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Thriving with Anxiety · Life and How to Live It with Dr Rocco

0:00
SPEAKER_02: Do you sometimes feel like life is passing you bad?
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SPEAKER_02: How would you like to get more out of life?
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SPEAKER_02: We explore all things life in this podcast.
0:09
SPEAKER_02: Welcome to the Life and How to Live It podcast with Dr.
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SPEAKER_02: Ruff.
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SPEAKER_01: Live it.
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SPEAKER_01: Oh yeah.
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SPEAKER_02: Welcome to another episode of the Life and How to Live It podcast with me, Dr.
0:34
SPEAKER_02: Rocco.
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SPEAKER_02: In today's episode, we will be talking about anxiety.
0:39
SPEAKER_02: Anxiety is a hot topic these days, as it should be, since we are experiencing an epidemic of anxiety in our country.
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SPEAKER_02: A few months ago, I was at a conference and I saw a speaker with a unique and interesting approach to anxiety.
0:55
SPEAKER_02: That speaker is today's guest, David H.
0:58
SPEAKER_02: Rossmarin, PhD.
1:00
SPEAKER_02: I bought his book, Thriving with Anxiety, and read it, and found his ideas and approach to be insightful and they just made sense to me.
1:09
SPEAKER_02: So I reached out to him and he's gracious enough to join us today.
1:14
SPEAKER_02: Before I introduce him though, I want to say that what we talk about in this episode today is not meant to be medical advice.
1:24
SPEAKER_02: It is not meant to replace the care of your personal physician, psychiatrist, or therapist.
1:30
SPEAKER_02: David H.
1:31
SPEAKER_02: Rossmarin, PhD, is an associate professor of psychology at Harvard Medical School, a program director at McLean Hospital, and founder of Center for Anxiety, which services over 1,000 patients per year in multiple states.
1:48
SPEAKER_02: Dr.
1:49
SPEAKER_02: Rossmarin is an international expert on spirituality and mental health, whose work has been featured in Scientific American, the Boston Globe, The Wall Street Journal, and The New York Times.
2:02
SPEAKER_02: Dr.
2:02
SPEAKER_02: Rossmarin, welcome to the show.
2:04
SPEAKER_00: Thanks so much for having me.
2:06
SPEAKER_00: You're making me anxious already, but in the best way.
2:10
SPEAKER_02: Well, thank you for agreeing to join me today on the Life and How to Live It podcast to talk about this really important issue.
2:18
SPEAKER_02: So, how big a problem is anxiety?
2:21
SPEAKER_02: What do the statistics say?
2:23
SPEAKER_00: Sure.
2:24
SPEAKER_00: The statistics are very clear.
2:25
SPEAKER_00: Every human being who is not dead has anxiety.
2:29
SPEAKER_00: And uh that is a part of life that I think many people don't want to make peace with and don't want to accept.
2:36
SPEAKER_00: And because of that fact, the fact that we don't accept it and the fact that we don't deal with it and we don't have a game plan because hey, you don't want to deal with this, we have an increasing number of people who are debilitated by anxiety, which is not the same thing as having the emotion of anxiety.
2:50
SPEAKER_00: So everyone has the emotion of anxiety, and the number of people who are struggling with significant clinical anxiety is increasing because of our general approach to this emotion.
3:02
SPEAKER_02: Yeah.
3:02
SPEAKER_02: So, you know, I mentioned at the top of the show that we have an epidemic of anxiety.
3:07
SPEAKER_02: You know, I know that it's really common.
3:10
SPEAKER_02: And, you know, I wonder why it is, you know, that our society is so anxious.
3:16
SPEAKER_00: Let's be clear, we have an epidemic of anxiety disorders.
3:19
SPEAKER_00: Okay.
3:20
SPEAKER_00: We have an epidemic of clinical anxiety, we have an epidemic of when anxiety is a problem.
3:26
SPEAKER_00: The simple existence of anxiety is not an epidemic.
3:29
SPEAKER_02: Okay.
3:29
SPEAKER_02: Okay.
3:30
SPEAKER_02: Fair enough.
3:30
SPEAKER_00: Yep.
3:31
SPEAKER_00: That's part of being human.
3:32
SPEAKER_00: And I think that that misconception is actually the primary reason why we have an epidemic in the first place.
3:39
SPEAKER_00: Because when we teach, and I say we because hey, I'm in the medical profession too.
3:45
SPEAKER_00: And when me and my colleagues and teachers and parents and people in Hollywood and wherever they are teach this message that you're supposed to have an anxiety-free life, then the minute we have turbulence, the minute we have trouble, the minute our heart starts to flutter and we feel a little queasy or short of breath, we assume the worst.
4:07
SPEAKER_00: We assume we're faulted and we're flawed, and then we panic.
4:11
SPEAKER_00: And that sends us into clinical anxiety more faster than you can say the word anxiety.
4:18
SPEAKER_02: Yeah.
4:18
SPEAKER_02: Okay.
4:19
SPEAKER_02: And and so is there something unique about, you know, American society in this regard?
4:26
SPEAKER_00: Great question.
4:27
SPEAKER_00: It's not just America, it's also the the Western world.
4:29
SPEAKER_00: It's actually what industrialized countries in general have, well, put the put this way, um, high high-income countries have twice as much anxiety as middle-income countries, and middle-income countries have twice as much anxiety as low-income countries.
4:42
SPEAKER_02: Okay.
4:43
SPEAKER_02: So if you're in a very low-income country, you would think your life would be more stressful or anxiety-inducing.
4:52
SPEAKER_00: So why do we have why do we have that paradox?
4:55
SPEAKER_00: Uh objectively, in a low-income country where you don't have running water in your village, and there could be a warlord who turns the tears down the place in a hot minute, there are no roads, there's no infrastructure, you know, internet has to be provided by satellites because they're, hey, there's no plug.
5:09
SPEAKER_00: Yeah, you're gonna objectively have more stress.
5:12
SPEAKER_00: And that's the reason.
5:14
SPEAKER_00: People in low-income countries and middle-income countries don't expect to have an anxiety-free life.
5:19
SPEAKER_00: But if you live in California, you're done, you're done because you expect that everything should be great.
5:24
SPEAKER_00: You're driving on engineered surfaces, you've got Amazon that can probably, if not now, soon we'll be able to drop things off by drone within a couple of hours.
5:34
SPEAKER_00: You've got, you know, there's that we don't have the we don't have those issues.
5:37
SPEAKER_00: So anything is wrong in our world, we turn inward and we say something's wrong with us.
5:41
SPEAKER_00: Yeah.
5:41
SPEAKER_02: So it's uh it sounds like what you're saying is this has something to do with expectations.
5:46
SPEAKER_02: It has everything to do with expectations.
5:48
SPEAKER_02: Everything to do with expectations.
5:50
SPEAKER_02: Now, you have made the distinction in your book that uh there's a difference between stress and anxiety.
5:57
SPEAKER_02: Sure.
5:57
SPEAKER_02: Yeah, could you explain that a little bit?
5:59
SPEAKER_00: Yeah, that's chapter one of thriving with anxiety.
6:01
SPEAKER_00: Thanks for the shout-out.
6:02
SPEAKER_00: Appreciate that.
6:03
SPEAKER_00: Um, so stress is different than anxiety.
6:06
SPEAKER_00: Stress is when stress it stress is higher in low and middle income countries, interestingly.
6:10
SPEAKER_00: And that's when your resources do not uh add up to the demands in your life, when there's too many demands and not enough resources in your life.
6:18
SPEAKER_02: Okay, so that's a like a supply-demand mismatch kind of pretty much.
6:23
SPEAKER_00: And it can be a subtle, it can be, you know, it doesn't have to be uh monetary, it could be time.
6:27
SPEAKER_00: So, for example, if you're uh 20 minutes away from a meeting that started five minutes ago, um, you're gonna have 15 minutes of stress.
6:34
SPEAKER_02: Yeah.
6:35
SPEAKER_02: Right.
6:36
SPEAKER_02: So, so your your resources are less than the demands that are upon you.
6:41
SPEAKER_00: Correct.
6:42
SPEAKER_00: And the reason it's important to distinguish is because sometimes people aren't anxious, they're actually just stressed out and the symptoms feel the same.
6:48
SPEAKER_00: And if that's the case, then recalibrating and rebalancing so that way your demands are either less or your resources are more, or both, will resolve the issue of anxiety, having nothing to do with anxiety and fear and other and other things as well.
7:03
SPEAKER_00: It's it's a it's a simpler equation.
7:06
SPEAKER_02: Do you find yourself having to clarify this for clients frequently?
7:10
SPEAKER_00: For many clients, but not all.
7:12
SPEAKER_00: I'll tell you who uh needs it sort of by profile, you know, the the busy moms of the world, the busy working moms of the world who are caught between multiple generations and jobs and family and you know, these kinds of things.
7:26
SPEAKER_00: The the entrepreneurs of the world who are starting up a company and feeling very taxed and having to do everything from payroll to administrative work to sales to you know handling their own families, kids applying for college, you know, those are the sort of uh, you know, uh residents in the middle of their residency when they're when they're studying, um, people during exams, you know, these kinds of situations.
7:50
SPEAKER_00: Um, those are telltales.
7:52
SPEAKER_02: So that is those are stressful situations.
7:55
SPEAKER_02: So how would you then define anxiety?
7:58
SPEAKER_00: Great.
7:59
SPEAKER_00: Anxiety is a fear response without a fear stimulus.
8:02
SPEAKER_00: That's jargony.
8:03
SPEAKER_00: So let me pan pack that.
8:05
SPEAKER_00: Fear is a healthy emotion when you have an actual threat in your life.
8:08
SPEAKER_00: The proverbial saber-toothed tiger.
8:11
SPEAKER_00: But uh in the modern day, if people are, you know, in in danger in some way, then there's anxiety, which is when there's not an actual clear and present danger, but in your mind you see it that way.
8:22
SPEAKER_02: Okay, so there is no saber-toothed tiger.
8:26
SPEAKER_01: Correct, which is usually the case today.
8:28
SPEAKER_02: Yeah, I would I would expect.
8:30
SPEAKER_02: So there's no saber-toothed tiger, but somehow we're responding as if there is the equivalent of one.
8:36
SPEAKER_00: Correct.
8:38
SPEAKER_02: So what yeah, I'd like to talk more about that in a minute, but I I just, you know, I want to go back to the book, right?
8:44
SPEAKER_02: Thriving with anxiety is the title.
8:46
SPEAKER_02: And that title just I think sounds pretty counterintuitive to a lot of people.
8:51
SPEAKER_02: Sure.
8:52
SPEAKER_02: You know, what do you mean by thriving with anxiety?
8:55
SPEAKER_00: Well, especially for us who live in the Western hemisphere and you know, high-income countries, and we're experiencing anxiety, it's going to happen.
9:04
SPEAKER_00: You're gonna have a false alarm.
9:05
SPEAKER_00: You know, I like to say a fire alarm going off if there's an actual fire, it would be fear.
9:10
SPEAKER_00: If there's no fire, if it's just you know the key smoke in the kitchen, that would be anxiety.
9:14
SPEAKER_00: Now, that's not a bad thing.
9:16
SPEAKER_00: It's not a bad thing to have a smoke alarm that goes off.
9:19
SPEAKER_00: The question is, what do you do?
9:20
SPEAKER_00: Do you unplug the batteries?
9:22
SPEAKER_00: And you know, like many people do, not a good idea.
9:24
SPEAKER_00: But do you keep the system intact, work with it, expect that you're gonna have false alarms, and then use it in a constructive, positive way?
9:32
SPEAKER_00: And that's where the thriving with anxiety paradigm comes in, where we use this emotion that we all, hey, let's acknowledge we all experience to some degree in a constructive, positive way to create better beta relationships, more closeness, more awareness, more resilience, and potentially even more spiritual growth if we're so in tune.
9:52
SPEAKER_02: Yeah, so so the the premise here of thriving with anxiety is not as I don't know, I don't want let's call it embracing anxiety or learning to learning, you know, accepting the fact that it is a a universal human condition to have some anxiety and not path pathologizing it.
10:12
SPEAKER_00: Correct.
10:13
SPEAKER_00: That's step one.
10:14
SPEAKER_00: And now then we get into the actual work, which is making lemonade out of lemons, as they say, but using it in a constructive way.
10:21
SPEAKER_02: So, you know, I I'm I know you've seen you know thousands of clients and worked with people.
10:27
SPEAKER_02: And you know, how do people accept this this thing?
10:30
SPEAKER_02: You know, it sounds like you know, we just want e I a medication or some way to avoid it.
10:36
SPEAKER_02: We don't want to feel this way.
10:37
SPEAKER_02: You know, how do people respond to this when you start telling them this approach?
10:42
SPEAKER_00: Usually people have come to me after trying those approaches to get rid of their anxiety and they see that it doesn't work.
10:48
SPEAKER_00: And almost everyone eventually gives up hope on that because it's just not an effective strategy.
10:54
SPEAKER_00: Anxiety cannot be completely removed from your life.
10:58
SPEAKER_00: But that's not a bad thing.
11:00
SPEAKER_00: If you learn to use it in a constructive way, it can actually be a blessing, not a burden.
11:05
SPEAKER_00: It can be your friend, not your enemy.
11:07
SPEAKER_00: It doesn't have to be that way.
11:09
SPEAKER_00: Most people, again, coming to me or reading the book, they've they've been dealing with this for a while and they see something's up, you know.
11:15
SPEAKER_00: They see that their medication is increasing and the effects are diminishing.
11:20
SPEAKER_00: They see that they're trying to live an anxiety-free life and it's just not effective.
11:26
SPEAKER_00: They, you know, they've been provided, uh, as one of my friends calls it, hopium, right?
11:31
SPEAKER_00: Very dangerous drug, hopium.
11:32
SPEAKER_00: Uh-huh.
11:33
SPEAKER_00: Um, and it it's people come down from that.
11:36
SPEAKER_00: Um, and they it's actually more debilitating to live to try to set up that straw man and have it knocked down in your face.
11:44
SPEAKER_00: It's very unnerving.
11:46
SPEAKER_00: People think something's wrong with me, and you know, the first thing I say is no, like I get anxious too, and let's be human and figure out how to be constructive in dealing with our anxiety as opposed to selling you more more hopium.
12:01
SPEAKER_02: Yeah, yeah.
12:02
SPEAKER_02: Now, in in the book, you you talk about the anxiety spiral.
12:07
SPEAKER_02: Sure.
12:07
SPEAKER_02: Leah, what is what is that?
12:09
SPEAKER_00: Yeah, I was speaking about it a little bit at the beginning, but it's great to unpack it.
12:13
SPEAKER_00: When you feel anxious and you are upset or distressed or judging yourself or thinking you're doing something wrong or something shouldn't be feeling this way, that thought, that perception that something's wrong will trigger more adrenaline to be released into your system.
12:31
SPEAKER_00: Your mind and your body are connected, especially when it comes to anxiety, and whatever you perceive will trigger a physiological response.
12:41
SPEAKER_00: So if you perceive anxiety as a threat, you trigger more adrenaline, which increases the physical sensations of anxiety.
12:50
SPEAKER_00: And as those sensations surge, whether that's a beating heart or whether tachycardia, or whether it's uh difficulty breathing, whether it's stomach upset, whether it's a lump in your throat or tingling sensations or whatever the feelings are, that just creates more of a sense, oh no, now something's really wrong.
13:07
SPEAKER_00: And then those thoughts trigger more adrenaline, and then we end up in a cascade, otherwise known as a cycle negative anxiety spiral, is what I called it in the book.
13:18
SPEAKER_02: Yeah.
13:19
SPEAKER_02: Yeah.
13:19
SPEAKER_02: And and we've all been there.
13:21
SPEAKER_02: You know, we've all been there where we're, you know, you start you something makes you a little uncomfortable, then you're like, well, I shouldn't feel this way.
13:29
SPEAKER_02: What's wrong?
13:30
SPEAKER_02: Why am I this way?
13:31
SPEAKER_02: Next thing you know, you're like, you know, if if it goes to an extreme, you're in the ER thinking you're having a heart attack.
13:38
SPEAKER_00: It's one of the top reasons why people go to the emergency room in this country is with the f with the panic attack.
13:43
SPEAKER_00: And they're usually sent home saying everything's fine, taken out of an.
13:48
SPEAKER_02: Yeah.
13:49
SPEAKER_02: Yeah.
13:49
SPEAKER_02: So so I I found it interesting, you know, I don't know if it's jumping ahead here, but also from the book, this, you know, the the I don't know, it's the cure or the answer to this anxiety spiral is the positive spiral, right?
14:04
SPEAKER_02: The positive spiral is the way I guess maybe this is like getting into like how people are supposed to try to work with their anxiety.
14:13
SPEAKER_02: Correct.
14:14
SPEAKER_02: So what what is the positive?
14:16
SPEAKER_02: How how you know, I don't want to leave the le the uh listeners out on a lurch, you know.
14:21
SPEAKER_02: We told them about the anxiety spiral.
14:23
SPEAKER_02: What's the positive spiral?
14:24
SPEAKER_00: Yeah, positive spiral is when you actually get into a place where you understand anxiety is part of life, there's nothing wrong with you, and it's either giving you new information about the situation, it's giving you an opportunity to deal with emotions that will help you to become more connected to other people, it's helping you to, I would say, work out in an emotional gym for a couple of minutes where you're building your resilience to handle something.
14:50
SPEAKER_00: It's not pleasant, just like building weights sort of is, you know, tough and feels hard on the physical system, it's giving you an opportunity for that.
14:58
SPEAKER_00: And it might be giving you an opportunity to let go in your life and to tolerate uncertainty and humbly accept the limits of your control.
15:08
SPEAKER_00: And once you click into one or more of those ways of dealing with anxiety, you stop judging yourself for how you feel, you stop trying to shunt the feelings and get rid of them, and you actually channel them forward in a way that they start to settle down a little bit.
15:25
SPEAKER_00: And the goal can't be to get rid of the anxiety because then you actually defeat the purpose, but that ends up becoming a secondary byproduct, if you will, of channeling it forward in a productive way.
15:37
SPEAKER_02: And and that I is what you mean by thriving is that channeling forward.
15:42
SPEAKER_02: That's the thriving.
15:44
SPEAKER_00: Thriving is from it's not a Greek root, it's actually a Nordic word.
15:48
SPEAKER_00: Threefos.
15:50
SPEAKER_00: Three foss.
15:51
SPEAKER_00: Threefos is to grow.
15:54
SPEAKER_00: And anxiety doesn't feel good, it's not like flourishing, it's not like the which is a Greek root, by the way, flower, flower flourishing.
16:03
SPEAKER_00: Three fos is to grow, and anxiety can help you to grow to the next step.
16:09
SPEAKER_00: It's not pleasant.
16:10
SPEAKER_00: I'm not whitewashing the unpleasant emotions associated with anxiety.
16:15
SPEAKER_00: I don't like feeling anxious, okay.
16:18
SPEAKER_00: But that is a catalyst to thriving or growth, and that's that's the intended meaning of the of the title.
16:26
SPEAKER_02: Okay.
16:27
SPEAKER_02: All right.
16:28
SPEAKER_02: So so you mentioned, you know, something about like accepting, you know, like I just want to go back to some, you know, there's these nine tools, right?
16:38
SPEAKER_02: And so the first three of them have to do with uh enhancing your connection with your yourself, and one of them was is knowing yourself or knowing ourselves, and the next is accepting ourselves, and the third one in that group is transcending ourselves.
16:58
SPEAKER_02: And and and I found it interesting that the transcending ourselves chapter really talks about exposure therapy quite a bit.
17:07
SPEAKER_02: So what what is that?
17:09
SPEAKER_00: Sure, exposure therapy.
17:10
SPEAKER_00: Yeah, exposure therapy is a clinical technique, which is I would say the gold standard for treating people with clinical anxiety, and it involves facing anxiety head on by doing things that are challenging.
17:25
SPEAKER_00: So if people are afraid of you know specific phobia, let's say of dogs or spiders or snakes, they will confront those, whether that's still images or videos, or actually being in the same house or the same room, or maybe even coming into physical contact with those said animals.
17:42
SPEAKER_00: Um, and obviously that's done, I shouldn't say obviously, that is typically done in a graded way or in a in a in a step-by-step manner, starting with the lower ones and working up one's muscles and one's capacity to be able to eventually hit the higher ones.
17:57
SPEAKER_00: But if people are motivated and and uh you know, no comorbidities, no extra complicating factors, they can actually make very steady progress even in a couple of days.
18:06
SPEAKER_00: We've done this intensive exposure therapies.
18:09
SPEAKER_00: And for other anxiety issues as well, not just specific phobias for people who are more shy, you know, usually that takes longer, many weeks as opposed to more intensives, but those are clear also uh ways of uh of moving forward.
18:22
SPEAKER_00: Um, similarly, doing things that are socially risky, so to speak, um, raising your hand, going over to a stranger, asking for the time, paying, you know, paying for uh Starbucks and nickels and uh having people upset at you.
18:35
SPEAKER_00: Usually it's not too dangerous to do that, depending on where you live in the country.
18:39
SPEAKER_00: Anyhow, people, you know, doing these kinds of things, you know, there's a there's a strategy we have for intentionally worrying about what you're upset about and scheduling time to do so, which is for people with GAD.
18:50
SPEAKER_00: So these are these are methods of exposure therapy.
18:53
SPEAKER_00: I think when you use them for anxiety in general, they have potentially transcendent quality if uh people are so inclined, like I mentioned before.
19:03
SPEAKER_00: Uh, but the idea is to really shoot past your anxiety, not to let it get in the way of living the life that you want.
19:10
SPEAKER_02: Yeah, so so what is going on inside inside a person's brain or you know, neurologically when they have exposure?
19:18
SPEAKER_00: Great question.
19:19
SPEAKER_00: At the very simple level, you are continuing to engage the frontal cortex or learning to continually engage the frontal cortex while the midbrain, while the emotion center, if you will, amygdala and adjacent regions are getting a lot of blood flow.
19:40
SPEAKER_00: The idea is to feel anxious, and in the presence of that anxious stimulus, whether it's the dog or the you know spider or the person or blood will flow to the midbrain, it will go to the amygdala, to the center, if you will, the heart of the brain.
19:56
SPEAKER_00: And that's the emotions, because that that's what happens when you feel anxious.
19:59
SPEAKER_00: Blood will flow there.
20:01
SPEAKER_00: And the goal of being able to face that is by being in those situations, people eventually learn to have more cognitive control.
20:09
SPEAKER_00: I'm not dying, I can make it through this, I can regulate myself, I can think about other things, I have more control over the situation.
20:19
SPEAKER_00: It's not a deathly situation, it's not a real fear, it's anxiety.
20:24
SPEAKER_00: Somebody else is with me.
20:25
SPEAKER_00: I can connect with them, I can make a joke even during exposure therapy.
20:28
SPEAKER_00: We're offering bantering with our clients.
20:31
SPEAKER_00: And all of that in some way restores cognitive control or blood flow to the uh more developed, if you will, areas of the brain, specifically the front brain, the frontal cortex.
20:42
SPEAKER_00: Um, so that's at the simplest level.
20:44
SPEAKER_00: I'm I'm obviously, you know, sort of distilling uh cognitive mechanisms, neurobiological mechanisms, and exposure into you know, a sound bite for the general public.
20:54
SPEAKER_00: So, you know, this is more of an academic discussion, but uh at the simplest level, yeah, you're you're getting more a better sense of confidence and composure in the face of anxiety.
21:08
SPEAKER_02: Yeah, and and I think that um that simple explanation is perfect for for this podcast.
21:15
SPEAKER_02: Um I wouldn't want it to be to be not discussed though, you know, and the reason being because I I think that it's it really explains why the exposure works, you know, why, you know, what is going on inside that that makes this a powerful treatment option, you know, as opposed to the natural treatment or the natural uh inclination is to avoid the things that cause anxiety or to medicate them away.
21:45
SPEAKER_02: You know, like when you take a medication, you feel better, but you haven't really changed anything at the basic level.
21:52
SPEAKER_00: Correct.
21:53
SPEAKER_00: And there is certainly a place for medication, um, specifically in the area when people can't face their anxiety.
22:00
SPEAKER_00: Because they haven't done the therapy yet, or because it's just too intense and they need to take it down to a reasonable level.
22:06
SPEAKER_00: But the goal should not be to get rid of anxiety with uh medication.
22:10
SPEAKER_00: I don't think that's responsible pharmacology in almost all cases.
22:14
SPEAKER_00: I think people need to learn how to face it and to be constructive and move it forward as opposed to trying to get rid of it.
22:21
SPEAKER_00: I think that's sending us in the wrong general direction.
22:24
SPEAKER_00: Although at a certain point, it could be people cannot tolerate this.
22:28
SPEAKER_00: They need to get up, they need to get to work, they have to get on a plane, they have a meeting the next day, they haven't had time to do exposure therapy, or they're behind, or they live in the area of the country where it's not available.
22:37
SPEAKER_00: You know, there are cases, there are many use cases.
22:40
SPEAKER_00: Um, but I just think the general philosophy and approach needs to be this is a holdover or a reduction as opposed to an elimination of these fears and not a medicalization of a normal emotional state.
22:52
SPEAKER_00: That's very important here.
22:53
SPEAKER_02: Yeah, I think that's a really important say statement right there.
22:57
SPEAKER_02: You know, I think we over-medicalize a lot of things in our culture, and um uh and and these are normal emotions or normal reactions to life.
23:08
SPEAKER_02: And so better to know how to handle them than to just try to erase them and numb ourselves from them.
23:15
SPEAKER_02: Now, that being said, I agree with you.
23:18
SPEAKER_02: You know, as a physician, you know, medications are extremely important and and allow people to function.
23:24
SPEAKER_02: So I would not want the audience to get a different impression, but absolutely important.
23:29
SPEAKER_02: In the second portion of the book, the it you really talk about enhancing connection with others and how anxiety or being a person who has experienced anxiety can actually allow you to be better connected to other people.
23:47
SPEAKER_02: How is that?
23:48
SPEAKER_02: How does that work?
23:49
SPEAKER_00: Also counterintuitive.
23:50
SPEAKER_00: Yeah, most people think that in order to connect to other people, you have to be strong, you cannot be anxious, you cannot be vulnerable, you cannot have needs, especially emotional needs.
23:59
SPEAKER_00: And I think that that is just a bold face lie.
24:03
SPEAKER_00: If you think about it, the people you're most emotionally connected with are usually those who you've opened up to in a vulnerable, raw way about the challenges that you're experiencing.
24:15
SPEAKER_00: As a psychologist, I speak, I experience this every day.
24:17
SPEAKER_00: And if I get on a plane and the person next to me is anxious, if I make any comment that I'm in mental health, they are the whole it's a free therapy session for the length of that flight.
24:29
SPEAKER_00: And they and they often will message me afterwards it was so nice to meet you.
24:33
SPEAKER_00: I really appreciate it because they opened up about their life and their family and their experience, and you know, and that's that's fine.
24:40
SPEAKER_00: That's a human trait, it's a human characteristic that when we are able to uh be anxious in the presence of another, it creates a bond.
24:51
SPEAKER_00: The irony of human connection is that we're the strongest when we're together, but in order to get there, you need to have some needs and be vulnerable.
25:00
SPEAKER_00: No one likes a perfect friend.
25:01
SPEAKER_02: Good point.
25:02
SPEAKER_02: I like that.
25:03
SPEAKER_02: It's we connect with people when they need us or when we need them.
25:08
SPEAKER_02: And yeah, absolutely.
25:10
SPEAKER_02: Yeah.
25:10
SPEAKER_00: And that means having some anxiety.
25:13
SPEAKER_00: Um, now obviously, if it's overwhelming anxiety and you have, you know, needs that the other person cannot provide for, then you might have to get some of those needs met in a different way, whether that's with a professional or with other friend groups or through your own self-regulation.
25:29
SPEAKER_00: But the goal is not to be perfect.
25:32
SPEAKER_00: Years ago, I was uh at a panel at Harvard College, and uh the head of the Harvard Counseling Center made a comment, um, just an offhand comment, but I will never forget what he said.
25:42
SPEAKER_00: So the number one predictor of Harvard students doing well in their first semester is that they have just a single friend, or I should say at least one friend, on campus that they can speak to about real issues on their mind.
25:55
SPEAKER_00: Top predictor.
25:56
SPEAKER_00: Can you be vulnerable with another human being?
25:58
SPEAKER_02: Yeah, yeah.
25:59
SPEAKER_02: And um, you know, I I in in reading the book, one of the things that struck me was this idea that, you know, if you if you understand your own anxiety, the way you know that you struggle with this kind of thing, uh, it helps you to accept other people better, to like see it in them.
26:20
SPEAKER_02: Maybe, maybe we'll call it increased empathy or compassion for another person.
26:26
SPEAKER_02: And I I thought that was really spot on.
26:29
SPEAKER_02: Thank you.
26:30
SPEAKER_00: Yeah, when you are able to be anxious, you're also able to tolerate other people's idiosyncrasies and challenges, because anxiety is a false alarm.
26:38
SPEAKER_00: I mean, it's not, you know, it's not a it's it's a sign of imperfection, and that's okay.
26:43
SPEAKER_00: And once we can be okay being imperfect ourselves, then other relationships become a lot easier because hey, no one's perfect.
26:50
SPEAKER_02: Yeah, so so in the last couple of minutes, I I want to talk about that last section of your book where it's about enhancing spiritual connection.
26:58
SPEAKER_00: Sure.
26:59
SPEAKER_02: Right.
26:59
SPEAKER_02: And so um, you know, say something about that part of the book.
27:03
SPEAKER_00: Sure.
27:04
SPEAKER_00: You know, spirituality is any way of connecting with that which we see as sacred or separate from the physical world.
27:10
SPEAKER_00: And for some people, that's God or religion, you know, and for me as a religious individual, that's you know, that's the case in my life.
27:16
SPEAKER_00: But for many people, it's it's more secular and it has to do with meaning or purpose or things that are higher level, things that really give them their why.
27:24
SPEAKER_00: You know, what's your why?
27:25
SPEAKER_00: What's something that's not material?
27:28
SPEAKER_00: It's not a material thing, why you do what you do, what's your higher level motivation, what are your values or your virtues?
27:34
SPEAKER_00: Um, you know, I think I have in some ways an advantage coming from a religious community.
27:38
SPEAKER_00: It's more clear to me, and I also have a community which supports me and I can talk to you about these matters, but really regardless of what it is, transcendence is moving beyond the what and moving in the how and moving into the why and the purpose and things that are more immaterial, frankly.
27:57
SPEAKER_00: And anxiety can get you there.
27:59
SPEAKER_02: Yeah.
27:59
SPEAKER_02: How does anxiety get you there?
28:01
SPEAKER_00: I think there are a couple ways.
28:02
SPEAKER_00: No, number one is let's face it, life is uncertain, and we don't know what's going to happen next.
28:09
SPEAKER_00: We don't know geopolitically, terms of climate, economically, you know, AI.
28:14
SPEAKER_00: I mean, who knows?
28:16
SPEAKER_00: Like we are living in, you know, we were living in a very uncertain period of human history.
28:21
SPEAKER_00: Just before this, I was on the call with a bunch of business leaders, and they were going around the table and saying how difficult it is to get decision makers to make any decision today because things are being appended so quickly at the highest level within enterprise level companies and other companies as well.
28:38
SPEAKER_00: It's just there's so much conglomeration and dismantling and system like at the highest levels.
28:44
SPEAKER_00: And just making basic decisions is people are like, we don't know what's going to happen, so we can't make commitments, we don't know.
28:50
SPEAKER_00: And to operate in an environment like that takes a lot of tolerating uncertainty, which means you can't really focus on the how and the what all the time because those answers are not present in those moments.
29:06
SPEAKER_00: Can you embrace the anxiety and focus on why?
29:10
SPEAKER_00: Can you focus on what you like what you really want to aim for at the end of the day?
29:14
SPEAKER_00: What makes you do this?
29:16
SPEAKER_00: Why are you doing it?
29:17
SPEAKER_00: Honestly, that's in some ways, maybe not in some ways, in every way.
29:22
SPEAKER_00: That's the guiding light that we all need.
29:25
SPEAKER_00: And when you're anxious, you're just tied into the reality that you're not in control, and then you can actually focus on why in a in a fundamental way.
29:36
SPEAKER_00: It's not easy to get there, but I think that's the goal.
29:38
SPEAKER_02: Yeah, I I think that's beautiful.
29:41
SPEAKER_02: I, you know, I agree, you know, uh having that why, you know, and that why it can be it's different for every person.
29:49
SPEAKER_02: And I also agree with you that coming from a particular um, you know, religious group, you know, gives you a little like a like a little head start or like like a I don't know what, what do we call it?
30:01
SPEAKER_02: Almost like a support group or group of people that it is a support, you know, are there, you know, you have common ideas and beliefs and they're there for you and and you're there for them.
30:12
SPEAKER_02: So um I love I love these ideas.
30:15
SPEAKER_02: I I wonder, you know, do you need to go stepwise?
30:20
SPEAKER_02: Do you need to have this like step one before step nine?
30:25
SPEAKER_00: It's a great question.
30:26
SPEAKER_00: So I don't think so in that book, but I had a since writing Thriving with Anxiety, I've consolidated the approach into four steps.
30:35
SPEAKER_02: Oh, okay.
30:36
SPEAKER_00: That is a new book coming out.
30:38
SPEAKER_00: That's a new book coming out with with a chat.
30:40
SPEAKER_00: Um, I realized that you know, thriving with anxiety really has kind of almost everything I've got, you know, everything I learned in 25 years about anxiety, I put into that book.
30:49
SPEAKER_00: Uh the best compliment I ever got on it is that it's two years of therapy in an afternoon.
30:54
SPEAKER_00: So I don't know if you'd agree to that, but that was that was a that was that was a very nice, very nice review I got from a podcaster who I worked with.
31:01
SPEAKER_00: Um the four steps is not, I think it's more of a sequence where um and that that is sequential.
31:08
SPEAKER_00: I don't think thriving with anxiety needs to be read like that.
31:11
SPEAKER_00: I think people can in some ways read section one, section two, or section three out of order, or depending on what they need to work on.
31:17
SPEAKER_00: So I've tried to make it more sequential and simple over the last couple of years since moving into the space out of the academic medical world and sort of moving more into the um thought leadership and trying to make this uh have more public health impact, frankly.
31:33
SPEAKER_02: Yeah.
31:34
SPEAKER_02: So did you say that book is coming out or it's been published already?
31:37
SPEAKER_00: It has not been published yet.
31:39
SPEAKER_00: But the provisional title is The Four Steps and uh the uh publishers has that balance.
31:44
SPEAKER_00: So I'm excited to be under contract with them with a pub date of fall 27th.
31:48
SPEAKER_02: Okay.
31:49
SPEAKER_02: So we'll keep that, we'll keep an eye out for that one.
31:52
SPEAKER_00: Sure.
31:54
SPEAKER_02: Yes, I'd love to have you back and and talk about that and how it's similar and different to from this book.
32:00
SPEAKER_02: But um thank you again for joining us.
32:05
SPEAKER_02: Is there any sort of last you know parting thing you want to say about these ideas before we move on to the billboard question?
32:13
SPEAKER_00: You got your billboard question.
32:14
SPEAKER_00: I've been waiting for it, I've been anxiously waiting for it the whole time.
32:17
SPEAKER_00: So I think uh it's sort of my opportunity to thrive with my own anxiety there.
32:21
SPEAKER_02: So uh if you have nothing else that you want to add, I I'll ask you the billboard question.
32:29
SPEAKER_02: So the billboard question is uh something I ask all my guests, and it is if you had the opportunity to put a message on a billboard in your town and you knew that thousands of people would drive by it every day and see your message, what would your message be?
32:47
SPEAKER_00: It would say anxiety is not your enemy.
32:50
SPEAKER_02: Okay, I love it.
32:51
SPEAKER_02: Anxiety is not your enemy.
32:55
SPEAKER_02: Well, Dr.
32:56
SPEAKER_02: Rossmarin, thank you once again for joining us to talk about this uh very timely and important topic.
33:03
SPEAKER_02: Thanks again.
33:04
SPEAKER_00: Thanks so much.
33:05
SPEAKER_00: It was a great conversation.
33:06
SPEAKER_00: I really you know I appreciate it.
33:08
SPEAKER_00: You you know clearly read the book and did your you know your homework and so to speak.
33:12
SPEAKER_00: And uh yeah, I'm I'm touched by that.
33:14
SPEAKER_00: It does mean a lot to me when when people engage with my work.
33:17
SPEAKER_00: Um, just really thoughtful questions throughout.
33:19
SPEAKER_00: And uh, you know, I I I think I survived and thrived with my own anxiety during this conversation.
33:24
SPEAKER_00: Already feeling better.
33:26
SPEAKER_02: Yeah, and I had anxiety too, and we needed each other, and therefore it worked, right?
33:31
SPEAKER_02: So um, well, that's it for today's show.
33:34
SPEAKER_02: Thank you so much for joining me.
33:36
SPEAKER_02: I hope that uh made you think today and you learned something.
33:40
SPEAKER_02: Until next time, so long.
33:43
SPEAKER_02: Thanks for listening to the Life and How to Live It podcast with Dr.
33:47
SPEAKER_02: Rocco.
33:47
SPEAKER_02: If you'd like to book a coaching session with me, simply visit the show notes and schedule a discovery call.
33:54
SPEAKER_02: And if today's episode encouraged you or added value to your life, please subscribe and leave a review.
34:01
SPEAKER_02: Remember, life is not addressed rehearsal.
34:04
SPEAKER_02: Until next time, stay late.