Speaker 1: Hello everybody, and welcome back to the Psychology of Your Twenties,
Speaker 1: the podcast where we talk through some of the big
Speaker 1: life changes and transitions of our twenties and what they
Speaker 1: mean for our psychology.
Speaker 2: Hello everybody, Welcome back to the show. Welcome back to
Speaker 2: the podcast. New listeners, old listeners. Wherever you are in
Speaker 2: the world, it is so great to have you here,
Speaker 2: back for another episode today. I think I am possibly
Speaker 2: the most excited for this guest of all of our
Speaker 2: guests this season, because, as you know, we love an
Speaker 2: evidence based background, we love an informed guest, we love
Speaker 2: an actual scientific opinion in this space, and I think
Speaker 2: this person does all of those things. So we have
Speaker 2: doctor David Rosmarin, who is a associate professor at Harvard
Speaker 2: Medical School and the founder of the Center for Anxiety,
Speaker 2: which provides is it services to a thousand patients a year.
Speaker 2: I think so he is incredible. He works a lot
Speaker 2: in obviously mental health, and a lot around anxiety, and
Speaker 2: he's also been featured in a number of amazing journals
Speaker 2: that we use on this podcast all the time. He's
Speaker 2: here today to talk about people's anxiety, their experience of anxiety,
Speaker 2: particularly in their twenties. So welcome.
Speaker 3: Thanks so much for having me on your show. It's
Speaker 3: a great honor and pleasure to be here.
Speaker 2: Yeah, I'm really really excited. Actually, I'm super pumped because
Speaker 2: I feel like maybe we should start firstly with letting
Speaker 2: you introduce yourself before I jump straight into my line
Speaker 2: of questioning, Maybe talk about your journey to where you
Speaker 2: are now, why you took an interest in this particular
Speaker 2: area of research, this particular field as well.
Speaker 3: Sure well, I myself have definitely struggled with a deal
Speaker 3: of a good deal of anxiety over the years. And
Speaker 3: learning to deal with that, especially as somebody who helps
Speaker 3: others and who does research in this topic and who
Speaker 3: now you know, my clinics, like you mentioned, we're servicing
Speaker 3: over a thousand people every year, has been so positive.
Speaker 3: It's been such a blessing for me to be able
Speaker 3: to have these challenging experiences. I'm not going to say
Speaker 3: that anxiety is fun. It is not. Nobody likes it.
Speaker 3: It's so uncomfortable. It's the kind of thing that we
Speaker 3: want to get rid of. But the times in my
Speaker 3: life when I've had that have made me so able
Speaker 3: to connect with my patients and in some ways more resilient.
Speaker 3: And I actually think today that anxiety can be a
Speaker 3: great catalyst for growth and for thriving if we use
Speaker 3: the right tools and approaches in order to get there.
Speaker 2: Yeah, I love that. I think often people talk about
Speaker 2: these things without having a personal experience with them, which
Speaker 2: can be so frustrating. But I do think that that
Speaker 2: shared vulnerability, that shared experience is a bit of a
Speaker 2: unify a bit of a superpower.
Speaker 3: You know, I appreciate that. Now, let me ask you
Speaker 3: a question. Have you ever met anybody who didn't have
Speaker 3: anxiety before?
Speaker 2: It's so funny that you asked me this, because I
Speaker 2: think I've met a couple and one of them is
Speaker 2: actually my partner, and he I'm gonna I'm gonna share
Speaker 2: all here. He's got a pretty stressful job. He's a solicitor,
Speaker 2: he's a lawyer, and I've never seen that man anxious.
Speaker 2: He'll be up till two am, never, And I think
Speaker 2: it's thinking in yang, right, But in general, I know
Speaker 2: you are you were expecting a different answer.
Speaker 3: It's very few of them, far between the individuals who
Speaker 3: have never had anxiety before. And I think one of
Speaker 3: the biggest issues and one of the reasons anxiety gets
Speaker 3: out of control is that often we judge ourselves and
Speaker 3: we get very upset and when we start to feel anxious,
Speaker 3: as opposed to realizing that this is a very human emotion.
Speaker 3: This is the kind of thing that's gonna happen to
Speaker 3: the vast majority of people except for your partner and everyone,
Speaker 3: almost everyone. At some point. It's going to butt up
Speaker 3: against these feelings, these sensations, and they're uncomfortable. We want
Speaker 3: to get rid of it, but you know, learning to
Speaker 3: grapple with it and to parlay that into positive ways
Speaker 3: in our life is really the name of the game,
Speaker 3: as opposed to trying to squelch it and combat it.
Speaker 2: I think that really personally relates to me as well.
Speaker 2: The times I've been most anxious is when I've been
Speaker 2: asking myself to be least anxious, when I've really been
Speaker 2: suppressing that feeling because it you know, it wasn't comfortable,
Speaker 2: it wasn't it wasn't necessary. At the time, I felt
Speaker 2: like it was interrupting other things in my life. But
Speaker 2: I do kind of want to just quickly start at
Speaker 2: the basics, because I feel like when it comes to anxiety,
Speaker 2: there is somewhat a bit of misinformation around there sometimes people,
Speaker 2: you know, I think people love to self diagnose, people
Speaker 2: love to throw terms around, like I'm just so you know,
Speaker 2: I've just got such bad anxiety, I've got such bad OCD,
Speaker 2: I've got such bad social anxiety, social phobia, whatever. Maybe
Speaker 2: so can we just quickly strip back to the basics
Speaker 2: what exactly is not just anxiety, but some of the
Speaker 2: distinctions within the broader anxiety space, you know, perhaps between
Speaker 2: a panic disorder, social anxiety, generalized anxiety. Not everyone obviously
Speaker 2: experiences it the same way.
Speaker 3: Absolutely, Yeah, if you strip it down when you want
Speaker 3: to define anxiety, you really have to start with fear. Now.
Speaker 3: Fear is a healthy emotion that everybody, almost everyone is
Speaker 3: programmed with, which involves adrenaline. Adrenaline gets pumped into your
Speaker 3: bloodstream the minute you perceive a threat, and the fear response,
Speaker 3: otherwise known as the fight or flight response, is a
Speaker 3: healthy adaptation which helps you to survive. So you'll either
Speaker 3: flee or fight or freeze if you're in a certain situation,
Speaker 3: and you're more likely to survive those situations. Babies neonates
Speaker 3: who do not have a fight or flight response are
Speaker 3: usually they usually don't survive. They usually will not survive
Speaker 3: be on thirty days. It's a neuro it's a neurot
Speaker 3: it's a neurological problem. In fact, if people don't have that, now,
Speaker 3: what's anxiety. Anxiety is the exact same thing. It shares
Speaker 3: the same brain circuitry, it shares the same neurobiology as fear. However,
Speaker 3: there's one key difference. It's a false alarm. So fear
Speaker 3: would be a real alarm, like oh no, I really
Speaker 3: have to get out of the way of this bus
Speaker 3: which is careening towards me down a city street, and
Speaker 3: anxiety would be I'm in this social situation and I
Speaker 3: feel afraid. My fear response is going off, but it's unnecessary.
Speaker 3: Now I want to clarify in other words, In other words,
Speaker 3: like I said, it's a false alarm, So I want
Speaker 3: to clarify. You are going to have false alarms. You're
Speaker 3: going to have them sometimes. If you know, sometimes in
Speaker 3: your kitchen or wherever it is you're going to have
Speaker 3: you know, your your smoke alarm is going to go off,
Speaker 3: and that's good. That actually indicates that the batteries are working,
Speaker 3: the circuitry is working, and you have the protective factor
Speaker 3: in there, the protective mechanism in place that if there
Speaker 3: were a fire, it would wake you up and it
Speaker 3: would save your life. That's much better than what's deadly
Speaker 3: with the smoke alarms is batteries, when the batteries die
Speaker 3: or when you don't have it. Yeah, so anxiety just
Speaker 3: shows you that it's actually working, but it's a misfire
Speaker 3: of the fear system.
Speaker 2: Can I ask you a question, because there's it was
Speaker 2: just kind of going back a little bit, but it's
Speaker 2: something that people ask me about all the time. To
Speaker 2: its obviously fight flight and freeze response, parasymnthetic and the
Speaker 2: automatic nervous system, No, parasympathetic and the sympathetic. What about
Speaker 2: the foreign response? Have you spoken? Do you know much
Speaker 2: about this new edition?
Speaker 3: Well, the newest edition has really been freeze. You know
Speaker 3: that that has historically been ignored. In the last several
Speaker 3: years in the scientific literature, that's been brought up, especially
Speaker 3: in the context of sexual assault. There was some recently
Speaker 3: some New York Times pieces about that, and a couple
Speaker 3: of high level scientific pieces about you know, about people
Speaker 3: freezing during during sexual assault as being a part of
Speaker 3: the feared response. I don't know about form. What can
Speaker 3: you tell me about it?
Speaker 2: Yeah, well, it's interesting that you don't know about it,
Speaker 2: because now I'm thinking that perhaps I'm not getting it
Speaker 2: from the best sources. But the faun response is basically
Speaker 2: mainly to do with I think social anxiety, where you
Speaker 2: feel obviously that false alarm that someone perhaps is going
Speaker 2: to reject you, someone doesn't like you, someone is going
Speaker 2: to do you harm in a social capacity, and instead
Speaker 2: of running away, instead of obviously fighting the person, both
Speaker 2: of which would be socially inappropriate, freezing might actually hurt
Speaker 2: your case more. You faughn, so you overly compliment them.
Speaker 2: You kind of make yourself seem quite subservient and like
Speaker 2: they are in control. So it's interesting that perhaps this
Speaker 2: isn't coming up as much in your space because maybe
Speaker 2: it's I don't know. The freeze response I understand. The
Speaker 2: faun one is one that I think I don't understand
Speaker 2: as well, because it doesn't seem as natural to me
Speaker 2: as part of a fear response. It feels more like
Speaker 2: an intentional behavior rather than an automatic behavior.
Speaker 3: I'll tell you what I think is really going on there.
Speaker 3: In some ways, the person that you know fight the
Speaker 3: fight responses when you're doing something in order to ward
Speaker 3: off anxiety. The flight responses when you're running away and
Speaker 3: you're escaping. So it actually in some ways is under
Speaker 3: the category of the fight response. I understand it's not
Speaker 3: fighting because you're not fighting against the person, but really
Speaker 3: it's in the category of are you doing something positive
Speaker 3: in order to tamp down your anxiety and to deal
Speaker 3: with it, or are you withdrawing from a situation, which
Speaker 3: would either be in the form of freezing and it's
Speaker 3: extreme force form or in the form of fleeing or withdrawal.
Speaker 3: So form is a socially appropriate way of trying to
Speaker 3: engage people, And yeah, that could definitely be mediated. Social
Speaker 3: anxiety is one context, one way in which anxiety manifests,
Speaker 3: perhaps particularly for young people, even.
Speaker 2: Matter I honestly, I think that is the case. I
Speaker 2: think generalized anxiety disorder and social anxiety social anxiety something
Speaker 2: I get questions about all the time, but something else
Speaker 2: I want to speak about, because like, one thing you
Speaker 2: talk about is how and you spoke about this in
Speaker 2: your Washington Post Washington Journal article, Well Street Jennal article. Yeah,
Speaker 2: and it was super fascinating. It's how perhaps our experience
Speaker 2: of anxiety has changed in recent decades, but also the
Speaker 2: approach to diagnosing anxiety has also changed. You know, Previously, obviously,
Speaker 2: in decades long gone, we really only had like kind
Speaker 2: of the broader term of like neuroses, and people would experience,
Speaker 2: you know, a great deal of stigma and discrimination. There
Speaker 2: wasn't really a system for dealing with this pattern of symptoms,
Speaker 2: this pattern of behaviors, this pattern of tendencies. Nowadays we
Speaker 2: have that cybeway so much more accepting, we're so much
Speaker 2: more aware of what this is. But what has that changed?
Speaker 2: Has it had any consequences now that perhaps the bar
Speaker 2: has been lowered, the threshold is lower.
Speaker 3: Yeah, I believe there have been some unintended consequences of
Speaker 3: our greater literacy of mental health. And I think on
Speaker 3: the one hand, it's been a great thing, like as
Speaker 3: you say, you know, we have more technologies today, we
Speaker 3: have more solutions. On the other hand, there is an
Speaker 3: insidious message that your generation has that had I grown
Speaker 3: up with this, I would have had crippling anxiety. And
Speaker 3: that message is that you need to feel good all
Speaker 3: the time, you need to look good all the time,
Speaker 3: you need to be high achieving, you need to be
Speaker 3: hidden to the nines. You know everything's got to be perfect,
Speaker 3: and that is just not going to happen. It's if
Speaker 3: you're expecting perfect equanimity and perfect happiness, you know you're
Speaker 3: going to be disappointed. And then the minute you start
Speaker 3: to feel anxious, then you're judging yourself, You're nervous that
Speaker 3: something's wrong, you're comparing yourself to everybody else, and then
Speaker 3: you're just going down the tubes. It actually literally releases
Speaker 3: more adrenaline when you perceive anxiety as a threat, which
Speaker 3: from a biophysical standpoint, increases your anxiety. I think this
Speaker 3: is the core of the anxiety epidemic today, is that
Speaker 3: we have bought in and sold We have sold this message,
Speaker 3: especially to younger generations, that you need to feel good
Speaker 3: all the time. It's a lie. It's just not going
Speaker 3: to happen. And the more we can accept that distress
Speaker 3: is part of life, the better we're, the more resilient
Speaker 3: we can be, and the better position we are to
Speaker 3: be able to handle normal adversity.
Speaker 2: So I completely agree with that. I think that the
Speaker 2: pressure to be exceptional is significant, is something that every
Speaker 2: single person in this generation would tell you about. So
Speaker 2: do you think that is specifically cultural or social or
Speaker 2: that other factors The one that I always think of,
Speaker 2: and perhaps it does play into a certain environmental environmental
Speaker 2: causes the rise of social media and certain technologies which
Speaker 2: have made it so much easier to compay yourself to others,
Speaker 2: so much easier to say everything that's absolutely terrible in
Speaker 2: the world. Do you think that has a role as well?
Speaker 3: It does? It definitely does. I think it worsens trends
Speaker 3: within countries, but if you look between countries it's different.
Speaker 3: Like levels of anxiety in Europe are substantially better than
Speaker 3: they are in the United States, and in Middle Eastern
Speaker 3: countries it's even better. And even in India, where it's
Speaker 3: very common for people to use social media, people's anxiety
Speaker 3: is not quite as bad. And the reason why is
Speaker 3: because in many cultures. I don't know about Australia, unfortunately,
Speaker 3: I don't know very much about it, but I know
Speaker 3: in the United States social media is used to replace
Speaker 3: in person social engagement. That's usually not in Mediterranean countries,
Speaker 3: it is not usually like that. In the Far East, uh,
Speaker 3: it's not as much. There's still social engagements which occur,
Speaker 3: and those are complicated. You have to get in a subway.
Speaker 3: You have to, you know, deal with somebody, I don't know,
Speaker 3: they have bad breath. You have to, you know, see
Speaker 3: somebody at that party who you don't like. You have to,
Speaker 3: you know. It's more, you can't just shut off the conversation.
Speaker 3: And if you don't look good, you're still there, Like
Speaker 3: if someone spills copy on you, like you're you're at
Speaker 3: the party, like you're you're we have to deal with
Speaker 3: those you're there. You can't just shut it off or
Speaker 3: like you know, go to your cupboard and then change
Speaker 3: and then come back on with the pixelated image. So
Speaker 3: all of those are great for building resilience and something
Speaker 3: that at least in the United States, we are not
Speaker 3: doing very well. Hm.
Speaker 2: That's really interesting because I think that it's massive in Australia.
Speaker 2: I literally just finished a project for Manibank called We
Speaker 2: Are Learnedly, and it talks about how social media has
Speaker 2: reduced that sense of connection. But the other thing that
Speaker 2: I find this is like a personal that I have
Speaker 2: all the time, is our society is kind of moving
Speaker 2: towards a place where we don't have community anymore. You know,
Speaker 2: previously we used to a lot of you know groups
Speaker 2: were quite religious. You know, used to go to Sunday
Speaker 2: church or you know, used to be able to pop
Speaker 2: over to your friend's house, and now that's kind of
Speaker 2: replaced with being able to have those interactions online. And
Speaker 2: so I really kind of agree with what you're saying
Speaker 2: in the sense that you no longer get that exposure
Speaker 2: to perhaps the everyday stresses that you can engage with
Speaker 2: in media.
Speaker 3: Is that kind of relationships are messy, you know, they're
Speaker 3: all messy. And the people who you love the most
Speaker 3: and you feel connecting with the most, and the people
Speaker 3: who you're going to feel the most elated with and
Speaker 3: the most excited with are also probably the people who
Speaker 3: are going to drive you the most insane. That's usually
Speaker 3: where it goes.
Speaker 2: Yeah, I think people need that reminder coming up to Christmas. Honestly,
Speaker 2: that's incredibly contextually relevant now.
Speaker 3: Of course, like if we're talking about trauma, and if
Speaker 3: we're talking about you know, a dangerous situations and you know,
Speaker 3: people who are sociopaths, like I have no tolerance for that,
Speaker 3: and you know, I'm not saying that we should subject
Speaker 3: ourselves to actual danger, but you know, the people who
Speaker 3: I know who are most connected with others also put
Speaker 3: up with a lot of garbage, and I see I
Speaker 3: see that as a strength. I see that as a
Speaker 3: strength and one that we don't really talk about very much.
Speaker 2: I also think it's this interesting thing where it's like
Speaker 2: you can still interact with those people with boundaries, like,
Speaker 2: you know, not completely withdraw. I think this is a
Speaker 2: completely different topic we're getting onto. I'm just trying to
Speaker 2: pick your brain for all of it, but.
Speaker 3: I want to, well, it's related to anxiety because when
Speaker 3: we are dealing with people, you know, those people who
Speaker 3: need those boundaries, there's that sense of inside of us,
Speaker 3: like should I put up a boundary? Do I just
Speaker 3: walk away? Do I tell them off? Like? And that
Speaker 3: creates a lot of anxiety. Do we actually face that
Speaker 3: anxiety and deal with the issue or do we just
Speaker 3: walk away? And I think are narcos culture when we
Speaker 3: are trying to cultivate our emotional experience on a minute
Speaker 3: by minute basis. The minute I started to feel anxious,
Speaker 3: I'm like, I'm not dealing with this. I don't think
Speaker 3: that's healthy. I don't think that's the way we're meant
Speaker 3: to be learning to have boundaries put and to enforce
Speaker 3: those boundaries continuously is a great, great skull. It's not easy,
Speaker 3: but it's an important skull that I don't think we
Speaker 3: practice enough.
Speaker 2: I think it's also this trend of conflict aversion as well,
Speaker 2: like wanting to avoid all kinds of conflict. I've seen
Speaker 2: that in my own life, perhaps that people pleasing tendency
Speaker 2: as well, which I think our generation has a lot
Speaker 2: more of not to offend.
Speaker 3: I think there is a lot more people pleasing in
Speaker 3: for people, for folks in their twenties than there was
Speaker 3: when I was when I was twenty.
Speaker 2: Yeah. Absolutely, But I want to ask you this question
Speaker 2: because this is the thing I think kind of the
Speaker 2: main part of the sandwich here that I'm super fascinated by,
Speaker 2: which is, how do you think that our approach to
Speaker 2: treating anxiety has changed? And I'm going to say, my
Speaker 2: fascination with this, you know, with this philosophy that you
Speaker 2: have with perhaps your opinion on this is quite selfish
Speaker 2: of me, comes from my personal place. It's, you know,
Speaker 2: the over medicalization of anxiety. Now, I was diagnosed with
Speaker 2: anxiety when I was quite young. It's been a constant
Speaker 2: in my life. As it sounds like it has been
Speaker 2: in yours, And when I was on nineteen, I went
Speaker 2: on Lexipro, which is kind of a dual anxiety depressure medication.
Speaker 2: Was also like very quickly prescribed Valiant, which I no
Speaker 2: longer use. And so I guess by way of my actions,
Speaker 2: I've kind of benefited from this more medical, biomedical approach.
Speaker 2: But you say that we can do things differently, and
Speaker 2: obviously this is not me asking you for personal medical
Speaker 2: advice that would be entirely inappropriate, but more in the
Speaker 2: sense of, like, what does that mean? What is this
Speaker 2: this different approach? How can we do this differently without
Speaker 2: perhaps taking a pill that sometimes people think is going
Speaker 2: to be this miracle, this one thing that is going
Speaker 2: to change that A lot great questions.
Speaker 3: First and foremost, I'm not against pharmacology in any way,
Speaker 3: and I do see I would say more than fifty
Speaker 3: percent of my patients use pharmacology, use medicine psychiatric medications,
Speaker 3: and I'm a supporter of that as long as it's
Speaker 3: taken with certain intent. Now, I don't know what you
Speaker 3: were told when you were nineteen and put on lexapro,
Speaker 3: but the fact that you were put on lexapro first,
Speaker 3: in valium second indicates that probably it was something along
Speaker 3: the lines of I'm going to take this in order
Speaker 3: to reduce my anxiety so I can manage day to
Speaker 3: day and be able to overcome it. If the lexapro,
Speaker 3: if your intent was I would need to get rid
Speaker 3: of these feelings that I cannot have them. Ever again, firstly,
Speaker 3: that doesn't work. There's no medication that will take away
Speaker 3: your anxiety because if it could, it would take away
Speaker 3: your fear response, which would actually be maladaptive. That would
Speaker 3: not be healthy for you at a neural level, at
Speaker 3: an emotional level, behaviorally, or in any other way. We
Speaker 3: need people's fear systems to be in place so that
Speaker 3: you can be protected if you need it. So we're
Speaker 3: not going to strip that down. You know, there would
Speaker 3: be catastrophic consequences if that were the case. But what
Speaker 3: can be done is to tamp it down a little
Speaker 3: bit so that a person has enough anxiety that they
Speaker 3: can tolerate. Sometimes people's anxiety gets so high that they
Speaker 3: just cannot tolerate it. They can't use it to thrive
Speaker 3: in a positive way in their lives, So we need
Speaker 3: to pharmacologically reduce it to a regular level. Now, benzodiazepines, Valuum,
Speaker 3: ad van, valuum, klonipin and the like are completely different.
Speaker 3: They work on a different brain system called GABBA. And
Speaker 3: what those do is they sort of immediately reduce your anxiety.
Speaker 3: Xanax as your classic one, right, they immediately reduce your anxiety. Now,
Speaker 3: often people are given those as a first line treatment,
Speaker 3: and I do not think that's in general, in general,
Speaker 3: I don't think that's a wise practice. I don't think
Speaker 3: that's a wise medical practice because what ends up happening
Speaker 3: is people assume the minute I feel anxious, they're taking
Speaker 3: this fast acting medication. Lexapro is slower acting over time,
Speaker 3: so it'll reduce your anxiety over a period of four
Speaker 3: to six weeks to a reasonable level, and then you
Speaker 3: can reduce it over time if you want. You can
Speaker 3: reduce your dose and then tolerate higher levels. With benzos,
Speaker 3: it's a different game, and that approach is really in
Speaker 3: some ways reinforcing the idea I shouldn't feel anxious. I
Speaker 3: don't want to ever feel anxious. I have to get
Speaker 3: rid of this anxiety or something catastrophic will happen. And
Speaker 3: all of those messages just sensitize us further often, and
Speaker 3: I've seen this in hundreds of cases where people were
Speaker 3: told by a pharmacologist, you need to take this xanax
Speaker 3: or whatever it is in order to cope with their anxiety.
Speaker 3: It will take it away, and it doesn't, and then
Speaker 3: they feel even worse about themselves. The next time their
Speaker 3: anxiety goes higher and they end up on three, four
Speaker 3: or five medications. Then you know, it can get very complicated,
Speaker 3: very quickly.
Speaker 2: I find that very personally relevant. That made a lot
Speaker 2: of sense to me. I think it's also something I realized.
Speaker 2: I used to have a really terrible fear of flying, terrible claustrophobia,
Speaker 2: and that's why I used valium. And you know what,
Speaker 2: the fear response was not there, but the level of
Speaker 2: avoidance that I had towards the activity increased like crazy,
Speaker 2: because I became more fearful of that fear response, right
Speaker 2: because I was teaching myself that it was so dangerous,
Speaker 2: that it was so scary, that I was so unable
Speaker 2: to cope, that I needed to be taking this medication
Speaker 2: at higher doses.
Speaker 3: What did you think would happened? What did you think
Speaker 3: would happen if you just let your anxiety go?
Speaker 2: Oh? I had some crazy irrational fears. That's the other
Speaker 2: part about you know, I think anxiety it's quite irrational, right,
Speaker 2: And it was you know, if I was on this
Speaker 2: plane and I wasn't taking valium, I was going to
Speaker 2: have a panic and I was going to try and
Speaker 2: rip open the doors of the plane because I was
Speaker 2: so scared. I was like, is this a possibility? Could
Speaker 2: I completely could I seriously hurt other passengers on board?
Speaker 2: Or I think worrying about embarrassing myself? And then I
Speaker 2: think I examined the fear further and I was like,
Speaker 2: and the thing I always say for people to do
Speaker 2: is is this so what so you have a panic
Speaker 2: attack on the plane, So what so I'm going to
Speaker 2: embarrass myself? So what? I think? The thing that I
Speaker 2: realized in that And you say this, and you said
Speaker 2: it before, and I love love this phrase. You have
Speaker 2: to get comfortable with being uncomfortable. How do you think
Speaker 2: we get there? Because being uncomfortable is not something that
Speaker 2: we particularly enjoy doing.
Speaker 3: Nobody likes it, but it's going to happen sometimes and
Speaker 3: we do have to get used to it. Now, the
Speaker 3: question is how much discomfort can we when we listen
Speaker 3: I feel anxious throughout. I wouldn't say on a weekly basis,
Speaker 3: certainly a couple times a month something comes up that
Speaker 3: makes me feel viscerally uncomfortable, and when my stress level
Speaker 3: is high, I'm more likely to have that. I'll tell
Speaker 3: you what I do. I'll be very hoarded by graphical here.
Speaker 3: I lean right into it. I'm feeling terrible right now?
Speaker 3: What am I upset about? And I bring it on.
Speaker 3: I think right towards it. And if I'm feeling if
Speaker 3: something makes me feel more uncomfortable, I will gravitate even
Speaker 3: more towards it. I'll talk about it in great detail
Speaker 3: with people. Get her off my chests, embrace it, let
Speaker 3: the fear wash over me. It is. It's sort of
Speaker 3: like ripping off a band aid, right, just like we're
Speaker 3: gonna do this, do it and it hurts, It really hurts.
Speaker 3: It's bad. But I'll tell you what ends up happening
Speaker 3: when you lean into it. Is this what we've talked
Speaker 3: about before, the parasympathetic system. You have wiring and you
Speaker 3: have chemicals inside of you which will calm you down. Okay,
Speaker 3: we see over a thousand patients a year in my practice.
Speaker 3: How many of them have had a panic attack that
Speaker 3: lasted more than ninety minutes. Ever, I'm sure it's zero. Zero.
Speaker 3: The number is zero. And my colleagues who have similarly
Speaker 3: sized clinic treating tens of thousands of patients on an
Speaker 3: annual basis for decades, I have spoken with them and
Speaker 3: a number of patients who have had a panic attack
Speaker 3: more than ninety minutes. Ever, I'm gonna go from the
Speaker 3: zero having the number of people who have crashed their
Speaker 3: car during a panic attack. It doesn't happen. The number
Speaker 3: of people who've gotten up in the middle of a
Speaker 3: plane and started running around and stabbing people with the
Speaker 3: plastic fork.
Speaker 2: Listen, I'm gonna say maybe at least one. I'm seeing
Speaker 2: some weird power videos, but it probably is theero.
Speaker 3: Well, there was that one time. No, I'm kidding. The
Speaker 3: answer is zero. People don't do that. When you're anxious,
Speaker 3: you're actually more in control of yourself. You're dealing with
Speaker 3: your own emotions. You're not and often you can't even tell.
Speaker 3: Like people say, everyone can see I'm anxious. No, they're
Speaker 3: looking at themselves. They're not looking at you.
Speaker 2: What is it called the spotlight effect? Everything that we
Speaker 2: do seems to be like super stuper obvious to other people,
Speaker 2: but we're all now kind of own internal lives and
Speaker 2: internal minds. That's really interesting. I think that that's a
Speaker 2: really important reminder to people who experience kind of the
Speaker 2: shame cycle of like this is super embarrassing. The one
Speaker 2: thing I do, and I is really similar to you,
Speaker 2: is like I tell myself I'm excited by the feeling,
Speaker 2: because I think anxiety and excitement feel very, very similar.
Speaker 2: So I'm like, this is the most exciting feeling ever.
Speaker 3: It's actually the same chemical. It's adrenaline, you know, adeneraline
Speaker 3: happy different? Those are those Those are the chemicals that
Speaker 3: are that are secreted when we're excited and when we're anxious.
Speaker 2: Yeah, so you can just tell yourself that it's something different.
Speaker 2: So anxiety is obviously incredibly limiting at times, can feel
Speaker 2: someone like a life sentence. But what I really really
Speaker 2: love about your work is that it kind of offers
Speaker 2: this more positive alternative to this perspective, you know, seeing
Speaker 2: anxiety not so much as a superswer, you know, per se,
Speaker 2: but kind of you say this as your own personal
Speaker 2: confidts to kind of learn your limits. So can you
Speaker 2: expand on that a little bit, what is anxiety useful for?
Speaker 2: How can we listen to anxiety as a way to
Speaker 2: kind of teach us more, not just about our environment,
Speaker 2: but also about ourselves.
Speaker 3: Yeah, that's a good question. I think for people in
Speaker 3: their twenties especially. I want to go back to the
Speaker 3: conversation about loneliness and the people I know, The patients
Speaker 3: I know who have had anxiety have the ability, I
Speaker 3: would call it a superpower to understand and to probe
Speaker 3: and to respond to the emotions of other people much
Speaker 3: better than people who don't. Who aren't I would say
Speaker 3: blessed with anxiety, especially social anxiety. You know, people who
Speaker 3: are accessionsly shy, excessively socially anxious can pick up on
Speaker 3: incredible cues like facial changes in the facial expression, or
Speaker 3: changes in voice intonation or in rate of speech. In
Speaker 3: people's body language. The specific words that they that they
Speaker 3: pick up on are much more nuanced, and that can
Speaker 3: enhance our connection with others. Now, they might have a
Speaker 3: smaller group of friends, they might not be life of
Speaker 3: the party and have five hundred or one hundred people
Speaker 3: or whatever it is, but those intimate connections. If we
Speaker 3: use our anxiety to understand the emotional experience of others,
Speaker 3: it can make us into a much better friend. And
Speaker 3: more importantly, let me ask you a question. Are you
Speaker 3: closer with people who you divulge intimate emotional details of
Speaker 3: your life to.
Speaker 2: Yeah, absolutely, I think, yeah, I think. But also on
Speaker 2: a selective level, I think when you do that excessively
Speaker 2: sometimes it actually puts the relationship a risk.
Speaker 3: That's a fair point. That's a fair point. But when
Speaker 3: we have one or two friends who we can really
Speaker 3: cry on their shoulder and open up to them and say, hey,
Speaker 3: I'm having a hard time, like I really need your love,
Speaker 3: your support, your hug right now. Like when we can
Speaker 3: be vulnerable in those relationships, that's it's so critical. It's
Speaker 3: such a critical human need to be able to express
Speaker 3: our vulnerabilities and anxiety. I think is one of the
Speaker 3: things that gets us there. When we're feeling anxious and
Speaker 3: we reach out and get the love and support we need,
Speaker 3: those can be the best relationships that we'll ever have.
Speaker 2: I agree, one hundred percent. Agree. It's interesting because we
Speaker 2: talk about friends, but perhaps you know, divulge even more
Speaker 2: about myself on this episode. You've made me open up.
Speaker 2: You know, the relationship that I actually see that is
Speaker 2: benefited from that. The most is the relationship with my dad,
Speaker 2: because my dad has I think, yeah, has really has
Speaker 2: long struggled with anxiety, and I think I didn't realize
Speaker 2: that as a kid, and now I've realized, I've realized
Speaker 2: it more, you know, when I was a teenager, now
Speaker 2: into my twenties where I'm like, ah, this is a
Speaker 2: shared experience, and I can tell when my dad is
Speaker 2: more ready to open up to me in a way
Speaker 2: that I think a lot of Australian men really aren't
Speaker 2: because of the cultural milieu here, Like you know, it's
Speaker 2: the sun burnt country. You're meant to just go out
Speaker 2: and make a fair go for yourself and work really
Speaker 2: hard for your family, and it's you know, got that
Speaker 2: whole like convict mentality. That's how we were colonized. Obviously
Speaker 2: a history lesson for everyone. But I think the thing,
Speaker 2: like the times that I've understood him the best is
Speaker 2: when we've been able to bond over that experience and
Speaker 2: also he's you know, he's been able to open up
Speaker 2: to me and been like this is you know, I'm
Speaker 2: having this this anxious feeling and let's connect on that
Speaker 2: and get through it together. So I do think it's
Speaker 2: definitely helped my relationship with my dad, and there's probably
Speaker 2: not a relationship he had with his father at all,
Speaker 2: And the same I could probably say about my mom
Speaker 2: and now my sisters as well. So I actually think
Speaker 2: that's really fascinating that point.
Speaker 3: So you're telling me that the fact that you experienced anxiety,
Speaker 3: you were able to recognize it in your father get
Speaker 3: him to open up about it, despite cultural facts to
Speaker 3: the contrary, and that has enhanced your bond and your relationship.
Speaker 2: I'm giving myself too much credit. I think that he
Speaker 2: was doing his own work. Yeah, I think that there
Speaker 2: was like a moment. I also think it was necessity.
Speaker 2: It was there was it was by necessity whereby you know,
Speaker 2: he's a parent. I'm not a parent. But I'm sure
Speaker 2: that when he was seeing me experience that pattern of symptoms,
Speaker 2: he was like recognized himself in that, and I don't
Speaker 2: know it, probably really wanted to comfort me and then
Speaker 2: really share like I've been through the same thing. Maybe
Speaker 2: he didn't have a word for it. He came with
Speaker 2: me in my sessions. You know, it's like that whole process.
Speaker 3: But that's exactly what Thriving with anxiety is about you
Speaker 3: and him have used anxiety to connect with each other,
Speaker 3: and that's what it's here for. I mean, it's not
Speaker 3: have you. You know, if you only medicated it away
Speaker 3: without also engaging therapy and also engaging with your father
Speaker 3: about it, it would have been a tremendous opportunity missed. And
Speaker 3: I think many times that's what happens, and people are
Speaker 3: just left more alone, more anxious, more upset about the
Speaker 3: fact that they're anxious. And I'm seeing a lot of
Speaker 3: pain and a lot of isolation and a lot of
Speaker 3: just loneliness in our world because of we don't realize
Speaker 3: that anxiety is so normal and something that we can
Speaker 3: use for positive if we use the right techniques.
Speaker 2: So that kind of leads me to my last question.
Speaker 2: You have a book coming out tomorrow. By the time
Speaker 2: people are listening to this, you will be able to
Speaker 2: get your hands on it. I have my hands on
Speaker 2: this book, but if not, I would be buying an
Speaker 2: extra copy. I think it's going to be a Christmas
Speaker 2: present for a few of my close family and friends,
Speaker 2: maybe my dad, that you talk about these nine tools
Speaker 2: to make anxiety work for you, not to give everyone
Speaker 2: a sneak peek, but can you maybe discuss maybe some
Speaker 2: of the most relevant ones you think would apply to
Speaker 2: people specifically in their twenties, for who anxiety is definitely
Speaker 2: in everyday reality.
Speaker 3: The most relevant piece of information in the book is
Speaker 3: that our cultural tendency to try to squelch and get
Speaker 3: rid of our anxiety is not it's not helpful. It
Speaker 3: is a not going to happen. You will never get
Speaker 3: rid of all your anxiety. B. The more you try
Speaker 3: to get rid of your anxiety, the worst it comes back.
Speaker 3: You know, anybody who's done cognitive behavior therapy knows this
Speaker 3: one that if you don't accept it, and if you
Speaker 3: don't you know, to let yourself feel it, then it's
Speaker 3: just going to make it worse. But see, most importantly,
Speaker 3: anxiety can teach you a lot about your own thoughts,
Speaker 3: about your own feelings. It can allow you to have
Speaker 3: more resilience that when you feel uncomfortable, it's not that
Speaker 3: anything else is. It's not that everything is going wrong,
Speaker 3: it's not that there's something that catastrophize about. That's called
Speaker 3: having a human tapestry, a rich tapestry of human emotion.
Speaker 3: And like we spoke about with you and your dad.
Speaker 3: You can parlay that into our relationships, perhaps the most
Speaker 3: important for your generation. You know a lot of people
Speaker 3: are very ambitious today. If you're going to pursue your dreams,
Speaker 3: you are going to hit stress, You are going to
Speaker 3: hit struggles, you are going to feel anxious. And the
Speaker 3: more we can learn to experience and let allow ourselves
Speaker 3: to experience anxiety, the better positions we are to truly
Speaker 3: accomplish our unique goals and dreams in this world. So
Speaker 3: that's kind of a summary of the book. And I
Speaker 3: don't know what was that ten sentences or.
Speaker 2: So, I think so pep talk. I didn't know I
Speaker 2: needed it. Feels like that was that was hand selected
Speaker 2: for me. Oh, I want to say thank you so
Speaker 2: much for coming on. One final question, what do you
Speaker 2: think is the current biggest misconception about anxiety in this generation?
Speaker 3: I believe we have construed anxiety as a disease, as
Speaker 3: a malady, And yes, of course it can get disordered
Speaker 3: in certain cases and excessive to the point that it
Speaker 3: becomes debilitating. But one of the primary reasons why we're
Speaker 3: doing that is because we don't embrace it. We don't
Speaker 3: understand that this is part and parcel of our humanity.
Speaker 3: We are limited, finite creatures in a very complex world.
Speaker 3: And if we're going to feel overwhelmed and stressed and
Speaker 3: anxious at times, well, guess what that means. You're a human.
Speaker 3: We don't have that perspective. And when we start to
Speaker 3: accept and understand this is part of life, we can
Speaker 3: use it. I think we can use it for good.
Speaker 3: I really do think we can use it for good.
Speaker 2: I'm hoping that everyone is listening loud and clear to that.
Speaker 2: I think I agree with that. I want to say
Speaker 2: thank you so much for coming on, and I'm super
Speaker 2: excited about your book. I want to really plug it
Speaker 2: to the listeners here. If you have an interest, it
Speaker 2: looks amazing. I think that if you love this podcast
Speaker 2: it's evidence based, you're going to love this book as well.
Speaker 2: So thank you so much, doctor Resmond for coming on
Speaker 2: the show and for joining us with this conversation.
Speaker 3: Thanks for having me. What an honor and a pleasure
Speaker 3: to meet you.
Speaker 2: Absolutely anytime. Thank you so much for listening to today's episode.
Speaker 2: If you enjoyed this episode, please feel free to leave
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Speaker 2: be back next week for another episode.