Self Help

Hardcore Self Help F__k Anxiety - Robert Duff

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Matheus Puppe

· 8 min read

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Here is a summary of the key points from Hardcore Self Help: F**k Anxiety by Robert Duff, Ph.D.:

  • The book takes an informal, casual tone using swear words and analogies to explain anxiety and ways to cope with it.

  • Anxiety is examined through the lens of the brain’s fight or flight response, which was evolutionarily adaptive for survival but causes problems in modern life.

  • Causes of anxiety and when it becomes a clinical problem are explained. Anxiety disorders are also reviewed.

  • Various self-help techniques are presented for managing anxiety without medicine, including challenging negative self-talk, managing technology/social media use, lifestyle habits like exercise, and cognitive techniques.

  • When to consider therapy or other professional help is discussed. Different types of professionals and treatments are briefly outlined.

  • Overall the book aims to arm readers with simple strategies for coping with anxiety in a relatable, straightforward style unlike traditional self-help books. It encourages taking action rather than just gaining knowledge.

So in summary, it provides an accessible introduction to understanding anxiety from a biological and psychological perspective, along with practical non-clinical suggestions for overcoming anxious feelings and thoughts.

  • The chapter introduces the cognitive triangle - how thoughts, feelings and behaviors influence each other. Unhelpful thinking patterns (cognitive distortions) can lead to negative feelings and behaviors.

  • Common cognitive distortions discussed include filtering, overgeneralization, polarized thinking, catastrophizing, “should” statements, mind reading, fortune telling and personalizing. Examples are given for each.

  • Everyone engages in cognitive distortions sometimes, but it’s the frequency and impact that matter. The goal is to recognize unhelpful thought patterns.

  • The chapter then introduces an ABC thought log exercise to help identify negative automatic thoughts and challenge them. This simple tool can grab distorted thinking “by the balls” and be an effective way to start changing patterns.

The key idea is that recognizing how our thinking impacts our emotions and actions is an important part of addressing anxiety through cognitive behavior therapy techniques. Spotting cognitive distortions can help gain insights on mental “douchebaggery” and how to counteract anxious patterns.

  • The cognitive triangle (A-B-C model) is used to break down anxiety-provoking situations into the activating event (A), beliefs about the event (B), and emotional consequences (C). This helps identify maladaptive thoughts that are fueling anxiety.

  • An example is provided of a friend texting to say they need to talk, where the beliefs (e.g. they are dying) drive extreme emotional consequences like worry and fear.

  • Common cognitive distortions that fuel anxiety are identified, like fortune telling and catastrophizing.

  • The process of challenging negative beliefs by generating alternative explanations and evaluating their likelihood is described. Repeated practice of this technique over time can help rewire harmful thought patterns.

  • For some people, anxiety is driven more by physical symptoms than thoughts. Common bodily symptoms of anxiety are listed.

  • It is emphasized that panic attacks are physically harmless, though very uncomfortable.

  • Deep breathing is presented as a tool to help diffuse physical anxiety symptoms, by overriding the fight-or-flight response. However, effective deep breathing must be practiced regularly, like a skill.

The passage discusses the importance of deep breathing techniques for managing anxiety. It introduces the 4-7-8 breathing method, where you breath in for 4 counts, hold for 7 counts, and exhale for 8 counts.

It emphasizes that these techniques require regular practice when not feeling anxious, so that they become second nature and can be accessed during anxious moments. Practicing at home in a relaxed setting is recommended at least 3 times per week initially.

Along with breathing, the passage recommends taking regular breaks throughout the day to recharge. It notes that feeling guilty about taking breaks often exacerbates anxiety. Taking time for hobbies and relaxing activities is important for managing stress levels and future productivity.

Finally, it suggests being kinder to oneself by challenging negative self-talk and replacing it with more supportive internal dialogue. Regular breaks, deep breathing practices, and reducing self-criticism are presented as important lifestyle habits for coping with and reducing anxiety.

The chapter discusses how technology can both help and hinder managing anxiety. While technology is useful for things like sharing information, it can also interrupt important activities and negatively influence mood.

Some tips provided include setting boundaries around technology use, like only checking email at certain times of day. Apps and tools that can help include reminders to take breaks, tracking technology usage to increase awareness, and blocking distracting websites.

The key is finding a balance - using technology to support anxiety management goals, but avoiding overuse that causes problems. Setting boundaries, limiting interruptions from notifications, and creating reminders/habits for self-care are suggested as ways to gain more control over technology instead of feeling controlled by it.

While technology offers benefits, the chapter cautions that it’s important for mental health to not let it completely take over one’s life and disrupt important activities like sleep, meals, relaxation and breaks from work/information flow. Awareness of personal habits and impacts is presented as the first step to making positive changes.

  • The chapter discusses various anxiety disorders including generalized anxiety disorder (GAD), panic disorder (PD), and phobias.

  • GAD involves persistent and excessive worry about everyday matters that interferes with functioning. Physical symptoms are long-lasting rather than episodic.

  • PD involves recurrent panic attacks where physical symptoms peak at 10 minutes along with intense fear. Sufferers fear having future attacks which can trigger more anxiety.

  • Phobias involve an intense fear response when exposed to a specific object, situation, or activity. The fear is disproportionate to the actual threat.

  • Social phobia/social anxiety disorder involves an intense fear of being judged or evaluated in social situations where one feels on display, though others are typically not paying attention.

  • Exposure therapy is recommended, where patients gradually face feared situations to desensitize the anxiety response over time in small, managed increments rather than all at once. The goal is to teach tolerance of anxiety symptoms.

This chapter discusses how to deal with people who don’t understand anxiety. It proposes writing a letter to such people to help explain what anxiety feels like from the perspective of someone experiencing it.

Key points made in the sample letter include:

  • Anxiety feels like a constant “fight or flight” response, not just temporary discomfort. It makes daily functioning very difficult.

  • Having anxiety doesn’t mean the person can do whatever they want. But try to understand their behavior in context of heightened anxiety.

  • Reassure the person that they are supported no matter what, as feeling out of control of their environment increases anxiety.

  • Don’t claim anxiety is “all in their head” as that dismissal ignores the very real physical sensations experienced.

  • Ask how you can help, but don’t expect a clear response when anxiety is high - things can feel confusing. Offering space may be most helpful initially.

  • Take things said or done during anxious episodes less personally, as the person’s behavior may not reflect their normal self.

The chapter aims to help those with anxiety better communicate their experience to people who don’t understand the disorder or its impact.

  • Therapy can help many people with anxiety in different ways, such as changing unhelpful thought patterns, understanding the roots of anxiety, and learning new behaviors. However, it’s not necessary for everyone - some can find relief through self-help methods alone.

  • Different types of therapy exist, including cognitive-behavioral therapy (CBT), psychodynamic/insight-oriented therapy, and more. Therapists also vary in their individual approaches.

  • Treatment length can vary from just a few weeks to ongoing, depending on the issues. A good therapist will start with immediate relief and then help uncover deeper roots over time.

  • Group therapy can provide education and support from sharing experiences with others. However, groups vary in quality depending on the participants.

  • It’s important to “shop around” for a therapist if the first experience is poor, as therapist skills and fit with clients vary individually. Don’t judge all therapy by one example.

  • College counseling centers and training clinics offer lower-cost options. Insurance directories can help find in-network providers in the community. Online searches allow filtering by specialty or approach. Confidentiality rules protect privacy even if the therapist is encountered elsewhere on campus.

  • The chapter discusses options for therapy if someone does not have insurance, such as looking for therapists that offer sliding scale fees based on income or free community resources.

  • It emphasizes that seeking professional help is nothing to be ashamed of and can help with issues beyond what family/friends can provide.

  • The chapter covers medication options and the role medication can play in managing anxiety by lowering baseline anxiety levels to facilitate learning coping skills, with the goal of building emotional skills rather than lifelong medication reliance.

  • It advises speaking to a psychiatrist about medication options rather than relying only on a primary care provider.

  • The final section encourages the reader to get motivated about making changes, perhaps by conceptualizing their journey metaphorically through gaming, leveling up skills, or constructing an impressive castle. It emphasizes that improvement is not always linear and there will be ups and downs.

So in summary, the chapter discusses affordable therapy and medication options, and encourages the reader to get pumped and take actionable steps towards managing their anxiety through skill-building.

  • Resources mentioned for self-improvement include, following psychologist Duff the Psych on Twitter and liking his Facebook page.

  • The private Hardcore Self Help subreddit at is recommended to connect with others on a similar journey and keep each other accountable.

  • An approximately 10-minute guided muscle relaxation exercise is included in the appendix to help relax the body from head to toe.

  • Informal references are made throughout the book to other sources like works by cognitive behavioral therapy pioneers Ellis and Beck, artist Bob Ross’ philosophy on happy accidents, and films/shows like The Matrix, The Simpsons, and Family Guy.

  • Popular books referenced include The Four Hour Work Week by Tim Ferriss and The Secret by Rhonda Byrne.

  • The Diagnostic and Statistical Manual (DSM) is noted but diagnosing oneself is not recommended.

  • Recent pop culture references include Taylor Swift’s new single “Shake It Off” and the UFC octagon. Diablo II is called out for the time commitment it required.

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