them and very, very busy. 

She said on Facebook one day, “People ask me how I keep it all together,” because she's constantly go-go-go between having a wonderful relationship with her boyfriend, being a great mom, being there for her daughter, and running her own business. How does she do it all? She says, “I see a therapist three times a week. Therapy for me is what allows me to keep my sanity, and it is something that people should do like they go to the gym. You take a shower, you should go to a therapist because if I didn't go to therapy, I'd be blowing up at my daughter. I'd be putting my stress on to other people in my life instead of processing it. I don't bring my work home. I don't bring my stress work home. If I'm stressed about something I process it, I don't project it onto other people, and that's what therapy has done for me.” 

She said that there are certain generations that still think that therapy is something that you have to wait to get sick and then it's taboo. It’s like they're touched with the plague or something if you're going to go to therapy, whereas other people are beginning to see that therapy is something that you go to the gym for your physical body, you go to a therapist or a counselor for your mental and emotional body. Maybe if you could explain the different types of therapies. Cognitive therapy is so vastly different from Freudian, for example, which is the stereotypical therapy that we've been exposed to if we've followed Hollywood.

[00:20:02] Seth Gillihan: I love the comparison to the gym because we're not surprised when someone who goes to the gym is in really good shape, but as the example you gave shows, we might be surprised when someone who's really well-adjusted emotionally goes to therapy. But it could be that someone is able to cope with things because they go to therapy, not that everyone has to be in therapy. There’s certainly no shame in it. The way you describe it is how I tend to see it that it’s really for anyone at any level of things they want to work on whether for really debilitating issues or because they feel like they just want to get more out of life and live as fully as possible.

The therapy we’re most used to seeing, if I ask someone to describe what happens in therapy, they'll probably imagine someone comes in and maybe lies on a couch. Maybe some people still have that image from classic Freudian psychoanalysis where the analyst is sitting behind the person. Maybe they imagine sitting face-to-face, but the person who’s there for treatment does most of the talking and focus on issues with their mother or things from early in life. That is the kind of more traditional Freudian or the psychoanalytic or what's now called psychodynamic approach. It's influenced by Freud but not exactly the type of therapy that Freud delivered because the real analysis is four times a week and it was for many years.

With Freudian or psychodynamic therapy, there is a lot of focus on the past and in talking about a person's earliest relationships. The emphasis is on things that a person isn't really aware of. These unconscious conflicts, so conflicts between different parts of my psyche. The part that I identify with that I'm aware of called ego and then the id, which is the more primitive drives like drives for sex, power, and domination. On the other hand, the super-ego, which is like our conscience. It’s sort of seen as a battle between these forces and most of the id and superego are said to be unconscious. They're operating outside of our awareness. If that's your model of what the human mind is, then it makes sense you need a therapist to walk you through that and help you to uncover these unconscious drives and motivations and to integrate them more so they're not exerting these effects that we’re not aware of.

A lot of what happens in the therapy relationship in Freudian therapy is about what takes place between the therapist and the client. People may have heard of this idea of transference that the way that I treat the therapist is going to be based on earlier relationships. For example, if I tend to see authority figures as overly controlling, then that's how I might respond to the therapist, not because of anything the therapist is doing, but because I'm projecting those early experiences onto them, so a lot of the therapy is going to require understanding, identifying, and working through those transference reactions. That’s a very different set up from CBT where the emphasis is more on things that all of us can learn and observe within ourselves. That each of us is seen as the expert on who we are. That we know ourselves better than other people do, and then we can really become our own therapists.

That's done through really understanding the CBT model, which is about the relations between our thoughts, our emotions, and our actions. That there are links between those that we can recognize and start to shift in a way that serves us. A quick example is if I have a tendency, when someone doesn't respond to my text messages, to think they don't like me or they think I'm not you know worth their time, to first of all recognize that as the story that we're telling ourselves. It may or may not be true like that story that I was telling myself about what my wife did as I was making that frozen pizza back in DC. Recognizing the stories we tell ourselves and then we can examine whether they're true, or maybe there are alternative explanations. Is there any other reason why someone might not have texted or responded to my text? Maybe they didn't get it, maybe they're busy, maybe it got buried in other messages, maybe they're homeschooling their kids in the middle of a pandemic. It could be anything.

That's something we can all learn to do. That's one of the emphases within CBT, and it's also highly collaborative. It's not that I am, as the therapist, have this specialized knowledge that you'll never have access to and you'll require my input and interpretation to figure things out, but rather, I have some tools that I've been trained in that may be helpful to you. It really is going to take the two of us coming together to figure out what's going to work for you through trial and error and through really this evidence-based approach of trying things out. See what works, keeping what does, and trying new things as we need to. The cognitive part is about our thoughts. The behavioral part is about becoming more aware of our actions and the things that influence our behavior and the effects of our behaviors. Again, an example might help.

If I'm someone who has a lot of social anxiety and I also am dealing with a low mood, then I might pine on this choice where I can go to a party or I can stay at home. If I look at the different payoffs for those different choices, then I have a better chance of making one that's going to really serve my longer-term goals. The short-term payoff for not going to a party that I know it's going to make me feel socially awkward is I'll get some relief. I don't have to face that anxiety and so that avoidance will be rewarded in the short-term, but the downside is, I don't have the eventual enjoyment of going to the party, I don't feel a sense of accomplishment from facing that fear, and my mood is going to tend to be worse because I'm going to continue to be isolated and alone. By understanding those payoffs, I can choose the action that's going to have the best long-term outcome.

The cognitive-behavioral approaches are the first two waves of CBT and then mindfulness came along as a third wave. I'll pause for breath there in case you have questions.

[00:28:06] Ashley James: With cognitive-behavioral therapy, the client is not seen as a victim or seen as broken. They're seen as someone who's the expert of their own person, and you are a collaborator with them as their therapist. You are a collaborator, you have tools, they're the master of themselves, and you're helping them master their inner world and then their effect on the outer world.

[00:28:37] Seth Gillihan: Yes. That's a nice way of saying it. Yes, definitely not broken. I always ask in the first interview about a person's strengths because those strengths are the things we're going to emphasize that are going to help a person to address the things they want to change.

[00:28:58] Ashley James: Brilliant. I love it, I love it. I'm so passionate about cognitive-behavioral therapy because everyone can benefit from it. Is there anyone that shouldn't do cognitive-behavioral therapy?

[00:29:13] Seth Gillihan: That's a really good question. Going back to Aaron Beck, he was kind enough to write a blurb for my second book on CBT. He said something to the effect of these principles would be helpful basically for everyone. I tend to agree with him. We would need to tailor the approach for different people. Maybe a person needs a certain level of cognitive ability, I mean, minimal level, not like you have to be a Rhodes Scholar or something to do this because the approaches really are frightfully simple when you come down to it.

[00:30:01] Ashley James: They'd have to be able to follow directions, basically.

[00:30:04] Seth Gillihan: Yeah, they'll be able to follow directions. I mean, there are definitely people who don't want that kind of approach. They would rather be in a more exploratory therapy, or an insight, or in at one, or there are some people who come and they really don't want to work on things between sessions. Maybe they want to but they know that there's a really high likelihood that they're not at a place where they're going to follow through on an activity plan that they come up with the therapist and it's going to end up being a punishing experience like all right, great. You go out to work on those things. I'll see you next week. Then they come back and have to say, yeah, I didn't do any of that stuff. 

That may not be the best therapy for someone in that position. I should say, as much as I love CBT, I've also had major reservations about it over the years. I want to put that out there. I don't think that everyone should do it or if someone's doing different kinds of therapy they're doing the wrong therapy. There are lots of types of therapy that could be effective, but if someone is interested in CBT, I can think of very few cases where it wouldn't probably be helpful.

Image by jamesoladujoye from Pixabay

[00:31:34] Ashley James: You've taken CBT and you’ve shifted it. As you said, you had some reservations. You've seen where it could be improved upon and that you've brought in more mindfulness, more of a spiritual approach. Tell us about your approach to CBT.

[00:31:53] Seth Gillihan: That's a really nicely worded question, Ashley, because you asked about the more spiritual aspect, and that's really what I came to. This goes back to what you asked about my own experiences and developments along the way. Through that period of my illness, there were so many nights where my energy would just get worse and worse throughout the day and by the evening, I would just feel completely despondent and suicidal at times and just lying on the couch so many nights just despairing and feeling like I had reached the end of myself. Yet there was something in me that kept me going. I didn't understand it because all I wanted to do was just stop, was just give up. I don't know what that would have looked like, although, as I said, there are times when I thought I should just do everyone a favor and end my life.

I realized in one of those moments when this phrase is going through my mind—I've just reached the end of myself. I've reached the end of myself. But I realized that that wasn't the end. That there was something else there. It felt, at that moment, like I needed to come to that place in order to find what was next. What I found next was my spirit was there. My spirit was undiminished by anything that I'd been experiencing. That it was as big, as vibrant, and as alive as it had ever been. That it was unperturbed by anything that was happening on the surface of my life. I felt such strength coming from it. When I felt like I had nothing to give that it was this spirit within me that was me and yet was more than me that I was drawing strength from, that I was drawing sustenance from. I felt like it was that spirit that actually drew me back to CBT, which seems a little bit funny to me that that feeling of something eternal and grand drew me to such a mundane approach—something that is so concrete and nuts and bolts.

What I love about it is that it feels very integrated. That the sacred in my life is intimately tied to something as simple as what I put on my calendar. That really is what led me to see. I understood as I realized the spirit within me in this connection to the spiritual, I realized that’s why mindfulness tends to be so effective. It's not just a way of hacking our attention system and not focusing on the future because that makes us anxious, but that our spirit is like our bodies. It exists in the present. When we really come into the present moment, we open to our experience just as it is, we invite ourselves to connect with our spirits, and that is such a vital place. That's a place of such vitality. I actually thought about calling the Think Act Be approach, that’s my shorthand for mindfulness-centered CBT. Think for cognitive, Act for behavior, and Be for mindful presence.

I thought about calling it spirit-centered CBT, but I thought that might be a little less accessible for people. People might scratch their heads a little too much with that, but to me, it feels interchangeable. That really is what it's about. It's about operating from that spiritual connection. It's why I think CBT is more effective when it comes to that deeply grounded place. I think that CBT can help us to move toward that place of connection with our spirits. It ends up being this really beautifully circular process, this virtuous circle of spiritual connection drawing us to right action, right thinking, which in turn reinforces our spiritual connection and really keeping us healthy and grounded and continuing in that direction.

So much in my life has changed over these past few years as I've been drawn, not even really through. It hasn't felt like all right, I made a decision. I'm going to start living a mindful CBT type of way, but it's just what I've been drawn to. That's really strongly affected my work and my approach with CBT because it felt superficial, it felt like it wasn't really getting at the heart of what people were coming to me for. Yet there were times when so many people, I had seen in working with them, these really profound breakthroughs they had made just through mostly a cognitive and behavioral approach, but they really had been able to come home to themselves in a way that did feel deeply spiritual.

[00:38:22] Ashley James: I love it. I think we're spiritual beings at our core. If you could remove the blocks to get us there, if you can remove any blocks to allow us to get back to being connected with the source, then that would just enhance all the quality of every part of your life.

[00:38:47] Seth Gillihan: Yes. That’s exactly how I think of it. That we are spiritual at our core. You were saying earlier it'll be interesting to see in 20 years, when you're 60 and I'm 65, who we are. I love thinking about that because I believe there is that core about us that will endure. So many things will change but something will be the same, and I think it is that eternal core within us—that spiritual core. Yes that we naturally tend toward that connection if only we remove the blocks that keep us from being there. That's [you and I 00:39:30] right now about cognitive and behavioral approaches. That's how I think about them. That the idea is we're removing those things that are blocking us from our natural inclination towards spiritual connection.

I used to be so self-conscious to talk about these kinds of things so explicitly. I have a very strong background in science. I moved away from a fundamentalist Christian upbringing after college. There's kind of squeamishness about things that are overtly spiritual, but what I realized is that I guess I care less on the one hand, but also I think all of us are aware that we are something beyond these minds and these bodies. Whether we call it spirit or something else, there is something eternal about us.

[00:40:33] Ashley James: You said I care less and I think that's interesting. I think it's an interesting saying, but I don't think it's accurate. I think you care as much as you've always cared, but you don't care about what other people think as much.

[00:40:50] Seth Gillihan: That's right.

[00:40:51] Ashley James: Your care has shifted. You probably care in a different way. Something that we heard—my husband and I, followed this guy, it was pretty neat. He said a lot of very interesting Tao spiritual sayings, and we liked following him. This was like an online radio show 12 years ago. He said, “It's none of your business what other people think of you.”

[00:41:24] Seth Gillihan: I love that.

[00:41:26] Ashley James: We had to hear it a few times and he said it over and over because, at the time, my husband was so self-conscious he wouldn't hold my hand in public. I mean it was bizarre. Bizarre, right? I'm your wife, hold my hand. He got it. He was just so worried his whole life. He was so worried about what everyone thought of him, and he was constantly creating these alternate realities in his mind where people were judging him for things. It's just made up, right? This is what we do. We're meaning-making machines, but we typically like to go to the worst-case scenarios in our minds. When he heard that it hit him like he almost fell over. It's none of your business what other people think of you. It just gave him so much freedom. After hearing that he just let it go. He stopped worrying as much about what other people thought of him or stopped caring as much about what other people thought. He's a very caring person, but he stopped making up these realities in which people were judging him.

I've had an experience in the last few months where I had a really good friend who I felt very close to. I'd known her for a long time and then I found out that she was telling lies about me—very horrible, nasty, and really hurtful lies. I had poured so much support into her over the years. I had helped her. I'd invested in her with a lot of money, a lot of time into her business, and any possible way I could help her. At one point she was living on our couch. For over the years, we helped her and helped her and helped her and helped her and helped her. We were doing nothing but just being supportive friends and then she turned around and she said these really, really nasty things to another friend about us that were not true. I mean, they're all lies, but in her mind they were true.

At first, obviously, I was very hurt. I was very angry, but then I sat back and I asked myself what reality does she live in in which she interpreted my kindness as evil or my support as a friend as that way? She must be living in such a sick world or such a warped reality to have interpreted my generosity as something other than just generosity. Then it hit me. I started laughing. I went from just being angry and so deeply hurt because someone I considered where my best friends betrayed me, but I didn't make it about me. I was thinking about like wow, what's going on in her life that that’s her reality? That's really like a scary reality she's invented for herself. Then I started laughing because I got that. 

I spend so much of my time worrying about what other people think of me. I create, in my mind, like I'm worried that people are going to judge me because I didn't pluck the chin hairs today. Oh gosh, I got out of the house without plucking these chin hairs. People are just going to be judging me. I left the house and there's a tear in my pants or whatever. In my mind, I'm worrying about what other people think of me. I've decided that they're going to worry about what I think they should worry about, but she created. What she made me realize is that there's no use in investing your energy in inventing things for people to worry about because people are going to come up with their own stuff. They're going to make up their stuff about you that is so wrong, that is so off-kilter that you would have never guessed, that you should have been worrying about that. 

I laugh because why invest energy into worrying about what other people think when people are going to come up with their own stuff to judge you on, and you can't control it no matter how virtuous you are, no matter how good of a person you are. I mean, even people interpreted Jesus the wrong way. No matter how good you are, there's going to be people that don't like you, but it's not about you. It's them and their life and their baggage. Don't invest any of your energy in making up what to worry about because they're off doing their own thing inventing their own stuff about you, and it's not you, it's them.

It gave me a lot of freedom. It was a hard lesson to learn to lose that friendship, ultimately, but at the same time, it was a beautiful lesson she gave me. When I walk out of the house with my chin hairs unplugged, I rest assure that the people who love me will see past them no matter what, and the people who are judging me are going to invent their own things and probably not even see the chin hairs because they're just going to be making up their own stuff. I can live my life just connecting with those who love me and moving on and letting go of the worry of judgments. When you said that, it reminded me that when we focus on worry, we're self-creating so much anxiety and stress, and it doesn't serve us.

It's actually really interesting, why is it that we have this mechanism? Because it doesn't help our survival. In fact, it harms our physical health to have a mechanism in which we are constantly in anxiety and worry. That doesn't actually help us survive anymore so why do we do it?

[00:47:31] Seth Gillihan: I think as best we know, it's because when we were being selected for it was helpful. There was a time when your neighbors rejecting you could be a life or death matter. If you were excluded from the clan, then that could be a matter of survival. But, yes. Now, it’s completely counterproductive that we spend all our time worrying about things that don't happen. As you pointed out, worrying about the wrong stuff. We get it wrong. We probably worry about dying from the wrong things. It's probably not that thing we're worried about that's going to get us, it'll be something else, but I love how you described it. It's not like we have to trick ourselves into thinking no one's ever going to think anything bad about you or you know you're never going to get sick, but you don't know what it's going to be, so you may as well stop trying to figure it out. Just live what's in front of you.

I think so many of us are asking ourselves that question, Ashley. Why am I spending so much time unproductively in my head—doing things that aren't helpful, thinking in ways that aren't helpful? I think it does go back to that. Our minds are trying to do us a favor. They think they're doing something positive for us. That they're keeping us safe by warning us about all these potential disasters, and that's why I think we really have to retrain our minds because our default is toward threat, danger, and insecurity.

[00:49:14] Ashley James: Yeah. How much are we still running on default? How much are we still running on the tools we had as a child where it's that survival brain? At some point, we have to become our own parents. We have to raise ourselves. I've been looking at this a lot, thinking about this a lot, this idea that we are adults that are still children in many ways. We look to the government as our parents. Take care of me. Take care of us. I feel good that the government is going to take care of us. Some people give over their power to their doctors. It becomes a parental relationship where it's like take care of me. I am helpless. I don't know what to do. Take care of me. We revert back to becoming a child where someone else has the answers, and we can just go about our day because someone else is going to handle it.

Being a parent now, we have a 5-year-old, and watching how to be a 5-year-old again where someone's doing all of the major decision-making for you. Where someone is feeding you and putting a roof over your head and all you have to worry about is playing with your toys and having fun all day. Anytime something bad happens you look to your parents to solve it, right? At some point, we grow up, but even in my 20s, when I was looking at this recently I'm like, when did I stop blaming my parents? When did I stop? Something happened and I was like I can't believe I spent my 20s still blaming my parents. If they only did this right then my life would be bettered. I was like wow. At what point did I figure out that it's me, I'm responsible for it.

No matter how good or bad your parents were as being parents, it's not their fault your life is the way it is because you are the one who gets up every day and does what you do. Catching myself and going, what parts of me are still at the default setting where I haven't grown up—I haven't grown myself up—I haven't gained the tools? Looking at what parts of me are still acting like a teenager—rebellious teenager still acting like a child, still handing over my power, and looking for someone else to solve my problems. I've been going through that mental exercise lately. It's interesting that you say that. Cognitive therapy and especially your form of cognitive therapy that really includes mindfulness is also about helping us grow up. Grow up and grow up those parts of ourselves that are still acting like that survival mode, especially if anyone is running around feeling anxiety right now and running around in worry and feeling overly stressed out. That’s when they need your tools for sure. Can you teach us some things? I'd love for the listeners to learn especially since stress is so bad for our health. Are there any tools that you can teach us to help us decrease stress?

[00:52:38] Seth Gillihan: Yes. First of all, I'm glad that you saw through that idea that your parents were to blame for everything in your 20s because we can hold on to that belief well beyond in our 30s, 40s, 50s, or older. I think that’s a positive thing. I think I discovered some of that later in life, not blaming my parents, but looking to the medical establishment to fix me. When I'd exhausted what mainstream medicine could offer with tests, labs, and things. Then it's going to be this practitioner, it's going to be this type of therapy. I definitely got help through a lot of those, but I kept reminding myself it's not going to be that one person that's going to be the Savior that I'm looking for. I’m not going to find that one diet that's going to tell me to eat this and don't eat that. I'm going to have to figure these things out the best I can for myself through trial and error and just listening to my body.

It is such a stressful time and such an anxious time for so many of us. The mindfulness-centered CBT approach that I use, the emphasis, it's not on short-term like rescue fixes like a Pepto-Bismol for anxiety. If you're anxious take this, this will knock it out. Try this trick or this technique. I think a lot of the practices that can be helpful in the middle of anxiety, but the most effective approach is to build the type of life where anxiety is not the dominant force or stress doesn't have the upper hand. It starts with very basic wellness exercises like literally moving our bodies and attending to our sleep. Treating sleep as a sacred activity and honoring our bodies and our minds with the foods that we put in them and what and how much we drink. It starts there.

My approach, to be honest, for my first few years of doing CBT, I really ignored those kinds of somewhat superfluous details. Maybe a person was drinking six bottles of Diet Coke a day then maybe they'd be a little jittery from anxiety, we could talk about that, but I wasn't attending to just the overall wellness in the machine, so to speak, and attending to the machine of our bodies and how that affects our minds and our spirits. I think starting there or thinking about the way we treat our body as being as important as anything else in dealing with anxiety. But then in terms of more specific practices, obviously, the parenting idea made me think of an exercise that I often encourage people to do.

Think about the bookends of your day from one being when you wake up and the other being as you're going to sleep or preparing for bed. When we wake up in the morning, it’s common that we wake up with a lot of anxious arousal because our stress hormones, cortisol, and norepinephrine are going up during that time because we're preparing to mobilize for the day. That can jolt us awake. That can launch us headlong into our day and our busyness. Going back to the premise of mindfulness-centered CBT, starting our day from that wobbly place of being out of balance, it's not going to set us up for having the best kind of day.

Even taking a few moments when we wake up just to say hello to ourselves. I'm thinking about the reparenting idea that you talked about. When a parent goes into their, let's say, two-year-old’s bedroom in the morning and then your child wakes up, the parent doesn't say, hey, you're awake. All right, come on. Let's go. They don't grab them, bring them out of the crib, and overwhelm them. At least I hope not with a lot of energy and intensity, but they say, hey, good morning. How are? How did you sleep? Whatever questions you ask a two-year-old. Our kids are older than this now. I don't know if we asked them how'd you sleep last night, but you greet them. You connect with them. 

I think we can do that to ourselves, just say hello to yourself in the morning before you jump into your day. Maybe it involves taking five calming breaths in the morning can be a useful exercise—lying in bed, just feeling your body, and coming into your body as you emerge from sleep. Then asking ourselves what kind of day do I want to have rather than what our default question is something like how are things going to go today, or I wonder if there are going to be problems today, but those questions really make us feel like victims as we start our day. What is today going to do to me? I hope I can survive today versus what do I want to bring to this day? Who do I want to be? How do I want to serve today? Where can I find opportunities to show love? Where do I want to direct my attention today? 

Those kinds of questions, it's such a different emphasis. All these things, again, for me this is not an academic exercise. These things I rely on even as recently as this morning. I woke up and my first inclination was all right, got to get upstart that blog post that came to mind last night. I thought, no. Let me just yes spend a few moments here and see what it's like to start the day that way. That’s number one. That’s a long explanation, but really, the beauty of most of these things is they take anywhere from a few minutes to a few seconds. It only takes a few seconds to say hello to yourself before you get up and do whatever is next.

[01:00:05] Ashley James: Would you recommend journaling or meditation, or do you have exercises for people to follow in the morning?

[01:00:14] Seth Gillihan: I do. I have a couple of decks that I'm excited about because I think they work. They're card decks. They're just literally a deck of cards with a practice on each card. The one that’s been out for I guess a couple of years now is more general CBT approaches for probably anyone could find helpful. Then I've got one coming out soon that's focused on anxiety, rumination, and worry. Both of them have practices that can be and some of them are for any time of day, some of them are specific to morning—kind of setting your course in the morning, and some of them are useful at night.

There are different types of meditative activities. One is called thank you goodnight where you do write down things you're grateful for from that day, but I like a gratitude breath exercise that you can do anytime. I found it to be useful like if you wake up in the middle of the night and can't fall asleep. It's easy to turn to worries or frustrations like why am I not falling asleep? If I fall asleep now I’ll only get four and a half hours, come on. We can redirect that energy with every breath cycle. Bring to mind one thing, one good thing in your life. Inhale, exhale—at least I've got a bed. Inhale, exhale—some specific friend, I've got a refrigerator, or I've got a house. All these things and we don't have to try to force ourselves to feel grateful, but just direct our attention to the things that we have. It's a meditation, but it's also training our attention to notice what's going right in our lives instead of what's going wrong.

Photo by Simon Migaj on Unsplash 

[01:02:29] Ashley James: I love it. I had a man named Michael Weinberger on the show a few times. He has manic bipolar, has attempted suicide several times, and his life has been plagued with mental health issues. He found therapy to be essential. He got to a place where he needed tools in order to just not kill himself that day, basically. What he found that his morning routine was the difference between whether he was going to kill himself or not. His morning routine was—he would wake up and ask himself, on a scale of 1 to 10, where is my mood? Where am I on a scale of 1 to 10? Whether it's happiness, sadness, or whatever. He might wake up and be like a three, and then he would write down or text or something—write it down in a journal three things he's grateful for. Then ask himself again, on a scale of 1 to 10, where am I? 

He'd notice that always, his mood would improve simply by taking the 90 seconds it takes to write down great things he's grateful for. No matter what, no matter how bad he felt, he'd get out of bed and take a shower. That would shift his mood. But he had a certain routine in the morning in that there was an inward reflection, just checking in with yourself, how am I feeling? Not judging it, not making a story like because I feel this way my whole day's going to be… No, just checking in like hey, how are you doing? Just like you said. Then he'd write down three things he's grateful for and then he’d check in again. 

Another thing he added to his routine was reaching out to someone, anyone, and just letting them know that you are thinking about them, you care about them, or thanking them for something. It could be someone professional like hey, when you helped me with that thing, I just want to let you know that it really meant a lot to me. Thank you. You could reach out to your wife, your husband, your kids, or your mom and say thank you, I love you, or I'm thinking about you. Just connect with someone. It could be a text, an email, phone call, or in person—every day. Basically, just get out of yourself and thank someone for the impact that they have had on your life. He ended up taking all these things and making an app so that people can log into the app, and the app also has reminders that you can set for medications. It's like a mental health app that he created.

[01:05:26] Seth Gillihan: Oh, wow.

[01:05:27] Ashley James: In the morning you press the number, on a scale of 1 to 10, how are you doing? Then you type in the three things you're grateful for, and then it has reminders set up for mindfulness, for connecting with others, and letting them know that you're grateful for them. He created his app because those were his tools that helped him to like to stay alive and on track towards mental health. Now he's much more stable. It's just really neat that a lot of parallel with what he noticed really works. He was at a point where he was ready to break. Those tools really helped him, and then you're saying these same things. It's just really neat that there's a lot of parallels there between the two.

You really help people with anxiety, and you have this online course. Listeners can go to learntruehealth.com/calm, that's learntruehealth.com/calm to gain access to your course. Tell us about your course. Also, I'd love for you to teach us something about eliminating anxiety.

[01:06:36] Seth Gillihan: Great. I'm really excited about this course. I'd wanted to do one for a while and finally did one this year. It’s a pretty deep dive into mindfulness-centered CBT for anxiety, stress, and worry. It's 24 lessons. A person could do it over for weeks if they wanted, six lessons a day. I'm sorry, that would be ambitious. It's six lessons a week. Or they can space it out longer than that. Really, it's up to the person. Once they enroll they have lifetime access to the materials. Each lesson begins with a guided mindfulness exercise or 24 different mindfulness exercises. You were asking earlier about some specific practices, we offer a lot of different ones. A person can sample a lot of different approaches and find what works for them.

Then there's a video-based lesson for each day focusing on recognizing and reducing stress or finding cognitive tools or behavioral approaches that help us to deal with anxiety. Then I spend a full five lessons talking about worry because worry is such a common issue that so many of us struggle with and also a really difficult one to break out of because it’s mental. It's easy for our minds to do it automatically. Worry actually is really interesting, and maybe I'll focus here in terms of ways of reducing anxiety because worry, I think we often think of worry as I'm anxious and worried. Almost like worrying is something that happens to us. It is somewhat automatic, but it's also something that we do. It's a mental behavior that becomes a habit because it feels safer in a way to worry than not to worry.

We will tell ourselves things like why I should worry because it shows that I care, or I can prevent bad things from happening if I worry. All these beliefs and assumptions that reinforce our tendency toward worry. The problem with worrying is that it's self-reinforcing. If I'm worried about my plane, for example, and I'm thinking about is everything okay? Those sounds I'm hearing during the flight, is that a bad sign? I'm looking at all the faces of the crew and seeing are they worried? Imagining what I would do if the plane suddenly dropped in altitude. I'm suffering as all that's happening, but when the plane lands, the lesson that my brain is going to take from that is not well that was silly, I shouldn't have worried, but it's going to be thank goodness you worried because you got the plane here safely.

We don't think that rationally, but when things go badly in our lives, our brains want to know why. They're going to look to see what happened before things turned out okay. A lot of the time the answer is you worried. The lesson is we better worry next time because that's how you keep the plane up, that's how you keep people from thinking badly of you, right?

[01:10:31] Ashley James: Oh my gosh. There's a payoff.

[01:10:34] Seth Gillihan: There’s a total payoff.

[01:10:35] Ashley James: We see that worrying gives us something because we're still alive, we're still safe, and so it must have been the worrying that got us there.

[01:10:41] Seth Gillihan: It must have been, yes. Thank goodness for that worrying. Imagine what might have happened if I hadn't. It's our magic feather. We believe that. Again, probably not consciously and cognitive therapists can believe in the unconscious mind. We want to break out of that cycle by not arguing with our worries, not getting into a back-and-forth with them. If the worried mind says what if the plane crashes? Then the most effective long-term response is to say that's a possibility that could happen. That's not going to lower anxiety immediately, most likely. No, I don’t want to crash.

[01:11:35] Ashley James: Because in our mind the plane is still crashing so the body is still reacting to it. The body is still in stress mode.

[01:11:40] Seth Gillihan: Yes, exactly. We can reassure ourselves and say there are 20,000 planes land safely every day in the United States alone. That might give a little bit of relief, but then the mind is going to come back with how do you know? How do you know your plane’s not going to be that one? Because it does happen. It's not like it's impossible for planes to crash. We can get out of that back and forth like what if. Okay, now it's good, it's probably not going to happen. It's probably okay. Oh no, but what if? Saying, yup, that could happen. Treat worry like an annoying bully that keeps trying to get a rise out of you. Saying you're stupid. No, I'm not. Then, of course, all you've done is guaranteed that the bully is going to keep teasing you. But if you say like yup, you're right, I'm an idiot. The bully is going to be confounded.

With worry, the same thing. You could say, yup, that's a possibility. That's not something that ultimately I control. But then we don't have to stay there. We don't stay there. Okay, this plane might crash. From there, we want to say what is in my control? What do I actually have power over? I can choose where I direct my thoughts, I can choose how I spend my time, I can choose whether I try to get engaged in conversation with the person I'm flying with versus I get annoyed with them because I'm trying to keep the plane up—even though I'm not to pilot.

[01:13:11] Ashley James: My worry is keeping this airplane in the air.

[01:13:16] Seth Gillihan: That's right. Don't break the spell. Are you insane? That's where mindful presence comes in is using our senses then to focus on what's real, to get out of that fantastical thinking about possible plane crashes. It's all fantasy and telling myself the plane’s not going to crash. That's also a fantasy, that's also a made-up story of the mind. We can focus instead on what's real. I think focusing on what’s real, again, it brings us into a real connection with ourselves, and it's also where long-term peace can be found.

[01:13:58] Ashley James: For those who have anxiety about their future now because of the long-term effects of the COVID shutdown, people are worrying about their long-term security. Whether their job is at stake, or whether the food chain has been affected, or whether they're schooling. I have a friend who is in school, in college. I was just talking to him last night. He graduated with his AA online. They had to transition to online classes, and then he's going in to get his next level of education at another university. They're considering having it be online even though he's going in as a music major. These are classes that require me to be with someone.

He goes, “I have to learn every instrument that an orchestra plays.” He knows how to play nine instruments professionally, but he has to learn the entire orchestra for his master's, and he has to learn how to play quartets. It's just he was telling me all about the different things that he'd had to do in person. He's really concerned, again, it's a genuine concern because this university, which is in California is like we're not sure your next semester is going to be in person, and that's months and months away.

People have legitimate concerns, but as you said, it's a fantasy. We can fantasize over the worst-case scenarios or we can fantasize over the best-case scenarios. Either one is a fantasy. Focusing on the worst-case scenarios induces anxiety, worry, panic, and stress. But how do we prepare? There's a difference between lamenting and preparation. How do we prepare for our future even though it's uncertain and take the actions we need to take now to be the most responsible we can be, but not give in to worry and anxiety?

[01:16:09] Seth Gillihan: Great question, Ashley. There are two things we need to prepare for. One is we can prepare for the unknown. We don't know what it's going to be, but we can prepare as best we can. I mean, to be honest, I've had some fears about getting coronavirus for one, but also the possible disruptions to the food supply chain. I found that's kind of a hot button for me even though I've never really wanted for food, but that does trigger some anxiety in me. It's not an unreasonable thing to do to prepare as best we can. I’m not renting a pod to stockpile food in. I think having a certain amount of food on hand is probably a good idea, but then also recognizing the limits of our control. If I try to guarantee that my family will never go hungry that there's no way to guarantee that. That's going to reinforce our anxiety because we're going to be trying to control the uncontrollable.

There are some good studies showing that the more we try to be certain about things that can't be known, we actually increase our level of uncertainty and make ourselves more anxious in the process. It's this double process of preparing realistically and also accepting the limits of what’s actually in our power. That goes for the virus too. None of us ultimately know or can completely control whether we contract the virus and how it turns out for us if we do. But that doesn't mean we just throw up our hands and say whatever will be will be. I'm just going to let fate run its course because fate will depend, to some extent, on our actions, so we do what we can.

We also need to ask not just how do I prepare for the outside world but how do I prepare my internal world for whatever comes? That to me actually is striking me as the more important question because there are going to be challenges that come, and we don't know exactly what those are going to be, but we do know we're going to need strength, we're going to need courage, and we're going to need grace to get through them. I would want each of us to be asking ourselves that question as much as anything else. Again, it's a bigger version of that question we might ask ourselves first thing in the morning. Who do I want to be regardless of what happens with my courses, my career, my health, or my family situation? How do I want to respond to challenges? Where do I want to look for my strengths? How can I deepen my spiritual connection in a way that it's available for me? What's my mission and my purpose in life and how can I enact that regardless of what happens? I think that may be the best preparation we can make.

[01:19:59] Ashley James: Oh my gosh. That makes so much sense. Imagine six months ago everything seemed so certain, right? The economy was doing so well. The economy was great. Everything was great. We didn't have the coronavirus, the murder hornets.

[01:20:22] Seth Gillihan: It was greater than we knew.

[01:20:24] Ashley James:  Exactly. It was great. We live in that idea that the parental figure is this certainty that we've invented in our minds, certainty that everything's going to keep going the way it's going, certainty that the future is going to be the same. We're just going to keep going as status quo. I can plan out my life because it's always going to be fairly the same. We, in our lifetime, have had several things shake that to our core like 9/11, right? Obviously, this virus is another example. We've had big events happen every twenty years or so that completely shake us to our core and make us realize that we cannot keep planning for everything's always going to be certain to a certain extent. To a certain extent, everything's going to be guaranteed like the sun's always going to come up tomorrow. We always think that the library is going to be open. Just the amount of what we take for granted. That taking for granted is like this idea of the parental figure that we give over our power to in our thinking. Then, all of a sudden, now it's not certain. 

Our life is not certain and we have worry and fear because we're constantly worrying about this fictitious future because we're making up in our mind what if I don't have any food? What if I'm homeless? What if this, what if that, what if this. We're just imagining threat after threat after threat, which triggers the stress response in the body because the body goes into the fight-or-flight mode whenever we imagine worst-case scenarios. We're actually feeling a physical—that's why we have panic attacks. Physically in the now, our body's having a real tangible physical reaction to a made-up future, to a fictitious future. We're having a physical reaction which makes it feel even more real, so it doesn't feel fictitious. 

I'm imagining the grocery store is empty. Of course, not being able to feed my family, now I'm in stress mode. I go into anxiety, and now I'm having somewhat of a panic attack. I'm feeling the panic so now I'm actually feeling something in the now, which is real. Then it seems certain in my mind. It really all comes down to mindset because it's not certain. We cannot live in that anything is certain in the future. As you said, we can only control who we are in the now. You said wake up and say who do I want to be right now? That's what we can control. Never assume that the future is going to be any one way—good or bad.

Now we could plan. We should always plan. I like the analogy of planning for an earthquake. I live in the Pacific Northwest, apparently, we're going to get a really big earthquake one day, and people worry about it. They stress about it. They're imagining these worst-case scenarios in their mind. That's not actually preparing, that's lamenting. Preparing is like let's get together the family, create a family plan, have some seven days of storable food, or whatever, and have a first-aid kit. Have everything you need to have and prepared for these different possibilities. You've got the storable food, water, emergency kit, and everything that you should have. Then you move on with your life. You're not waking up every morning living like the earthquake is today.

I think that people who are in constant worry and anxiety wake up every morning imagining that their worst fears are going to come true. They're just creating a fictitious reality, which we all do. We all imagine the future. Even making a grocery list is imagining a fictitious future because we haven't done it yet. Anything that we're planning to do in the future we haven't done yet so it hasn't happened so it's fiction until we can do it and then it's a fact. But what future are you imagining because that impacts your physical body right now? 

Your stress levels are directly impacted by the fictitious future you're imagining. So which one are you going to imagine? I'd like to prepare for the possibility that we might have a disruption in our food chain so I have a garden in the backyard, we've got storable food. Just that level of planning, but I don't lament and I don't let it affect my physical body right now. I don't allow it to impact my stress levels right now in my body because I'm not going to constantly imagine a fictitious future in which I don't have food for my family. That's a big difference.

[01:26:02] Seth Gillihan: It's a huge difference. What you're suggesting is that by stepping out of worry, we actually get better at problem-solving.

[01:26:12] Ashley James: Yes.

[01:26:13] Seth Gillihan: We think we can solve problems in our heads, but we don't take that what if question the right way. We said what if there's an earthquake? We just think oh no, would that be bad? And just treat it like a mental issue. But if we treat it as a real question, what if there were an earthquake? Well, I would need X, Y, and Z and you prepare as best you can. Then the rest is fantasy. Yeah, we figure out what we can really act on and focus there.

[01:26:47] Ashley James: Do you have anything else you want to make sure that you teach us today or that you covered today? Was there anything else that you were really excited to share today?

[01:26:59] Seth Gillihan: I think we've touched on this to some extent. You had alluded to when you were talking about the morning routine for your guest. So much of our stress and our anxiety comes from and feeds a kind of self-focus. I know this so well, Ashley, from a lot of my life but most intensely from when I was really sick and our struggles really tended to focus our energy and attention inward. That makes sense on the one hand just like it’s completely understandable during really stressful times like now that we're anxious, worried, and focused on our own well-being, but the more we can deliberately get out of our heads and direct our attention toward others, the better it is for all of us. Obviously, for the people that we’re attending to but also for ourselves. We end up swallowing our own tail in a way when we're struggling and just burrowing deeper into our suffering, but if we can get out of ourselves it can be quite liberating. 

Maybe it means asking if there's someone who may also be struggling. That we can reach out to or just connecting with someone around us. It's a way of showing ourselves that we can be of service to others even were not feeling 100%. Even if that doesn't miraculously make us feel better, at least it might bring a greater sense of meaning into our lives at a time when it might feel like there’s not much point to us because we're feeling so low. Service is something that I try to think more about and I want to emphasize too that it's really a crucial part of self-care is asking how we can conserve others.

[01:29:20] Ashley James: I love it. Once we get outside of our own head and we focus on helping others there's so much peace that comes with that. There are many studies that show that people who are depressed have the depression lift, that people who are in service in some way, volunteer in some way, they live happier longer lives.

[01:29:47] Seth Gillihan: Yes. I like this idea of even if all you feel like is you are a broken empty cup, to just offer that up, to offer up whatever you have in service.

[01:30:03] Ashley James: The links to everything that Seth does is going to be the show notes of today's podcast at learntruehealth.com. Tell us a little bit about your books. You have a few, and you've got your online course, which listeners could go to learntruehealth.com/calm to gain access to. Tell us about each of your books so that our listeners can know which one would be best for them.

[01:30:30] Seth Gillihan: Great. The two most recent CBT books aren't actually books but they're there card decks that people seem to find quite useful. One is just called the CBT deck. That's for more general daily practices. Its 101 practices. So 1/3 of the deck—roughly 1/3—are more cognitive approaches, so there's the Think cards. Then there are behavioral exercises that are the Act pile of cards, and then the Be cards are mindfulness-based practices. They're brief things that a person can do each day. These are practical exercises for bringing mindfulness-centered CBT into our lives. To be honest, I've actually used the cards a lot myself because I depend on these types of exercises as much as anyone. Probably by the time this show comes out the CBT deck for anxiety, rumination, and worry will be available. That's a few more practices—108—because I had more than would fit on 101, plus 108 is kind of an auspicious number in some traditions.

Those practices are under the Think Act Be approach but really focused on dealing with an anxious mind or a mind that’s stuck in unproductive trains of thought like dwelling on regrets and things like that. For someone who's dealing with a lot of anxiety, I think that the more recent deck may be the more useful one. Then I've got a couple of books for those of you who are interested in self-directed CBT in a book format. The earlier one came out in July 2016. It's called Retrain Your Brain: Cognitive-behavioral Therapy in 7 Weeks, and that's the workbook for managing anxiety and depression. As the title suggests, it's divided into seven lessons across seven weeks, and it's really my effort to make my therapy approach into a self-guided workbook format. There are worksheets, exercises, and things to go through there to bring the practices to life.

I have a more recent book that came out of 2018, Cognitive-behavioral Therapy Made Simple. It's not a workbook so it's not a step-by-step approach, but it's divided in chapters on mindfulness. It incorporates the Think Act Be approach. There's a chapter on self-care. It's really a broader approach to managing difficult emotions using mindfulness and CBT. For those who just want a daily short reading with an invitation at the end of each day's reading—each day is about a page long—a really good friend of mine, fellow psychologist, Dr. Aria Campbell-Danesh and I wrote to each other every day for a year, go back and forth taking turns who wrote, just writing each other messages with reflections on a quote for the day, and an invitation to do some specific practice to bring mindfulness and CBT into our lives each day. That book is called A Mindful Year. That came out, I guess, in 2019.

Those are the books. I hope people find them useful and get a lot out of them.

[01:34:38] Ashley James: That's so cool. That book where you wrote each other letters, that’s really neat. Did you ever include any information? Do people feel like they're reading your personal letters back and forth?

[01:34:52] Seth Gillihan: I appreciate that, no. It’s a good question. Our initial entries, there were a lot more. There were probably two or three times the length then we had to edit it down to because it would have been about 1,000-page book. Coincidentally, I just reread today's entry, which I had written and I described briefly some of my wife's and my struggles with conceiving, fertility, and having miscarriages along the way. We did try to incorporate things from our lives that would make it feel like really two human beings we're writing to each other but also trying to keep it broad enough that people would find it applicable for their own lives. We're getting nice feedback about that, that people are finding these surprising connections with the day's entry and something that they're dealing with that day. As I reread it, I also find wow, gosh, that's really timely. I wrote this three years ago. So yeah, that's that book.

[01:36:02] Ashley James: Very cool. Do you have any stories of success that you'd like to share either from people who've read your books, or worked with your decks, or even your podcast? Do you have any stories of success of specific people who have had some great results working with your content?

[01:36:25] Seth Gillihan: Yeah. I get a number of emails from people just out of the blue. People who have used the book or a deck and found it useful. I'm always touched because it's the most, I think any self-help writer could hope for, is that people are actually not just reading what you write but finding it useful. There's a young woman who just had a heartbreaking story about losing a family member recently and dealing with substance use issues and just overwhelming depression and anxiety. Having gone through one of the CBT books and just finding it comforting. I don't mean this to sound self-congratulatory but just to describe what the person's experiencing to be was not just that they were reading a how-to book but that there was a real voice on the other end, that there was a person who didn't know them but understood somewhat intimately the kinds of things they were going through. I have to say, Ashley, thank God I've had some of the struggles that I've had because otherwise, I would know much less about what it actually means to struggle and to suffer and to be afraid and to feel lost. She just described—she was still working on things but said she no longer felt hopeless. She felt like she had hope, and she was going to get through it, and was grateful that she had tools to do that. I'm always touched by those kinds of stories.

[01:38:27] Ashley James: I love it. Do you have any other stories of success that you’d like to share in working with people?

[01:38:37] Seth Gillihan: I treated a man for— this was actually a longer course of CBT. It's kind of slow going, and he was uneven at times. This was someone who had dealt with a lot of trauma and loss as a child and really despised himself, just was filled with self-loathing and he saw himself as pathetic and assumed other people did too and assumed that I would see him in that way. I think this was where a lot of the mindfulness was helpful. The behavioral things that we worked on and the cognitive techniques certainly played a part, but so much of it was just about staying present with someone, being witness to someone's experience, and letting ongoing relationship with someone be direct evidence against their assumption that they would be despised and abandoned by everyone. 

Over the course of a couple of years, and this was someone who actively and expressly wanted to die—wanted to end his own life—and saw that as an inevitability. It's scary as a therapist when someone tells you that because suddenly it can feel like a liability, but if we focus on it as what's my risk here, I think that people quickly detect that? And no, this is no longer about my well-being, this is about your legal defense. The person was not in immediate danger so it wasn't like hospitalization was necessary, but by not making that the focus, by making it okay for a person to have thoughts of suicide at times and to have a part of him that sincerely wanted to die, I think there was a kind of mindful acceptance that had to be there to allow. That I had to bring to the therapy room to allow all that experience to be there in a way that helped this person to feel fully embraced exactly as he was even with his suicidal thoughts.

That really became defining in a way of our relationship that that feeling of acceptance even of that perhaps most distressing part of his experience, I mean, from the point of view of a therapist. Through the course of our therapy, this person gradually was able to start to question the beliefs he had about himself about his own inadequacies, failures, and assumptions about how other people must see him. Eventually, this just broke my heart in the best possible way. This person told me that he actually cared about himself and he actually loved himself and I’m just blown away. I could not believe when he said this because that idea of loving himself, probably for a lot of us, just made him feel really squirmy for the longest time, ugh. Feeling of like loving myself, eek. I can't possibly imagine directing that kind of regard toward this person. Eventually, he did.

That goes back to the point you made early on, Ashley, about how we don't come to therapy because we're broken. I think we're driven to therapy by the part of ourselves that's whole, and that wholeness was still there. It was there the whole time, and it was finally able to express itself more fully across the course of therapy. It’s that kind of experience along with my own personal experience of spirit-centered CBT that restored my excitement about CBT. That it's not a superficial approach, it's not a collection of hacks. It's not just a way of tinkering with thoughts and behaviors, but it's as deep an experience as we’ll allow it to be.


[01:43:42] Ashley James: Beautiful. Thank you so much, Seth, for coming on the show today and sharing with us. I definitely urge listeners to check out your podcast Think Act Be, and also go to learntruehealth.com/calm to check out your membership. Of course, the links to everything that Seth does including the cards, the decks, and the books are going to be in the show notes of today's podcast at learntruehalth.com

It's been such a pleasure having you on the show. Mental health is just as important as physical health, and mental health impacts our physical health. We can't separate our mind, our heart, and our body. We are one, and we need to take as much time to foster a healthy heart, a healthy mind, along with a healthy body. I'm glad that we got to spend time today really focusing on that. It's been such a pleasure having you on the show, and I'd love to have you back.

[01:44:48] Seth Gillihan: That's beautifully said, Ashley, I really appreciate talking with you. Thank you for having me on your show. You really asked lovely questions and clearly know a lot in this area and care a lot, so thank you very much.

[01:45:04] Ashley James: I hope you enjoyed today's interview with Seth Gillihan. Check out his online course. I think it's such a valuable resource for us, especially in these trying times. Go to learntruehealth.com/calm to check out Seth's online courses and all his materials—his resources. I know he'd love to see you there and love to see you join his online platform.

If you have any questions, feel free to jump in to the Learn True Health Facebook group and share, or if you have any great insights from today's interview or any interview that you listen to, start up a conversation in Learn True Health Facebook group. We'd love to see you there, we'd love to connect and communicate with you. Go to learntruehealth.com/calm for more of Seth's information and access to his online course and materials. Then go to learntruehealth.com/group, or just go to Facebook and search Learn True Health and join the Facebook group, join the discussion, and join a community that wants to support you and your success. Have yourself a fantastic rest of your day.


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Ashley James

Health Coach, Podcast Creator, Homeschooling Mom, Passionate About God & Healing

Ashley James is a Holistic Health Coach, Podcaster, Rapid Anxiety Cessation Expert, and avid Whole Food Plant-Based Home Chef. Since 2005 Ashley has worked with clients to transform their lives as a Master Practitioner and Trainer of Neuro-linguistic Programming.

Her health struggles led her to study under the world’s top holistic doctors, where she reversed her type 2 diabetes, PCOS, infertility, chronic infections, and debilitating adrenal fatigue.

In 2016, Ashley launched her podcast Learn True Health with Ashley James to spread the TRUTH about health and healing. You no longer need to suffer; your body CAN and WILL heal itself when we give it what it needs and stop what is harming it!

The Learn True Health Podcast has been celebrated as one of the top holistic health shows today because of Ashley’s passion for extracting the right information from leading experts and doctors of holistic health and Naturopathic medicine


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