When you're living with a healthy body, you don't have to think much about your body. You can fall asleep or wake up when you need to be awake or asleep. You can eat a variety of foods and stay nourished and energized. You can move easily and use your body for activities you enjoy. You can decide whether you want to use substances to alter your consciousness and in what quantity. Your relationship with your body isn't a relationship you have to spend much time on. It's a relationship you live in, rather than work on.

Living with a healthy mind is similar. With a healthy mind, you can choose what you attend to and what you ignore. You can perceive all kinds of information from your environment and then make conscious decisions about how you want to respond. You can experience sensations, feelings, and thoughts, accept their existence, and either redirect your attention away from them or use them as data to inform your decisions. You get to decide what you think is valuable and meaningful and how you want to act on that which is valuable and meaningful to you. Like a relationship with a healthy body, your relationship with your mind becomes one that you live in and from, rather than one you work on.

If you are suffering because of what occurs in your mind, you need to work on it until you don't need to work on it. You'll be able to tell when you don't need to work on it anymore.

Mental suffering starts as avoidance. We're still in a spot in culture where the nature of emotions is not well understood by most people and most of us immediately resist uncomfortable private experiences (that is, thoughts, feelings, and sensations), rather than immediately accepting them. When you have a lot of private experiences that you think you shouldn't be having and you try to avoid them or push them away, you will have more and more of them.

The degree to which we respond effectively or ineffectively to our private experiences is a spectrum, not a binary category. Because these moments are private and many of the ways that people cope is also private, it almost impossible to get a good read on how others are coping compared to yourself. It's especially hard to tell what other people are doing well when they do it well.

Eventually, I want you to get to a point where you know your mind so well that you aren't surprised or afraid of any of your sensations, feelings, or thoughts. Once you're there, you won't have to work on your relationship with your mind. Like a great friendship or romantic partnership, you and your mind will know each other. All the uncertainties of new ideas and experiences become fun. Getting there isn't one moment where you did your exposure homework correctly. It’s thousands of moments of turning towards yourself with openness and curiosity until that just becomes the way you think.

As you get to know your mind, self-monitoring can help you observe yourself with curiosity.

Self-monitoring is helpful for two reasons:

The first reason is that one of anxiety’s best tricks is hiding itself from you. You may have gotten into the habit of avoiding so quickly that you don’t actually observe what’s happening. You are having thoughts, the thought is arriving in your body with sensations, and your mind is interpreting the thoughts as important. Since the thought feels important, you are responding to it as if it is important. Whether you distract yourself, analyze yourself, get reassurance from others, or do anything else to try and make the thoughts go away, the point is that you are responding to your thoughts as if they are facts, and threatening facts at that.

Self-monitoring is the opposite of avoidance. The act of slowing yourself down, identifying, and labeling the thought as a thought shifts you from content to process and you are on your way toward mindful observation.

Self-monitoring often sounds like a good idea when you hear about it but practicing it in real life is a challenge. It isn’t because you’re lazy, you don’t understand, or it doesn’t work. You don’t need the perfect explanation or the perfect device to practice this skill. Self-monitoring is challenging because it’s the first step toward getting distance from the content of your thoughts and it’s the opposite of your natural reaction.

The second reason self-monitoring can be helpful is that it helps you identify what types of thoughts you typically get stuck on. You may notice that you are worried about a number of different things. When you track what you actually worry about day to day, it is in fact only a couple of different themes.

Some anxious thoughts remain concerning due to inaccurate information, as happens if you misinterpret a rapid heart rate as a heart attack. Other thoughts maintain their power through what I call belief problems. One example of a belief problem is believing that having a thought is as bad as doing something. Once I see the content of your self-monitoring, I can help you identify and challenge your belief problems.

If courage is the opposite of behavioral avoidance, curiosity is the opposite of cognitive and emotional avoidance. When you are curious about something, you really want to know all about it, to understand it deeply. Anxiety and depression often make people disinterested in their minds. You might only want to understand your experience enough to make your anxiety stop. You might not even want to know about that experience at all and simply want it to stop.

The capacity to observe your experience of anxiety with curiosity — like you really want to know it — is crucial for willing acceptance. If you are wondering whether you are curious about your experience of anxiety and depression, look at how you behaved in response to learning that you suffer from an anxiety disorder, OCD, or a mood disorder. Some behaviors that convey curiosity are reading about it, listening to audiobooks or podcasts, watching videos, and joining a support or advocacy group. All of these behaviors are ways to get more information and more understanding about your suffering. They push you towards acceptance rather than pulling you away from it.

Self-monitoring of your internal experience is another way to build curiosity. It sounds like a simple task, but staying with your experience long enough to notice your triggers, your thoughts, your feelings, your sensations, and your urge to act can be a tremendous challenge when you are feeling anxious. Moreover, self-monitoring can easily turn into an opportunity for self-criticism, and that feels aversive.

If you are new to self-monitoring, I strongly suggest that, when you self-monitor, you make sure to give yourself credit for showing up to the task in the first place. Also, keep in mind that you wouldn’t have to self-monitor if you already had a friendly relationship with your anxiety, so it might be painful at first. That said, since suffering is pain plus resistance, you’ll suffer less if you go towards your pain without resistance.

In order to practice self-monitoring, you’ll benefit from seeking out triggering situations and watching your experience. You want to observe the following aspects of your experience:

1. What was my trigger? Was it internal or external?

2. What sensations did I feel?

3. What thoughts am I having?

4. What is my reaction to my thoughts and sensations?

5. What types of avoidance do I want to engage in?

6. Did I engage in any avoidance/neutralization/compulsions?

7. If yes, what did I do? If no, why didn’t I?

Try to answer these questions as soon after (or during!) the experience as possible. Try to answer in as few words as possible, as if you are a scientist taking notes in a lab.

As you start to self-monitor, you’ll notice that triggers can be internal and they can be external. External triggers are the things that show up in your environment that make anxiety more likely. Common triggers include the kitchen, the door, or any part of your home that reminds you that something could go wrong. It could be your car. It could be showing up to work, being in a meeting, getting an email, or giving a presentation. There are all kinds of external triggers that are frequent and common for many people.

You could also have an internal trigger, such as an intrusive thought or anxious sensation, that doesn’t necessarily have an additional predictable external trigger. The internal sensation or thought could show up at any time.

We want to shift our way of thinking about those triggers away from bracing and avoiding and over into opportunity.

In order to teach yourself that you can handle the anxious moment, you need to go towards your triggers. Trigger those sensations and those thoughts on purpose. Any time you have either an internal or an external trigger, it’s a huge opportunity to practice and to show yourself that you can relate to it effectively, rather than avoiding.

Here are some examples of self-monitoring for different disorders.

Example of self-monitoring for Panic Disorder

1) What was the trigger? Was it internal or external or both? Driving on the highway

2) What sensations do you feel? I’m having the sensations of heart racing, sweating, stomach in a knot, shoulders tight, arms and legs tingling, head hurts a little, dry mouth

3) What thoughts are you having? I’m having the thought, what if I panic while driving?

4) What is your reaction to the sensations and the thoughts? Initially I didn’t like that I was having these sensations and thoughts, but then I remembered that I should practice wanting them, and I told myself, ‘Good job!’ for triggering them.

5) What types of avoidance do you want to engage in? I wanted to avoid driving.

6) Did you engage in avoidance/neutralization/compulsions? No

7) If yes, what did you do? If no, why didn’t you? I didn’t avoid driving because I remembered that I was uncomfortable, but not in danger, and that if I keep driving when I have these sensations and thoughts, they will eventually go away. Once I was a few blocks away, my sensations did in fact subside.

Example of self-monitoring for Social Anxiety Disorder

1) What was the trigger? Was it internal or external? Being at a social event, having critical thoughts about my competence

2) What sensations do you feel? Stomach in a knot, muscle tension, light-headed, pain in chest

3) What thoughts are you having? What if other people notice how anxious I am and judge me? What if my mind goes blank when I’m trying to talk to someone? What if I don’t know what to say?

4) What is your reaction to the sensations and the thoughts? I remembered that I talked about this happening in therapy, but in the moment I just felt so embarrassed that I couldn’t bear it. The sensations felt out of control and I believed my thoughts.

5) What types of avoidance do you want to engage in? Reassuring myself, getting reassurance from my friend who was there, comparing myself to other people there, leaving the party

6) Did you engage in avoidance/neutralization/compulsions? Yes

7) If yes, what did you do? If no, why didn’t you? I did all of them and it just kept getting worse. The more reassurance I tried to get from myself and my friend, the more anxious I felt. Comparing myself to others made me feel awful too.

Example of self-monitoring for Obsessive Compulsive Disorder

1) What was the trigger? Was it internal or external? My mom told me about her friend that was diagnosed with cancer

2) What sensations do you feel? heart beating faster, tightness in chest, short of breath, light-headedness

3) What thoughts are you having? what if I have cancer?

4) What is your reaction to the sensations and the thoughts? what if I can’t stop thinking about this? what if my anxiety doesn’t go away?

5) What types of avoidance do you want to engage in? I knew it was OCD, but I wanted to check my symptoms on WebMD. I wanted to ask my mom about it. Then I wanted to distract myself.

6) Did you engage in avoidance/neutralization/compulsions? Yes

7) If yes, what did you do? If no, why didn’t you? Immediately after my mom told me about her friend, I told my mom I was anxious and asked her if I could possibly have cancer. She said no, but then I felt a weird sensation in my arm and looked it up online. Later in the night, I kept thinking about it and watched some movies to distract myself.