Speaker 1: This is the Anxiety Bites podcast and I am your host,
Speaker 1: Jen Kirkman. Today my guest is Dr Luana Marquez. But
Speaker 1: before we get to that, well, I don't know what
Speaker 1: why am I compartmentalizing here? She wrote a book titled
Speaker 1: almost Anxious? Is my or my loved ones wary or
Speaker 1: distress a problem? And uh so I thought almost anxious?
Speaker 1: I don't know, I just at first glance thought it
Speaker 1: was just a catchy title, and uh I wasn't aware
Speaker 1: until I read her book and spoke to her that
Speaker 1: actually it's kind of a clinical term. The medical literature,
Speaker 1: as she says in her book, currently recognized as many
Speaker 1: problems or syndromes that don't quite meet the standard definition
Speaker 1: of a medical condition. They're what medical professionals often referred
Speaker 1: to as subclinical, and it's what they call the almost effect.
Speaker 1: So in this episode, we'll talk about how anxiety is
Speaker 1: a spectrum. It's not a dichotomy normal and then full
Speaker 1: blown pathology. You have an anxiety disorder. There are things
Speaker 1: in the middle. There are a lot of us who
Speaker 1: are in the almost effect of anxiety. We sort of
Speaker 1: use bad tools for lack of a better term, and
Speaker 1: can move over into the full blown anxiety disorder category.
Speaker 1: But I loved talking with Dr Marquez because we talked
Speaker 1: about some things that hasn't come up on this show yet,
Speaker 1: specifically avoidance, which is you know, it's come up here
Speaker 1: and there, but it's it's really it's the go to
Speaker 1: tool of the anxious person or the person who has
Speaker 1: panic disorder. It's the go to tool before you get
Speaker 1: help with learning how to cope in the situation. And honestly,
Speaker 1: it's it's a lifelong go to tool, and it's not.
Speaker 1: It's a broken tool, but I still find myself using
Speaker 1: it in certain situations. And we talk about um ways
Speaker 1: that we are in avoidance that aren't even obvious. One
Speaker 1: obvious way of being in avoidance is don't go into
Speaker 1: a building that scares you. But another non obvious way
Speaker 1: of being in avoidance is seeking reassurance. So I'll get
Speaker 1: into all of that, but it was interesting while I was,
Speaker 1: you know, reading her book and getting to know the doctor.
Speaker 1: As I was researching, I happened to be away. I
Speaker 1: my parents, who live on the East Coast, had to
Speaker 1: come out to Palm Springs for something, and so we
Speaker 1: drove down together. I drove now that is a huge
Speaker 1: feat for me. In the past, I used to have
Speaker 1: a fear of driving on freeways. And it wasn't about
Speaker 1: driving alone. I just didn't want to drive on them
Speaker 1: at all, and even if people were with me, UM
Speaker 1: just wasn't a thing, And mainly because I would have
Speaker 1: panic attacks, and I don't want to have a panic
Speaker 1: attack while I'm driving, because it feels like you're dying.
Speaker 1: Sometimes I would physically start shaking so badly. I mean
Speaker 1: it would look like, you know, my knees are bouncing
Speaker 1: up and down under the steering wheel, and and you
Speaker 1: feel like you're going to lose control and or pass
Speaker 1: out and die. And it's it's really tough to drive
Speaker 1: a machine while you're panicking. So it's a sensation that
Speaker 1: I didn't want to experience UM ever, and had experienced
Speaker 1: a few times. And so I spent most of my
Speaker 1: life in avoidance of driving on freeways. And now I
Speaker 1: do it freely. But I do remember one of my
Speaker 1: first um, you know, day jobs, just to pay the bills.
Speaker 1: When I first moved to Los Angeles, I was twenty eight.
Speaker 1: It was two thousand two, and I worked for a
Speaker 1: guy who worked out of his home and he was
Speaker 1: in I don't know, just some low level production. So
Speaker 1: in other words, he had some audio equipment and you know,
Speaker 1: a studio might call him and say, hey, you know,
Speaker 1: one of our speakers blew out. Can you get a
Speaker 1: speaker to us, you know, sometime today. And so it
Speaker 1: was of the utmost importance that if my boss Jim
Speaker 1: had a speaker, you know, a huge industrial size speaker
Speaker 1: to deliver to the studio that would need it. That
Speaker 1: part of him having his own little warehouse was that
Speaker 1: he could get it to you, you know, within the hour.
Speaker 1: It's like nowadays, it reminds me of like a Postmates,
Speaker 1: you know, rush order or something. But I was the
Speaker 1: person that had to deliver it. And if you know
Speaker 1: anything about Los Angeles, you know there's traffic, but it's
Speaker 1: not always what you think. During the day, there are
Speaker 1: certain freeways that it's not bumper or bumper, it's you know,
Speaker 1: you're driving along the freeway at a normal pace, and
Speaker 1: it's much faster than taking what we call surface streets
Speaker 1: or the back roads. I mean, if you need to
Speaker 1: get somewhere, you jump on that freeway in the middle
Speaker 1: of the day when it's not rush hour, traffic, you
Speaker 1: will get to where you need to go ten minutes,
Speaker 1: as opposed if you took the back roads forty five minutes. Well,
Speaker 1: I didn't know that was going to be part of
Speaker 1: my job. I was mainly just a bookkeeper. And then
Speaker 1: suddenly this delivery aspect gets introduced and I can hear
Speaker 1: him on the phone saying, yep, Jen will be there
Speaker 1: in oh, I don't know, uh, thirty minutes. And then
Speaker 1: I would hear this is way before you know Google
Speaker 1: Maps and all that thing, and he would say, yeah, okay,
Speaker 1: so you take the one thirty four to the two
Speaker 1: and the five and the six, and my head would
Speaker 1: already start spinning, sitting at the desk, just thinking I can't,
Speaker 1: I can't, I can't, I can't. I can't get on
Speaker 1: the freeways. And so so many times I just took
Speaker 1: those surface streets and the order was late, and I
Speaker 1: would say, oh, there was crazy traffic, and thank god,
Speaker 1: there was no way to tell back then you couldn't
Speaker 1: get on some kind of online mapping thing and say no,
Speaker 1: there isn't. But um, eventually, at one point a job
Speaker 1: was important enough that I had to do it. And
Speaker 1: I remember, I mean, I'm not kidding. I'm acting it
Speaker 1: out physically. Understand that this is a podcast, but I
Speaker 1: don't have the words for it. I was going the
Speaker 1: whole time. My entire body was shaking up and down
Speaker 1: in such an intense panic attack. And I know that.
Speaker 1: On last week's episode, UM, we talked to Dr Angela
Speaker 1: and she said a lot of people don't ever let
Speaker 1: their panic hit its highest point and just sort of
Speaker 1: burnout on its own. Well, I had no choice, and
Speaker 1: the panic was so overtaking me. It did hit its
Speaker 1: highest point, but I swear it felt like the panic
Speaker 1: attacks were lasting five or ten minutes, which is a
Speaker 1: long time when you are driving on the freeway. And
Speaker 1: so now I really don't have that. I've spent a
Speaker 1: lot of my life as a comedian on the road.
Speaker 1: I do a lot of my own driving between cities
Speaker 1: and just living in Los Angeles. Jump on the freeway,
Speaker 1: jump off. It's not always my favorite thing, but it's
Speaker 1: not from an anxiety standpoint. It's more I don't feel
Speaker 1: like sitting in traffic, or everyone's driving crazy today, they're
Speaker 1: in a mood, or it's raining whatever. However, going back
Speaker 1: to my original point, I was in Palm Springs. When
Speaker 1: I was interviewing Dr lauana Um, I was there half
Speaker 1: on a little thing with my parents, and then at
Speaker 1: the end of the week I had a wedding to
Speaker 1: go to, So there was a few days where I
Speaker 1: was just there hanging out and doing my research for
Speaker 1: this week's episode and conducting the interview. And during those
Speaker 1: days I kept picturing the drive home and how i'd
Speaker 1: be driving home by myself from Palm Springs. Now, again,
Speaker 1: I don't really know why I was worried that I
Speaker 1: would panic. I've driven by myself to and from San
Speaker 1: Diego from Los Angeles, which is a longer distance, so
Speaker 1: it's about the same. But I don't know why. Uh.
Speaker 1: And I kept thinking, well, okay, Jen, if you have
Speaker 1: a panic attack, you'll have a panic attack. What is
Speaker 1: the problem? And I kept just thinking, I wish I
Speaker 1: didn't have to and I hope I don't panic, and
Speaker 1: it's going to be miserable. And I think it's my
Speaker 1: theory is um, the more I have going on in
Speaker 1: life that's a little stressful, a little unknown, I will
Speaker 1: tend to panic in certain situations that can cause a
Speaker 1: panic attack, And for me, that is again it's more
Speaker 1: now not driving on the freeway, but getting stuck in traffic.
Speaker 1: That that is something that I find I will have
Speaker 1: anything from uncomfortable sensations to full blown panic attack. And
Speaker 1: you know, I'm sort of in the middle of a move,
Speaker 1: just a lot of new things happening, and I felt
Speaker 1: a little pressed for time. I felt like I didn't
Speaker 1: really even have time to be in Palm Springs that long.
Speaker 1: Wasn't quite a vacation for me. So I just feeling stressed.
Speaker 1: And when I have a lot of other things going on,
Speaker 1: um situations that can cause me to panic most likely will. So.
Speaker 1: Dr Marquez talks a lot about exposure therapy in her book.
Speaker 1: She's worked with patients that, you know, have a fear
Speaker 1: of getting in an elevator, of fear of heights. And
Speaker 1: I never did exposure therapy about driving on the freeway.
Speaker 1: I just sort of did it and applied all of
Speaker 1: my panic disorder and generalized anxiety tools to it. But
Speaker 1: I thought to ask her a question about, you know,
Speaker 1: what what do I do in this case where it's
Speaker 1: three days from the drive and I'm still I'm kind
Speaker 1: of dreading it, and it's almost making me think I'm
Speaker 1: not even gonna enjoy this wedding I'm going to the
Speaker 1: night before because I'm just thinking about this drive and
Speaker 1: it was starting to pick up steam in my brain,
Speaker 1: and I wanted to ask her, should I think of
Speaker 1: it more as something that you know, Do I get
Speaker 1: in the car and start assuming there will be panic
Speaker 1: and doing a breathing tape or whatever a tape? I
Speaker 1: have a car with an eight track tape player, you know,
Speaker 1: doing a breathing app or what? I don't know? Or
Speaker 1: do I just kind of ignore it because I have
Speaker 1: conquered this. I have more examples than not of driving
Speaker 1: on the freeway alone in traffic without panicking. Do I
Speaker 1: just live my life and if it happens, I do
Speaker 1: have tools, but I don't have to anticipate it. And
Speaker 1: she did answer, and I will have an answer for
Speaker 1: you on the flip side of this episode about what
Speaker 1: ended up happening. But it was interesting in that more
Speaker 1: meant to, you know, I don't know, get a little
Speaker 1: free advice from a therapist, but but I figured I
Speaker 1: would take you all into that situation so that you
Speaker 1: could see in real time what talking to someone looks like.
Speaker 1: If you've never been to therapy, does that make sense.
Speaker 1: And something else she mentioned that I that I wanted
Speaker 1: to talk about is, you know, a lot of times
Speaker 1: we do avoid situations that scare us, you know, airplanes,
Speaker 1: tall buildings, the mall. I don't know anything. A lot
Speaker 1: of times we do avoid things because these are places
Speaker 1: we have panicked before, and we associate that place with
Speaker 1: the panic attack. And for me, I avoid you know,
Speaker 1: tall buildings. Now, there are few cases where I do
Speaker 1: have to go up to the forty floor of certain buildings,
Speaker 1: and there's just there's just no option that I'm not
Speaker 1: going to. There are certain radio stations. If I have
Speaker 1: to go do press for something, you've got to get
Speaker 1: on the floor, and I have my coping skills and
Speaker 1: I make it work. But in general, UM, if you
Speaker 1: tell me that you just bought a penthouse and you
Speaker 1: live on the fifte floor, I'm probably not going to
Speaker 1: your Christmas party. I just the discomfort would be too much.
Speaker 1: I don't like roller coasters. I don't see that happening,
Speaker 1: but unlike the Christmas party that I bet would be great.
Speaker 1: And thank you for inviting me in your new penthouse.
Speaker 1: Uh No, regrets not going back on a roller coaster.
Speaker 1: Ben once I get it, but I probably would do
Speaker 1: some exposure therapy around trying to get to that Christmas
Speaker 1: party because that's something I really want to do. And
Speaker 1: so that was something that Dr Marcus and I talked about,
Speaker 1: and she uses this with her patients, which is, you know,
Speaker 1: it's fine to avoid certain things if you if it's
Speaker 1: just not even worth it, But what's your quality of
Speaker 1: life like with your anxiety in the sense that we
Speaker 1: can avoid certain things. You don't need to go on
Speaker 1: a roller coaster, right, you don't need to go on
Speaker 1: a zip line down a mountain. You don't need to
Speaker 1: bungee jump, you don't need to sky I have. All
Speaker 1: of those things could cause anyone to have a panic attack.
Speaker 1: But when we look at everyday things like getting on
Speaker 1: an airplane to go, you know, across the country, or
Speaker 1: driving on a freeway, when we look at those things
Speaker 1: as inherently as dangerous, as taking some big risk, that's
Speaker 1: when we start to convince ourselves that that we're right,
Speaker 1: you know, and then our life gets really small. And
Speaker 1: so what I loved about talking to Dr Marquez was
Speaker 1: she reminded me that one of the emotionally very sad
Speaker 1: things about panic and anxiety is that my life was
Speaker 1: kept small in a lot of areas. And she posed
Speaker 1: a question to me during another part of the interviewer
Speaker 1: I retroactively got some therapy. She reminded me by by
Speaker 1: saying to me what she would say to her patients
Speaker 1: about what kind of life do you want to live?
Speaker 1: And working from there and so I'll tell you we
Speaker 1: mentioned UH nine eleven in this episode. And the reason
Speaker 1: I brought it up to her was because when I
Speaker 1: was living in New York and that was, you know,
Speaker 1: working my temp jobs and wanted to be a comedian
Speaker 1: at night and was doing comedy at night, but unpaid,
Speaker 1: and you know, just a few years into comedy and
Speaker 1: just doing when everybody else did, working out your material,
Speaker 1: doing your day job, whatever it may be. And I
Speaker 1: was hooked up with a temp agency. And you get
Speaker 1: a job anywhere from a day last it could last
Speaker 1: a day, it could last a week, a could last months.
Speaker 1: And I would get these calls, well, you have a
Speaker 1: job at this building and it's uh. When you get there,
Speaker 1: check into the thirty six floor, and that's always where
Speaker 1: I'd say, Nope, can't take that job. The building is
Speaker 1: I can't, I can't I can't with the elevator, I
Speaker 1: can't be up that high. And I was offered a
Speaker 1: job in the World Trade Center, I don't know, answering
Speaker 1: the phones at some such company, and I said no
Speaker 1: because I've always had a fear of the World Trade
Speaker 1: Center and I was just thought, nah, I don't want
Speaker 1: to go in that building. It. I don't know what
Speaker 1: if something happens, what was something. I always thought that
Speaker 1: even just like a helicopter could fly into it. I
Speaker 1: just better for me to avoid that building. And so
Speaker 1: I didn't take the job. Now. Of course, as I
Speaker 1: said in the interview, I don't know if I would
Speaker 1: have been working that temp job a year later, probably not.
Speaker 1: But as someone who at the time I was living
Speaker 1: in New York City and wasn't in therapy, I had
Speaker 1: a really bizarre reaction Among many reactions to nine eleven,
Speaker 1: but one of the most bizarre ones was thinking I
Speaker 1: was right. I knew it. See, I'm I'm keeping myself
Speaker 1: safe by not going to places like this, and I
Speaker 1: don't care what these therapists say, you know. No, So
Speaker 1: I'd had a really great therapist, which I've i think
Speaker 1: mentioned in previous episodes, the woman who taught me about mindfulness,
Speaker 1: and she was my therapist when I first first went
Speaker 1: in the mid nineties when I was living in Boston.
Speaker 1: But when I went to New York, I didn't get
Speaker 1: a new therapist right away. And I had this one
Speaker 1: woman and she fell asleep during my sessions and I
Speaker 1: don't think I'm that boring, and uh, she said something once, well,
Speaker 1: if you want to be a comedian, be a comedian,
Speaker 1: why do you why do you answer phones at this
Speaker 1: tech company? And I went, well, you can't just be
Speaker 1: a comedian. Goes up, there's that can't and I said, no, no, no,
Speaker 1: like literally, that's not how it works, Like I'm still
Speaker 1: at the open mic level. You literally just it's not
Speaker 1: you can't like And I couldn't explain to her because
Speaker 1: she kept insisting I was being negative, and I was like, well,
Speaker 1: you had to go to school for this, you didn't
Speaker 1: just get to say you were a therapist. Um, and
Speaker 1: then she kind of looked at me and she's like,
Speaker 1: you seem like you're being very stubborn, and then she
Speaker 1: fell asleep. So you know, I was a little down
Speaker 1: on therapist at that point, so I I asked Dr
Speaker 1: Marquez what she would have said to me back then
Speaker 1: if I came into her and said, well, I told you,
Speaker 1: you know, planes hit buildings, they fall. Uh, I don't
Speaker 1: really need any of this therapy where you're telling me
Speaker 1: that I need to, you know, get out there and live,
Speaker 1: because look what happens when you do. You know, she
Speaker 1: gave me a great answer that just stopped me short.
Speaker 1: Even even here twenty years later, it's like, right, it's
Speaker 1: not about looking at it in terms of what we
Speaker 1: need to avoid. It's about what kind of life do
Speaker 1: we want to build? And you'll hear more about it
Speaker 1: if I ever stopped talking. Okay, let's get into it.
Speaker 1: Dr Luanna Marquez is an Associate professor of psychiatry at
Speaker 1: Harvard Medical School. Have it. I'm from Boston. I was
Speaker 1: talking to her. She was in Boston. It was exciting
Speaker 1: a lot of wicked, smot people there. And she's the
Speaker 1: director of Community Psychiatry at mass General Hospital. She is
Speaker 1: a national and international expert in cognitive behavioral therapies. Oh,
Speaker 1: you can tell to when you hear this episode, You'll
Speaker 1: be like, she's good anyway. She's the president of the
Speaker 1: Anxiety and Depression Association of America and Also, as I
Speaker 1: mentioned the author of Almost Anxious, is my or my
Speaker 1: loved ones wary or distress a problem? Now there is
Speaker 1: a longer biography and I will put the link in
Speaker 1: the show notes. You can see it wherever whatever app
Speaker 1: you're listening to this on. You can click to buy
Speaker 1: her book. You can click to read her longer bio.
Speaker 1: But as for anap enjoy my chat with Dr Lawana Marquez.
Speaker 1: Thank you Dr Lawana Marquez for joining me on Anxiety Bites.
Speaker 1: So let's just jump into it now your book, Almost Anxious.
Speaker 1: What I loved about the title, um is that I'm
Speaker 1: always learning something new about anxiety. And honestly, sometimes I
Speaker 1: think I know everything there is to know and I'm
Speaker 1: obviously wrong. And something I didn't know about was this,
Speaker 1: you know, very real medical situation of as you put it,
Speaker 1: a bunch of things can be classified as the almost effect.
Speaker 1: So one of the things that you said and here
Speaker 1: is you know, a sunburn, right, it's not skin cancer,
Speaker 1: but it could lead to skin cancer. A glucose intolerance
Speaker 1: may not always lead to diabetes, but but it could.
Speaker 1: So in other words, diseases they developed slowly and after
Speaker 1: an amount of years they could become full blown and
Speaker 1: so can you talk to us about the almost effect
Speaker 1: of anxiety? Sure? And so I think about anxiety is
Speaker 1: a spectrum. We are all anxious, right, that's their reality.
Speaker 1: Everybody has anxiety, and the question really is what is
Speaker 1: the anxiety doing to you in your life and you
Speaker 1: loved ones? And the idea behind that almost the fact
Speaker 1: is that there's plenty of research suggesting that subclinical anxiety,
Speaker 1: so not at the level diagnosing um generalizing side of
Speaker 1: disorder panic for example, but enough symptoms that start to
Speaker 1: interfere with people's lives. And so that's really why I
Speaker 1: wrote Almost Things, just to bring awad to this idea
Speaker 1: that you may be in the path to develop a
Speaker 1: full blown anxiety disorder, but the skills that we used
Speaker 1: to treat full blown anxiety disorder the same that can
Speaker 1: help you prevent getting there. And so to really get
Speaker 1: people to think about where they are in that spectrum,
Speaker 1: how is interfere in their life and and then what
Speaker 1: can you do about it? How does someone know if
Speaker 1: they're in the almost or if they're in the normal
Speaker 1: amount of anxiety that we humans get. So, you know,
Speaker 1: when you think about anxiety, the first thing you want
Speaker 1: to think about is what's it doing to you and
Speaker 1: what's the impact? Right, Um, A little bit of anxiety
Speaker 1: actually propels us and in the normal quote unquote normal
Speaker 1: um helps you actually do things right. For me, when
Speaker 1: I feel anxious, it motivates me, It signals something important,
Speaker 1: and it gets me to think about where am I
Speaker 1: in that spectamen, and what I need to do. When
Speaker 1: we get to sort of almost you start to have
Speaker 1: things like your brain is just not on. You start
Speaker 1: to have a little trouble focusing, or you might have
Speaker 1: a little trouble with sleeping. You might notice that starts
Speaker 1: to change your fear in different domains of your life.
Speaker 1: It doesn't feel debilitating the sense that you were having
Speaker 1: a full blown panic attack and you feel like really
Speaker 1: exhausted and paralyzed, but it certainly feels um troublesome. Starts
Speaker 1: to interfere with your life. So in other words, someone
Speaker 1: could have a night or two of sleepless nights. I
Speaker 1: don't know, you know, for normal I keep saying normal,
Speaker 1: but I'm saying it sarcastically. For normal reasons, they just
Speaker 1: had a kid, or their jet lagged or something. That's
Speaker 1: not what you're talking about. You're talking about out of
Speaker 1: the blue, someone who doesn't normally have insomnia. I'm just
Speaker 1: using that as an example, starts to have it, I
Speaker 1: don't know, every night, once a week, And how long
Speaker 1: does it have to go on before they've kicked over
Speaker 1: into maybe a full blown anxiety disorder? And when do
Speaker 1: they have to start, for lack of a better word,
Speaker 1: I'll say, for lack of a better word, worrying about
Speaker 1: it but addressing it. So let's say, out of the
Speaker 1: blue tonight, I have insomnia. Now, am I gonna go
Speaker 1: rushing to you know, my you know, rushing to a psychiatrist?
Speaker 1: I'm in the almost anxiety part, you know. How do
Speaker 1: we know when it's going? How do we know when
Speaker 1: we're going from almost to own? There might be something there.
Speaker 1: It is a really interesting question, especially um during a
Speaker 1: pandemic where we've seen increased in levels of clinical levels
Speaker 1: of anxiety. And I don't know anyone in the last
Speaker 1: eighteen months and didn't have almost anxiety, So how how
Speaker 1: do you define it? It's really individual to you, and
Speaker 1: I wouldn't InCor on one symptome like sliplessness. I anchor
Speaker 1: on how is it impacting my life? Is it getting
Speaker 1: in the way of me producing functioning, Is it getting
Speaker 1: in the way of my relationships? And so when starts
Speaker 1: interfere across the means and the symptoms are going to
Speaker 1: be different. For some people. Is difficult sleeping, Some people
Speaker 1: are are having a trouble because they feel like their
Speaker 1: hearts bounding too much. But I want to encourage our
Speaker 1: listeners here to really think about is it starting to
Speaker 1: get in the way of my life? Right? And most
Speaker 1: people that I've talked to you for the last twenty
Speaker 1: years as a clinician, the sort of know, they have
Speaker 1: a sense of like, you know, this is just not me.
Speaker 1: And when you start to say that to yourself, that's
Speaker 1: what you need to say, Okay, what about this is
Speaker 1: not me? And and what can I do to get
Speaker 1: back to the you that you're used to. So they
Speaker 1: start to notice that this is impacting their life, whether
Speaker 1: it's sleeplessness or whatever. Now they're not necessarily going, ah,
Speaker 1: I'm I'm in the almost anxious category. You know, they're
Speaker 1: going to call it insomnia, they're going to call it stress,
Speaker 1: they're going to call it loss of appetite or too
Speaker 1: much appetite. And then they're gonna say, oh, well it
Speaker 1: was a pandemic. Oh well, my husband's bothering me lately
Speaker 1: because he's out of work. I mean, it's I don't
Speaker 1: see people running to admit that something has crossed over
Speaker 1: into the territory where they need to be careful and
Speaker 1: watch it because it could develop into full blown pathology
Speaker 1: of anxiety, or that it does. I feel like it's like, no, no, no,
Speaker 1: I don't have anxiety. That's for crazy people. I've got
Speaker 1: I've got stressed. You know, it's all these other words.
Speaker 1: And do you find that you have to break it
Speaker 1: to people like this is anxiety and do they tend
Speaker 1: to I mean, do people kind of go, You're you
Speaker 1: don't know what you're talking about it? Or am I
Speaker 1: being Am I making that up? I feel like if
Speaker 1: it's hard to get people to accept that it's anxiety,
Speaker 1: because then they think, oh, I'm screwed. The rest of
Speaker 1: my life is going to look a certain way. I
Speaker 1: can't have anxiety. I have a job, you know it.
Speaker 1: Do you find that or am I making that up?
Speaker 1: I don't think you're making it up. I think they're
Speaker 1: behind the where you're saying is there's still a huge
Speaker 1: stigma on mental illness, right, and whenever you call something
Speaker 1: a mental illness like full blown anxiety disorder, then um,
Speaker 1: there's a perception that people are going crazy or there
Speaker 1: something is really wrong with you. Just talk about my
Speaker 1: rest of my life is going to be this way. Um.
Speaker 1: It's it's hard to say clinically though, because by the
Speaker 1: time somebody comes to me for treatment, they've identified something
Speaker 1: is not going well. And so usually my patients really
Speaker 1: want to get rid of their anxiety. They come in
Speaker 1: and they're like, Okay, I have this anxiety, just get
Speaker 1: rid of it, which I can't really write. Knowing anxiety
Speaker 1: is actually not helpful either, and so I have less
Speaker 1: trouble with identifying a more trouble convincing somebody that, listen,
Speaker 1: the enemy may not be the ansiety completely. What you
Speaker 1: do with it attends to get you into trouble. Well,
Speaker 1: that's what I've heard you say in in other interviews,
Speaker 1: that it's your relationship to your anxiety that tannon should
Speaker 1: be fixed. Who knows if anxiety itself will ever go away.
Speaker 1: Like you said, we do need a healthy amount so
Speaker 1: that we don't just like walk out into the street
Speaker 1: and let of cars. But you know, um, what does
Speaker 1: that mean exactly? Then? So what what what is the
Speaker 1: responsibility of the patient from there in terms of how
Speaker 1: they see it? The way I think about this, and
Speaker 1: it's we hate this comfort as human beings. Right for
Speaker 1: some people, it's really exciting some people with sadness. But
Speaker 1: whenever we experience this comfort, we tend to run away
Speaker 1: from it. Right. It's what psychologists called avoidance, And avoidance
Speaker 1: helps because you feel a little better. You know, I
Speaker 1: was afraid of heights, and so not going to roller
Speaker 1: coaster was great. I didn't have to deal with it, right,
Speaker 1: But that avoidance teaches you that it's really dangerous to
Speaker 1: do something when the reality is most of the time
Speaker 1: it's a false alarm. It's like a brain fart, your
Speaker 1: brain saying you know, there's align in front of you winning,
Speaker 1: for there isn't. And so the real enemy is that
Speaker 1: avoidance is sort of continually to avoid anything. I have
Speaker 1: an example often with patients that you know, sometimes before
Speaker 1: before interviews like this, I get a little excited and
Speaker 1: my heart pounds a little fast, and it's to me,
Speaker 1: what it means is, I'm excited to talk to Jed.
Speaker 1: But if I had a full blown anxiety disorder. My
Speaker 1: patient would be like, what's going on? Wise? My heart pound? Like,
Speaker 1: oh my god, am I having a heart attack? And
Speaker 1: that becomes your relationship with anxiety becomes this fear relationship
Speaker 1: instead of curiosity. Given a little excitement while my heart's
Speaker 1: bounding supposed to be faster. If I'm excited, I'm excited.
Speaker 1: So it's almost like, you know, the the usual that
Speaker 1: that that's been brought up a lot on this podcast
Speaker 1: is being the observer, being mindful, saying okay, that's that sensation.
Speaker 1: It's it's excitement, but it could turn to anxiety if
Speaker 1: I start believing the stories my brain is telling me.
Speaker 1: Not having a heart attack, I'm just talking to a
Speaker 1: new person. It's exciting a little anxiety producing what will happen?
Speaker 1: And so that's your relationship, right to or not you.
Speaker 1: But the universal your relationship to anxiety in that moment
Speaker 1: is sort of how you're observing it is that in
Speaker 1: the ballpark. It's definitely the ballpark. And you know, mindful
Speaker 1: is just one way to observative. You're talking about another one,
Speaker 1: which is the narrative in your brain, the stories that
Speaker 1: we to ourselves and our brain is programmed to jump
Speaker 1: to conclusions pretty fast, right, That's how we process information fast.
Speaker 1: And so if our interpretation is always that hard pounds
Speaker 1: equals anxiety, then the brain is not gonna pause and
Speaker 1: say what a second? Is it right? And and in
Speaker 1: the domain of cognitive therapy, they is becoming a detective
Speaker 1: looking at your thinking going wait a minute, does this
Speaker 1: actually that makes sense? Is this really true? Or is
Speaker 1: this my interpretation of it? Because that narrative in your
Speaker 1: brain certainly can lead to more anxiety. Will be right back.
Speaker 1: The avoidance thing is interesting because that was my only
Speaker 1: coping mechanism before I found therapy, and it does work
Speaker 1: until it doesn't, you know. Um, My first experience was
Speaker 1: having panic attacks on airplanes. As a kid. My parents
Speaker 1: used to take me to Disney World once a year,
Speaker 1: and then at a certain ange said I can't do
Speaker 1: it anymore. So okay, now we don't go to Disney World.
Speaker 1: Sad but worth it for me because I never had
Speaker 1: fun anymore. I was panicking about the flight even on
Speaker 1: the way there, and at Disney the whole time. Okay, great,
Speaker 1: but now I'm getting in my twenties and now I'm
Speaker 1: missing opportunities. I'm not going on free trips to go
Speaker 1: to someone's wedding or study somewhere or whatever. Um, so
Speaker 1: that doesn't work anymore, you know. Um avoiding driving. I
Speaker 1: used to have a fear of driving on the freeway.
Speaker 1: That worked until it didn't. There were just times when
Speaker 1: I needed to get somewhere fast and you have to
Speaker 1: take the freeway. And to be honest, I love driving,
Speaker 1: but I didn't love having a panic attack while driving.
Speaker 1: And there was no way I couldn't have a panic
Speaker 1: attack while driving. So it's a it's it gets very sad,
Speaker 1: you know. You go, I actually like this thing. I
Speaker 1: don't want to avoid it, but I have to to
Speaker 1: stay safe, quote unquote. So I've worked on those things.
Speaker 1: I now fly all the time. I love it. Um.
Speaker 1: I'm in Palm Springs as I'm interviewing you, which is
Speaker 1: not where I live, and I have to drive back
Speaker 1: to Los Angeles in a few days by myself, about
Speaker 1: a hundred mile trip. I'm not loving the idea of it.
Speaker 1: I'm already sitting here getting anxious thinking about it. I
Speaker 1: will not avoid it, but there's part of me that
Speaker 1: doesn't want to work on it too too much and
Speaker 1: think about it too too much while I'm driving. There's
Speaker 1: a world where I may not panic, but there's a
Speaker 1: world where I might, you know, but I don't want
Speaker 1: to think about it too much when I'm driving. So
Speaker 1: is there a way? You know, I know that there's
Speaker 1: like exposure therapy and all that, but if someone has
Speaker 1: cry us over into okay, I don't avoid anymore, but
Speaker 1: I might still panicle. I'm doing this thing. Is it
Speaker 1: best to not think about it when you're doing it?
Speaker 1: Or is it best to just try to think about
Speaker 1: it and prepare just in case? M what are you
Speaker 1: preparing for it? Though? Preparing for the possibility of a
Speaker 1: panic attack? So so, in other words, I might instead
Speaker 1: of listening to music, I might put on a podcast
Speaker 1: about breathing and anxiety, which I'm wondering that might trigger it,
Speaker 1: as opposed to just having some fun listening to some music.
Speaker 1: You know, it's like, can can you get into over
Speaker 1: correcting in a way where it's like you're aggravating it?
Speaker 1: You're you know, you're fine, you can drive, You don't
Speaker 1: have to keep thinking about I might panic? What can
Speaker 1: I do about it? Does that make sense? Absolutely? So?
Speaker 1: Two things. The first one is it's so important for
Speaker 1: you to share you know how avoidance really robbed you
Speaker 1: from trips and important things. And it is said, right,
Speaker 1: and I think it works, but us make life smaller
Speaker 1: and smaller, right, And so that's why I still think
Speaker 1: it's it's the enemy, because although it brings the fever down,
Speaker 1: it doesn't cure the infection that that panic continues to
Speaker 1: live there. The second thing you're talking about is this
Speaker 1: idea of like do you overcorrect it? And so it's
Speaker 1: it's tricky because if you're doing exposure therapy right with
Speaker 1: the idea of facing your fears, then you don't want
Speaker 1: to be listening to the music. You don't want to
Speaker 1: be distracting. However, if you were really in the possession
Speaker 1: that you haven't had many panic attacks when you're driving
Speaker 1: and you like driving, then drive because preparing for it
Speaker 1: makes it bad? Right? What is preparing? And I'll start
Speaker 1: of joking to him because when you prepare, what you're
Speaker 1: doing is you're trying to tell your brain, Okay, if
Speaker 1: it's happening, what am I gonna do? Am I gonna be? Okay?
Speaker 1: And it's actually have a narrative, right, your brain, your
Speaker 1: limbic system, your old brain, here's dangered dangered danger. It's stupid,
Speaker 1: it doesn't actually under and there's an a line. So
Speaker 1: it's increasing your fear response. And now you are actually
Speaker 1: priming yourself for a panic attack because you get to
Speaker 1: the car and you're like skinning to be sure it's
Speaker 1: gonna be okay, scanning that's right. Yeah, I do all
Speaker 1: the yeah. And you know it's funny. I already know
Speaker 1: what will happen if I have a panic attack, which
Speaker 1: is it's going to suck for a minute. Um. I
Speaker 1: may not get into full blown panic attack. I may
Speaker 1: just get into feelings of discomfort. And there's something I
Speaker 1: tell myself, which is, I'm not alone on the road.
Speaker 1: There's a million other cars with friendly people, and they
Speaker 1: all care about me. And if I have to, I
Speaker 1: will pull over and I will wave and maybe someone
Speaker 1: will stop and I'll just say I'm having a bank attack.
Speaker 1: Or maybe I'll get off at a rest stop and
Speaker 1: I'll just calm down. You know, there's a million options,
Speaker 1: and that usually helps for me in a panic attack.
Speaker 1: The deep breathing doesn't always help, but but something like
Speaker 1: that where I just make up stories. As long as
Speaker 1: making up stories, I make up nice stories now instead
Speaker 1: of you're gonna die, the car is gonna crash. Now,
Speaker 1: I say, oh, look at these friendly drivers. They're here
Speaker 1: to help if I need it. I don't need it
Speaker 1: just yet, and I kind of keep putting it off
Speaker 1: so that that's like my little gen thing that I
Speaker 1: made up that I do. Now it's a great job.
Speaker 1: I mean, you're sort of becoming your own Cogni therapist,
Speaker 1: which is incredible. You're refraining from focusing on the worst
Speaker 1: case and error, which, by the way, it has happened
Speaker 1: to you and you survived, so you sort of know
Speaker 1: what's going to happen, and you're saying to yourself things like,
Speaker 1: you know what, I can handle even if it happens,
Speaker 1: I can handle it. That's sort of the summary and
Speaker 1: and that's really helpful. It helps your brain to hear
Speaker 1: it's okay, I can handle this. Yeah, and you know,
Speaker 1: and this kind of it is the point of my
Speaker 1: podcast is that like we can still talk to ourselves
Speaker 1: in silly ways and have fun with it, and we
Speaker 1: don't have to bring like, you know, this encyclopedia of
Speaker 1: psychiatric terms with us every time we think we might
Speaker 1: pack you know, no, absolutely not. And I want to
Speaker 1: actually reaffirm something you said. It's really important deep breathing thing,
Speaker 1: and panic attack will make the panic attack worse, not better,
Speaker 1: because what happens is you're ready doing it. You're trying
Speaker 1: to force your breathing. Your body can't just shut down
Speaker 1: for an a panic attack. That's not It's gonna peak
Speaker 1: and it's gonna come down, right, So trying to get
Speaker 1: ahead of it by changing your thinking, now, that works
Speaker 1: that that seems to work for me. So it's good
Speaker 1: to hear that that's actually because it's it's true. Now
Speaker 1: I will throw a wrench in this. I know you'll
Speaker 1: have an answer to it. But I used to live
Speaker 1: in New York City. Again, I don't like heights, don't
Speaker 1: like elevators and tall buildings. And I was a you know,
Speaker 1: performer at night and had temp jobs as an assistant
Speaker 1: by day. My temp agency called and said, we've got
Speaker 1: you a job in the World Train Center and it's
Speaker 1: on the floor and I said, I do not go
Speaker 1: near that building. It is too tall. Something's gonna happen
Speaker 1: some day to that building. And this was one year
Speaker 1: before eleven, and I didn't take the job. Now again,
Speaker 1: I don't know if I would have been in the
Speaker 1: building on nine Ole, it was a temp job, it
Speaker 1: probably would have lasted a few months, you know. But
Speaker 1: in my mind when it happened, I said to myself,
Speaker 1: I'm right. You know, that's the anxiety is an anxious
Speaker 1: person who still wasn't driving on freeways and still wasn't
Speaker 1: flying on vacation. That was my thrill was to say
Speaker 1: I'm right, everybody. I told you something would happen in
Speaker 1: that building, and thank god I wasn't in it. And
Speaker 1: so if you had been my doctor when I came
Speaker 1: to you the next year, I would have just said,
Speaker 1: why are you taking all of my safety precautions away
Speaker 1: from me? Why are you telling me lies? Yes, buildings fall,
Speaker 1: planes hit them. We saw it happened, now what you know.
Speaker 1: I would have been that defiant, And so I know
Speaker 1: there's an answer in there that you will have about Okay,
Speaker 1: you were right that time sort of, but dot dot dot,
Speaker 1: why does it not matter? Like? Why is that not
Speaker 1: helpful at all in my recovery? So I wouldn't actually
Speaker 1: have told you that bad things don't happen, because bad
Speaker 1: things happen, and we would love for bad things not
Speaker 1: to happen. But the realities, bad things happen, and so
Speaker 1: the question is what do we do when they happen?
Speaker 1: And most of the time it is not like But
Speaker 1: that being said, I work with a lot of trauma
Speaker 1: survivors and really bad things have happened to them. So
Speaker 1: the question then is um for you? At that point,
Speaker 1: I'd have said to you, J you know what, let's
Speaker 1: talk all the life you want to live and and
Speaker 1: and what matters to you. Right A tip job may
Speaker 1: not have mattered tremendously, and so maybe that's the right decision.
Speaker 1: I'm not sure i'd have agreed with your conclusion because
Speaker 1: there's a couple of steps removed. But I go back
Speaker 1: to like Disney World, you sort of talked about it
Speaker 1: like you wanted to go all right, I talk about
Speaker 1: the life you want to live, and then what are
Speaker 1: the things they can tolerate to live that life or not?
Speaker 1: Some people say to me, know what, I'm fine. I
Speaker 1: never have to go in a place that's tall, and
Speaker 1: it's fine, and they're right, Then it's the life they
Speaker 1: when I live. Right, for you, you'd have to make
Speaker 1: the decision before we could figure about what kind of
Speaker 1: treatment we need. Because without annoying and I can't help you.
Speaker 1: It's so true because let's say, um, at the time
Speaker 1: I was I am now a professional comedian. At the time,
Speaker 1: that's what I wanted to be, and I wasn't. So
Speaker 1: if someone said to me, well, you can only be
Speaker 1: a professional comedian. Your dreams can only come true in
Speaker 1: this building, the World Trade Center, I would have had
Speaker 1: to take that job because I'm not saying it like
Speaker 1: it's worth dying for, but it's worth living for. And
Speaker 1: when we live, right we don't know what's going to happen.
Speaker 1: Um as I'm talking to you right now, the roof
Speaker 1: could follow in my head, you know. But but U
Speaker 1: So it's sort of like that's a great way of
Speaker 1: putting it, which is like, yeah, working at a temp job,
Speaker 1: I don't want to put up with any more discomfort,
Speaker 1: like a tall building an elevator, So I'm not gonna
Speaker 1: if I don't have to there the buildings. And I
Speaker 1: love that you're putting it in terms of what's important
Speaker 1: to you in your life, and I think what can
Speaker 1: be so sad. It just makes me so sad to
Speaker 1: think about other people still struggling with anxiety. Is like
Speaker 1: you said, it makes your life small. And then some
Speaker 1: people they don't really mean it, but they go, no,
Speaker 1: I'm gonna get by with just this, you know. And
Speaker 1: I'm sure you can tell though as as a as
Speaker 1: a doctor, when someone comes into you and they really
Speaker 1: mean it, no, no, I truly don't need to go
Speaker 1: into tall buildings. I'm good. And when someone is saying
Speaker 1: to you, no, no, I don't need anything else, and
Speaker 1: can you see it in their in their behavior and
Speaker 1: psyche that that they aren't living the life they want
Speaker 1: but they're just they don't even know anymore because they're
Speaker 1: so used to keeping it so small. You know, usually
Speaker 1: can tell. But the way I negotiate with my patients,
Speaker 1: like we do a little bit of what a cloud
Speaker 1: behavior experiment. You know, there was part of your brain
Speaker 1: to say you don't need it, but then you're sitting
Speaker 1: here with me sort of saying your life doesn't really
Speaker 1: feel great, and so let's experiment and do some of
Speaker 1: the things. Let's drive in the highway and see what
Speaker 1: happens and and how does that change your life? Does
Speaker 1: it change your life? And if people can't explore sometimes
Speaker 1: I thought having to be like I have to do
Speaker 1: it right I don't like people telling you what to do,
Speaker 1: and so as a therapist, I'm not gonna tell you
Speaker 1: what to do. I'm gonna say, can we experiment And
Speaker 1: sometimes we find out that the patient really was leaving
Speaker 1: a small life and they wanted something different. Sometimes they
Speaker 1: want to be in their conference zone, and I would
Speaker 1: never judge, you know, comfort zones feels good for most people.
Speaker 1: It just limits our ability to push ourselves. It's like
Speaker 1: me with the roller coaster. I hate roller coasters, terrifying,
Speaker 1: I'm missing nothing. I don't like it, so never going
Speaker 1: on one. But yeah, there was a time when I
Speaker 1: convinced myself, no, no, no, I just I'll never go
Speaker 1: anywhere and I'll just stay. You know. Imagine it was
Speaker 1: going to get to where I'm just standing in a
Speaker 1: corner going this is great, this is great, you know,
Speaker 1: but you you're a book blew my mind when I
Speaker 1: read this thing that I had never thought of. And
Speaker 1: I've done it, and I've had people do it to me.
Speaker 1: Reassurance seeking as a form of avoidance. And you say
Speaker 1: it can function as a form of avoidance since it
Speaker 1: immediately reduces your anxiety level, but it can keep you
Speaker 1: stuck on their hamster wheel by keeping you from facing
Speaker 1: your fear. So can you tell our audience and I'm
Speaker 1: sure they might hear themselves in this description. What is
Speaker 1: a reassurance seeker doing? For insurance seeking is this, you're
Speaker 1: so uncomfortable you have to have somebody else make you
Speaker 1: feel comfortable, so you seek reassurance. It's sort of like
Speaker 1: you're saying to me, you know what, am I gonna
Speaker 1: be okay? If I drive home today? And I said, oh, absolutely,
Speaker 1: you can hand away. You know you've had panic attacks
Speaker 1: before where you can handle it. And by giving you
Speaker 1: that reassurance immediately most people start to feel better. Right,
Speaker 1: it's it's gonna be okay. But the reality is number one,
Speaker 1: I don't know if it's gonna be okay. Number two,
Speaker 1: you need to learn to tolerate this comfort to overcoming
Speaker 1: and you, I mean any of us. And so reassurance
Speaker 1: is a quick being d and we all do it
Speaker 1: and always say to our loved ones, he do you
Speaker 1: love me? Or And so it's not it's bad necessarily,
Speaker 1: it's just that if it is the only way you
Speaker 1: manage your anxiety is by seeking reassurance, then you were
Speaker 1: preventing yourself for an opportunity to overcome anxiety that's stabilitating.
Speaker 1: And then you were saying in this little blurb in
Speaker 1: the book too, that someone can seek reassurance. Am I
Speaker 1: going to be okay when I go to the mall? Oh? Absolutely?
Speaker 1: And then well that wears off after a few minutes
Speaker 1: for them, and then they have to ask it a
Speaker 1: different way. Well what if I went to them all that,
Speaker 1: you know, like they keep asking in a different way, right,
Speaker 1: it just gets almost like more addicting. It definitely does,
Speaker 1: because your brace clever. Right. In fact, when I start
Speaker 1: with patient, say to them, I will always answer your
Speaker 1: question once. But if you ask the same question five
Speaker 1: different ways, you're seeking resurance, And so I can't. And
Speaker 1: my patients start getting in the in the random and
Speaker 1: they go, oh, that's resurance, right, I'm like, that's resurance
Speaker 1: And I can't tell like to me and you're making
Speaker 1: you sick or if I keep giving you reassurance, anxiety
Speaker 1: bites will continue on the flips out of this message
Speaker 1: from our sponsors. So I wanted to before I let
Speaker 1: you go here. Uh, there was a case study in
Speaker 1: your book about this man named Ricardo, and he's like,
Speaker 1: you know, I'm a fiery Latin man and I just
Speaker 1: I'm passionate, and but eventually his irritability would cause him
Speaker 1: to blow up at people. And you're saying, you know,
Speaker 1: he'd get in a relationship about three months go by
Speaker 1: now that irritability comes out and he was exhausted by
Speaker 1: the end of the day from muscle tension. And you
Speaker 1: were talking about how irritability is a sign of anxiety,
Speaker 1: and I know for me that was definitely one of mine.
Speaker 1: And again, I think this is something that might be
Speaker 1: new to a lot of people that they think anxiety
Speaker 1: is I'm nervous and I'm biting my nails and I'm shaken.
Speaker 1: But irritability, really, um can be anxiety. And can you
Speaker 1: explain to us how you know it is and how
Speaker 1: you know it's not like an anger management problem or
Speaker 1: is it all the same? Mm hmm. Yeah. I mean,
Speaker 1: so that's the thing. You're You're hitting something important that
Speaker 1: people have a idea within anxieties in their brain and
Speaker 1: and you know it's the panic attack, is the worry.
Speaker 1: But for different people is different things, and for something
Speaker 1: it's really real ability. They just feel edgy. And the
Speaker 1: way you describe to me is like if you poke them,
Speaker 1: it's like a balloon that's just about to explode. And
Speaker 1: so the whole time they're trying to keep that inside
Speaker 1: because they don't want to explode, but eventually they do, right,
Speaker 1: And so it's really what is the function? What's happening
Speaker 1: there for them? You know in this case, somebody this
Speaker 1: patients like spinning all the time, You get little edgy
Speaker 1: and then they try to dismiss it, but then it
Speaker 1: blows up, right, And so how do we defer for
Speaker 1: an anger management? Anger management tend to go around different
Speaker 1: domains in your life. And you notice that's a lot
Speaker 1: more anger than irritability. Right, I'll first benger versus like
Speaker 1: just feeling edgy, feeling edgy, feeling edgy, and then you
Speaker 1: might have an anger outwurst. But what I'm really talking
Speaker 1: about the aridability of like edgeinists feeling on a lot.
Speaker 1: And then eventually, of course you're gonna have muscle tension
Speaker 1: because you are right, you're tighten up. As I talk
Speaker 1: about this, I like compress the immediately because I can
Speaker 1: see my patients doing it. So it's sort of like
Speaker 1: an irritability example would be I'm running errands and every
Speaker 1: single thing annoys me. Why is a person in front
Speaker 1: of me using pennies? Oh? Why didn't the cashier know
Speaker 1: that that was on sale? Oh my god, look at
Speaker 1: how that person parked. It's just like every single thing
Speaker 1: is like a mild irritation. But it's like not funny,
Speaker 1: you know, it's not You're not saying it in a
Speaker 1: funny way. It's like you just can only laser focus
Speaker 1: on things that are irritating. That's a great example, and
Speaker 1: and in that way you can see how it gets exhausting, right,
Speaker 1: because your brains on all the time. We'll go back
Speaker 1: to that skinning, and it's hyper focused on things that
Speaker 1: sort of few really annoying. Is there any reward in that?
Speaker 1: Like our people in any way at all, it's soothing
Speaker 1: their anxiety, but in a bad way by being that
Speaker 1: irritable or like what is happening there that that wouldn't
Speaker 1: it be better to just be anxious? For some of us?
Speaker 1: Maybe the brain is always filter information, right, and it's
Speaker 1: based on our belief systems. The way we see the
Speaker 1: world our lens is how I think about it. And
Speaker 1: for some people, you know, they say the world that
Speaker 1: way that things are annoying to them. And that's just
Speaker 1: and so when the brain is scanning its skins for that,
Speaker 1: and it does because of a concept called cognitive dissonance,
Speaker 1: which just means your brain does not like when things
Speaker 1: don't fit. Right. If you walk in the middle of
Speaker 1: the woods and you see a cow and that called meows,
Speaker 1: you're gonna go, wait a minute, what happened? Right? It
Speaker 1: just doesn't make sense. And so this is sort of
Speaker 1: the idea. If your brain skins for irritability, that's what
Speaker 1: it does. It is not rewarding, but certainly it's consistent.
Speaker 1: It's it's less energy than not. Okay, that makes sense,
Speaker 1: and so you know he's going to bed stiff muscles
Speaker 1: and all that. And and I found in my work,
Speaker 1: like with recovering from anxiety, that progressive muscle relaxation one
Speaker 1: of my favorite things to do. And I feel like
Speaker 1: people talk so much about meditation, and meditation is great,
Speaker 1: but the real thing for me where you actually do
Speaker 1: feel because anyone who's an experienced meditator knows you don't
Speaker 1: necessarily feel relaxed after it's challenging, you know, thing to
Speaker 1: sit with your thoughts. But I love progressive muscle relaxation,
Speaker 1: just the simple tightening of muscles and then relaxing, going
Speaker 1: from head to toe. That is my favorite thing to do.
Speaker 1: And I feel like nobody talks about that. We've all
Speaker 1: jumped to mindfulness meditation, and I feel like people need
Speaker 1: Don't you think if people focused on their bodies a
Speaker 1: little more it could maybe help? Because I heard somewhere
Speaker 1: that if your body has relaxed, your mind can really
Speaker 1: be anxious. I don't know if that's sort of a myth,
Speaker 1: but so it's interesting. What's so powerful about progressing must
Speaker 1: realization And for those that don't understand, it's really the
Speaker 1: idea of like Titan muscles and and releasing them. And
Speaker 1: what he does is by contracting the muscles immediately they released.
Speaker 1: And you know there are seven and it's sixteen progress
Speaker 1: progressive muscle relaxation. It was in every treatment protocol when
Speaker 1: I was in graduate school twenty years ago. Every protocol
Speaker 1: for everything had progressed a must realization. Then the third
Speaker 1: wave of con to behavior therapy came in and mindfulness
Speaker 1: became the thing progressing smust realization that is super powerful.
Speaker 1: By you just mentioned it, chin, my shoulders relaxed because
Speaker 1: I've done. It was so many patients just the term
Speaker 1: of it. My body went, oh right, And so what
Speaker 1: I think It's important to find the recipe that works
Speaker 1: for you. That's what I suggest is like for some people,
Speaker 1: meditation works for some people. Per works for some people.
Speaker 1: Is you know, going for a yoga class regardless whatever
Speaker 1: brains your temperature though, that's the thing you gotta do. Yeah,
Speaker 1: I'm a big fan of progressive muscle relaxation. It just
Speaker 1: I can. I like to think you know, it's a
Speaker 1: result you can feel right away. That's always nice. Um.
Speaker 1: So lastly, I'll just ask you about this very subtle
Speaker 1: part of your book, almost Anxious. Is my parentheses or
Speaker 1: my loved ones worry or distress a problem? Now? I
Speaker 1: have so many people saying, will you talk on the
Speaker 1: podcast about you know, what do I do? My husband's anxious?
Speaker 1: My wife is anxious? And it's like, listen, I think
Speaker 1: we're getting into a whole other area. We could veer
Speaker 1: off into code dependency. Who knows, But what do you
Speaker 1: do if someone close to you is anxious and they
Speaker 1: don't know, but you can kind of how they are.
Speaker 1: Is there any way to approach that person and suggest
Speaker 1: I mean to me, it seems like g walking into
Speaker 1: a bear trap. But what what what do you tell
Speaker 1: people who ask you? Or do you tell them no,
Speaker 1: you're gonna mind your own business, you can't do anything.
Speaker 1: It really depends on the relationship, right. But um, if
Speaker 1: you've seen somebody around you that they are suffering and
Speaker 1: you seem to think what it is, I think it's
Speaker 1: appropriate to sort of say, hey, John, I've noticed that
Speaker 1: you're really tense lately. I want if you want to
Speaker 1: talk about it, or hey, every time I asked you
Speaker 1: should do something, you sort of jump at me. That
Speaker 1: doesn't feel so good? Right, You can talk about what
Speaker 1: they're in desiety does to you because you can own
Speaker 1: your own emotions, your own behaviors, and it's one way
Speaker 1: that you can say not that you're bad, but like, listen,
Speaker 1: you yelling at me doesn't feel so good, or um,
Speaker 1: slamming doors doesn't feel so good, or the fact that
Speaker 1: you're in your head thinking all the time. Um. I
Speaker 1: I also like the idea of talking to somebody about
Speaker 1: you know, I've noticed the intense and how is that
Speaker 1: getting the way of your life? Right? So, going back
Speaker 1: to this, like do they want a different life? So
Speaker 1: how does impact you? Do they want a different life?
Speaker 1: The last thing I think you can say to somebody
Speaker 1: as well, it's it's sort of um, understanding that concept
Speaker 1: of your sturtans seeking that we talked about and agree
Speaker 1: that you know what, maybe you don't want to seek treatment,
Speaker 1: but I can't give you reassurance because I learned that
Speaker 1: that actually makes you much more anxious. So whenever you
Speaker 1: seek reassurance, I'm gonna stop doing this. And I've had
Speaker 1: lots of success treating couples that way. When you know
Speaker 1: they maybe the husband is really anxious and the wife
Speaker 1: comes in and we agreed the assurance is off the table.
Speaker 1: It makes the person usually a little more uncomfortable, right
Speaker 1: because now they don't have their fix or reassurance. But
Speaker 1: being a little uncomfortable sometimes is what propels people to
Speaker 1: seek treatment and try to get better. Yeah, it's like
Speaker 1: a little mini intervention in a way, right, Like I
Speaker 1: cannot be a part of this anymore. If you're going
Speaker 1: to be anxious, you know, these are the ways I
Speaker 1: cannot support you and it or enable you, I guess
Speaker 1: is kind of what people are doing. Um, okay, that's
Speaker 1: great advice. And then lastly, I know that you are
Speaker 1: the president of the UM, the Anxiety and Depression Association
Speaker 1: of America. Do you find that there is a connection
Speaker 1: between anxiety and depression? UM? Do do most anxious people
Speaker 1: who are pathologically diagnosed with generalized anxiety disorder or phobia
Speaker 1: or whatnot, do they have a tendency for depression or
Speaker 1: is it really two separate things? It can beat your
Speaker 1: separate things, but they tend to come together. Not always though,
Speaker 1: but you know, again we're talking about the almost effect here.
Speaker 1: Sometimes somebody is anxious in a little set. They're not
Speaker 1: depressed clinically, but they do tend to come together. A
Speaker 1: lot of patients that I've treat have some anxiety and
Speaker 1: some depression, but for most people there's one that is
Speaker 1: worse than the other. And and that's really UM how
Speaker 1: I think about it. But they do tend to correlate.
Speaker 1: I know, for me, I had anxiety first and then
Speaker 1: the depression showed up years later. And for me it
Speaker 1: would be when the depression days would come, What a
Speaker 1: relief because I'm less turned on and heightened and anxious,
Speaker 1: and with depression it was never as bad as suicidal
Speaker 1: or anything. But with depression there's a sort of I
Speaker 1: don't care, and that felt so good as opposed to
Speaker 1: the anxiety, and so I kind of learned to love
Speaker 1: my depression days, and on those days I was a
Speaker 1: little more fearless, if that made sense, because I just
Speaker 1: then the energy didn't care. And so eventually I learned
Speaker 1: to in a healthy way, you know, not be heightened
Speaker 1: and not care, not of anxiety. But for me it
Speaker 1: was almost like, oh good, it's like a rain storm
Speaker 1: after a drought. Like I kind of was like, oh
Speaker 1: thank god, the depressions coming into soothe me. You know,
Speaker 1: I've heard that from many patients actually who really hate
Speaker 1: their anxiety, and when they feel depressed, it does have
Speaker 1: that sense of I don't care of help, listening, hopelessness,
Speaker 1: and just like and so it really is about your
Speaker 1: relationship again to your anxiety. And for some people, so
Speaker 1: rid I hit a patient as we say, I just
Speaker 1: feel like I'm gonna explode, and Nephelie is uncomfortable for sure. Well,
Speaker 1: thank you so much for talking with me. I mean
Speaker 1: I couldn't go on and on for a million years
Speaker 1: and and ask you things. But I definitely think this
Speaker 1: episode is so unique to all the other ones because
Speaker 1: we've we've talked about things that I just have not
Speaker 1: heard people really articulate. And uh, I'm so grateful to
Speaker 1: you for taking the time. Thank you. No, no, I'm
Speaker 1: delayous to be here and I'm glad that you're talking
Speaker 1: about it because I used to open so many people
Speaker 1: that need it. It's really just a flash which you
Speaker 1: get to know even be here. And that was my
Speaker 1: chat with Dr Lawana Marcusin. So coming up are the
Speaker 1: takeaways from this episode. But if you are curious, I
Speaker 1: will let you in on the flip side of my
Speaker 1: driving home from Palm spring So even though her advice
Speaker 1: was fantastic, it's just sometimes anxiety doesn't quite give up
Speaker 1: its fight. And I felt like I was in an
Speaker 1: arm wrestling match with anxiety and we were just, you know,
Speaker 1: maybe it was a tie. So basically the bottom line
Speaker 1: is I just overthought the whole thing, and then also
Speaker 1: circumstances beyond my control happened. So my plan was to
Speaker 1: get up at six thlirt in the morning, get on
Speaker 1: the road by seven. There is zero traffic from Palm
Speaker 1: Springs towards l A at that time of day. You
Speaker 1: can get home in an hour and fifty minutes, which
Speaker 1: is about normal for a hundred mile drives. So I thought,
Speaker 1: that's great, I'll do that. And you know what, if
Speaker 1: I'm freaking out, I can get off at any exit
Speaker 1: and just calm myself. There is really the worst case scenario,
Speaker 1: Jen Moore's case. You just pull over for a while
Speaker 1: and I don't know, I don't know, or drive home
Speaker 1: on a side road, which isn't a thing really. And
Speaker 1: for some reason, when I woke up that morning, I
Speaker 1: was so tired that I convinced myself that driving while
Speaker 1: you know, tired after only getting six hours of sleep
Speaker 1: as opposed to eight, would induce panic. Now, sometimes that's true,
Speaker 1: but other times, being sleepy kind of works for me
Speaker 1: because I, you know, it feels relaxing. I wasn't worried about,
Speaker 1: you know, anything physical like motor skills being affected, even
Speaker 1: though I have read Sure Sure Sure that driving well
Speaker 1: tired is is almost akin to driving well buzzed. But
Speaker 1: besides all that, for a second and I decided, no,
Speaker 1: I'm gonna look at my um app, the ways app,
Speaker 1: and it's predicting that traffic will be this clear until
Speaker 1: about noon. You know, around noon, it starts to get
Speaker 1: a litle heavier. I said, well, let's split the difference.
Speaker 1: I'll leave around nine, and so I let myself sleep
Speaker 1: another hour. I got some yogurt, I was had some food,
Speaker 1: and I got on the road and there was a
Speaker 1: sign that said, you know, accident up ahead. It's all good,
Speaker 1: but there will be traffic, and I saw it. It
Speaker 1: was bumper to bumper traffic like a parking lot, not
Speaker 1: moving for miles, tens and tens of miles, and my
Speaker 1: app said it would take four hours to get like
Speaker 1: most of those hours would be the first two hours
Speaker 1: of the trip, which just sitting. And I went, uh no,
Speaker 1: I mean, who could do that, even in the sense
Speaker 1: of like what if you have to pee or something.
Speaker 1: And I just said, that's not gonna happen. And luckily
Speaker 1: I was at a point in the road where I
Speaker 1: could do a U turn it wasn't quite the freeway
Speaker 1: yet and go back, and so I went back, and
Speaker 1: there there actually was a post wedding day brunch that afternoon,
Speaker 1: and I went, I'll go to the brunch, and I
Speaker 1: went and I just watched the traffic on my app,
Speaker 1: and it was just getting worse by the second because
Speaker 1: of all these weird minor fender vendors. But I had
Speaker 1: some friends who were leaving and getting on the road
Speaker 1: at the same time as me, and so we both drove.
Speaker 1: For some reason, I'm stopping. My neurosis is saying, people
Speaker 1: are going, why didn't you drive with other people? Because
Speaker 1: I had come up a week earlier with my parents,
Speaker 1: these people were in a car with their kids and
Speaker 1: this whole thing, that's just how it happened to be.
Speaker 1: So we were driving sort of near each other. I
Speaker 1: could see my friends on the road as we sat
Speaker 1: in this parking lot of a freeway, and it felt good.
Speaker 1: I could old, there's my friend, I can see them,
Speaker 1: and it moved a lot quicker. I got home in
Speaker 1: two and a half hours rather than four. It ended
Speaker 1: up fine, but yeah, I did have some moments of
Speaker 1: feeling like I was having a panic attack. It didn't
Speaker 1: go full blown, but it wasn't very comfortable either. And
Speaker 1: then ultimately it just got more boring than anything. And
Speaker 1: as I got closer and closer to Los Angeles, it
Speaker 1: just got like not it was nothing. It was fine,
Speaker 1: and I realized I've spent more time worrying about it
Speaker 1: then was necessary. Zero seconds worrying about it is unnecessary.
Speaker 1: But I thought about it too much. But that's what
Speaker 1: ended up happening is I had just I had already
Speaker 1: done it for so long. I really just my tools
Speaker 1: were just I don't know, just wasn't working day. But
Speaker 1: you know, I made it through. It was fine. The
Speaker 1: biggest thing that I know how to do now is
Speaker 1: sit with my discomfort and not add on crazy stories
Speaker 1: to what I'm thinking. I just sometimes have to have
Speaker 1: some anxiety, Like sometimes you're just going to have some anxiety.
Speaker 1: Sometimes you're just going to be on the verge of
Speaker 1: a panic attack. But the one thing I know I
Speaker 1: can do now is not add crazy stories like oh
Speaker 1: my god, you're stuck here and you're all alone. And
Speaker 1: I didn't do any of that, And I guess that
Speaker 1: is a win. I know that's a win. As I
Speaker 1: would tell someone else, that's a win. I believe it
Speaker 1: is hard for me to acknowledge that for myself, if
Speaker 1: that makes sense, But I'm going to acknowledge that's a
Speaker 1: huge win, even if I want to shout from the
Speaker 1: roofs I'm normally not anxious like that. All right, Well,
Speaker 1: on the days you are, you did great, Jen so
Speaker 1: some of the takeaways from Dr. Lauana Marquez is that
Speaker 1: anxiety is a spectrum. We are all anxious at times.
Speaker 1: A little bit of anxiety is normal and can propel us.
Speaker 1: If anxiety is interfering in your life, but it's not
Speaker 1: going into full blown panic attacks, you are in the
Speaker 1: almost If you aren't sure if you need help with anxiety,
Speaker 1: don't just base the decision on maybe a symptom you're having,
Speaker 1: but asked yourself, how is this symptom impacting my life?
Speaker 1: Is it getting in the way of me producing or functioning?
Speaker 1: Is it getting in the way of my relationships? A
Speaker 1: therapist can't get rid of your anxiety, but the enemy
Speaker 1: may not completely be anxiety. It's what you do with
Speaker 1: the anxiety and how you handle it that can get
Speaker 1: you into trouble. People tend to run away from discomfort,
Speaker 1: which psychologists call avoidance. When you give into avoidance, you're
Speaker 1: falsely teaching yourself that something is dangerous that isn't. Avoidance
Speaker 1: can bring down the fever, but it doesn't cure the infection. Again,
Speaker 1: it's not really possible to overall, for the rest of
Speaker 1: your life get rid of anxiety, but instead it is
Speaker 1: possible to see what our relationship to anxiety is. When
Speaker 1: trying to over hum using avoidance, we have to ask ourselves,
Speaker 1: what's the life you want to live, what matters most
Speaker 1: to you? What are the things that you can tolerate
Speaker 1: to live that life. Another way that we avoid is
Speaker 1: by asking people to reassure us. And it gives us
Speaker 1: what we want in the moment, but it doesn't last
Speaker 1: very long. And if we are giving in and reassuring
Speaker 1: our loved ones who are anxious, we're actually helping them
Speaker 1: stay sick. Progressive muscle relaxation is a great way to
Speaker 1: get rid of anxiety in our body. That's it. I
Speaker 1: hope you enjoyed this week's episode. Of course, come back
Speaker 1: next week for more, and just remember anxiety bites, but
Speaker 1: You're in control. For more podcasts for my Heart Radio,
Speaker 1: visit the I Heart Radio app, Apple podcast, or wherever
Speaker 1: you listen to your favorite shows.