I’m going to begin this blog a little differently than my usual posts. I’m going to share an example of how I’ve experienced today’s topic: Red Herrings.

My Story

My dad had idiopathic pulmonary fibrosis.  He had a lung transplant and was in the ICU for four months post-op before succumbing to his illness.  He was at a hospital in Virginia, and I was living in Tucson.  This meant I was flying back and forth as much as possible (thank you again to those who shared their airline points with me to soften the financial burden.)

At one point, it was decided that my dad would undergo a tracheotomy after multiple failed attempts at getting off a respirator. These were concepts I was only familiar with through my love of Grey’s Anatomy. A year later, they would become part of the common vernacular when the COVID-19 pandemic swept the planet.

Fire Alarms

I am a seasoned traveler and don’t have anxiety about flying.  I do have anxiety in general, though.  That day, waiting in the Tucson airport for my flight, I became fixated with the fact that I wasn’t certain if there were fire alarms in my home.  By law, I thought there had to be, as I was a renter.  But maybe the lease said I was responsible for purchasing my own fire and CO2 alarms? If they were in the house, where were they? Why couldn’t I remember where they were? I had been living in this place for nearly two years and should have known this.  Where were the damn alarms?

Panic coursed through my body as I visualized my home catching on fire while my dog sitter was at work and my dogs were trapped inside alone.  I visualized my dog sitter at home with the dogs, forced to cope with a burning building without the warning of an alarm.  My breathing became shallow as my heart raced and my body became rigid and tense.

Ok, I thought, I can fix this, and proceeded to search for dual-fire and CO2 alarms with next-day delivery. I was simultaneously aware that the intensity of my fear was wildly disproportionate to the situation.  I knew this and couldn’t detach from my tunnel vision. This had to be dealt with now, and I was going to fix it. I proceeded to buy, not one, but two dual-fire and CO2 detectors, just in case one had shipping delays.  I messaged my dog-sitter, who was not nearly as concerned as I was, to keep an eye out for the deliveries and to install them asap.

The Red Herring

Then I got to Virginia and essentially forgot all about it.  Worrying about the fire alarms wasn’t my real issue. My mind was grabbing on to something, anything, that could give me any semblance of control.  My mind wanted to protect me from how out of control I felt, coping with my father’s illness and the fact that he was having another surgery when he should have been out of the ICU and home weeks ago. Was becoming obsessed with fire alarms particularly helpful? No. Did it exacerbate my suffering and make me feel worse? Yes. Does this happen to folx all the time? Also, yes.

Anxiety Red Herrings

I call these situations Red Herrings.  The things that distract us from what is at the core.  These red herrings can suck all our focus and energy. They can spiral our anxiety out of control.  They are often disproportionate or unrelated to the underlying situation driving our suffering.  They can often make us feel worse. And they are often based on some degree of reality and necessity. This makes them very difficult to see, assess, and modify objectively and effectively.

How do we catch them?

As clinicians, it can be our job to help detect the presence of a red herring and bring our client back to the more vulnerable events and emotions they are seeking to distract from. This can be a challenging process.

How do we know it’s actually a red herring and not a significant issue warranting attention? The clues are typically in the intensity and duration of the fixation, with an emphasis on problem-solving. And your Spidey-sense is telling you there is more to the story. For that, you need to call upon your conceptualization. Is there something else going on in your client’s life that may be having any underlying impact? Or that you have seen them wanting to avoid or minimize? Does their reaction to the proposed red herring topic fit with their usual presentation? If the client has generalized anxiety and/or trauma, particularly that manifests through overcontrolled tendencies, the answer to this may be yes. This is just another Tuesday. And that doesn’t also mean a red herring might be present.

Common Triggers

For example, the combat Veteran who is furious when he can’t find the television remote. It isn’t really about the remote. It’s muscle memory of needing to know where personal items, especially a firearm, are at all times. A minute lost looking could mean life or death. Maybe it did mean life or death. The remote is the red herring; the “real” issue is the challenge of adjusting post-deployment. It is the fear that one wrong move and something catastrophic will happen, and it will be your fault.

Another common trigger for red herrings is grief. Tolerating the pain of loss, particularly in our society that is generally uncomfortable with death and the grieving process, we often grab on to whatever we can to distract, even if it causes us more pain, like feeling guilty about, well, anything. It paradoxically feels “better” to be torn up by guilt than to sit in the sadness of our grief (I speak from experience). Guilt gives us a false sense of control and something to do, even if it’s just beating ourselves up. Meanwhile, the sadness and the pain of loss just is.

How do we challenge them?

How do we guide the client away from the red herring and to the core issue? Your first attempt at redirection may not go very well. You may get a “no, I’m fine with X, it’s not bothering me at all.” Or they may respond adamantly that the presenting problem is what needs to be addressed, right now. This is where our clinical skills of validation, curiosity, the “Columbo technique,” checking-the-facts, and more come in. We can gently guide our client to take a step back from the red herring, expand their tunnel vision (to use mixed metaphors), and see what else might be going on. We can also provide a conceptualization: “I wonder if you are focusing on X because it feels safer and more accessible than Y?”

Sometimes, we may need to leave it alone. The client might not be ready to face “Y” head-on and needs their red herring for a while. That’s ok too. We can support them in problem-solving and coping with the here and now issue while holding awareness of the bigger picture. We do this all the time in therapy. It’s the art, more then the science, of mental health care. When do we push, and direct, and confront? When do we hold back, build skills, and get there in due time?

Our Own Red Herrings

In the context of the ongoing volatility and fear of our political climate, you may be experiencing some red herrings of your own. Have you found yourself getting overly fixated on making sure the gardening is done just right? Or becoming paralyzed by “simple” decisions, like what to make for dinner? If so, this is a natural response. Again, red herrings are about creating a sense of control in uncontrollable situations. Be gentle with yourself. Soothe and ground by checking in. Consider if this is really about the garden or about dinner, or if you are feeling overwhelmed by the state of the nation.

For Clinicians: I hope this gives you a new metaphor for working with the subtitles of cognitive and emotional avoidance. I hope it gives you some new insights for being able to catch and work with red herrings. Do you have red herrings of your own? Are they showing up in your work at all? How can you be gentler with yourself and seek the support you need and deserve?

For Those Seeking Healing: Is there something you might be getting fixated on as a way to avoid deeper, more complex feelings or a situation you cannot change? How can you be gentler with yourself and seek the support you need and deserve?