PuddnheadWhere to turn

You're allowed to be here, nobody says it's okay.It's not what you feared, and the ones who look fine were crawling inside too.

One man's map, from the chair you're in. Free, one page, no catch.

The whole path · What this is

The path

In this order.

  1. The room
  2. The door
  3. Coming down from survival mode
  4. Seeing it straight
  5. One small change
  6. Compassion as a tool
  7. The wheel

Where to turn · What this is

1 of 7 · the path

The room

You're in the right place. It's allowed, and it isn't what you feared. None of this is done alone, and nobody who got out did it alone either.

The tweak

Go to one meeting this week, and stay to the end, when they say the three words.

Why, and how sure

The first thing is not a method; it is a room with people in it who sat where you are sitting. You hear them name what you are doing before you can name it yourself, and that is how the names get to you. Where to turn is beside this on the page: the meeting, the doctor, the rehab, the line to call. The book never does those; it says where they are. How sure: this rests on the rooms, seventy years of them, and one man's year sat in it for want of a sentence; not on trials.

This rests on the old wisdoms and one man's journal, not on trials.

It's okay that you're here

You're in the right place. It's allowed. And it isn't what you feared.

Nobody told Mike that. Nobody said it would be okay to go, that the help was there, that it wasn't as miserable as it sounds. So he sat in it a year longer than he had to. If you're reading this in the chair, or in the parking lot after, you've already done the hardest part.

The rooms have said it to every newcomer for seventy years, in three words at the end of every meeting: keep coming back.

Next: the door

2 of 7 · the path

The door: the list

You can start with one thing, today, that takes five minutes and costs nothing. The people who were where you are started exactly there.

The tweak

Write three things down tomorrow morning, on paper, before anything else.

Why, and how sure

A list of three to five things you are grateful for, on paper, first thing in the morning. It changes the filter the rest of the day is seen through. How sure: the rooms have handed this on person to person for decades, and the traditions longer; the trials on gratitude practices are small and short-term, and the vault holds one concept on it with little behind it yet. The shelf holds this one, not the science.

This rests on the old wisdoms and one man's journal, not on trials.

Start a gratitude list

Write down, on paper, three to five things you are grateful for, first thing in the morning. Not typed. Not spoken into a phone. Written. It changes the filter you see the rest of the day through.

It will feel too simple, and some mornings it will feel fake. Do it anyway. It is the first thing to change, and the other things follow from it.

Where it comes from

It is the program's own practice, handed from one person to the next in the rooms for decades. It is older than the program. Don Miguel Ruiz, in The Four Agreements, puts "the mastery of gratitude" in the same breath as the mastery of love and of life. Counting blessings was a practice long before either.

One man's day

These are from Mike's notebook, written the way they were written. One man's route, not yours.

The first one that hits the hardest, and everything else flows from, is gratitude. There is no one way to do anything. You find what works for you. But the map is clear. Write down — put on paper — inscribe — not type, not voice-to-text — write down 3–5 things that you are grateful for. Do it first thing in the morning. That changes the filter that you see the rest of the day in.

Mike's notebook

Some of this seems too simple to be of service, and it's so simple and easy that it can't work, so give me the hard nuggets so I can get down to some serious make-my-life-better stuff — or, my life is okay, I am already grateful, let's move on. (NO!!) These are the building blocks for everything.

Mike's notebook

As I kept refuting the intrusive the gratitude slipped into its place.

Mike's journal
Next: coming down from survival mode

3 of 7 · the path

Coming down from survival mode: sleep, food, moving

The body you are in right now is braced for survival, and that comes down. You cannot think your way out while you are in it; you can let it settle, and then the mind has room.

The tweak

When you notice you are braced, breathe out slower than you breathe in, for one minute.

Why, and how sure

Sleep, food, moving, and a slower breath. When the body stops bracing, the thinking that was impossible becomes possible, and the rest of this method becomes something you can do rather than read. How sure: slow breathing has trials behind it for anxiety over weeks, small and short-term; sleep, food and moving are what every rehab and every tradition already puts first, and the vault says little about them yet. Noticing what is going on in you is the start of all of it.

This rests on the old wisdoms and one man's journal, not on trials.

Next: seeing it straight

4 of 7 · the path

Seeing it straight, and stopping the fight

You can look at where you are without the story that makes it bearable and without the fight against it, and it will not finish you. The people who did it say it was the first free breath.

The tweak

Say one true thing about where you are, out loud, to one person who will not argue with it.

Why, and how sure

Seeing it straight: the plain facts of your situation, said to yourself without softening and without arguing. Accepting that it is so is not approving of it, and it is not giving up; it is where the fight stops wasting you. Radical acceptance is one part of this, not the whole. How sure: taught in DBT, drawn from Zen; some trials, short-term, small samples; not in the vault. The Serenity Prayer and the shelf's own line hold it.

This rests on the old wisdoms and one man's journal, not on trials.

See it straight, stop fighting it

Look at where you are without the story that makes it bearable and without the fight against it. The plain facts, said to yourself, without softening and without arguing. Seeing it straight is not approving of it, and it is not giving up.

Accepting that it is so is where the fight stops wasting you. That acceptance is one part of this, not the whole; the seeing comes first.

Where it comes from

The rooms close every meeting with it, and have since 1941: the serenity to accept the things you cannot change, the courage to change the things you can, and the wisdom to know the difference. It was a theologian's prayer before it was the program's. Forty years ago Marsha Linehan brought the same move into the clinic from her Zen practice and called it radical acceptance: accept what is, all the way, so that the pain of it does not become the suffering of fighting it.

One man's day

These are from Mike's journal, written the way they were written. One man's route, not yours.

Clarity is a Bitch. It is facing the stark cold naked truth… But it is very liberating.

Mike's journal

Becoming aware of the things I accept, and acceptance of the things I become aware of.

Mike's journal

It's funny along with my 9 month chip came with the gift of more clarity

Mike's journal
Next: one small change

5 of 7 · the path

One small change, every day

A small thing done every day grows into something you could not have done in one go. Nobody got out by one big move.

The tweak

Pick the smallest version of one change and do it tomorrow at a fixed time.

Why, and how sure

One change, small enough to do on a bad day, done every day until it carries itself. The size is the point: small enough that you will do it, repeated until it no longer needs deciding. How sure: the vault holds habit formation and the gap between meaning to and doing, with trials behind implementation intentions over days; the one study that counted found a habit took anywhere from 18 to 254 days to become automatic.

This rests on the old wisdoms and one man's journal, not on trials.

One small change, every day

One thing, small enough to do on a bad day, done today and again tomorrow. The size is what makes it possible. The repeating is what makes it yours, until it no longer needs deciding.

Not all of it at once. One thing.

Where it comes from

The program does not ask you to stay sober for life. It asks you to stay sober today, and says so on the wall of every room: one day at a time. Don Miguel Ruiz, in The Four Agreements, says it word for word, and says what the repetition does: taking the action over and over strengthens your will and lays the foundation for the new habit to grow.

One man's day

These are from Mike's journal, written the way they were written. One man's route, not yours.

Change one small thing everyday. Even if you change the same thing in a completely different manner. Do something new everyday.

Mike's journal

You can't want a change in your life without making a change. Do one small change consistently - allow it to grow. Change will come to you.

Mike's journal

Anything, make it something small. Don't fix all of it at once. Do something small. But you have to do it. And again. And again.

Mike's journal

Now all I have to do is keep doing it. Every day.

Mike's journal, eighteen months alcohol-free
Next: compassion as a tool

6 of 7 · the path

Compassion as a tool: be nice to someone and your day gets better

You can use kindness to move your own day, on purpose, when you are wound up. It works on you, not only on the person you are kind to.

The tweak

The next time you are aggravated, do one kind thing for someone within reach, before you do anything about the aggravation.

Why, and how sure

Being decent to someone else when you are aggravated swings the pendulum back: your day gets better and less stressful, and the aggravation has somewhere to go that is not you. Compassion here is a tool you pick up, not a feeling you wait for. How sure: no vault concept and no trial behind it on the shelf yet; the traditions and the rooms have held it for as long as there have been rooms.

This rests on the old wisdoms and one man's journal, not on trials.

Compassion as a tool

When you are wound up, be kind to someone else. Not because they need it; because of what it does to your own day. You do not wait to feel it. You do it.

It is a tool you pick up, on purpose, when you are aggravated. The aggravation gets somewhere to go that is not you.

Where it comes from

The program found this out the hard way and wrote it down in 1939: nothing so much insures immunity from drinking as intensive work with other alcoholics. The twelfth step makes it the practice, and the rooms say it shorter: you have to give it away to keep it. The traditions had it first. The Buddha's loving-kindness practice is a thing you sit down and do, on purpose, toward people you did not pick.

One man's day

These are Mike's words, the way they were said. One man's route, not yours.

You use compassion to swing the pendulum from aggravated: be nice to someone else and your day gets better and less stressful.

Mike, talking it through, 31 October 2026

By giving love you defeat hate. You don't have to love what you hate. By being self aware you can learn not to hate. And then you Love.

Mike's journal

Where to turn

A doctor or therapist can help.

If you're in crisis, call or text 988 (the Suicide & Crisis Lifeline, US, any hour), or your local emergency number.

For drinking or drugs, SAMHSA's helpline is free, confidential and open every hour: 1-800-662-4357.

Next: the wheel

7 of 7 · the path

The wheel

The spokes are your reactions to what comes in through your senses. The reactions are the same in everyone; what comes in is yours alone. There is no first spoke and no order here: the map is the same for everyone, and the route is your own.

Hearing them named is how you start to notice one in yourself. The names:

Anger: the heat that comes up

You might say: angry, mad.

Anger is heat that comes up when someone does what you think they shouldn't. It's real, and it's yours to set down. You don't have to fight the man to be free of it.

Tools

Any one of these. There is no order, and none is first.

  • Ask yourself whether you're also hungry, lonely or tired.

    This rests on the old wisdoms and one man's journal, not on trials.

  • Say it to yourself: I'm not angry with you, I just don't have to stay. Then step back from his company.

    This rests on the old wisdoms and one man's journal, not on trials.

  • When the heat comes up, stop before you answer, and ask yourself for the right thought or action.

    This rests on the old wisdoms and one man's journal, not on trials.

Why, and how sure

Nothing in the vault is about anger yet, so this rests on the old wisdoms and one man's day. An emperor wrote, nearly two thousand years ago, that he wasn't angry with a man. He only wanted him to go away. The anger was his to put down, and the distance was his to keep. The program says the same in its own words: when you're worked up, stop before you act. How sure: this rests on the traditions and the rooms, not on trials. The library has no study yet that treats anger and follows people afterwards.

This rests on the old wisdoms and one man's journal, not on trials.

Craving: the pull

You might say: obsessive.

The pull

The pull is the part of wanting that gets you moving toward a thing before you have it. It can run low, and a low pull looks like not caring when it may be nearer to wanting that has gone quiet. That is something the system does, not a flaw in you.

The tweak

Pick one small thing you used to like. Tomorrow do it for ten minutes, wish or no wish, and write one line afterward on whether the wish turned up once you were in it.

The brain gives the things that point to a reward, a cue, a smell, a message from a friend, a pull that makes them worth the effort. The pull is thought to be a separate part from the pleasure of getting the thing, and dopamine is thought to serve the pull more than the pleasure. When the pull runs low a man can wait a long time for the wish to arrive before he moves. How sure: thin, and mostly brain scans. A pooled analysis of 24 fMRI studies, 822 people (depressed, at-risk and symptom-scored volunteers against healthy ones), found less activity in the caudate and left putamen, parts of the striatum, while waiting for a reward; it appeared only once studies of chosen brain regions were added, since the 12 whole-brain studies alone found nothing after correction, and it is a difference between groups at one time, not a cause. A review that read, but did not pool, a few follow-up studies of adolescents (three or four, two from the authors' own groups) reports a smaller striatal response in fMRI and a blunted feedback signal in EEG before depression began; no adults, and the EEG signal is a response to feedback, so it shows what came first, not what caused it. On dopamine: one review of anhedonia starts from animal evidence that dopamine serves the motivation side more than the pleasure, which is the premise the authors argue from, not a result they test; and a PET study of 25 healthy adults found those whose dopamine system responded more to amphetamine chose the high-effort option more for larger rewards, mostly when the chance of winning was low, a correlation in one small healthy sample. Nothing on file tests whether acting without the pull brings it back.

Well tested. Large studies, or reviews of many trials, back this.

Claim by claim
  • dopaminergic signalling influences reward anticipation: Good evidence, not yet the strongest kind.
  • reward anticipation influences depression: Well tested. Large studies, or reviews of many trials, back this.
  • reward anticipation occurs in depression: Well tested. Large studies, or reviews of many trials, back this.
Fear: being afraid of what's coming

You might say: fearful, afraid.

Being afraid of what's coming is something the body and the mind do to get you ready, not a measure of you. Two things you do can keep it going: staying away from what you fear, and your eyes going to the threat first. Both are things you do, and a thing you do can be noticed.

Tools

Any one of these. There is no order, and none is first.

  • When you catch your eyes on the bad thing, name it in two words, then find three ordinary things in the room and name those. Thirty seconds.

    Not tested at this size yet. It borrows from the readings on attentional bias.

  • In one conversation that scares you, notice the moment you start watching yourself, and for two minutes put all of it on the other person: what they are saying, and one question about it.

    The evidence is split. Good studies point both ways.

  • Pick one thing you have been staying away from, in its smallest form: the phone call, the street, the room. Go toward it once this week, and stay until the fear has dropped by about half before you leave.

    Not tested at this size yet. It borrows from the readings on avoidance.

Why, and how sure

Staying away from a thing takes the fear down right now. That is what it is for, and it is why the fear is back the next time: every dodge misses the one lesson that would end it, that the thing has changed or was never what you thought. Your attention can do something alike, finding the worst thing in a scene first and holding it longest. How sure: thin, and the readings say so. That staying away lowers fear in the moment is the DSM-5's own sentence, with no size behind it. That it keeps the fear alive is argued in Bandura's 1977 theory paper and in a narrative review by the fear-avoidance model's own developers, from older phobia work and lab studies of pain, not from a trial. In 291 bereaved adults, avoiding reminders of the loss predicted more depression a year on, but only within the first year of the loss, and it added little. A review's account of one bereavement study says going over it at the start predicted staying away at six months. On attention: 49 students with raised low-mood scores, eyes tracked over word pairs, then mood weekly for five weeks; those whose eyes stayed longer on negative words got worse (r = .42), though that is mood and not fear, and nothing was changed to see whether mood followed. On watching yourself in social fear: a lab experiment with 40 people found they rated more anxiety giving a speech about their own sensations than about their partner's; a review says self-focus increases anxiety and keeps it going; against that, a trial of an 8-week internet course (464 adults) found self-focused attention at week four did not predict symptoms, where safety behaviours and avoidance did. All of that is social fear, not everyday life. The trials of meeting the feared thing on purpose are not yet read into the vault. Experiential avoidance, the fear-avoidance model and extinction learning have no reading yet.

Early evidence. Not tested well yet. One part is split.

Claim by claim
  • attentional bias influences depression: Early evidence. Not tested well yet.
  • avoidance influences anxiety: not rated yet
  • avoidance influences depression: Early evidence. Not tested well yet.
  • avoidance influences extinction learning: Good evidence, not yet the strongest kind.
  • rumination influences avoidance: Early evidence. Not tested well yet.
  • self focused attention influences anxiety: The evidence is split. Good studies point both ways.
Going over it: going over and over it

You might say: mind loops, intrusive thought, trap, morbid reflection.

Going over it again and again is a thing you do, not proof of what you are. It can be caught in the act, and what you believe about it, that it helps or that you cannot stop it, is a belief that can be tried.

Tools

Any one of these. There is no order, and none is first.

  • Tell the thought a time: half past six, and not before. At half past six, sit with it for twenty minutes.

    Not tested at this size yet. It borrows from the readings on worry postponement.

  • When you catch the same thought on its third lap, ask it one question out loud: what, exactly, happened? Answer in one plain sentence, name the one next thing, and do it inside ten minutes.

    Good evidence, not yet the strongest kind.

  • Next time it will not stop, write down the one belief under it, 'this helps' or 'I can't stop this'. Then put it down for ten minutes by the clock and write one line on what happened.

    Not tested at this size yet. It borrows from the readings on metacognitive beliefs.

  • Notice the thought as a thought. Say 'there it is again' and let it pass while you turn to the next ordinary thing in front of you.

    Not tested at this size yet. It borrows from the readings on mindfulness based cognitive therapy and mindfulness meditation practice.

Why, and how sure

Going over it is turning over what went wrong, and why, and what it says about you, without getting to what to do next. It feels like working on the problem; the thinking stays abstract and the body stays braced. It runs on the trouble of letting a bad thought go, and on beliefs about your own thinking: that chewing on it helps, and that once it starts you cannot stop. The way out in the trials is to make it concrete, what exactly happened and what is the one next thing, and to notice the thought as a thought and let it pass. How sure: a mix. A meta-analysis of 29 trials found mindfulness-based cognitive therapy cut rumination by about half a standard deviation after treatment, mostly in depression, with the gain shrinking after three months and small against CBT. A trial of 121 people in GP practices found the concreteness exercise cut rumination more than relaxation at eight weeks, though not symptoms. One study found a mindfulness intervention lowered rumination and negative mood but did not change how either moved from day to day. The therapy built for rumination has only a pilot of 42 people behind it, with its developer among the therapists. That going over it predicts who falls into depression held in about 1,300 adults over a year and again in a one-year follow-up. Its links to sleep, to staying away and to pulling back from life rest on reviews of lab work and one bereavement study inside a review. The beliefs: two theory papers say beliefs and learned routines drive rumination; in 433 students over three months, worry held steadier in the half with stronger beliefs about their thinking, a survey and not a trial. No trial of changing the beliefs is read in. Postponing is described in a meta-analysis whose trials come mostly from the method's originator. Nothing here is a trial of a single move at this size.

Early evidence. Not tested well yet.

Claim by claim
  • attentional control influences rumination: Early evidence. Not tested well yet.
  • concreteness training targets rumination: Good evidence, not yet the strongest kind.
  • metacognitive beliefs influences rumination: Early evidence. Not tested well yet.
  • metacognitive beliefs influences worry: Early evidence. Not tested well yet.
  • mindfulness based cognitive therapy targets rumination: Well tested. Large studies, or reviews of many trials, back this.
  • mindfulness meditation practice targets rumination: Early evidence. Not tested well yet.
  • rumination influences avoidance: Early evidence. Not tested well yet.
  • rumination influences behavioral withdrawal: Good evidence, not yet the strongest kind.
  • rumination influences depression: Good evidence, not yet the strongest kind.
  • rumination influences sleep disturbance: Early evidence. Not tested well yet.
  • rumination influences worry: Early evidence. Not tested well yet.
  • rumination focused cbt influences rumination: Early evidence. Not tested well yet.
  • worry postponement targets rumination: Well tested. Large studies, or reviews of many trials, back this.

Grief: missing what's gone

Guilt: feeling bad about what you did

You might say: remorse.

Hopeless: hopelessness

You might say: hopelessness, broken.

Hopelessness is a forecast, not a report. It says nothing you do will change anything, and it says it with such certainty that you stop checking. Not seeing a way through is what a stuck mind does with a hard problem: it stops looking for the next step. Both are places you are standing in, not verdicts on the road.

Tools

Any one of these. There is no order, and none is first.

  • Pick one thing you have stopped doing because it seemed pointless, the smallest one. Do it once tomorrow, before noon, and write one line that night on whether anything at all moved.

    Not tested at this size yet. It borrows from the readings on hopelessness.

  • Set a timer for ten minutes. Write the one problem that keeps coming back as a single plain line, list three things you could do about it, silly ones included, and circle the smallest. Do that one before the day is out.

    Not tested at this size yet. It borrows from the readings on problem solving steps and problem solving therapy.

Why, and how sure

Hopelessness is the expectation that what you want will not come and that nothing you do will change that. In the theory it is built from evidence you gather yourself: go over it long enough and you have a mountain of proof that you might as well give up. Giving up is what it costs you: you stop starting things, and the stopped life then proves the forecast. When a trouble has gone round enough times, the working parts of solving it can go quiet too: no list of things you could do, no picking one, no trying it. How sure: thinner than most, and said plainly. The two readings on hopelessness are both reviews restating a theory: a narrative review by the rumination theory's author and her lab, whose own hypothesis it is that rumination builds the case for giving up, and a systematic review of 67 studies of the hopelessness theory whose definition lists slowed starting among the symptoms. Neither tests a link from hopelessness to pulling back. On a way through: a review by the same lab says in its abstract that rumination impairs problem solving, and says nothing on whether poor problem solving leads to pulling back from life. For the therapy built on that picture, a meta-analysis of 13 trials reports a mean effect of 0.34 or 0.83 depending on the model, with very high heterogeneity, and a later one of 30 randomised trials (3,530 people) found g = 0.79 across all trials but g = 0.34 in the 9 low-bias ones, with waiting lists doing most of the work and follow-up in three trials. Both measure depression only, and neither tests whether the gain comes from better problem solving. So they back the therapy working on depression, not a deficit it fixes. No paper on file defines or measures the deficit. Treat it as a working picture, not a finding. Loss of pleasure, the looser fit, has one reading, on pulling back from people, and says nothing on hopelessness.

Good evidence, not yet the strongest kind.

Claim by claim
  • hopelessness influences behavioral withdrawal: Good evidence, not yet the strongest kind.
  • problem solving deficit influences behavioral withdrawal: No studies on this yet. It rests on what people in the rooms have found.
  • problem solving steps targets problem solving deficit: No studies on this yet. It rests on what people in the rooms have found.
  • problem solving therapy targets depression: Well tested. Large studies, or reviews of many trials, back this.
Isolating: pulling back

You might say: isolated.

Pulling back is something you do, a call not returned, a plan dropped, and it often follows things losing their pleasure or seeming pointless. It is a pattern, and a pattern can be looked at without being a verdict on you.

Tools

Any one of these. There is no order, and none is first.

  • Pick one thing you have stopped doing, the smallest one. Do it once tomorrow, wish or no wish, and write one line that night on whether anything moved.

    Not tested at this size yet. It borrows from the readings on behavioral withdrawal.

  • Before noon tomorrow, send one line to one person you have been meaning to answer. Five words will do. No call, no visit, no reply needed, and do not wait to feel like it.

    Not tested at this size yet. It borrows from the readings on social withdrawal and social support.

Why, and how sure

When company, or the things you used to do, stop giving you the lift they did, passing on them starts to make sense. The pulling back is what others notice; the wish for company often does not go away with it, so the quiet is lonely. How sure: thin, and about what goes with it more than about what undoes it. A selective review of social anhedonia in psychosis, depression, PTSD, eating disorders and autism says that across them people who take less pleasure from social contact then pull away and function worse, though loneliness often stays; that is the abstract's own summary, with no numbers, and the authors say study designs differ. A review of lab and survey work says low-mood ruminators knew what would help and were unwilling to try it, and another says rumination makes people less willing to do pleasant things. The hopelessness theory's definition lists slowed starting of actions among its symptoms, and the same lab suggests people who go over it build a case that they may as well give up and withdraw; both are theory restated in reviews, not tests. A review by that lab lists poor problem solving as something rumination causes and says nothing on whether it leads to pulling back. No paper on file defines or measures pulling back directly, and nothing on file tests whether a small contact or a small act undoes it. Feeling alone sits close by and has no unit of its own. In 229 Chicagoans aged 50 to 68 followed for five years, feeling lonelier one year went with a few more depressive symptoms the next (B = 0.18), and people with more social support were less lonely a year later (B = -0.66) though not less depressed; self-report, one county, an author manuscript not checked against the printed paper.

Early evidence. Not tested well yet.

Claim by claim
  • anhedonia influences social withdrawal: Early evidence. Not tested well yet.
  • depression influences loneliness: Early evidence. Not tested well yet.
  • hopelessness influences behavioral withdrawal: Good evidence, not yet the strongest kind.
  • loneliness influences depression: Early evidence. Not tested well yet.
  • problem solving deficit influences behavioral withdrawal: No studies on this yet. It rests on what people in the rooms have found.
  • rumination influences behavioral withdrawal: Good evidence, not yet the strongest kind.
  • social support influences loneliness: Early evidence. Not tested well yet.

Lonely: feeling alone

You might say: loneliness.

Meaning to and not doing

Resentment: holding it against someone

You might say: resentful, bitter, hate.

Holding it against someone is the mind going back to the wrong, again and again. That going back is something you do, and it can be caught while it is happening.

Tools

Any one of these. There is no order, and none is first.

  • Ask the thought one question, out loud: what, exactly, happened? Answer it in one plain sentence.

    Good evidence, not yet the strongest kind.

  • When you catch it going round, say 'that's the story again' and turn to the next ordinary thing in front of you.

    Not tested at this size yet. It borrows from the readings on mindfulness based cognitive therapy and mindfulness meditation practice.

Why, and how sure

Nothing on file is about grudges. What the vault has read is on the mind going over what went wrong, and holding it against someone looks like that from the inside: the same scene, the same verdict, no next step. In the readings, that going over is tied to the trouble of letting a bad thought go, and to being less willing to do the things that would help even when you know what they are. How sure: thin, and borrowed. Every reading here is about rumination, mostly in low mood, and none is about resentment. A review puts poor control of attention, the trouble letting go of a negative thought, at the root of rumination that will not stop; that is a model argued from the literature, not a trial. A review of lab and survey work says low-mood ruminators knew what would help and were unwilling to try it. On the way out: a trial of 121 people in GP practices found that making the thought concrete cut rumination more than relaxation did at eight weeks, though not symptoms; a meta-analysis of 29 trials found mindfulness-based cognitive therapy cut rumination by about half a standard deviation after treatment, mostly in depression, with the gain shrinking after three months. Nothing on file tests any of it on a grudge. Two of the three concepts under this word, how you read what just happened and reasoning your way to the answer you wanted, have no reading yet.

Early evidence. Not tested well yet.

Claim by claim
  • attentional control influences rumination: Early evidence. Not tested well yet.
  • concreteness training targets rumination: Good evidence, not yet the strongest kind.
  • mindfulness based cognitive therapy targets rumination: Well tested. Large studies, or reviews of many trials, back this.
  • mindfulness meditation practice targets rumination: Early evidence. Not tested well yet.
  • rumination influences behavioral withdrawal: Good evidence, not yet the strongest kind.

Restless, irritable, discontented: can't settle

Self-pity: feeling sorry for yourself

You might say: self-pitying.

Attention stuck on yourself

Watching yourself from the inside, how you sound, how you look, what your body is doing, is something you do, not something you are. In one small lab test, people felt more anxious speaking about their own sensations than about someone else's, so where the attention points may matter.

The tweak

Once tomorrow, in one ordinary conversation, catch the moment you start watching yourself. For the next two minutes put all of it on the other person: what they are saying, and one question about it.

When attention sits on yourself, the self becomes the loudest thing in the room: the pounding heart, the voice, what the other person must be thinking. The feeling you are watching may grow for being watched, and pointing attention at the other person or the task gives it less to feed on. How sure: three readings, and they pull different ways. A lab experiment with 40 people, 20 with social phobia and 20 without, found the anxiety they rated during a 2-minute speech was higher when they spoke about their own sensations than about their partner's (partial η² = .14), in both groups; the authors only suggest this is how self-focus keeps social anxiety going, nothing was followed past two speeches, and the larger observer-rated effect may be tangled with speakers naming their symptoms. A narrative review of self-focused thinking in social anxiety, with no search counts or pooled figures, says self-focus increases anxiety and keeps it going; the 'increases' rests on lab studies, the 'keeps it going' on models and correlational work. Against that: a randomised trial of an 8-week internet CBT course for social anxiety (464 adults) found self-focused attention at week four did not predict symptoms (β = 0.11, p = 0.09), where safety behaviours and avoidance did; it used a trait questionnaire, not attention in the moment, corrected for no multiple tests, and the authors say other trials found the opposite. All of it is social anxiety, none is everyday life, and nobody here trained people to move their attention and followed them.

The evidence is split. Good studies point both ways.

Claim by claim
  • self focused attention influences anxiety: The evidence is split. Good studies point both ways.

Shame: feeling there is something wrong with you

Worry

Worry is a thing you do, not weather that happens to you. It can be put down for a while, and what you believe about it, that it helps or that you cannot stop it, is a belief that can be tried.

Tools

Any one of these. There is no order, and none is first.

  • When a worry starts, write it in one line and tell it: half past six. At half past six, sit with the list for twenty minutes, and not before.

    Well tested. Large studies, or reviews of many trials, back this. One smaller study found otherwise.

  • Next time the worry will not stop, write down the one belief under it, 'this helps' or 'I can't stop this', then put the worry down for ten minutes by the clock and write one line on what happened. One test, one line.

    Not tested at this size yet. It borrows from the readings on metacognitive beliefs and metacognitive therapy.

  • When a worry shows up, say 'that's worry' and turn to the next ordinary thing in front of you for a minute.

    Not tested at this size yet. It borrows from the readings on mindfulness based intervention.

  • Tie the set time to something you already do every evening, in an if-then line: after I wash up, I read the list.

    Good evidence, not yet the strongest kind.

Why, and how sure

Worry keeps a bad feeling steady so nothing can catch you by surprise; that is what it is for, and why it feels like work you cannot stop. Two beliefs run it: that worrying helps, and that once it starts you cannot stop. The first calls it up; the second keeps you braced against it, so you never try to put it down. Test the belief and the worry has less to run on. How sure: mixed, and said plainly. For saving worry for a set half hour: a meta-analysis of 7 randomised studies (999 people) found a small cut in daily worry time against just logging worries (d = 0.36) over one to four weeks, with no follow-up; a waitlist trial of 82 outpatients found worry fell more than waiting in the 47 with generalised anxiety and not in the 35 with health anxiety; and a four-arm online trial of 186 adults found the two postponement arms together no better than a diary-only control, with heavy dropout. The vault holds postponement as contested, and this piece says so. In that same online trial, people who tied the slot to an evening habit with an if-then plan reported worry periods about 15 minutes shorter than plain postponement; one test at the edge of significance, and nobody checked that the slot was kept. On the belief: in 433 students over three months, worry held steadier, and rumination fed later worry, in the half with stronger beliefs about their thinking; a survey, not a trial. In 206 people followed for a year after a cancer diagnosis, the belief that worry is uncontrollable and dangerous predicted anxiety a year on, though once the starting level was allowed for it added little. That the beliefs drive worry is argued in theory papers. Treatments that change the thinking style or step back from the reaction to worry could help, says a review of 19 studies with no pooled figure; the account of metacognitive therapy comes from a depression trial that did not measure worry. Worry and bad sleep go together at the level of the person, not the day (182 adults, seven days).

Early evidence. Not tested well yet.

Claim by claim
  • implementation intentions influences worry: Good evidence, not yet the strongest kind.
  • metacognitive beliefs influences anxiety: Early evidence. Not tested well yet.
  • metacognitive beliefs influences worry: Early evidence. Not tested well yet.
  • metacognitive therapy targets worry: Good evidence, not yet the strongest kind.
  • mindfulness based intervention influences worry: Well tested. Large studies, or reviews of many trials, back this.
  • rumination influences worry: Early evidence. Not tested well yet.
  • worry influences sleep disturbance: not rated yet
  • worry occurs in anxiety: Early evidence. Not tested well yet.
  • worry postponement influences worry: Well tested. Large studies, or reviews of many trials, back this. One smaller study found otherwise.

Where to turn

A doctor or therapist can help.

If you're in crisis, call or text 988 (the Suicide & Crisis Lifeline, US, any hour), or your local emergency number.

For drinking or drugs, SAMHSA's helpline is free, confidential and open every hour: 1-800-662-4357.

What this is

Where to turn

A doctor or therapist can help.

If you're in crisis, call or text 988 (the Suicide & Crisis Lifeline, US, any hour), or your local emergency number.

For drinking or drugs, SAMHSA's helpline is free, confidential and open every hour: 1-800-662-4357.

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What this is

Puddnhead is for anyone who is alive and miserable: after drink or drugs, trauma or loss, or with a life that just isn't what you want it to be. The life is good enough to work with; it's the details and the way you see them that can change. If you're alive, there's hope.

It hands you a map: what the science can show, and what the old wisdoms have shown for longer, said plainly and honest about how sure anyone is. The map is the same for everyone; every terrain is different, so the route is your own. Puddnhead never prescribes.

Use it alongside whatever help you already have (a program, a doctor, a counsellor), not instead of it. It is not treatment, and it does not replace care.

Puddnhead is a non-profit in the making, so that the map is never sold.

puddnhead.org · This page will grow as the shelf behind it grows. Nothing here is a plan or a treatment.

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