Diagnosis to Normal: History, Medicine or One Skill

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Diagnosis to Normal
History, Medicine or Skill

By Namita Gujral


My friend tells me whenever he feels stress, this happens to him: he has thoughts about slashing people’s throats. Stress makes him have thoughts of murder. 

Surely, I thought, only the worst forms of stress would provoke such gruesome thoughts. Is it when he lost his job or his wife? Is it when he feels like his masculinity is challenged or when he’s in a bar fight with drunk bullies?

Nope. It’s just about anytime he’s even mildly annoyed. Even mundane, harmless occurrences do this to him. Shoelaces opening while running. TV stops working. Customer service being sloppy.

Basically, when he’s triggered, he has thoughts about murder.


A second friend tells me he frequently ruminates over why his life hasn’t lived up to its childhood promise of happiness. 

A fifty-five-year-old grown woman I know closely often worries about what people think of her.

A fourth tells me he often finds himself fantasizing about debilitating poverty, even when he makes a million dollars, with no debt or family to support. 

And one more friend who frequently thinks about how his childhood upbringing has seriously let him down. 

Some group, no? 


Given the nature of their thoughts, it’s probably easy to guess which category of emotional disorders they’d belong to. 

Going chronologically, this should read: Pure OCD, depression, social anxiety, generalized anxiety and complex-trauma.

Instead, they get to be “normal”. None of them has ever been diagnosed with anything. 

Rather, here is what I get to see from several decades of knowing them.

They’re fine.

Even by their own standards, they say they have decent lives. Their lives may not have followed the precise straight line they’d drawn for it and are certainly marked by constant swings of ups and downs,  but more or less, they say life did them okay. They have careers and goals and family and children and hobbies and purpose. 

They get to be “normal”. 

You know, the kind of “normal” anxiety sufferers feel is out of reach. 

If we deconstruct the moments when my group of people have their unpleasant thoughts, what can we wonder? 

Everything about that moment should be anxiety. Difficult thoughts and painful feelings about nonideal circumstances.

How did they escape a diagnosis? Why don’t they crash?

The path to derive the answer to this may split us off. But we’ll likely arrive at the same conclusion: their blessings or circumstances have been easier than ours. Childhood learnings, brain circuitry, trauma-free experiences.  Very likely, all better than ours. 

Even if this were true - and it very much could be - what exactly does that advantage offer them? What is it that they’re able to do in a given moment that anxiety sufferers can’t, when both sides confront the same kind of difficult stimulus.

I have difficult thoughts? So do they. 

I have difficult memories? So do they. 

I have difficult emotions? So do they. 

Then why are we different?

What specific skill do those “normal” guys practice in a given moment, that perhaps their advantageous histories created for them, that enables them to respond to the same kinds of thoughts differently?

And more importantly, can I have the same skill today, given who I've become after all this anxiety? Or does access to this skill get decided by what happened to me in my history? 


The skill is this:

Psychological Flexibility.

Think about being physically flexible. 

If Shonda can touch her feet without bending her knees, and I can’t, it’s because Shonda’s lower back, hamstring and calf muscles are more flexible than mine.  Shonda is physically flexible. 

If Ryan can stay grounded and on course even with a thought that tells him he’s the biggest loser in the world, it’s because Ryan is psychologically flexible.

He’s flexible to this thought. 

He knows the thought isn't telling the whole truth. Just like we know our anxiety thoughts aren't telling the whole truth. They may have some truth, but when they pretend how the future is known is absolute, fully certain or extremely black or white (no grey), then it's not a reliable truth. We know that.

But are we flexible to having it? The question is not about believing it. The question is just about having the thought. Are you okay that it exists in our head?

To our naked eye, we don’t see that the difference between normal people and us is psychological flexibility to having difficult thoughts. We assume it’s the absence of difficult thoughts.


Anxiety is a difficult state to be in.

Our brain’s fear center (the amygdala) has activated physical sensations in our body in response to a false threat posed by some extreme, black and white kind of thought. 

The sensations created by an amygdala activation can be horrible to feel, so the motivation to get your body to reverse itself to normalcy is reasonably quite strong.

The absolute worst thing you can do to achieve this is deciding to be psychologically inflexible to sharing space with the very extreme thoughts that created this false alarm.

If “you will die” (literal or symbolic) or "it will be horrible if...." created your panic, you have to stay even more flexible to accepting having this thought in your head once it's triggered you into a panic. 

Because if you say no to staying flexible with this thought, you’ll do the only other thing there is to do. You’ll try to quash it. You’ll try to bury it under consciousness or you’ll try to negotiate it with it. And with every one of these, you’ll make the thought stronger while you start to go off the desired track of your life. Remember all the exercises you tried and research you read in my book “The #1 thing to Stop Doing”? 

Staying flexible means saying “yes” to having your thoughts. To any thought. To all thought.

It means you say “Yes thought, you get to stay in my headspace. You get to stay because there’s nowhere else for you to go. I’d rather have you in my knees or my toes than in my head, but that’s not up to me. So fine. You can live in my head….

….but that doesn’t mean I have to believe you.”

The belief is up to you. The presence of the thought is not.


How to build & practice Psychological Flexibility

By wholeheartedly knowing that the mind can be treated as an EXTERNAL event.

If the chair you are sitting on can be external to you, so can the mind.

The mind can be treated as an external object, an external identity or an external event.

You don’t have to merge yourself with the mind completely.

You don’t have to treat both of you as the same thing.

You don’t have to assume that what the mind says, you say.

You don’t have to assume that what the mind believes, you believe.

You don’t have to assume that what the mind evaluates as “good” or “bad” is evaluated by “you” as good or bad.

If you want, you can decide to be separate event from the mind. 

But never, ever insist (no matter much how much therapy you've done) that your mind has to alter itself for this separation to exist or be accepted by you.

This is where meditation, mindfulness, therapy or life accomplishments can still fail to satisfy you no matter how much you try or how much you cry. If you insist that the mind (well,  at least the part of your mind you don’t like) has to go away or say something else for you to be comfortable again, then you're still being as psychologically inflexible as before; what you’ve done is added thousands of dollars of treatment bills.

The expectation of “why do I still think this after years and years of treatment” is misguided.

You think “this” because you will. There is no subtraction button in the mind’s design. There is only addition.

Past thoughts aren’t going anywhere. Can you be flexible to coexist with them?


If you separate yourself from your mind, I believe you can.

When it gets hard, remind yourself of the practical reasons to still keep going at it until such mindfulness starts to become your default.

Remind yourself that the separation is truer than anything else your mind has put out there. This separation is what enables  you to recognize the irrationalities of your extreme thoughts. If all you were was your mind, you won’t be able to look at the mind at the same time. 

And secondly, if you don’t separate yourself from the mind, your identity will beg you to protect it by controlling your thoughts and asking them to leave. There are few failures that are quicker or more painful to experience than the failures of thought suppression strategies.

Psychological flexibility means you accept that thoughts exist in your head for one reason or another. 

With that acceptance, you take back your power from these thoughts. 

It’s counterintuitive. The more flexible you are with having them around, the more you have proved that you don’t believe them. 

Think about it.

Why else do we try and try and try (and fail and fail and fail) to get rid of thoughts? Because we fear that we believe them.

If you decide that you are okay that the thoughts stay but the belief is up to you (no matter what the thoughts even say about this belief, or your skill or capacity for it), then you’ve started to win from anxiety.


“Normal” people are practicing this flexibility by deciding that the mind is a separate event to them.

Image of “ I'm slashing people’s throat” (Pure-OCD)? The mind, not me. Let’s carry on with movie plans.

Thought that says “you will die of embarrassment if….” (social or performance anxiety)? The mind, not me. Let’s go on stage and give that speech.

Memory flashes that remind me “you cannot trust people because of the past" (past trauma)? The mind, not me. Let’s accept the date and meet him for drinks.

Thought that says “get yet another medical exam to be fully sure, yet again" (hypochondria)? The mind, not me. Lets take my kids to soccer practice. 


If I am flexible with something sharing space with me, I am already deciding that it’s not a threat.

Hey mind, you get to stay, but whether I have to believe you? That’s up to me. 

This is how we become Shonda or Ryan.

And this is also how we move from disorder, label, diagnostic & chemicals over to “normal”.


Psychological flexibility is a skill we exercise. 

It comes from mindset and practice. Not always from fate or medicine.

And we don’t have to correct our history in order for this skill to be granted to us. It is impossible and not even necessary to go back in time, arrive at the day in your childhood when you first practiced being psychologically inflexible, erase that moment like erasing chalk writings from a wall, all to make sure the bad habit never started in the first place.

First, it’s not possible. Second, you’ll be more entangled in the very problem you're trying to erase. Third, it’s way too much work to get something that’s available right in front of you.

You want to be flexible? Be flexible. Ignore thought (by accepting thought) because it’s not you. It's the mind. Use your time, space and mental health on better pursuits. 


My progress accelerated leaps and bounds when I abandoned all kinds of treatments and listened to that one smart therapist who said this line:

“For the rest of your life”. 

My question to him was “How long will I keep having these negative thoughts?”. 

Oh well, alright then…

Almost overnight, I recovered from Panic Attacks, Insomnia, Pure OCD, OCD and Agoraphobia. 

For the rest of your life. Are you okay with? Just in your head. Not in your belief.

If you are okay with that, you're not in conflict. Without a conflict, anxiety cannot survive. You're touching the floor without bending your knees.

And what happens next?

You may start to see that your flexibility to negative thought will make them much kinder to you.

You'll start to feel "normal" again.


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