June 25, 2024 • 26 mins
In this bonus Shorts episode of The CBT Dive, we’ve taken the highlights from a previous season for you to dip into. Host and psychotherapist Rahim Thawer talks with Al about body image concerns amongst gay men and the pressures to either achieve or maintain a particular physique. This preoccupation is about optimising the ways they can participate in gay men's spaces, including dating and hookup culture.
Al seemingly has the body he's always wanted but we dig a bit deeper into the culture of 'never being enough' that begins with a fear of being overlooked and lands him in a place where he questions his worthiness.
ABOUT THE CBT DIVE PODCAST
The CBT Dive is a video podcast that brings therapy skills to the real world. Each episode welcomes a new guest who wants to explore a challenging situation using the most common cognitive behavioural therapy tool: the thought record.
ABOUT HOST
Rahim Thawer is a queer, racialized social worker and psychotherapist based in Toronto. He's created The CBT Dive podcast to support folks who want to learn how to use a thought record and to demystify what therapy can look like.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_00 (00:00):
Welcome to the CBT Dive, a video podcast that shows
you how to use cognitivebehavioral therapy skills in
real life.
I'm psychotherapist and socialworker Rahim Thawar.
Today's show is a CBT Shortsepisode from season one, where
we have collected the keymoments from the original and
created a shorter episode foryou to dip into.
(00:33):
Al, how are you today?
I'm good.
SPEAKER_01 (00:35):
You?
SPEAKER_00 (00:35):
I am good.
So just a bit about Al.
Al lives in Toronto, is a queerguy, loves animals and also
lives by the lake and used to bequite the party girl.
And now, from what I understand,enjoys a lot of Netflix and
(00:57):
pizza.
Is that right?
SPEAKER_01 (00:58):
Pretty accurate.
SPEAKER_00 (01:02):
Can you tell me a little bit about maybe your
experience with therapy oranything you've heard about
cognitive behavioral therapy?
SPEAKER_01 (01:09):
So I have never done it myself.
I know that it's a way of, Iguess it's like you change your
perspective about something oryou make it more realistic of a
perspective about something.
SPEAKER_00 (01:23):
Totally.
Yes, yes, yes.
So it's about shifting ourperspectives.
Absolutely.
So I'm just going to share myscreen.
All right.
So Al, before this call, wetalked about a situation that
might bring up difficultfeelings for you.
The situation we identified wasgoing to a party or a bar,
specifically a gay men's spacewhere you don't know many
(01:44):
people?
SPEAKER_02 (01:44):
Yes.
SPEAKER_00 (01:46):
Yeah.
Okay.
So because we wrote down theword going, let's assume you've
already made the plan and you'regoing later tonight, right?
What feelings come up for you?
Let's just list the feelings asthey come up.
SPEAKER_01 (01:58):
Anxiety.
Okay.
Excitement.
Fear.
Overwhelm.
SPEAKER_00 (02:07):
Yes.
I wonder if you're feelingconfident.
No.
Okay.
Self-conscious.
Yes.
Uncertain.
Yes.
I don't know if that's afeeling, but like inadequacy to
a certain extent.
Yeah, I think inadequacy is afeeling.
(02:29):
So is there a feeling of likefailure or not being enough or
rejection?
UNKNOWN (02:35):
Yeah.
SPEAKER_01 (02:36):
I think it's a fear of rejection.
I think it's the uncertainty ofwhether I'm enough.
SPEAKER_00 (02:47):
So when we talk about being enough, the feeling
that comes up for me is worthyor worthiness.
SPEAKER_02 (02:53):
Yes.
SPEAKER_00 (02:54):
Yeah?
Okay.
So we've got a good list here.
Now what I'm going to ask isthat we go through each feeling
and you really think about thissituation again.
You're going to a party or abar, specifically a gay men's
space.
where you don't know manypeople.
Typically when you go, I imagineyou, would you go alone or would
you go with a friend?
SPEAKER_01 (03:10):
With a
SPEAKER_00 (03:10):
friend.
Okay, so you're going with afriend, but you're going to a
place where you don't know a lotof people.
So how would you rate youranxiety on a scale of one to 10?
10 being that your anxiety ispretty high and one being that
it is quite low.
SPEAKER_01 (03:26):
So I think that the buildup to it and the anxiety is
very high.
I think that level of anxietyprobably starts at around, I
don't know, let's say an eightor like between eight and nine.
Yeah,
SPEAKER_00 (03:39):
so your anxiety is at an eight and then your
excitement is?
At a
SPEAKER_01 (03:46):
five or six.
SPEAKER_00 (03:49):
Okay, let's do a six.
And then fear?
SPEAKER_01 (03:54):
Seven.
SPEAKER_00 (03:55):
Feeling overwhelmed?
SPEAKER_01 (03:58):
Eight.
SPEAKER_00 (04:01):
Self-conscious?
SPEAKER_01 (04:03):
Eight as well.
SPEAKER_00 (04:04):
Okay, uncertain.
SPEAKER_01 (04:07):
Six.
SPEAKER_00 (04:10):
And inadequate.
SPEAKER_01 (04:12):
Six.
SPEAKER_00 (04:13):
Okay, and here we have worthiness, but I think the
feeling was unworthiness orunworthy.
So how would you rate unworthyor unworthiness?
SPEAKER_01 (04:26):
Six as well.
SPEAKER_00 (04:28):
All right, so when you're feeling anxious, maybe
also excited, but fear,overwhelm, self-conscious.
What are some things you do?
What do you find yourself doing?
So for example, do you thinkabout canceling?
Do you do pushups?
I don't know, whatever it is foryou.
SPEAKER_01 (04:45):
Yeah, I think that working out is one.
Yeah.
Drinking is another.
So
SPEAKER_00 (04:53):
I'm guessing usually you intend to drink at the party
anyway.
And so what you're talking abouthere is...
starting a bit earlier.
And if this is like with your,the friend that you're going to
go with, or even before yourfriend arrives?
With a friend that I'm going togo with.
Anything else you do?
So workouts, start drinking abit earlier with friend.
(05:13):
Spend
SPEAKER_01 (05:15):
quite a bit of time on trying to figure out what to
wear.
SPEAKER_00 (05:18):
Yes.
Now I'm a gay man too.
So let me just, I'm just goingto guess that you end up wearing
a t-shirt.
Am I right?
SPEAKER_01 (05:27):
I mean, it's either a t-shirt or a tank top.
There's really like justdifferent
SPEAKER_00 (05:33):
colors.
Yes.
Okay, great.
I'm glad your time is wellspent.
All right, so now we're movingon to the next column, which is
about automatic thoughts.
These are the thoughts thatusually come up when we're
thinking about a situation thatbrings up difficult feelings,
but they're not just automaticthoughts that are positive.
(05:55):
They tend to be negative orsomewhat unhelpful.
So when you feel anxious beforegoing to the party, what are you
thinking about?
Or you're anxious because youthink what will happen?
SPEAKER_01 (06:08):
Hmm.
I think that I'm anxious aboutwhat others are going to think.
SPEAKER_00 (06:14):
Okay.
Others will judge me.
And what might they judge youfor?
What might they say?
You are...
SPEAKER_01 (06:20):
Not fit enough.
That maybe I was fit to acertain extent and maybe I had
lost some of that fitness.
So it's like, oh, he's likechanged or lost something.
Are you thinking about it'sgained weight or you've lost
muscle
SPEAKER_00 (06:38):
mass?
SPEAKER_01 (06:39):
Lost muscle
SPEAKER_00 (06:39):
mass.
Okay.
Yeah.
And when you think about theexcitement, tell me a bit about
that.
What are the thoughts connectedto your excitement?
SPEAKER_01 (06:53):
Yeah, I think that it's, I'm going to have a good
time.
I'm going to experiencesomething with these friends
that I'm going with.
Potentially I might meet someonethere that you might click with.
So
SPEAKER_00 (07:10):
there could be relationship potential.
Right.
I do want to ask a bit moreabout some of the more
challenging feelings.
So when you think about theanxiety, others will judge me,
maybe I'm not fit enough, and mybody has lost some muscle mass.
So if somebody looks at you andthey say, hey, Al has, his
(07:34):
body's changed.
He looks different.
He used to be, he used to havebroad shoulders and now he
doesn't.
What does that say about you?
What does it mean if that's trueor if that's happened?
SPEAKER_01 (07:50):
I think that a lot of times I've tied it to my
self-worth.
So I've valued myself lessbecause of that.
So if there's a loss of musclemass, then there's a loss of
value in myself.
SPEAKER_00 (08:08):
Ah, okay.
So I'm going to say value andcurrency has decreased.
Now I use the word currencybecause you're talking about how
you, your value in yourself hasshifted, right?
But when you talk about otherpeople judging you and them
thinking about, um, yourworthiness.
(08:29):
I think it's a bit more aboutvalue, but also currency, like
how well you fit in.
So when your body is how youwant it to be, I'm guessing
you've got a certain level ofmuscle mass.
How do you see yourself and howdo other people see you?
I
SPEAKER_01 (08:46):
feel like there's more admiration.
There's more attention.
There's less effort paid by meto get an attention of somebody,
I feel more confident.
I feel like more at ease.
(09:07):
And you're at ease because?
Because I don't feel like I'm tobe judged or I'm an easy target
to be judged.
SPEAKER_00 (09:21):
Ah, that's interesting.
What do people think about yourthe energy you put into looking
that way.
Are there some things theythink?
SPEAKER_01 (09:30):
Like people will perceive it as in like you're
someone who's like moresuccessful or pays attention
more to himself, cares forhimself, cares for their body.
Okay,
SPEAKER_00 (09:47):
so when you say people judge you, it's a long
list of things, right?
And so what I've done isunderneath, just this idea, this
thought that you have, thisautomatic thought, others will
judge me.
There are so many other smallerthoughts, right?
So if your value or currency hasdecreased and you don't get
(10:09):
attention easily, what's theconsequence of that?
SPEAKER_01 (10:14):
Um, I will fade into the background.
I will not meet a partner or apotential whatever it is.
It's the other person, whetherit's a hookup or it's an actual
potential dating partner.
Yes.
(10:34):
It will be less interesting.
People will be less attracted.
Okay.
SPEAKER_00 (10:45):
Now you'll notice that there's some like
overarching thoughts that I putdown, right?
So when it was excitement, it's,I'm going to have a good time
and I'll have a good experience.
There could even be arelationship or dating
potential.
And then we look at this thoughtthat others will judge me.
And that seems to be the biggestthing that you're concerned
about.
Is that right?
SPEAKER_02 (11:06):
Yeah.
SPEAKER_00 (11:07):
Okay.
And then when we break thatdown, We think about the
specific ways they'll judge you.
And then we're looking atconsequences for what it means
for your life or yourself ifthat judgment happens.
So I want you to look at all ofthe statements that have a
little arrow beside them.
And what I want you to do isthink about which one of these
(11:29):
is a thought that you think isvery central in the difficult
emotions you have.
So something that you think isreally driving the anxiety, the
self-consciousness, theinadequacy, the sense of
overwhelm.
Okay?
I
SPEAKER_01 (11:51):
think it's probably the, I'll fade into the
background and I'll beoverlooked.
SPEAKER_00 (11:56):
Okay.
So what we're going to do nextis we're going to talk we're
going to try to evaluate thisthought that I've put in bold.
Now that's called the hotthought.
The hot thought is the centralthought, the most salient one,
the one that's driving the mostdifficult emotions.
So I'll fade into the backgroundand I'll be overlooked.
(12:19):
Can you share some experiencesor some evidence from your life
where that has happened, whereyou have felt like you faded
into the background and wereoverlooked?
SPEAKER_01 (12:28):
I think that I've been at times at bars or clubs
or places like that where I waspotentially in like a group and
I felt like I maybe see someonethat I'm potentially interested
in and then I noticed that theyare strictly interested in
(12:52):
someone who is like bigger thanme or fitter than me.
In that moment you I experiencedfeelings of not being worthy
enough and not being not, Andfeeling of like, I'm more fading
into the background than I am.
SPEAKER_00 (13:10):
Yes.
So yeah, absolutely.
So this thought that you havethat you'll fade into the
background is very real, right?
It's rooted in this experienceyou've had before where you've,
you've specifically beenoverlooked.
You're like, Hey, I'm looking atthat person.
They're looking at me for amoment.
And then they see my friend andmy friend, whatever, he's got a
(13:32):
Big Mac for for muscles and likeit's done um uh okay so any
other evidence from your lifewhere uh that justifies us fear
or concern or anxiety aboutbeing overlooked or fading into
the background
SPEAKER_01 (13:50):
um yeah i had a group of friends i guess that i
hung out with at some point umthat maybe had a lot of like
spent a lot of attention on bodyimage uh and making sure they
look a certain way and i've hadthey talked about it a lot and
they talked about it and i'vehad comments in the past where
(14:12):
like let's say for example i gota little bit smaller or lost a
little bit of like muscle massor whatever and i would get the
comment of like oh well itsounds like it looks like you
need to like go back to the gymor you need to like do better or
yeah
SPEAKER_00 (14:26):
that's kind of awful isn't it
SPEAKER_01 (14:28):
terrible
SPEAKER_00 (14:29):
yeah like i mean
SPEAKER_01 (14:31):
uh
SPEAKER_00 (14:32):
It's interesting.
Like, I think our bodies arelike, they change.
That's just what they do.
And so if it can do, if it canget to a particular place once,
that's like nice.
But to think that it couldalways be like that is, it's a
bit of a tough standard, huh?
(14:52):
Now, when your friends mentionedthis, like, what do you think
the tone was?
SPEAKER_01 (14:57):
The tone was jokingly, but there's definitely
proof behind it of what thethought is, right?
SPEAKER_00 (15:04):
Ah, so you're thinking if they thought that,
other guys are going to thinkthat.
SPEAKER_01 (15:08):
Yes.
SPEAKER_00 (15:09):
Okay, and that's when it really was solidified
for you.
It means something in thiscommunity to...
Okay, so I'm going to put thatas a separate piece of evidence,
right?
Now, this might be a bittougher, but it might support
this thought that you'll fadeinto the background.
Have you been one of thosepeople who has overlooked
(15:30):
somebody or, you know, you'veseen them fade into the
background for you because ofhow they looked?
SPEAKER_01 (15:38):
Yes.
Yeah.
That's definitely, like, yeah.
I think that if I do it, thenI'll...
then i know that others do itand yeah it solidifies it more
SPEAKER_00 (15:49):
yeah and look when i say that i'm not i'm not like
calling you out i i'm merelythinking like that's part of how
we we get our knowledge rightbut like hey i do this thing so
other people might as well sonow let's think about some
evidence that doesn't supportthis hot thought so what we're
specifically looking for isSomething that supports the idea
(16:09):
that you won't fade into thebackground and won't be
overlooked regardless of whatyour body looks like.
SPEAKER_01 (16:17):
Like the guy that I'm dating right now, let's say,
where like he's into fitness,but he's not like, there's no
like, oh, you need to be at thislevel.
It's like, your body's yourbody.
I like it for who you are.
If your body changes, itchanges, right?
And I think that
SPEAKER_00 (16:39):
that is one, yeah.
That's a great example.
Is there other evidence fromyour life that does not support
the idea that you'll fade intothe background or be overlooked
depending on your body?
SPEAKER_01 (16:49):
I don't feel like my friends associate my worth or my
value with the way that I look.
I think that- What do they
SPEAKER_02 (16:57):
value?
SPEAKER_01 (17:00):
Like my sense of humor, my ability to connect
with them, my ability to bethere for them.
SPEAKER_00 (17:06):
Okay.
And so circles of friends, theylike my humor, social skills,
reliability.
And what do your friends thinkabout how you look?
SPEAKER_01 (17:17):
I think that like my friends think that I look fit.
I think my friends make fun oflike, oh, like, do you want to
have bigger arms or like, do youwant to have this or have that?
Ah, I
SPEAKER_00 (17:30):
see.
I see.
So they actually make fun ofthe...
The goal of bigger muscles.
Is there any other evidence thatdoes not support the hot
thought, does not support theidea that you will fade into the
background and you'll beoverlooked depending on how your
body looks?
SPEAKER_01 (17:50):
I think outside of the gay community, yes.
I think that...
Tell me about that.
When I'm outside of the gaycommunity, when I'm in straight
bars or I'm with straightfriends or I'm with work
colleagues or...
yeah outside of that there'sthere's no worth on on body
(18:11):
image that i feel at all umbecause i don't feel like i'm
being judged i don't feel like
SPEAKER_00 (18:18):
what are people evaluating you on outside of
that community i
SPEAKER_01 (18:24):
think that there's more value placed on uh ability
to connect i think that there'sa value on success when it comes
to like professional life.
Yeah, I think those are the maintwo.
Yeah.
SPEAKER_00 (18:42):
Okay, that's good.
I'm going to return to theoriginal situation, going to a
party or bar, specifically a gaymen's space where I don't know
many people.
You've got anxiety, excitement,fear, feeling overwhelmed,
self-conscious, uncertain,inadequate, and unworthy.
Your biggest concern is thatI'll fade into the background,
I'll be overlooked.
(19:03):
And now you've come up withevidence that supports the idea
that you could fade into thebackground and be overlooked.
I'd like to see if we can comeup with an alternative thought
for I'll fade into thebackground and I'll be
overlooked.
What's something else you cantell yourself that might be a
bit more helpful or a bit morebalanced?
SPEAKER_01 (19:22):
I'm out to enjoy my time.
My body's healthy.
I'm lucky to have a healthy bodyand friends around to enjoy this
moment with.
Yeah.
And like lucky to have friendsin my life who I could enjoy
(19:42):
this moment with and maybe makethat the focal point of the
experience.
SPEAKER_00 (19:48):
Yeah.
You know, because so much ofthis has been about body, you
know, I wonder if like, youmentioned this a couple of
times, people, appreciate youryour a bit your like your
ability to connect and like yourhumor and social skills um i
(20:08):
wonder if prospective dates orguys who are into you will see
that when you like when youinteract with your friends is
that possible yes
SPEAKER_01 (20:20):
yeah yeah absolutely
SPEAKER_00 (20:23):
Now that's something that might be more easily
accomplished, you know, at ahouse party versus a bar, you
know, I'm just thinking aboutthe dynamics.
So what's something you mighttell yourself if you were at a
bar and, you know, you were, youare overlooked.
Like, I kind of think likethere'll always be somebody
who's got, I don't know, abigger arm or a bigger butt or a
(20:47):
broader chest, like potentially.
SPEAKER_01 (20:49):
Yeah, I think that, yeah.
It's hard to know.
the thought is that like peoplehave different types and you're
not necessarily everyone's type.
I think it is what it comes downto.
It doesn't say anything aboutmyself if that person is just
not attracted to me.
SPEAKER_00 (21:11):
Exactly.
So let's get one more in here.
I'm really thinking about, I'mthinking about the reality, you
know, of being overlooked andthe thing you miss out on,
right?
Like how do you coach yourselfwhen you're like, I know from my
(21:31):
experience of being more visiblein terms of muscle mass, it
pulls people's desire and itpulls their eye in.
It's just something that I'veseen happen.
So is there something you wantto tell yourself about that?
Like-
SPEAKER_01 (21:47):
I've experienced- the two sides of it in the sense
of being the guy who's moremuscular, the guy who gets a lot
of attention, but alsoexperiencing maybe not getting
as much attention and beingoverlooked and experiencing that
at different times.
(22:08):
But I think that just in thetimes when I did experience
getting more attention, they'renot things that have longevity.
They're not things that have...
like deeper value.
SPEAKER_00 (22:26):
All right.
So we've got a slew ofalternative thoughts here.
Which one of these is mosthelpful for you?
Or do you believe in the most?
SPEAKER_01 (22:34):
It's probably one of the last two.
It's either the, I'm notnecessarily everyone's type that
says nothing about myself, butthat person isn't attracted to
me or the last one.
I think that I believe thesecond one more.
I think that I believe,understand the one before from a
logical standpoint, but from anexperiential standpoint, it's
(22:57):
not as much.
SPEAKER_00 (22:58):
Totally.
Yeah.
I'm glad we made thatdistinction because I'm not
necessarily everyone's type isfactual.
And then the next part whereit's, it says nothing about
myself that a person isn'tattracted to me.
To me, that's like a really niceaffirmation, but I don't think
we always believe that.
I wonder if we could add tothis, like from your experience
of going to parties, do you atleast, do you always get some
attention?
(23:18):
Do you always get someconnection?
SPEAKER_01 (23:22):
Yes, I get some attention.
Okay.
Who do you get the attentionfrom?
Yes.
Yes,
SPEAKER_00 (23:30):
yes.
Okay.
Totally.
Okay.
I'm going to relist the feelingsthat we initially had come up
with.
And I'm going to ask you tomeditate for a moment or think
about the alternative thought.
Like just sit with it, read itto yourself a couple of times.
And then tell me when you thinkabout the alternative thought,
(23:51):
where is your anxiety at?
SPEAKER_01 (23:54):
I would say it's at a four.
SPEAKER_00 (23:59):
And how about your excitement?
Six.
Beautiful.
And fear?
Four.
Okay.
Overwhelmed?
Three.
Self-conscious?
SPEAKER_01 (24:16):
Three.
SPEAKER_00 (24:18):
Uncertain?
Four.
Inadequate?
Four.
Okay.
And unworthy?
SPEAKER_01 (24:31):
Three.
SPEAKER_00 (24:32):
All right.
Are there any other feelingsthat come up for you when you
think about this alternativethought?
Optimism is one.
Okay.
I wonder if there's some griefor loss around what your body
used to be or this ideal body,but you can also say no, because
(24:52):
I'm totally leading you into adirection that-
SPEAKER_01 (24:54):
Yeah, yeah, yeah.
I don't think so.
Okay.
I think it's the change inperspective that makes me not
fear, not feel like there's alot.
SPEAKER_00 (25:08):
Or that there's
SPEAKER_01 (25:09):
grief behind it.
SPEAKER_00 (25:10):
Okay.
And so tell me about that changein perspective.
If we were to add some feelingwords to that, would it be like
grounded?
Confident.
SPEAKER_01 (25:20):
Okay.
Clear-headed.
Yes.
UNKNOWN (25:26):
Okay.
SPEAKER_01 (25:27):
aware, more self-aware,
SPEAKER_00 (25:29):
I guess.
I love that.
Isn't that a nice shift fromself-conscious to self-aware?
I like that.
Yeah.
Yeah.
Okay.
So that's a good list.
Now we've completed the thoughtrecord, right?
You started with a situationthat brings up some difficult
feelings.
We identified your hot thought.
We came up with an alternativethought.
(25:51):
the intensity of a lot of yourfeelings went down.
How do you feel about havingdone this exercise?
SPEAKER_01 (25:57):
When I was talking about anxiety, excitement, fear,
there's an actual experiencingof those feelings in the moment.
And I think that as we developedand changed perspective, there
was an actual experiencing ofthe feelings.
So it's not just reflecting onit as if it was...
happening in the past but it'sactually like experiencing it
(26:17):
while like really being
SPEAKER_00 (26:19):
now yeah yeah that's kind of lovely and that's the
cbt shorts episode for today i'mraheem thauer and thank you for
joining us please subscribewherever you get your podcasts
and you can follow us on socialmedia platforms for more content
the cbt dive is intended foreducational purposes and is not
(26:40):
meant to replace therapy
Welcome to the CBT Dive, a video podcast that shows
you how to use cognitivebehavioral therapy skills in
real life.
I'm psychotherapist and socialworker Rahim Thawar.
Today's show is a CBT Shortsepisode from season one, where
we have collected the keymoments from the original and
created a shorter episode foryou to dip into.
(00:33):
Al, how are you today?
I'm good.
SPEAKER_01 (00:35):
You?
SPEAKER_00 (00:35):
I am good.
So just a bit about Al.
Al lives in Toronto, is a queerguy, loves animals and also
lives by the lake and used to bequite the party girl.
And now, from what I understand,enjoys a lot of Netflix and
(00:57):
pizza.
Is that right?
SPEAKER_01 (00:58):
Pretty accurate.
SPEAKER_00 (01:02):
Can you tell me a little bit about maybe your
experience with therapy oranything you've heard about
cognitive behavioral therapy?
SPEAKER_01 (01:09):
So I have never done it myself.
I know that it's a way of, Iguess it's like you change your
perspective about something oryou make it more realistic of a
perspective about something.
SPEAKER_00 (01:23):
Totally.
Yes, yes, yes.
So it's about shifting ourperspectives.
Absolutely.
So I'm just going to share myscreen.
All right.
So Al, before this call, wetalked about a situation that
might bring up difficultfeelings for you.
The situation we identified wasgoing to a party or a bar,
specifically a gay men's spacewhere you don't know many
(01:44):
people?
SPEAKER_02 (01:44):
Yes.
SPEAKER_00 (01:46):
Yeah.
Okay.
So because we wrote down theword going, let's assume you've
already made the plan and you'regoing later tonight, right?
What feelings come up for you?
Let's just list the feelings asthey come up.
SPEAKER_01 (01:58):
Anxiety.
Okay.
Excitement.
Fear.
Overwhelm.
SPEAKER_00 (02:07):
Yes.
I wonder if you're feelingconfident.
No.
Okay.
Self-conscious.
Yes.
Uncertain.
Yes.
I don't know if that's afeeling, but like inadequacy to
a certain extent.
Yeah, I think inadequacy is afeeling.
(02:29):
So is there a feeling of likefailure or not being enough or
rejection?
UNKNOWN (02:35):
Yeah.
SPEAKER_01 (02:36):
I think it's a fear of rejection.
I think it's the uncertainty ofwhether I'm enough.
SPEAKER_00 (02:47):
So when we talk about being enough, the feeling
that comes up for me is worthyor worthiness.
SPEAKER_02 (02:53):
Yes.
SPEAKER_00 (02:54):
Yeah?
Okay.
So we've got a good list here.
Now what I'm going to ask isthat we go through each feeling
and you really think about thissituation again.
You're going to a party or abar, specifically a gay men's
space.
where you don't know manypeople.
Typically when you go, I imagineyou, would you go alone or would
you go with a friend?
SPEAKER_01 (03:10):
With a
SPEAKER_00 (03:10):
friend.
Okay, so you're going with afriend, but you're going to a
place where you don't know a lotof people.
So how would you rate youranxiety on a scale of one to 10?
10 being that your anxiety ispretty high and one being that
it is quite low.
SPEAKER_01 (03:26):
So I think that the buildup to it and the anxiety is
very high.
I think that level of anxietyprobably starts at around, I
don't know, let's say an eightor like between eight and nine.
Yeah,
SPEAKER_00 (03:39):
so your anxiety is at an eight and then your
excitement is?
At a
SPEAKER_01 (03:46):
five or six.
SPEAKER_00 (03:49):
Okay, let's do a six.
And then fear?
SPEAKER_01 (03:54):
Seven.
SPEAKER_00 (03:55):
Feeling overwhelmed?
SPEAKER_01 (03:58):
Eight.
SPEAKER_00 (04:01):
Self-conscious?
SPEAKER_01 (04:03):
Eight as well.
SPEAKER_00 (04:04):
Okay, uncertain.
SPEAKER_01 (04:07):
Six.
SPEAKER_00 (04:10):
And inadequate.
SPEAKER_01 (04:12):
Six.
SPEAKER_00 (04:13):
Okay, and here we have worthiness, but I think the
feeling was unworthiness orunworthy.
So how would you rate unworthyor unworthiness?
SPEAKER_01 (04:26):
Six as well.
SPEAKER_00 (04:28):
All right, so when you're feeling anxious, maybe
also excited, but fear,overwhelm, self-conscious.
What are some things you do?
What do you find yourself doing?
So for example, do you thinkabout canceling?
Do you do pushups?
I don't know, whatever it is foryou.
SPEAKER_01 (04:45):
Yeah, I think that working out is one.
Yeah.
Drinking is another.
So
SPEAKER_00 (04:53):
I'm guessing usually you intend to drink at the party
anyway.
And so what you're talking abouthere is...
starting a bit earlier.
And if this is like with your,the friend that you're going to
go with, or even before yourfriend arrives?
With a friend that I'm going togo with.
Anything else you do?
So workouts, start drinking abit earlier with friend.
(05:13):
Spend
SPEAKER_01 (05:15):
quite a bit of time on trying to figure out what to
wear.
SPEAKER_00 (05:18):
Yes.
Now I'm a gay man too.
So let me just, I'm just goingto guess that you end up wearing
a t-shirt.
Am I right?
SPEAKER_01 (05:27):
I mean, it's either a t-shirt or a tank top.
There's really like justdifferent
SPEAKER_00 (05:33):
colors.
Yes.
Okay, great.
I'm glad your time is wellspent.
All right, so now we're movingon to the next column, which is
about automatic thoughts.
These are the thoughts thatusually come up when we're
thinking about a situation thatbrings up difficult feelings,
but they're not just automaticthoughts that are positive.
(05:55):
They tend to be negative orsomewhat unhelpful.
So when you feel anxious beforegoing to the party, what are you
thinking about?
Or you're anxious because youthink what will happen?
SPEAKER_01 (06:08):
Hmm.
I think that I'm anxious aboutwhat others are going to think.
SPEAKER_00 (06:14):
Okay.
Others will judge me.
And what might they judge youfor?
What might they say?
You are...
SPEAKER_01 (06:20):
Not fit enough.
That maybe I was fit to acertain extent and maybe I had
lost some of that fitness.
So it's like, oh, he's likechanged or lost something.
Are you thinking about it'sgained weight or you've lost
muscle
SPEAKER_00 (06:38):
mass?
SPEAKER_01 (06:39):
Lost muscle
SPEAKER_00 (06:39):
mass.
Okay.
Yeah.
And when you think about theexcitement, tell me a bit about
that.
What are the thoughts connectedto your excitement?
SPEAKER_01 (06:53):
Yeah, I think that it's, I'm going to have a good
time.
I'm going to experiencesomething with these friends
that I'm going with.
Potentially I might meet someonethere that you might click with.
So
SPEAKER_00 (07:10):
there could be relationship potential.
Right.
I do want to ask a bit moreabout some of the more
challenging feelings.
So when you think about theanxiety, others will judge me,
maybe I'm not fit enough, and mybody has lost some muscle mass.
So if somebody looks at you andthey say, hey, Al has, his
(07:34):
body's changed.
He looks different.
He used to be, he used to havebroad shoulders and now he
doesn't.
What does that say about you?
What does it mean if that's trueor if that's happened?
SPEAKER_01 (07:50):
I think that a lot of times I've tied it to my
self-worth.
So I've valued myself lessbecause of that.
So if there's a loss of musclemass, then there's a loss of
value in myself.
SPEAKER_00 (08:08):
Ah, okay.
So I'm going to say value andcurrency has decreased.
Now I use the word currencybecause you're talking about how
you, your value in yourself hasshifted, right?
But when you talk about otherpeople judging you and them
thinking about, um, yourworthiness.
(08:29):
I think it's a bit more aboutvalue, but also currency, like
how well you fit in.
So when your body is how youwant it to be, I'm guessing
you've got a certain level ofmuscle mass.
How do you see yourself and howdo other people see you?
I
SPEAKER_01 (08:46):
feel like there's more admiration.
There's more attention.
There's less effort paid by meto get an attention of somebody,
I feel more confident.
I feel like more at ease.
(09:07):
And you're at ease because?
Because I don't feel like I'm tobe judged or I'm an easy target
to be judged.
SPEAKER_00 (09:21):
Ah, that's interesting.
What do people think about yourthe energy you put into looking
that way.
Are there some things theythink?
SPEAKER_01 (09:30):
Like people will perceive it as in like you're
someone who's like moresuccessful or pays attention
more to himself, cares forhimself, cares for their body.
Okay,
SPEAKER_00 (09:47):
so when you say people judge you, it's a long
list of things, right?
And so what I've done isunderneath, just this idea, this
thought that you have, thisautomatic thought, others will
judge me.
There are so many other smallerthoughts, right?
So if your value or currency hasdecreased and you don't get
(10:09):
attention easily, what's theconsequence of that?
SPEAKER_01 (10:14):
Um, I will fade into the background.
I will not meet a partner or apotential whatever it is.
It's the other person, whetherit's a hookup or it's an actual
potential dating partner.
Yes.
(10:34):
It will be less interesting.
People will be less attracted.
Okay.
SPEAKER_00 (10:45):
Now you'll notice that there's some like
overarching thoughts that I putdown, right?
So when it was excitement, it's,I'm going to have a good time
and I'll have a good experience.
There could even be arelationship or dating
potential.
And then we look at this thoughtthat others will judge me.
And that seems to be the biggestthing that you're concerned
about.
Is that right?
SPEAKER_02 (11:06):
Yeah.
SPEAKER_00 (11:07):
Okay.
And then when we break thatdown, We think about the
specific ways they'll judge you.
And then we're looking atconsequences for what it means
for your life or yourself ifthat judgment happens.
So I want you to look at all ofthe statements that have a
little arrow beside them.
And what I want you to do isthink about which one of these
(11:29):
is a thought that you think isvery central in the difficult
emotions you have.
So something that you think isreally driving the anxiety, the
self-consciousness, theinadequacy, the sense of
overwhelm.
Okay?
I
SPEAKER_01 (11:51):
think it's probably the, I'll fade into the
background and I'll beoverlooked.
SPEAKER_00 (11:56):
Okay.
So what we're going to do nextis we're going to talk we're
going to try to evaluate thisthought that I've put in bold.
Now that's called the hotthought.
The hot thought is the centralthought, the most salient one,
the one that's driving the mostdifficult emotions.
So I'll fade into the backgroundand I'll be overlooked.
(12:19):
Can you share some experiencesor some evidence from your life
where that has happened, whereyou have felt like you faded
into the background and wereoverlooked?
SPEAKER_01 (12:28):
I think that I've been at times at bars or clubs
or places like that where I waspotentially in like a group and
I felt like I maybe see someonethat I'm potentially interested
in and then I noticed that theyare strictly interested in
(12:52):
someone who is like bigger thanme or fitter than me.
In that moment you I experiencedfeelings of not being worthy
enough and not being not, Andfeeling of like, I'm more fading
into the background than I am.
SPEAKER_00 (13:10):
Yes.
So yeah, absolutely.
So this thought that you havethat you'll fade into the
background is very real, right?
It's rooted in this experienceyou've had before where you've,
you've specifically beenoverlooked.
You're like, Hey, I'm looking atthat person.
They're looking at me for amoment.
And then they see my friend andmy friend, whatever, he's got a
(13:32):
Big Mac for for muscles and likeit's done um uh okay so any
other evidence from your lifewhere uh that justifies us fear
or concern or anxiety aboutbeing overlooked or fading into
the background
SPEAKER_01 (13:50):
um yeah i had a group of friends i guess that i
hung out with at some point umthat maybe had a lot of like
spent a lot of attention on bodyimage uh and making sure they
look a certain way and i've hadthey talked about it a lot and
they talked about it and i'vehad comments in the past where
(14:12):
like let's say for example i gota little bit smaller or lost a
little bit of like muscle massor whatever and i would get the
comment of like oh well itsounds like it looks like you
need to like go back to the gymor you need to like do better or
yeah
SPEAKER_00 (14:26):
that's kind of awful isn't it
SPEAKER_01 (14:28):
terrible
SPEAKER_00 (14:29):
yeah like i mean
SPEAKER_01 (14:31):
uh
SPEAKER_00 (14:32):
It's interesting.
Like, I think our bodies arelike, they change.
That's just what they do.
And so if it can do, if it canget to a particular place once,
that's like nice.
But to think that it couldalways be like that is, it's a
bit of a tough standard, huh?
(14:52):
Now, when your friends mentionedthis, like, what do you think
the tone was?
SPEAKER_01 (14:57):
The tone was jokingly, but there's definitely
proof behind it of what thethought is, right?
SPEAKER_00 (15:04):
Ah, so you're thinking if they thought that,
other guys are going to thinkthat.
SPEAKER_01 (15:08):
Yes.
SPEAKER_00 (15:09):
Okay, and that's when it really was solidified
for you.
It means something in thiscommunity to...
Okay, so I'm going to put thatas a separate piece of evidence,
right?
Now, this might be a bittougher, but it might support
this thought that you'll fadeinto the background.
Have you been one of thosepeople who has overlooked
(15:30):
somebody or, you know, you'veseen them fade into the
background for you because ofhow they looked?
SPEAKER_01 (15:38):
Yes.
Yeah.
That's definitely, like, yeah.
I think that if I do it, thenI'll...
then i know that others do itand yeah it solidifies it more
SPEAKER_00 (15:49):
yeah and look when i say that i'm not i'm not like
calling you out i i'm merelythinking like that's part of how
we we get our knowledge rightbut like hey i do this thing so
other people might as well sonow let's think about some
evidence that doesn't supportthis hot thought so what we're
specifically looking for isSomething that supports the idea
(16:09):
that you won't fade into thebackground and won't be
overlooked regardless of whatyour body looks like.
SPEAKER_01 (16:17):
Like the guy that I'm dating right now, let's say,
where like he's into fitness,but he's not like, there's no
like, oh, you need to be at thislevel.
It's like, your body's yourbody.
I like it for who you are.
If your body changes, itchanges, right?
And I think that
SPEAKER_00 (16:39):
that is one, yeah.
That's a great example.
Is there other evidence fromyour life that does not support
the idea that you'll fade intothe background or be overlooked
depending on your body?
SPEAKER_01 (16:49):
I don't feel like my friends associate my worth or my
value with the way that I look.
I think that- What do they
SPEAKER_02 (16:57):
value?
SPEAKER_01 (17:00):
Like my sense of humor, my ability to connect
with them, my ability to bethere for them.
SPEAKER_00 (17:06):
Okay.
And so circles of friends, theylike my humor, social skills,
reliability.
And what do your friends thinkabout how you look?
SPEAKER_01 (17:17):
I think that like my friends think that I look fit.
I think my friends make fun oflike, oh, like, do you want to
have bigger arms or like, do youwant to have this or have that?
Ah, I
SPEAKER_00 (17:30):
see.
I see.
So they actually make fun ofthe...
The goal of bigger muscles.
Is there any other evidence thatdoes not support the hot
thought, does not support theidea that you will fade into the
background and you'll beoverlooked depending on how your
body looks?
SPEAKER_01 (17:50):
I think outside of the gay community, yes.
I think that...
Tell me about that.
When I'm outside of the gaycommunity, when I'm in straight
bars or I'm with straightfriends or I'm with work
colleagues or...
yeah outside of that there'sthere's no worth on on body
(18:11):
image that i feel at all umbecause i don't feel like i'm
being judged i don't feel like
SPEAKER_00 (18:18):
what are people evaluating you on outside of
that community i
SPEAKER_01 (18:24):
think that there's more value placed on uh ability
to connect i think that there'sa value on success when it comes
to like professional life.
Yeah, I think those are the maintwo.
Yeah.
SPEAKER_00 (18:42):
Okay, that's good.
I'm going to return to theoriginal situation, going to a
party or bar, specifically a gaymen's space where I don't know
many people.
You've got anxiety, excitement,fear, feeling overwhelmed,
self-conscious, uncertain,inadequate, and unworthy.
Your biggest concern is thatI'll fade into the background,
I'll be overlooked.
(19:03):
And now you've come up withevidence that supports the idea
that you could fade into thebackground and be overlooked.
I'd like to see if we can comeup with an alternative thought
for I'll fade into thebackground and I'll be
overlooked.
What's something else you cantell yourself that might be a
bit more helpful or a bit morebalanced?
SPEAKER_01 (19:22):
I'm out to enjoy my time.
My body's healthy.
I'm lucky to have a healthy bodyand friends around to enjoy this
moment with.
Yeah.
And like lucky to have friendsin my life who I could enjoy
(19:42):
this moment with and maybe makethat the focal point of the
experience.
SPEAKER_00 (19:48):
Yeah.
You know, because so much ofthis has been about body, you
know, I wonder if like, youmentioned this a couple of
times, people, appreciate youryour a bit your like your
ability to connect and like yourhumor and social skills um i
(20:08):
wonder if prospective dates orguys who are into you will see
that when you like when youinteract with your friends is
that possible yes
SPEAKER_01 (20:20):
yeah yeah absolutely
SPEAKER_00 (20:23):
Now that's something that might be more easily
accomplished, you know, at ahouse party versus a bar, you
know, I'm just thinking aboutthe dynamics.
So what's something you mighttell yourself if you were at a
bar and, you know, you were, youare overlooked.
Like, I kind of think likethere'll always be somebody
who's got, I don't know, abigger arm or a bigger butt or a
(20:47):
broader chest, like potentially.
SPEAKER_01 (20:49):
Yeah, I think that, yeah.
It's hard to know.
the thought is that like peoplehave different types and you're
not necessarily everyone's type.
I think it is what it comes downto.
It doesn't say anything aboutmyself if that person is just
not attracted to me.
SPEAKER_00 (21:11):
Exactly.
So let's get one more in here.
I'm really thinking about, I'mthinking about the reality, you
know, of being overlooked andthe thing you miss out on,
right?
Like how do you coach yourselfwhen you're like, I know from my
(21:31):
experience of being more visiblein terms of muscle mass, it
pulls people's desire and itpulls their eye in.
It's just something that I'veseen happen.
So is there something you wantto tell yourself about that?
Like-
SPEAKER_01 (21:47):
I've experienced- the two sides of it in the sense
of being the guy who's moremuscular, the guy who gets a lot
of attention, but alsoexperiencing maybe not getting
as much attention and beingoverlooked and experiencing that
at different times.
(22:08):
But I think that just in thetimes when I did experience
getting more attention, they'renot things that have longevity.
They're not things that have...
like deeper value.
SPEAKER_00 (22:26):
All right.
So we've got a slew ofalternative thoughts here.
Which one of these is mosthelpful for you?
Or do you believe in the most?
SPEAKER_01 (22:34):
It's probably one of the last two.
It's either the, I'm notnecessarily everyone's type that
says nothing about myself, butthat person isn't attracted to
me or the last one.
I think that I believe thesecond one more.
I think that I believe,understand the one before from a
logical standpoint, but from anexperiential standpoint, it's
(22:57):
not as much.
SPEAKER_00 (22:58):
Totally.
Yeah.
I'm glad we made thatdistinction because I'm not
necessarily everyone's type isfactual.
And then the next part whereit's, it says nothing about
myself that a person isn'tattracted to me.
To me, that's like a really niceaffirmation, but I don't think
we always believe that.
I wonder if we could add tothis, like from your experience
of going to parties, do you atleast, do you always get some
attention?
(23:18):
Do you always get someconnection?
SPEAKER_01 (23:22):
Yes, I get some attention.
Okay.
Who do you get the attentionfrom?
Yes.
Yes,
SPEAKER_00 (23:30):
yes.
Okay.
Totally.
Okay.
I'm going to relist the feelingsthat we initially had come up
with.
And I'm going to ask you tomeditate for a moment or think
about the alternative thought.
Like just sit with it, read itto yourself a couple of times.
And then tell me when you thinkabout the alternative thought,
(23:51):
where is your anxiety at?
SPEAKER_01 (23:54):
I would say it's at a four.
SPEAKER_00 (23:59):
And how about your excitement?
Six.
Beautiful.
And fear?
Four.
Okay.
Overwhelmed?
Three.
Self-conscious?
SPEAKER_01 (24:16):
Three.
SPEAKER_00 (24:18):
Uncertain?
Four.
Inadequate?
Four.
Okay.
And unworthy?
SPEAKER_01 (24:31):
Three.
SPEAKER_00 (24:32):
All right.
Are there any other feelingsthat come up for you when you
think about this alternativethought?
Optimism is one.
Okay.
I wonder if there's some griefor loss around what your body
used to be or this ideal body,but you can also say no, because
(24:52):
I'm totally leading you into adirection that-
SPEAKER_01 (24:54):
Yeah, yeah, yeah.
I don't think so.
Okay.
I think it's the change inperspective that makes me not
fear, not feel like there's alot.
SPEAKER_00 (25:08):
Or that there's
SPEAKER_01 (25:09):
grief behind it.
SPEAKER_00 (25:10):
Okay.
And so tell me about that changein perspective.
If we were to add some feelingwords to that, would it be like
grounded?
Confident.
SPEAKER_01 (25:20):
Okay.
Clear-headed.
Yes.
UNKNOWN (25:26):
Okay.
SPEAKER_01 (25:27):
aware, more self-aware,
SPEAKER_00 (25:29):
I guess.
I love that.
Isn't that a nice shift fromself-conscious to self-aware?
I like that.
Yeah.
Yeah.
Okay.
So that's a good list.
Now we've completed the thoughtrecord, right?
You started with a situationthat brings up some difficult
feelings.
We identified your hot thought.
We came up with an alternativethought.
(25:51):
the intensity of a lot of yourfeelings went down.
How do you feel about havingdone this exercise?
SPEAKER_01 (25:57):
When I was talking about anxiety, excitement, fear,
there's an actual experiencingof those feelings in the moment.
And I think that as we developedand changed perspective, there
was an actual experiencing ofthe feelings.
So it's not just reflecting onit as if it was...
happening in the past but it'sactually like experiencing it
(26:17):
while like really being
SPEAKER_00 (26:19):
now yeah yeah that's kind of lovely and that's the
cbt shorts episode for today i'mraheem thauer and thank you for
joining us please subscribewherever you get your podcasts
and you can follow us on socialmedia platforms for more content
the cbt dive is intended foreducational purposes and is not
(26:40):
meant to replace therapy
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