Ep. 208 Managing Exhaustion

The Self-compassion Workbook for OCD is here! Click HERE to learn more. This is Your Anxiety Toolkit - Episode 208. Welcome back, everybody. We are on the final week of the 30-day Self-Compassion Challenge. You guys, the growth has been profound to watch you guys, to hear from you guys, sharing what's working, what you're struggling with, the major strides you've made. I have loved every single second of it. I will be doing my best to compile all the audio. I think about 27 of the 30 days we did a live or the 31 days. We'll be doing lives and I will compile them into one whole little mini-course that will be free for everybody on the cbtschool.com. That is yet to come. I cannot wait to hand that over to you guys. We are on the final week and I wanted to address the elephant in the room, which is exhaustion. Today, I want to talk to you about managing exhaustion because the one thing I know for sure is you're exhausted. I'm exhausted. We're all exhausted. It's so hard to get motivation. It's so hard to keep going. So we are going to talk about it today. Here we go. Before we go, I wanted to do the "I did a hard thing." We do it every weekend. This is from A Life With Uncertainty. They said: "The last two years have been FULL of hard things. The hardest was telling my husband in therapy that our marriage was the main obsession during my worst OCD spike. I was scared and anxious. He wouldn't understand. It was such a huge exposure, and I pushed through without seeking reassurance. I CRIED A LOT, but so did he. The hard thing brought a softness to our marriage that I will always have, no matter what OCD tells me." This is beautiful. This is the work. Because what does anxiety take the most from us? The people we love. It impacts the people we love. It impacts the relationships and the things we get so much joy from. Holy smokes, A Life With Uncertainty, you are doing such brave, such courageous work. I'm so happy you put that into the "I did a hard thing." How incredibly inspiring. I just love this stuff so much. I really do. Before we get into the episode, let's do a quick review of the week. This is from Nervous Nelly saying: "I'm so grateful I found this podcast a couple of months ago. It has changed my whole approach to my own and my loved one's anxiety. This podcast provided so many tools that I practice using and learning to look at my anxiety differently. The biggest change is recognizing that when I'm having anxious thoughts more quickly before they go too far and the automatic responses that I wasn't even aware of, or should I say that I wasn't aware, were so counterproductive to my mental well-being. Thank you from the bottom of my heart and please keep doing what you're doing." Yay, I'm so happy to hear that. Nervous Nelly, welcome. I'm so happy you're here and let's keep going together, which brings me perfectly into this episode. As you know, we've been doing the 31-day challenge. I think I've been calling it a 30-day challenge, and I'm just looking at my calendar and seeing that there's 31 days in the month. We'll just be imperfect. We will move on. We are celebrating the launch of my first and only book called The Self-Compassion Workbook for OCD. One of the things I talk about most in that book and talk about most on this podcast and in CBT School resources is how to stay motivated because it takes so much to stay motivated. But what's interesting is, so many people in the comments this week said, sometimes it's not even about motivation. It's just about getting through the day. How do I get through the day? I wanted to share with you a self-compassionate concept that I use. It may or may not be helpful for you, but this is something I have dedicated my self-compassion practice to and I have really received some amazing benefits from it. I'll tell you guys a little bit of a story. As you all know, I have postural orthostatic tachycardia syndrome with a nice side of generalized anxiety disorder in which I manage really well most of the time. But when I am unwell and I'm having a flare-up, which recently I've been doing really well, but I recently went through a horrific flare-up to the point where most days I couldn't get out of bed. I was doing all my sessions from an upright chair where I had my legs elevated. I would go to bed at 7:00 or 6:15 in the evening. It was just rotten, rotten, rotten, rotten. I was exposed to a concept called "the spoons concept." This was written by a person who suffered with Lyme. I'll put it in the show notes, the original article. What she did was she was saying, "Someone wants to ask me, what is it like to have Lyme disease?" Well, she assumed they knew because this person went to all of the doctor appointments and was with her when she was sick. She wasn't quite sure what they were asking until she realized they were saying, "What is it actually like to leave in your body?" And she said, "Well, think of it this way." She got all of these spoons out. I think she said she was in a college cafeteria at the time and she laid out these 10 spoons. She said, "For people who don't have this problem, they have unlimited spoons in their day, and think of each spoon as a degree of energy to complete daily tasks. So one spoon to make your breakfast, one spoon to have a shower, one spoon to go for a walk, one spoon to get to work, two or three spoons or five spoons for doing the day of work, another spoon to make dinner, another spoon to do your taxes and so forth." She said, "Most people have unlimited spoons. It just keeps going until the evening is done. They don't even really have to consider their energy and how they expend it. But for me, I want you to imagine that I only get 10 spoons a day, and I have to decide every single day how I use those spoons." This was profound for me because what I was struggling with was like, how come everybody else gets to have energy at the end of the day and I am a complete disaster? How come everybody else has breakfast, gets ready for work, goes to work, takes care of their children, comes home, makes dinner, does the taxes, and they're still not a grumpy, miserable mess at the end of the day? I realized it's because me having POTS or postural orthostatic tachycardia syndrome meant that I too have unlimited spoons. I'm going to have to either refuse to accept that and keep using up spoons I don't have. One of the main concepts she talks about in this Spoon Theory is, if you go over your 10 spoons, it's not like you can replenish them. You're using them up for tomorrow. Basically, if you use 13 spoons today, you only have seven left for tomorrow. I've talked to a lot of my patients with OCD about this, and we really agreed not to become compulsive about counting spoons. I want to really make sure we address that upfront. This is not a science. It's a concept. It's a theory. But think of it through the lens of, if you overdo it today, you're going to have to accept that you've got less spoons tomorrow. I have found that I was living on minus spoons day in, day out. Well, in fact, month in, month out, maybe even year in, year out. No wonder I'm exhausted. No wonder I'm miserable. No wonder I'm anxious. No wonder I'm depressed. No wonder I'm exhausted. I have completely used up all my spoons. So now, I've had to accept that I only have 10 spoons and I have to make really skilled decisions on how I'm going to use them. It has also involved me renegotiating my day. I no longer choose to make breakfast and lunch in the morning. I do it the evening before. I asked for help. I do it in a way where I sit at the dinner table. I always finish first because I inhale my food. As my children and my husband eat their dinner, I'm making the kids' lunches for tomorrow. That way I'm not standing, I'm still communicating with them, but I'm getting something done, and that works for me. I've found many, many ways to manage this, but I also had to accept that some things literally had to go. The most compassionate thing I could do is to protect my spoons. Now, how does this apply to you? Well, the developer of this theory has now extended it to people with mental illness. She believes it's not just physical medical illnesses that mean people don't have a lot of spoons. People with mental illnesses also have unlimited spoons because their spoons are being taken up with fear, depression, panic compulsion. For you now, I'm going to ask you to consider, number one, you get to decide how many spoons do you think you get a day? Because it's not unlimited. If you have a mental illness, it's not unlimited. It's not possible. You will use up all your spoons and you will go over and feel worse tomorrow. So determine how many you have, and start to be very, very articulate and disciplined and intentional with how you use them. You're going to probably be like, "Yeah, I expected her to say this." But one for me is I'm no longer going to beat myself up. I don't have the spoons for that. Literally, that is my reason for not beating myself up. Besides the fact that it makes me feel terrible is I don't have the spoons for that. Sometimes people will say to me, "You need to do more in a certain area." I will say to myself, "Yeah, I wish I could, but I actually, at this time, don't have the spoons for it." Sometimes I opt out of major disagreements, not because I'm afraid of disagreements, but I don't have the spoons for a ton of conflict. I do that as an act of compassion to myself and an act of compassion for my clients and my family. If I burn up all my spoons, I'm a terrible therapist. No, that's not true because that's black and white thinking. I'm not at my best. I'm not at a place where I'm sitting, and I'm connected with my patient. So forgive me. I'm going to correct myself. I'm not a terrible therapist. That's black and white thinking. I am not connected as deeply as I would like to. What I do here is depending on the day, I may need to rearrange some things. For you, and I will give you a case study here. One of my patients had a huge exposure hierarchy. She knew she had to get it done. Her OCD was impacting her life severely. So we brought in her family, her husband, or her partner, and she had conversations with her family and her parents and said, "I'm about to embark on exposure therapy. It involves me doing a lot of physical and emotional work. How can you guys support me by helping me and managing some of the things I have in my life so that I can keep track of my own spoons, metaphorically?" Somebody dropped the kids off in the morning for her. She ordered in a meal service, if you have the finances for such a thing. Her immediate thought was, yeah, but come on, Kimberley. Everybody else can do it. Surely, I can too. I'll say, "In a perfect world, yes. In a perfect world where you didn't have OCD, you could do your OCD while dropping your children off. But you do have OCD, or you do have depression, or you do have a medical illness. For that reason, can you give yourself permission to ask for help, to redistribute your spoons? Can you do that for yourself?" Many times I'll give you a personal experience that happened to me. Just this week is obviously, I'm a little overwhelmed with the launch of this book. I also run a very medium-sized private practice. I have eight therapists who work for me. I have CBT School, which I'm so proud of, but does take up some of my time. I called my husband and I said, "I give up. I am in over my head. I don't know how I got here. I completely lost track of my spoons." He sat me down and said, "Open up your calendar. What's on your calendar for today?" I told him, and he said, "This one, this one, and this one, just cross it off. It doesn't have to happen today." My mind was like, "But come on, come on. It should be done today. It would be so much easier if it was done today. Life next week will be hard if it's done today." He goes, "Kimberley, you don't have the spoons for it today. You either rest today or you use up your spoons for tomorrow." And I'm like, "You're right. You're right." See, even I'm not so great at this sometimes. That's why everybody needs help. I'm never above the work here. I'm always learning myself, but it's dropping your pride. It's dropping the ego. It's dropping the expectations and saying the facts here that I'm exhausted. The facts here is I need a break, or the facts here is I need to shuffle things around so that I can do the thing I need to get done today for the future me. The example would be a lot of my patients say, "Well, if I take on the Spoon Theory, I have never got enough spoons to do ERP. It's just too hard." I'll say, "You need to do ERP so that you can get your spoons back. Because these compulsions are taking up a lot of your time, or your depression is taking up a lot of your time. We have to do your calm work. For your future self, something else has to go. Something else has to go." That might be that you don't get as much exercise. Or like I said, you get a meal service, or that you get your laundry done, or you slow down a little, or you don't see as many friends on the weekend. A lot for me has been in COVID. As COVID has started to loosen up a little, it's also going, "Wow, I'm feeling a little overwhelmed by all the social events." I still think I need to be protective of my spoons here. Not that I'm avoiding them at all, I'm just making logical, compassionate, informed decisions based on the facts of the spoons that I have. So I want you to think about this. Again, this is not science. I'm not saying ten spoons is all you get and all this stuff. It's not a science, it's a concept. I want you to think about it and see how it applies to you, because having a mental illness qualifies you for being someone who needs to take care of their spoons. Some people don't like the spoon concept and they prefer to use it like a cup. Like my cup is full of energy, or it's low on energy. How can I manage my energy levels? That's fine too. It doesn't have to be in this method. I just want you to think about how you can manage your exhaustion without letting everything go. The alternative is, get really clear on what has to get done and what matters to you and rearrange the rest of it. Let some of it go. Don't please all the people. Don't please anybody. For me, again, I'm really trying to not think black and white, because that uses up spoons that I don't have. Not to think catastrophic thoughts, like telling myself bad stuff is going to happen. I'm trying to not engage in that thinking because that uses up spoons that I don't have. Not ruminating about something I'm angry about. No, I don't have the spoons for that. The compassionate thing to do right now is to search the internet or to do what you enjoy. Do some crafts or take a nap, read, sit in nature, go slow walk, call a friend, whatever fills up your cup. All right. That was a lot. I think what I'm going to say here is, a big piece of that is acceptance. That when you're exhausted because you're handling a medical or mental or physical disorder, it's changing your expectations to more realistic expectations and accepting where you are, dropping the shoulds, dropping the I should and I could and all the things and start to take care of you. Start to ask for help. I love you. That being said, you know what I'm going to say. It's a beautiful day to do hard things, folks, and managing your exhaustion is a hard thing. Saying no is a hard thing. Saying yes is a hard thing. Please take care of yourself. Please honor what your body needs. Sending you all love. I'm here for you. I'm loving on you. I am shouting you on. Thank you for joining me for 30 days. Do not give up. This is a 31-day challenge, but I ask that you take it for the next 31 years or 61 years or 91 years, or multiply, multiply, multiply. Do not give up on this practice. This is life. We have to do this work. All right. Love you guys. Bye.