Modern Wisdom - #469 - Dr Tracy Dennis-Tiwary - The Truth About How Anxiety Works

Episode Date: May 5, 2022

Dr Tracy Dennis-Tiwary is a professor of psychology and neuroscience, anxiety researcher, author and founder of Wise Therapeutics. Anxiety is one of the most common mental health disorders in 2022. Huge numbers of both adults and children are suffering, but just how natural is this? Is it normal for humans to be ambiently anxious for months on end or is our modern society causing this to occur? Expect to learn why anxiety developed as a human emotion and how it helped us survive, why anxiety is a signal for your next move, the size of technology's influence on our mood, how to reframe anxiety so it becomes a competitive advantage, why your anxiety and creativity are intrinsically linked and much more... Sponsors: Join the Modern Wisdom Community to connect with me & other listeners - https://modernwisdom.locals.com/ Protect yourself from identity theft online with Aura. Try 14 days for free at http://aura.com/modern (discount automatically applied) Get 15% discount on the amazing 6 Minute Diary at https://bit.ly/diarywisdom (use code MW15) (USA - search Amazon and use 15MINUTES) Get 10% discount on your first month from BetterHelp at https://betterhelp.com/modernwisdom (discount automatically applied) Extra Stuff: Check out Tracy's website - https://www.drtracyphd.com/ Buy Future Tense - https://amzn.to/3y2LNKw  Get my free Reading List of 100 books to read before you die → https://chriswillx.com/books/ To support me on Patreon (thank you): https://www.patreon.com/modernwisdom - Get in touch. Instagram: https://www.instagram.com/chriswillx Twitter: https://www.twitter.com/chriswillx YouTube: https://www.youtube.com/modernwisdompodcast Email: https://chriswillx.com/contact/  Learn more about your ad choices. Visit megaphone.fm/adchoices

Hello everybody, welcome back to this show. My guest today is Dr. Tracy Dennis Tawari, she's a professor of psychology and neuroscience and anxiety researcher, author and founder of Wise The Reputics. Anxiety is one of the most common mental health disorders in 2022. Huge numbers of both adults and children are suffering, but just how natural is this? Is it normal for humans to be ambient the anxious for months on end? Or is modern society causing this to occur? Expect to learn why anxiety developed as a human emotion and how it helped us survive.

Why anxiety is a signal for your next move, the size of technology's influence on our mood, how to reframe anxiety so it becomes a competitive advantage, why your anxiety and creativity are intrinsically linked, and much more. The insights that Tracy gives today are really valuable, and know that anxiety is a huge problem that a lot of people suffer with, and it's just important to have someone who understands the research and is knee-deep in the psychological literature who can tell you that you have control over how this impacts your life, and that you can reframe it to perhaps even be an advantage for you. I really like it. I like the fact that it is empowering people to take control of their own lives to regain a little bit of sense

of ownership over the way that their mind works. She's great. You're really going to enjoy this one. But now, please give it up for Tracy Dennis to worry. Why does anxiety exist? It's the new sort of hot topic concern for pretty much everybody to deal with on a daily basis. Why is it even a human emotion? So anxiety is sort of the word we use to describe everything going on for us today. We feel that we're in a new age of anxiety. of anxiety. I actually think, and the whole premise of my book is that we actually really have the wrong story of anxiety. That anxiety isn't this malfunction or a disease

that actually anxieties a triumph of human evolution. And that takes a little unpacking because anxiety is not necessarily an anxiety disorder. And we've come to equate the two. So anxiety is an emotion. It's evolved like many other things to be useful to us. And actually, when Darwin wrote his theory of evolution, it was a trilogy, there were three parts to it,

and the third part was called the expression of emotion in man and animals. And it was all about emotion and its adaptive value. And so when you think of it from that perspective, well, why would we evolve to have anxiety? It seems like this destructive, terrible thing. Anxiety is apprehension, this nervous feeling, or the physical thing feeling, the thoughts, all of those responses, it's but it's apprehension

about the uncertain future, which means that there's something coming around the bend, it could be bad, but it could also be good because it's uncertain, and anxiety actually prepares us to avert disaster and make good outcomes into reality. And so anxiety evolved to help us actually manage this perhaps the most critical challenge of humanity over our evolution, which is uncertainty, things that we can't protect ourselves immediately from. And it prepares us to imagine the future. That's why I called the book Future 10.

You can't be anxious without thinking into the future, being a mental time traveler. You imagine the future, you plan, and in response to those plans, you're more persistent, creative, innovative, and you prioritize social connections. And so anxiety is really, it has this aspect of being a real asset to us. So anxiety is fundamentally future focused. You can't be anxious, but we can be anxious about something that happened in the past. Oh no. No.

What we would be anxious about would be, I went in hard a conversation with my coworker, it went really, really badly. I feel like a fool. I am anxious about how they are going to treat me the next time that they see me. So even the stuff that we reflect on we're still going future focused with it. 100%.

That's right. And we think about anxiety because it's so amorphous. I mean, language is so crucial. Our mindset, what we believe and filter in about our world. So we've all come to assume that anxiety. And honestly, the reason I wrote this book, I mean, I've been a scientist for 20 years, I'm a researcher, I'm a neuroscientist, and I thought, oh, all right, we're going to

take great signs, we're going to beat back this mental health crisis we're facing. I actually became a psychologist officially on September 11th, 2001. That's 9-11. I was defending as the towers, my defense of dissertation, as the towers were falling. I didn't know that. I'm a New Yorker. And so here I am, this newly minted psychologist, and I'm like, okay, we have a crisis here. I'm just going to put my head down and do the science and create the interventions and do the work. And then 20 years goes by and I look up and mental health, if anything, is worse than it was before. It's been steadily mental illness has been on the rise. We have great treatments. We have anti-anxiety meds if you need them. We have

science-based wellness practices. We have self-help, we have a complete ecosystem that is there to help us prevent and eradicate anxiety, but it's only been getting stronger over the years. And so I realize that we've been doing something fundamentally wrong. As psychologists, we've been telling ourselves and others that anxiety is a malfunction, that it's probably a disease, that the discomfort of anxiety should be alarming to you. So suppress it right away, prevent it, eradicate it. But that is literally a recipe for making anxiety worse when we avoid it when we suppress it.

We know it always comes bouncing back stronger. And you don't develop ways of coping. And you forget that we can actually leverage anxiety to be this incredibly useful source of activation and energy. Even though it does feel bad, it sucks. Energy, I mean, the energy of anxiety now feel good, but it evolved to feel bad so that it grabs us, makes us pay attention. It's like a smoke alarm going off telling us, okay, there's something to care about in

the world. Now, you better do your job and make it happen. It's interesting when you look at emotions or traits that we have that are adaptive and fitness enhancing, but also uncomfortable. And the bottom line is, humans are built to be effective, not happy. We're built to be effective, survive and reproduce, survive and reproduce. What are the traits that helped us to survive and reproduce? Now we do have a mismatch between our current environment

that we're in now and the one that every single trait that we now deal with developed in. And in a world which would have been significantly more dangerous that would have had far more threats where you could have been killed by a cut on your knee or there was constant predators around and you didn't have shelter and you were cold in the winter and hot in the summer as opposed to the other way around which we now have with heating and air conditioning. All of those traits were adaptive, right? They helped us to survive and anxiety being everyone understands you walk toward I do a little morning walk in Austin where I am at the moment and there's a lot of squirrels here you guys Everywhere I know you are Queen of squirrels. We know from squirrels intimately. Yes and

There I was looking this morning. I was thinking about the factory gonna have this conversation and It was I was so far away from this squirrel and it can move so much quicker than I can move and yet it was moving away from me scurrying away from this squirrel and it can move so much quicker than I can move. And yet it was moving away from me, scurrying away from me because it's got presumably some form of anxiety or concern or threat response where it thinks that big thing in the hoodie over there is walking towards me. I need to make sure that I keep my distance. Even though we're ten yards apart. So there is always an advantage, the negativity bias, right, to err on the side of increased danger. And I suppose that, yeah, seeing anxiety is something which is malignant or a, like an aberration of the way that we're put together is probably not fully embracing what it can do. And also, maybe even more importantly than that, as soon

as you start to make anxiety a problem in itself, you get anxious, guilty, and resentful about feeling anxious, which creates this second order effect that can often be even bigger. It's a recipe for that. And something very interesting about what you said, and which I spend a lot of time exploring in the book, what you described about that squirrel, I believe that was probably closer to fear than anxiety. And we tend to equate the two. So fear is present, you're in the present tense, and you're certain there's danger right there facing you.

And you don't have to have simulations of the future, you don't have to be a mental time traveler. Here's this big hoodie guy, and he's coming towards me, and on this little squirrel acuity, and I need this little squirrel AQT and I need to do something about that I've learned, right? That's adaptive. But anxiety is about something you haven't seen yet. It's about being able to simulate

in your mind and hold it at once, both the positive and the negative possibility. What if the hoodie guy comes by tomorrow or next week? Yeah. And I think, I mean, you'd have to be the, like the Renee Day card of, you know think you'd have to be the, like, the Renee Day cart of, you know, you'd have to be, you know, you'd have to be this existentialist squirrel to be able to really think that deeply, you know, about, about that because that's not,

you know, the animals, I think, do have some anxiety. I mean, of course, because I wrote a whole book about anxiety, I have a very anxious dog. It's, that is not, I'm not. Is that a byproduct of you writing the book? I have no idea. I can't figure it out. He's a rescue, but suffice it to say, when I think about his experience,

it's really about this certain present danger. An anxiety, again, you're thinking to the future, so it's not just protective. And that's something we can wrap our mind around, right? Like fear can be protective too. It's actually productive. And this is where we've wrap our mind around, right? Like fear can be protective too. It's actually productive. And this is where we've been asking the wrong questions, having the wrong conversations about anxiety,

because well, here's something that's scientifically established, but we don't talk about it. So we know that dopamine is sort of the field-guored hormone, right? It's that neurotransmitter and our brain, we think about it as having to do with addiction on the bad side, but also any sort of pleasure you get a spike of dopamine, right? It's that it's that neurotransmitter in our brain. We think about it as having to do a with addiction on the bad side, but also any sort of pleasure you get a spike of dopamine, right? It's sex, drugs, and rock and roll. That's dopamine. And we think about this reward system, which also is helpful to you because dopamine also spikes when you're anticipating

pursuing something that's important to you, trying to work towards the goal. So dopamine's there as this little messenger among, you know, between your brain areas, trying to get your brain to work effectively to meet your goals. But guess what also causes dopamine to strike, to spike rather, is anxiety. So when we're anxious, dopamine has a huge increase in our brain. Now why?

Because when we're anxious, we still are hoping. We're in it to win it. We're caring about the future. And so anxiety by leveraging the reward system is actually allowing us to say, OK, there's this bad thing that could be happening. But there's also this really good thing in my body, which feels a lot like fear.

There's the fight flight. There's all these other things. But those are the fight flight and fear of the three Fs. Anxiety on top of that recruits your reward system. It recruits your social bonding system. It recruits all this other biology that allows us to be positively focused, not just defensive. Does that mean that people can get addicted to anxiety or they can become dependent or increasingly sensitive to it? Well, we actually have not asked a lot about that. It's a great question. What we think probably happens is that when you're tracking your emotional state, anxiety, it's uncomfortable, it spikes, but so does dopamine. But then when you meet your goal, when you either do the

thing you need to, you're worrying about that thing in the future, you're like, oh, I better just take care of business. Then when you've done that, dopamine will start to go down, your anxiety will go down, and that's negative reinforcement, right? So it can keep you doing that same thing, and maybe that's a good thing like persisting, because the absence of that feeling of anxiety is rewarding to you.

So in that sense, what you're suggesting is really interesting because you're saying, well, but if we get hooked on that cycle of feeling good, right, after we've done that thing, anxiety, I mean, that's one way that we know anxiety disorders operate. Like, take what we now don't term an anxiety disorder, but an obsessive compulsive related disorder, OCD. The trick with OCD is that the obsessions, which are these disturbing thoughts and ideas, we try to control them with the compulsions, the rituals. And so the rituals, we get stuck on these rituals because at least for a brief moment,

they reduce our anxiety, just in the short term. Of course, it comes screaming back later even stronger than ever. But it's that negative reinforcement cycle that keeps us hooked into obsessions. What is, apart from the dopamine, what is anxiety at a biological level? But it's that negative reinforcement cycle that keeps us hooked into obsessions. What? What is, apart from the dopamine, what is anxiety at a biological level? What's going on? I feel anxiety. What is being deployed within my body?

What's happening? So you have, you do have the autonomic nervous system, particularly the fight flight system that's activated. So I'm the kind of peripheral biology that's what you're having, what you see happening. You also though, you have your central nervous system, you have your brain activating. And a lot of people, you know, because mostly because we scientists have talked about it this way, we think, oh, you're anxious or fearful and you're a migdala starts firing, this fear center of your brain. But the amygdala, which is this sort of part of this limbic emotional area of our brain. It's much more than just a fear detector. It detects uncertainty.

It also detects reward. And when you've received treatment for anxiety disorders, it's as if the amygdala is representing all these important things in the world to us, not negative, positive, uncertain. And when you're treated for an anxiety disorder, that proportion shifts. So you start to maybe you're overemphasizing uncertainty and negativity. And then when you get your anxiety a little more roked in, you actually start focusing more on the reward aspects of what why anxiety is driving you.

So you have the amygdala, you have the limbic system, but you also have these cortical limbic circuits in the brain, which connect the emotional brain with the prefrontal cortex. And so that circuitry is crucial because it's the prefrontal cortex and other areas and the temporal, you know, and temporal lobe that allows you to regulate your emotional experiences. It allows you to bring in memories. The prefrontal cortex also allows you to be guided by your, and there's no chain of background, guided by your values, your goals,

these higher order things that can drive us and give us a sense of purpose. So anxiety doesn't just make the amygdala fire, it recruits this whole brain circuitry, this beautiful, elaborate, multi-layered aspect of who we are as human. And we just sort of put it in this, kind of we shuttle, we shuttle to of the side and sort of said, oh no, it's just fear and all the negative stuff, but it's all this other stuff too. Is there some adrenaline dump in there too? Is there anything else going on? When you have a sort of fight flight response, definitely there is this. I mean, and if you think about how anxiety feels, I mean, everyone knows how it feels, right? It's the heart

racing, the butterflies in the stomachs. And, you know, the word anxiety came from much older words like ungare, which is Latin for choking. And so you also have that sort of, you know, when you're, when all of a sudden you're like kick in your sympathetic nervous system, that branch, that fight flight system of the autonomic nervous system, you know, you can sometimes, you know, feel that that fight flight system of the autonomic nervous system, you can sometimes feel that tension. So it definitely activates that as well. But really what anxiety is helping us do is navigate uncertainty.

So if you think about that, we think, oh, in this stressful, terrible world, anxiety, of course it's spiking because there's so much uncertainty, there's so much it's a poor match with how we evolved to be in reality. But really, in that sense, because we have so much uncertainty now on so many different kinds of levels, anxiety is still this incredible ally, because it's an uncertainty detector.

The minute we face something, and a second from now is the future. So it doesn't have to be a year in the future or a month. The minute we detect something that's uncertain, anxiety is there to focus us in on the possibilities, both positive and negative, energize us, activate us, and it's there to help us navigate this ever-changing world. I'm not sure if I would say that there is more uncertainty in modernity than there would have been, ancestrally, but there's definitely more complexity and complexity, I think, can maybe display as uncertainty. I know, unless all hell breaks loose, that I should be okay waking up tomorrow morning, the predators at the door. One of the things that I wonder

is, let's say that I got to sleep tonight, but I'm not going to sleep with a dog snoring near me and a fire crackling, both of which have been shown to improve the depth of people's sleep. And presumably that's because, ancestrally, if you had a fire and you had a dog, that would mean that you could afford to go into deeper sleep, fewer micro awakenings, you're going to be able to be more responsive. The problem is maybe the real increase in actual safety and certainty that we have, I'm more certain, I would much sooner be in this locked bedroom than have a fire in a dog but out in wilderness, right?

But I just don't know if our systems are accepting that. So even though certainty from a sort of rational perspective has perhaps gone up, first off, it's maybe mismatched with what our body detects as certainty and safety. And then on top of that, there is absolutely more complexity, right? There is way, way, way more noise and far less signal what we consume on a daily basis.

As well, what you said about how the amygdala and the frontbrainer connecting makes a lot of sense because what you're doing usually when you're getting anxious is creating these elaborate dreams slash nightmares scenarios in which everything goes wrong, but you need to recruit a big chunk of brain power, right, to be able to do you it's this super colorful and you can almost feel it, you can hear what it would be like walking across the floor to speak to your boss, to have the conversation and what the door looks like and the handle looks like and you're opening and that's his face in front of whatever it is, right? That you're doing the awkward conversation with the partner. That takes a lot of imagination, right? So it's, I suppose

in one way, anxiety is a pretty complex and sort of high processing recruitment thing for our brains to do. Yeah, that's, I mean, that's why I think of it as a triumph of human evolution, because that being able to do mental simulations in exquisite detail like you described, that is a very human evolutionary achievement that I believe is probably unique to humans among other animals. You know, the thing is, it's a really great point about certainty and the nature of certainty and uncertainty. And we think of, and of course, we had much, a much longer time to evolve being concerned

about certainty with basic safety, threats, you know, and all of this. But we also have evolved to be highly adaptive to what a different context or a new context throws our way. And that's why there's a whole chapter in the book that I just call uncertainty. I don't actually use the word anxiety until the very end of the chapter. Because really what anxiety is solving the problem

of uncertainty for us. Because that, you know, we may have our physical well-being taken care of, but when we're in this complex world as you as you note, all of a sudden there are all these other concerns that we consider to be life and death. Will we have status? Will we have relationships? We've been taught to believe that there are, you know, there are these standards of what it means to be well, you know, these sort of toxic standards of positivity, right? That if you fall short of some perfection of being happy or content all the time, then it's just a failure. And so these are sort of, they are not survival needs, but the human brain perceives these kinds of goals that we have decided are central to what it means to live a happy life as

being almost like survival. So I agree with you there's so much that's more certain, but the level of complexity, information flow, and uncertainty and other higher-order domains, I just wonder if it's sort of evens it out in a way. How do you see anxiety relating to stress? So anxiety is an emotion, stress is not. Stress is about this combination of, it's our belief that we can handle and cope with certain events in the world, combined with the actual demands of the world,

it's put upon us. So stress is never just, I went down stairs and there's Union Square Park and Manhattan right below me. And I walked out there and someone pushed me. And that's very stressful and it's also aggressive. And so stress is that burden or that experience that requires you to respond, right? But it's also your belief that you can handle it.

So me, almost five foot four of me, I tend to believe that I have a lot of power in this world. I believe that if someone really came at me, I'd get that adrenaline rush and be able to take them on. And I would probably unwisely, I'd feel like I could defend myself. And so when that person pushes me and runs away, I might feel a little less stressed than a person who

doesn't believe that they have what it takes to handle a confrontation. So it's always this, your personal perception of what you can, how much control you have, how much ability, and the experience itself. That's just not anxiety. Anxiety is this picturing the future, there's threats, and there's rewards. It's interesting that you talk about stress through the same lens that one of my friends, James Smith, he's got a book How to Be Confident Coming Out Soon. And I think one of his fundamental assertions is that confidence is your ability to know that

you can deal with any challenges that come up and face you. So there is some sort of cash flow system that you have in your mind around what is the challenge, what is my capacity to meet the challenge. And I do think that I do think that your right anxiety just seems to be less rational. I mean, even less rational than stress is kind of impressive, but it does manage to remove. You're not thinking about unless you get very conscious about it, unless you're breathing deep and you're trying to formally move through a process. You don't really think like, oh, but think about all of the previous times that I've got through this. I know this one's going to be different.

This time's going to be the catastrophe that means whatever. And it's also hilarious to think about how acute the anxiety responses to something which totally has absolutely nothing to do with anything that we'd really genuinely care about long-term, right? So it's a lot of stuff to do with anything that we'd really genuinely care about long-term. So a lot of stuff to do with social comparison, let's say, you post a stupid comment on your friend's Instagram page and you think, oh, everyone's gonna see that

and it's gonna make me look dumb or you find out that one of your friends has unfollowed you. But yeah, you have this sort of anxiety dump the same way as if you needed to have a fight tomorrow Well, you know, that's interesting. I would take issue without a little if I heard you correctly that you think that anxiety is less rational than stress I don't know I would say that our ability to Interject into anxiety anxiety to me seems to be more acute. It seems to be more difficult to patent interrupt when it's occurring.

And perhaps that's simply because it is more acute and stress tends to be a little bit more chronic and long term. Maybe that both. Let me give you an example if I may. And I'm wondering what you're going to think of this. So, anxiety, any, so evolutionary theories about emotion, and actually the kind of emotion scientist I was trained to be,

it's called a functional emotion theorist. So, the whole idea of functional emotion theory is that emotions are profoundly rational, that they've, and this is really drawing on Darwin, that they evolved to give us information, which is called appraisal in the theory, and action readiness tendencies. And they're so automatic that they save energy,

so they're efficient. So for example, anger is the appraisal, the information that you have a desired goal that's blocked. And it's the action... So once you've said, okay, I'm angry because this thing I want, there's an obstacle to it. It's blocked for me. And that apprais said, OK, I'm angry because this thing I want, there's an obstacle to it. It's blocked for me. And that appraisal, that information, creates the action readiness tendency to overcome

the obstacle. So it prepares you to fight, to do what you need to do, to persist. And so that's fundamentally rational, right? Now, and it's also automatic and efficient. And so the way I think about anxiety is that it's this automatic appraisal that this future is uncertain. And it's, but it's something I think about anxiety is that it's this automatic appraisal that this future is uncertain. And it's, but it's something I care about. So your example about posting something stupid

on Instagram and I don't even do social media really that much anymore because I just can't get past the, like, how do I do this? And it's really, you know, and I don't know what to say. And I feel like I'm a brand and that's, I'm a Gen Xer, so that's fundamentally aversive to me. Anyway, but, you know, that, if you had that feeling, if you posted something and you thought it was stupid,

anxiety is the information that you care about that. You care about looking stupid on Instagram. I personally, like, may not, or, let's not talk about me, anyone, someone who can post something and just blindly post anything they want on, and they just don't care. They won't get anxious about it, because anxiety points you. You can only be anxious when you care about something. So it's that information.

And imagine, I don't know if you ever have this happen, but you wake up at 5 a.m. and you have those worries. It's like free-floating anxiety going through your head, right? So you can do one of two things. You can say, oh my god, I have to get rid of this, because it's painful. It's unpleasant. Or you can say, there's some information for me in here. Let me, let me, what's going through my mind here? So you might sit there

and say, oh, wait a second. Is it that fight I had with my partner last night? You're like, no, we've resolved that. You're like, okay, what is it? Is it something that work thing that I have to do? No, that's, that's okay too. And then you're, and then you're feeling it. And you feel. Oh, wait a second. I've been waking up every morning with searing pain in my stomach for two weeks. Oh, maybe I should be caring about that, and maybe I should go to the doctor. Yep, that's it. Bingo.

So anxiety is giving us this information about what we care about. And when we listen to it and interpret it as useful, it can be an incredible help mate to us. There's this beautiful study that was done by Jameson and colleagues in 2013, they're out of Harvard, also Matt Knock and other colleagues. And they brought in socially anxious patients. So people diagnose the social anxiety disorder.

And when you have social anxiety disorder, the key concern is that you fear social rejection and judgment. And so they brought in this group of people, and then they prepared them to do what is literally a torture session for a socially anxious person, which is to, in three minutes, prepare a speech about something very contentious, probably like the death penalty or something like that, and present it after this brief preparation in front of a panel of judges who will be evaluating you on your performance, and all the judges are sitting there like that.

So this is a torture session for someone who's socially anxious. And they're getting ready to do this and their hearts are racing, and then they take half of them aside, just half, and the other half are left. They take half of them aside and say, okay, listen, you're going to feel your racing heart and you're butterfly. All those feelings you're sweating, that's not about, you know,

that's not the feeling that you're about to fail. That's not a malfunction, that's actually your body performing what it needs to do. It's preparing to be at peak performance. It's actually your blood pumping through your veins so that your brain can be sharper. It's actually, you know, it's just, you know, and so there's this mindset resetting that was happening. They were also given some scientific articles, just in case they didn't believe it in their like, see these five scientific articles that show this and Darwin's evolutionary

theory and et cetera. So they get 10 or 15 minutes of this. And then they do this, they do this, of folks who didn't get this information about the adaptive value, the anxiety they do it to. And they were monitoring heart rate and blood pressure and performance during this speech. And what do you find? The half of these socially anxious people who are forced to do what is a torture session for them. Their heart rates are slower than the other half of the group.

Their blood pressure is lower. They perform better. They stutter less. They're more confident. Essentially, they look more like people who are kind of brave and preparing to act and doing their best in that peak performance than people who are overwhelmed by anxiety biologically and in terms of performance. And so this was, all this was helping these folks

take in anxiety as information and reframing what that information meant to them and they were actually then able to leverage it. What's the lesson that you take away from that from a applied sense? Well, interestingly, James and colleagues are developing a whole intervention for social

anxiety based on this concept. It's sort of the sole purpose of my book, which is, it's not really a self-help book in the traditional sense. There aren't tons of tips, it's really a mindset shift. It's really the idea that right now, our view of anxiety, our language about anxiety, our assumptions, and what we believe anxiety to be the role it plays in our life. These beliefs are setting us up for failure. They're making us do things that make anxiety worse like avoid anxiety, have metapher and metaworry, you know, and so if we can

reconsider what anxiety is, what that there are advantages, as well as really just being terrible too, because I feel no one wants to be anxious. So that's not the argument. But by making this mindset shift, you can actually learn better to cope with anxiety. You can benefit more from treatments if you do have clinical anxiety and need that extra support. And you can actually start using anxiety in your life, almost like this sort of alchemical process, where you can take that energy, take that emotion, understand what you care about, leverage it to hope and to work hard and to persist and to be more creative, that you have that opportunity that you didn't have when you thought about anxiety differently.

So, this can be directly embedded in a treatment approach, an existing treatment approach, and James and colleagues are developing whole new treatment approaches, just formalizing that kind of an instruction to people, mindset shift. It's interesting talking about how the framing that you place around the emotions that you're feeling or the state that you're in kind of fundamentally

changes what it is, right? I have a friend, Bridget Fettisie, who's a comedian, and she started doing comedy relatively late, and she gets super, super nervous before she goes up on stage. And she has a little mantra that she says to herself before she goes up on stage, and she's saying inside of her own head, I'm not nervous, I'm excited. I'm not nervous, I'm excited. Precisely, that's precisely it. And it's a small nudge,

but those kinds of nudges, many, many times, over repeated over time, they're incredibly powerful. I'm not nervous, I'm excited. It is such a good reframing before you've got to go and give something. Yeah, and that's the spectrum of anxiety. Anxiety is not a light switch on and off. It's a dimmer, it's a dimmer switch.

And on that spectrum, yes, there's panic. Yes, there's overwhelming anxiety. But on the other end of the spectrum, there's this shri salon of this kind of excitement, this, wait, I'm kind of in it to win it. I care about this thing. I mean, talk to any performance artist, like your friend, like your friend, any comedian, any dancer, any performer.

And many of them will tell you, if I'm not rolling up in the bathroom before I go out on stage, something's wrong. It means I don't care about it. And what I've learned, the performer might say, is that that signal is getting me ready. And it doesn't mean that I'm about to fail, or there's a malfunction. Another friend who is supporting Eric Prids on a world tour and has been for years and years, he's to play for us in Newcastle. And before he goes on stage, he's always very, very close to a toilet.

And this is a guy that's played Madison Square Garden on New Year's Eve. Wow. He's played the biggest gigs ever, and he's been doing this for 15 years, and he's one of the most competent, hardworking people that I know, and yet, every single time before he's about to go on stage, he still has that.

And it almost gets... But this is where you can see how superstitions and rituals of football players start to form, right? Well, I put the left sock on, then the right sock on, then I did a double bow on the left foot, but not on the right foot, because we don't do that. And then I'll touch the top of the tunnel as I go out. All of these sort of bizarre rituals and superstitions are part of that frame setting, that pre-game routine that gets them from perhaps nervous to excited to performing to flow. Exactly. And, you know, I wish, now in retrospect, that I'd had a whole chapter on sports in this book, because it's so clear that this mastery of anxiety,

having it, owning it, and using it, that this kind of mastery is central to, I think, sport grates and elite athletes. And they have those rituals. All those rituals are tools to channel and sort of transform that anxiety into something that they can work with. What mistakes did medicine make when it comes

to identifying anxiety, facilitating it, explaining it to the public? I think the biggest thing is the prime fallacy that we mental health professionals, really for the better part of a hundred years, really since fried and even before that. The prime fallacy is that any experience of anxiety is a malfunction or disease. And so we don't know anymore how

to distinguish between anxiety and an anxiety disorder. And the key distinction is not the level of anxiety. So you don't get diagnosed with an anxiety disorder if you have high levels of anxiety, even on a frequent basis. The only time you'll be diagnosed with an anxiety disorder is if the way you cope with your experiences of anxiety, start to get in your way. So that if you are socially anxious and you cope with that anxiety by not going outside anymore, not going to any parties, not being able to go to work, It's those ways of coping that actually that functional impairment, which is what you call

it when you're diagnosing someone, it's that that is a cynic one of an anxiety disorder. There's a beautiful, I'm also a child psychologist by training, and so I think a lot about kids and families. And there's this great treatment that takes us as a starting premise coming out of the Yale Child Study Center, Ellie LeBewitz and his colleagues. It's called space. It's about helping parents help their kids just experience and tolerate anxiety. So this treatment, what it involves is you'll bring clinically anxious kids, so kids with

anxiety diagnoses into the clinic. And in some of these controlled trials, half of the kids will get gold standard cognitive behavioral therapy, which is some of the best therapy out there. The other half won't. Instead, their parents will be taught to stop over accommodating anxiety in their kids.

What does that mean? The kid who's afraid to fly, parents who out of the best of intentions want to comfort the child will stop all family vacations that require taking a flight somewhere. The kid who's, you know, who doesn't want to be separated from the parent, they'll say, well, okay, you don't have to go to school today and you don't have to go tomorrow and you don't have to go the next day. That's a combination of anxiety in a way that's actually not helping, and we know makes anxiety worse. So the parents are simply taught to stop that and instead support the kids in actively

coping with all the discomfort of anxiety and all the distress. And what you find is after the parents get that six weeks of treatment and you compare them, the kids of those parents to kids who got treatment themselves, 80 per- I think that one of the first studies they did, 87% of those kids who's only their parents received therapy showed significant reduction in clinical anxiety. They did as well as the kids who got therapy themselves. So if you're able to combine the CBT with the parents therapy? No, there's no CBT for the kids. No, but is there not CBT on the control group? No. It's only the... Oh, so I'm sorry so in the comparison. Well, yes, so there were so the kids half of them just got CBT

Yes, and then the other half just got the parent right so what the magic Combination should be both. Yes. That's what I was that's what I was thinking what is what's what's How heritable is anxiety that why why do you have an anxious child and not an anxious other child? Have you got any idea about heritability? There's good evidence that anxiety disorders, again, this is the extreme of the spectrum,

are only moderately and probably mildly heritable, which suggests that there's probably a genetic and temperament component, but it's so much more sort of how, you know, what you bring to the world matches with the demands that are thrown at you, the stressors that are thrown at you, combined with how you learn to cope with that. So, you know, for example, I have two kids, a 13 year old son and a 10 year old daughter, and my son's going to kill me one day, But he's a little more on the anxious side, and there are several stories about that anxious experience that he's always brought to the table.

There's stories about how terribly I have failed in helping him with that. But I know that part of that is him. Part of that is the fit with my parenting style, and part of that's what fit with my parenting style and part of that's the what we help him how we help them cope. How effective is anti-anxiety medication? I think that for many people anti-anxiety meds are a really important temporary step. And you know, benzodiazepines are, they were really a revolution when they were created about 70, 80 years ago now. Of course, they were stumbled upon, it was by mistake.

But story that, do you know the story? Yeah, so prior to benzodiazepines, the treatments for anxiety were very, very dangerous. So essentially these tranquilizers, minor tranquilizers that were given to people, barbituits, to treat anxiety. So Judy Garland and Marilyn Monroe died of barbituid overdoses, which were anti-anxiety meds, because they suppressed the central nervous system. So if you take too much or combine with alcohol, you stop breathing, your heart stops beating. So this was sort of the go-to treatment.

And doctors having medicolized anxiety to be, oh, it's a disease, we heart stops beating. So this was sort of the go-to treatment. And doctors having metaclized anxiety to be, to be, oh, it's a disease, we better treat it. You know, really wanted some way to relieve people's pain. They didn't think about, well, how do we help them through it? So luckily, there was the discovery of benzodiazepines and essentially what happened is, you know, they're, these researchers and pharmacists, they were trying to create a better drug and

they finally gave up, they were working working, and one of the scientists literally just left his mess on a bench, like on a scientific bench, and went away for three months. And finally, someone was sent in to clean it up. And they found, I'm not a chemist, but they found these beautiful, like well crystallized, I guess little compounds, and they started looking at them. And it turned out these were benzodiazepines. And so now what you have is you have what they believed at the time to be less addictive, to be more tolerated, well tolerated, and very effective in reducing anxiety.

So the first anti-anxiety med was Valium. And it became so popular in the 50s that they had discovered it in the 50s and 60s and 70s. The doctors would just prescribe it and call it V. It was Valium. The Rolling Stones song, Mother's Little Helper, that was Valium. It used to be called Executive Accedron, the painkiller Accedron because all the executives, business people would be popping it as they went cross the world in their business trips.

Everyone was very optimistic and hopeful. But then what started to happen is we realized that benzodiazepines were very dangerous as well. They are addictive and they are also nervous system depressors. So that means, again, if you combine them with, say, opioids, or you combine them with alcohol, they can cause coma and death.

What we see, and there was a really interesting, a lot of awareness in general, but there was an interesting piece that came out in Complex Magazine a little while back, a few years back. I was actually interviewed for it, and it was about the crisis of anti-anxiety meds in the hip hop community. And so what you see is a lot of these hip hop stars were starting to take anti-anxiety meds all the time. But they were all on Percasset, Zannex. Yeah, and there was that guy in Little Zan. Do you remember Little Zan?

I think he renamed himself. Soundcloud wrapper, yeah, he's recently. He was a Soundcloud wrapper, all the Soundcloud wrappers. He's recently just called out his manager. A guy with the name Little Zan called out his manager for providing him with drugs. I'm like, bra, bra, it's in your name. But one of my favorite rappers, Juice World.

Oh, God, I was going to talk about Juicey. I have a whole section on him in my book because that is a tragedy. And he was so talented. Like, I adore. It satisfies two very big parts of me. The one part which used to be cool and to listen to rap. And the other part of me me which is still an emo

from when I'm 15. It's a perfect mix. It is exactly what I've always wanted. And I love it. And I discovered in post-geumously. I'm like, no, hang on a second. What, there's no more? There's going to be no more of this?

It's so sad. He was coming off his private jet. Well, that is a whole story. That's right. And I mean, here's the thing. And it enrages me in many ways about how we've taught our young people to think about emotional pain and physical pain, that we need to eradicate it.

So Juice World, he was singing about his emotions. I mean, that's what makes these soundcloud rappers and email rappers and I mean, little peep died of the same kind of unoverdose. I mean, this is wiping out this generation of artists. And you know, it used to be the 27th club, like Jimmy Hendrix and Janice Joplin, all these rock stars who died at 27,

now it's the 21th club, because these kids are taking these meds and they're trying to crush their emotional and physical pain and it's killing them. And so Juice World would be singing, you know, I have, you know, I have, what's the, what's the, there's the song where he's talking about feeling, oh, righteous, he's feeling, you know, he's, he's in his white Gucci suit, he's feeling righteous, he has all these pills in his hand and he has coding overflowing on his nightstand.

I mean, that is the song. He's talking about his anxiety, the size of a planet. He's talking about, and in his song, Bad Energy, he's talking about how he feels like, I feel, you know, I'm winning. Why do I'm winning, but I feel like I'm losing. What was that not the same with Avici as well? 100%. And so what is, you know, so in some ways, the reason I wrote this book is to say, listen,

if we're always talking about anxiety and emotional pain and distress is something fundamentally dangerous. Not only are we wrong about that, because there's real advantage if we listen to it, but we're also creating this strategy of constantly numbing that pain, of constantly eradicating and avoiding it. This is that disease model. What exactly do you say to people that say who you to say that anxiety is an advantage? Look at what downstream from it. It's killed people. It makes me feel terrible. I have anxiety and stuff like that. How can you try and tell me that my pain is something which is an advantage to me? It's a crucial question.

And my answer to that is that anxiety disorders are real. They're incredibly painful and people need to get support for them. I think we need to give complete acknowledgement of that. I mean, that's what I devoted my life to. At the same time, I also believe that anxiety is not always a disorder, that it is an emotion that actually is prepared to be helpful to us, that when even though it can spiral

out of control, when we learn to master it, not by eradicating it or numbing it, but by leaning into it, by examining it, it then can actually yield its benefit to us. But when we avoid it, and that is the crucial problem with anxiety disorders, when we chronically avoid and we cope in ways that are actually just trying to push away these experiences of anxiety, we're only going to make it worse. So even if you do have an anxiety disorder,

shifting your mindset can help you bring some of that back, own it more, so it doesn't own you, and benefit more from treatments that are already out there. I mean, actually, I have, it's not even just me saying this. So, Soren Kikagard, the philosopher, the Danish philosopher, 180 years ago, wrote, to learn to be anxious in the right way is to learn the ultimate, which shows,

from his perspective, and one I believe, that anxiety is a feature of being human. It's not a bug, and there is a right way to be anxious. And we can figure that out. In what ways do you think technology is contributed to the modern anxiety epidemic? I think that anxiety and digital technology, there is a relationship there.

As a scientist, I know that we have overstated that relationship and oversimplified it. So if you read the headlines, it's social media have destroyed a generation, or TikTok is causing mental illness in people. And it's really never that quite simple. One is that there's no, there are actually no data to actually show that if you go in,

with everything else being equal, you use social media and you become more anxious and more depressed. It's much more of a linchpin in those problems or digital technology and you're struggling and you're anxious and you're depressed. We can use these social media in ways that actually make it worse.

So, for example, where we do have some good research, it shows that it's the way you use social media, not so much how much you use them, makes a difference. And people have divided the ways into the kind of active passive distinction. So when you're using social media in active ways, you're actually creating something, you're seeking out information, you're doing something that's much more goal directed, and usually something that's also actually leveraging your creative powers. Passive use is when we're tuning out, we're using technology like a big, you know, avoidance machine, right, just this giant way of just, it's like eating a bag of chips, right, we're just we're doomed scrolling,

we're like reposting, you know, other people's stuff, we're social, we're like counting how many likes we have and we're doing social comparisons. When we use social media in passive ways like that, that tends to accelerate and exacerbate things like anxiety. So what I see the problem of being is that we have to shift away from black and white ways

of thinking about technology. And just, you know, we have to become good digital is that we have to shift away from black and white ways of thinking about technology. And just, you know, we have to become good digital citizens. We have to say, listen, I personally believe that that companies need to change their algorithms. I mean, they're not for human good. They're just for their bottom line profit. So I think those algorithms and all the toxicity of these of these platforms is a problem. But until we can figure that out, we need to be empowered to make choices and to know, hey, just like I know, I need to eat fruits and vegetables and once in a while salt and vinegar chips, which is my favorite. We have to make the same choices about social media. We have to know that if we're doom scrolling all day, it's going to make us feel bad.

It's going to make us feel crappy. Whereas if we create some really exciting content or a podcast or we're doing something really interesting That's going to elevate us and elevate others around us. What are your thoughts about the insight? Jonathan hate got when he managed to align I think is about 2012 2013 the introduction of Instagram with this huge spike in terms of young female anxiety and that wasn't mirrored across into men. Have you thought about this? A lot and I've critiqued those data heavily and this is really bringing it up. Send it, come on. And Alvin John-Hate is a great, I think John-Hate is a great

scientist. I mean he came out of a different field of study. You know he's, he's, you know, he really studies moral reasoning and and has done amazing work. I think his work on, work on, I think his book, The Coddling of the American Mind, is a very important and interesting one. I think his work in political psychology is very important. But here's where I think he's getting it wrong. Now, he's actually citing a lot of gene-twenging's work that he and gene-twenging have joined forces. She is a social psychologist who has conducted kind of taken large epidemiological data sets.

What do you mean when you say large epidemiological data sets? Survey data that she didn't, in most cases, actually gather. And you have 10, 10, 10s and 10s of thousands of people. And then you start to look for correlations among things. And so, and she tracks and she tracks these sort of generational shifts. And that's part of the work that she's contributed to psychology.

But where I feel she's gone a step too far, and where I think John Hayte is also looking at some of those data, is to say, okay, well, we do see that there's a correlation between the introduction of mobile phones, and this sort of spike in anxiety and depression that seems to be carried by girls. And you can also look at UC correlations between amount of technology use and these kinds of symptom profiles. Number one, these were not data that were about clinical anxiety or depression in most cases.

So these are, again, these are existing data sets. So these are not clinical studies of actual clinical anxiety and depression. Number two, a great group out of Oxford actually had access to those same data sets because they're publicly available, and they did a re-analysis. And they found that the effect size

of the link between technology and say anxiety or depression was quite small, and they could also find a similarly powerful effect size, a link between eating potatoes and mental health. So the more you ate potatoes, the more anxious and depressed you were. And it was literally at the same level of correlation as the link between technology and anxiety and depression. Now, all that to say, I don't think that rules out the fact or the possibility that there could be a strong link.

I think that digital technology and social media, I see lots of negative, potential negative impacts. But to say that there's this simple causal, all streams are bad, link between mental health and digital technologies, we just don't have the data. I think it's more useful to get nuanced and to say, well, what kinds of use are problematic and for whom and why?

So these large data sets are flash that's actionable, and there's also a lot of ways to reinterpret the data. I remember seeing a bunch of very strange correlations online that's to do with the graph. And I swear that one of them was the number of movies that Nicholas Cage starred in in a year and the number of people that died by overdosing on cheese. So given the right data sets, pretty much. You said beautiful things, but...

There was another one of the number of songs released by the Rolling Stones and the number of people who suffocated, tangled up in their own bedsheets So I am I mean, I just think honestly I think when we draw such strong conclusions from correlational data We should be laughed at because it should be just hypothesis generating it should be okay now We don't be testing yeah, yeah, and it's hard to test some these things, but it's hard work and we have to do that hard work. We need to get Nicholas perspective longitudinal studies and we have to get Nicholas Cage to get in a new movie so that we can experimentally control what happens after. Precisely correct. There was one of the things that I think is interesting around how that link between technology and the way that we feel after we use technology

is the expectation effect, which is a new book by David Robson came out a couple of months ago, he was on the show, he's a fantastic science communicator. The placebo effect, which everyone is familiar with, this is basically that, but scaled across everything and anything that you care to care about. And the best example that he gave was gluten intolerances have gone up by 10 times from

3% to 30% over the last 15 years. And they brought people into a study, they sat them down, some people did and did not have biological gluten intolerances, some people did and did not have self-reported gluten intolerances. They gave everybody the same meal and they told everybody that had gluten in it, but it had no gluten in it. And you ended up with people in a study who didn't have a biological gluten intolerance, who hadn't eaten gluten, coming out with hives, having inflammation, having diarrhea, having to go to the bathroom. And that basically scales across everything.

And I think the episode's so powerful, tons and tons of people really, really loved it. The reason being, I think that it reminds us that we have way, way, way more control through framing, right? How are you framing the experience that you go through? And I'm pretty adamant that part of the discussion that we're having around social media is that we've been told

that these tech companies are maligned and they're stealing our attention and it's bad for our memory and it's bad for our long-term health and it's bad for our dopamine levels and stuff like that. But the problem is that that creates an expectation effect for everybody. So you start to use your phone and you finish up and you feel guilty about your phone use and you expect to feel bad. Oh well, here comes the dopamine crash off the back end of being on Instagram for a couple of hours or whatever. And you go, well, yeah, of course, like it's so difficult right? Because you don't want to do false reporting. Like if there is a negative result

that comes from using technology, you can't lie about it. But by making it public, you make people begin to expect it more, which, it's like a recursive loop that just always makes it worse and worse and worse. I don't really know how to pattern interrupt that, but I certainly know that taking into account, look, you have control over the framing, and framing is, in some situations,

literally more important than the thing that actually happened. So there was this, the other, my favorite study from it was, he had people sit on a bike and do a VO2 max test, which is a pretty ugly fitness test to do. And they did in advance genetic market testing. Apparently there's a particular type of genetic market that means that your up regulation of oxygen in your lungs is better and you can blow off CO2 more efficiently.

Now they split the group into, split the, study into two different groups, but these people weren't based on the genetics, but they took one group to one side that had people who didn't, didn't have that genetic marker in and said, you should do really well on this test. You've got the right genetics that are going to make it easier and they said to the other group of people,

some that didn't, some that didn't, you've got the bad genetics, you're probably not gonna do very well in this test. Then they got them to do the VO2 max test and looked at the results after it. Now, like, surprise, surprise, the people that were told that they had the right genetics, they performed better. What was more interesting was that when they actually looked at the up regulation of what was going on in their lungs, their blood pressure, their HIV, their heart rate, all that stuff,

they found that the people that were told, that they had the right type of gene, outperformed the people who had the right gene. So literally what they believed was more powerful than their genetics. That blew my mind. I mean, I'm with you 100% on this and the data just keep rolling in on this, right? And that's why, you know, when you ask the question about what would, you know, what if someone who has an anxiety disorder tells you, you don't, you know, how can you say this about anxiety?

My answer is that this mindset shift about anxiety to actually see that it can make you more creative and persistent and hopeful. It can make you more creative and persistent and hopeful. And it can help you if you're struggling and trying to get therapy or trying to do wellness or exercise or whatever it is you're doing. It can't, this mindset set shift can help you benefit more from that. And that literally that's the sole purpose of my book. I really don't want it to be a self-help book, only a mindset shift book.

I guess that's self-help. I sort of resist the self-help category. What do most people get wrong when it comes to trying to deal with anxiety? They presume that as soon as they feel it, they should manage it and suppress it. So really, if we think about anxiety as information, the very first step needs to be that if it's information, listen to it. So whether that means like in that experiment, I mentioned with socially anxious people, when, okay, I'm going to listen to my heart racing, and rather than assume I'm about to fail at this public speech, I know it's preparing me, or that I care about this, you know, listen

to that information. When you're having free-floating anxiety, something's going to come to your mind that tells you what you care about and what you need to work towards. So listen to it. It's not always helpful information. So sometimes after we listen, we realize, okay, I just have to let this go. It's too much. It's, you know, it's, it's, it's just me spiraling out.

And that's when we do things that we know support our wellness. And for a lot of people that's exercise, Alan Cazden, who's a, who's one of the founders of Cognitive Behavioral Therapy Research in the US, he wants at this some 50th anniversary kind of meeting said, if we psychologists really cared about people and helping them, the first thing we do is get them all to exercise. And then we'd see what problems were left over.

And we'd create boutique, targeted treatments for those problems. So for a lot of, and why does that work? Why does exercise work? Well, there's biological reasons, but I believe when it comes to anxiety, it's also that we remove ourself from this future tense that can grab us when we're in the future and worrying and we immerse ourselves in the present. We find flow, we find relief, maybe we like

to take walks, maybe we do mindfulness meditation, maybe we, you know, there's so many things that we can do and we know what helps us. I write very bad poetry. I love to write poetry. It gets me out of whatever mindset I'm in and helps me immerse myself in my own personal sense of flow. And so these are things we can all do. And then, OK, so then you're in the present, and then you can turn back to anxiety and say, OK, if there's something to do here, how can I hit you to a sense of purpose? How can I use it to pursue what I care about?

My goals? Purpose doesn't have to be some grand vision. It can just be what makes your life meaningful. And I think back to the social media question, I think we do expect it to be bad in many ways. I think that's a good correction because before we thought that all those, black turtle necked, you know,

saviors were there to help us. And clearly they were not there to help us. They were there to line their pockets. I mean, that's just very clear. Or social media wouldn't look like it looks. But, you know, we can, you know, sort of have this view with technology that, you know, we're going to put it in its place.

We're going to, you know, understand where it's helpful for us and where it's not. We're going to stop treating ourselves like a brand, like something to be consumed. I think that's where some of the concern is. Because when all we can do, especially kids, they're forming their identities, they're figuring it out, when they have to sell themselves like a brand, when they have to think, how am I going to be consumed and approved of in this world, it just

distorts their ability to find a purpose that's about what gives their personal life meaning beyond the likes and the shares, what gives their life meaning in terms of what's greater than themselves? What is something that makes them feel alive that helps them find flow? I think the actual problem with a lot of social media is that we lose. We have so many lost opportunities to tune into those other things in our life. And so those opportunity costs can start to get in the way. So I think we need to question many aspects of social media and we also need to reignite our ability to find purpose in life and pursue it and help our kids do the same.

And anxiety can help you in that because it helps you work hard. Points you in the right direction. So if somebody does begin to feel anxious, if it was me, if one of my friends was saying, hey man, I've got this sort of anxious thought process, my prescription would be, here's a breathwork practice that's going to take five minutes and you're going to do box breathing, then

it would be go for a walk, then it would be go to the gym, then it would be have a cold shower. That would be my prescription, right? I'm aware that you're not trying to go super applied with this, but you've already mentioned training as one of the things. Are there any of the practices that you think people could do with educating themselves around if they want to mitigate their anxiety response? So I love all of those practices you mentioned. I would just put something on the beginning and end of it. So what I didn't hear you say was, well, what is your, you know, why are you anxious? You know, what is going on in your life? Is it telling you something? Is that anxiety actually pointing you to something? Because instead, we all habitually, including

we psychologists, we go to, okay, we better handle it. We better, you know, and that's completely skipping over the part about finding out if there's information to be learned. So I would say one really great practice is, how do you sit with anxiety even when it really feels terrible, and it does. Anxiety always feels terrible. That's its nature to make us pay attention. How do you find a way to sit with it, to tolerate the distress, and to know you're still OK,

and to find out what you can. So for some people that's journaling, for some people that's talking to a therapist or a good friend, for some people that might be just meditating and letting those thoughts arise instead of keeping them down and taking all that energy and all that the stress of suppressing. It just takes a toll over time. So when we think about those three parts,

listening, being in the present and managing when we need to, and then the third part is really again, since anxiety wants to take me into the future, where actually my dreams are coming true when all these good things are happening, how do I leverage anxiety in this way? My husband about, he's in the entertainment industry, he's a producer on Broadway and TV, et cetera, and he had a very big work stress about the

eight months ago. And I have anxiety around my own life, but I saw him and I was helpless to do anything to help him. It was really bad. It was some bad stuff he had to work through. And I was so overwhelmed with it. It was so toxic. It was some bad stuff he had to work through. And I was so overwhelmed to think it was so toxic. It was so I just didn't even know what to do with it. And I tend to be more of a depressed person than an anxious person. So even though I've written this book about anxiety, my real bugaboo is a little different, but they go hand in hand, which is a whole different conversation. But I realized that the only way I could work through this anxiety, which was feeling very extreme to me.

In addition to talking to people, and doing all those self-care, was to actually hitch it to a sense of purpose, which for me was to try to be a support to my husband and to try to use whatever skills I could to make sense of it. So I just, I decided because the anxiety was so present, I'm going to spend some extra time and just, I'm just going to listen to him. I'm going to spend some extra time and just, I'm just going to listen to him. I'm not going to try to fix it. I'm not going to, you know, maybe I will if he wants me to,

but just be there for him in ways that made me feel fulfilled. Because for me, being a good partner at that moment was really a, gave me a sense of purpose. And so I felt a little bit more in control, a little bit more, well, a little bit less uncertain maybe, because I knew that, okay, we can do this together, we can handle this together. And then I also started writing about this, and I actually wrote it essay, and I wrote,

you know, I just got it all out, and I started formulating thoughts and ideas, and we started discussing them. And so I found ways to sort of take what was overwhelming to me, and I felt completely helpless to do anything about it, and and define some outlet for that, some sense of purpose, maybe a little control, but really just kind of projecting myself into a future where we would be able to be past this. So those are the kinds of things that, you know, therapy is great. I think everyone should be in therapy, whether or not you think you have a clinical anxiety

disorder or not. I think with, you know, with medications, sometimes we need it to help bring us back down to baseline so we can benefit from other treatments, but that's like giving someone a fish instead of teaching them to fish. Medications like benzodiazepines which we talked about before can kill people if not used properly and can be addictive. They should be used temporarily and they should be used in combination optimally with therapy and that's when they're most powerful. I really want to know about the relationship between anxiety and repression.

No. I need to learn it. Yeah. Which part of it, the way that when we suppress anxiety, it only grows. No, just what you've said, that there is a relationship between anxiety and depression. Oh, and depression. I have a repression. I'm sorry.

So, it's really interesting, because I was a person who, when I was a teenager, suffered from clinical anxiety. And the thing about anxiety, sorry, when I suffered from clinical depression as a kid, the thing about depression, and again, it's sort of this almost functional emotion analysis, right? When you're depressed, you actually really, you've gone through a stage of really caring about things you want in the world. You have dreams, you've gone through a stage of really caring about things you want in the world. You have dreams, you have hopes. But what depression is, is this

feeling of real, of loss. You've lost that ability to get what you need and want in life. You have despair. You don't believe that those things are possible anymore. And so this positive, optimistic focus you might have had has just been dashed again and again and again and you can't find the hope anymore. And so that's quite different from anxiety where you're still sort of in it to win it, right? Because you're still working to make that positive thing come true. So what psychology is documented for a number of decades is that there's a high rate of comorbidity between anxiety and depression, about 50% of people who are anxious also end up being depressed at some

time if they're clinically anxious. And what we think might be going on in that in a way is, when you're anxious and you're like, okay, I want these things, I'm going to worry about them, I'm going to make them happen, I'm going to do everything I need to, I'm going to avoid threats, you know, I'm just so anxious about succeeding in life, for example. And it's a positive goal. I'm going to avoid threats. I'm just so anxious about succeeding in life, for example.

And it's a positive goal. It's a really productive goal, but life throws you curveballs. You fail. You try to pick yourself back up. You work towards it. You just can't quite manage it. You have some bad luck. So there's a series of things that happen externally and then internally in terms of

your ability to find ways to cope. And you know, it's really arrogant to say, oh, just shift your mindset about anxiety and everything will be okay. And that's really not what I'm saying because sometimes life is just overwhelming, you suffer and you can't always, it's messy.

You're not always gonna do well. And that's not a failure, that's a process. So sometimes when you're anxious and you just can't keep working towards what you dream of, you become hopeless. You start to despair. And that's when it can flip into the depression end of the spectrum. So the two, it's this sort of, what are you working towards in life? What are your goals? What are your dreams? And how you achieve them, whether you achieve them, how you perceive the obstacles, your mindset about that, those are the kinds of things that can lead us towards problematic anxiety

and depression and also be the ways in to help fix them as well. You mentioned that 50% of people wish that have anxiety are going to become depressed. Do you know if the reverse is true, do you know if the relationship between depression being the first mover is the same for anxiety? It tends to be a developmentally, it tends to be anxiety first followed by depression, but it does go the other way too. And then of course you have multiple comorbidities. So with depression, there's also high rates of eating disorders, especially in females. There's high rates of addiction and depression and anxiety as well. So it's always a double-edged sword with mental illness. It's always us humans, us messy humans trying to adapt

to what can be a terrible world sometimes, and a wonderful world. And so every symptom is just an attempt to adapt. So when we're anxious and we become, or when we have OCD, and we start developing all these compulsions that start to get in our way, it's just our human nature to try to adapt to overwhelming feelings and thoughts. And it's really effective for a short term.

It's kind of miraculous if you think about it. But over time, it's just the costs that weigh the benefits. So every, you know, I started my career studying child maltreatment abuse kids. My very first job was to go into the basement of child protective services and actually read the detailed reports of how kids were abused and what they suffered. I mean, literally to this day,

I get the sick feeling in my stomach, but this was a center at the University of Rochester in the United States that was starting to develop the science of maltreatment to understand how maltreatment happens, how it affects kids, and how kids can be resilient, and how people can be resilient in the face of it. And so here I was reading about this terrible maltreatment, I mean, real suffering, physical abuse, sexual abuse, neglect.

And then I would go and I'd be working with these kids in this sort of day therapy program, and I would see them, and they're beautiful, and they're creative, and yes, they were troubled, but they were still remarkable. How did that happen? How in the world did they have that resilience? And so what happens is they adjust to what should not be happening to them. They form weaknesses, but they also form strengths. And so every way of adapting, some kids become hyper-vigilant for negativity in the world around them, right? And that's an adaptation. It's helpful if you want to

prevent getting hit by your caregiver, right, to know when they're about to get angry. But if it starts to generalize to school, and you start getting in fights with everyone because you're looking for someone being hostile towards you, back gets in the way. But you also, a lot of these kids, there's great research to show. they also notice positivity more too. So they're ready to receive that positive feedback as well. So all of these are double-edged swords and the more that we think about our own struggles as opportunities, it's a mindset shift. The better we'll be able to work with them and own them instead of being owned by them. You just mentioned creativity there. What's the relationship between anxiety and creativity?

Oh, it's so interesting. So there's, I'll just start with one study that sort of illustrates this. So, there's this great study that came out around 2008 by De Dru and colleagues. And they were interested in this idea that anxiety and other emotions that they consider activating, activating meaning they get you revved up rather than slow you down. So that includes anger, anxiety, happiness, not just the positive negative distinction is much less important than how they activate you to do things in the world. And then deactivating emotions are more like sadness or boredom, right?

And so what they did is they induced these feelings in people. So they actually had them do a writing exercise where they thought about the most anxiety provoking thing or the happiest thing. And so they really induced that feelings in people. So they actually had them do a writing exercise where they thought about the most anxiety provoking thing or the happiest thing. And so they really induced that feeling in people. And then they had them do a problem solving task, a brainstorming task where they had to come up with a new solution, think outside of the box, come up with as many ideas as they could to a problem.

I think it was they said, oh, these teachers are trying to teach students this new thing. How would you do it to be innovative? And then they measured, they had induced people to have each of these emotions separately. And then they measured how many, how much fluency there was, meaning how many ideas people came up with. And then how innovative and creative they were. And they had a coding scheme to determine that. And they found that anxiety, when you induced anxiety, it made people not only more fluent,

there were more ideas, but they were more out of the box in their thinking, and they persisted more. They cared about what they were doing, and even when they hit some roadblocks, they just kept going, and so they came up with more ideas. There's also a great concept that Patrick Gojro, who's a Canadian psychologist, came up with, that I think is also about the creativity behind anxiety, and it's a concept called excellenceism. So we know that perfectionism is toxic. It's punishing, it's like this, you know, this pursuit of flawlessness that always fails. And it lead, you know, and we know that perfectionism, real punishing perfectionism is associated with more anxiety, clinical anxiety, more depression, suicidality, and actually worse performance.

People who are perfectionists tend to perform less well because they just don't know when to stop trying to get it right. They just don't know how to use their time wisely in a lot of cases. So that's perfectionism. Excellenceism is sort of the light side of that darkness. So excellenceism is knowing that, you know, I can never be perfect, but I can be really good.

I can be excellent. And I, I can never be perfect, but I can be really good, I can be excellent, and I believe I can be excellent. And I'm okay with failing in order to get there. And sometimes, on my way to getting to excellent, I can just be good enough. And I'll get there. And so, excellenceists, people who think about achievement that way, they tend to be more anxious, not clinically anxious, but just have a heightened level of anxiety, but they also have more curiosity, they're more open to experience, and they tend to be more creative and more productive. So here we have this anxiety fueling, this pursuit of excellence, not perfectionism, but excellence actually leading to more productivity and creativity when you measure it and

sort of divergent thinking tasks and all sorts of other ways that go draw in his colleagues of them. What about when you feel nerves or you have that sort of anxious, quasi-nervous response and your ability to think, literally, just feels like it's been completely shut down? And my entire mind has gone blank here. Is that something different? Is that not anxiety? That's totally anxiety. So your body, as we talked about with that, that study was socially anxious people in this giving a public speech. So say you're about

to come on a podcast with someone you've never met before and you have to go on this old school video conferencing thing called Skype. And you're feeling a little nervous. You can't quite get it. And the butterflies in your stomach start, right? So what do you do? You say, OK, first of all, that's information that I care about this interview. I'm not just falling asleep and like, who cares? This conversation is going to be interesting.

And actually, it really is my body preparing to overcome whatever obstacles I need to face. And to persist, even when I can't get that damn video on and it's like all talking. And so you interpret it that way and there might be a few times as you're listening to what's being said or you have ideas going through your head, you might draw a couple blanks but you know, especially if you're an exolences, you know that well, I can stumble a little but I have other ideas that are great. And I'll be able to, because I've mastered this topic, be able to come up with something

else interesting to say, or I could ask the person I'm talking to you a couple of questions. And that will, so you just have this curiosity and attitude of, it's okay, failure is not, failure is not failure. Failure is not a malfunction. You know, being anxious is not dangerous. It's part of being human. It's part of the messy act of being human. It just changes everything as soon as you accept that and really internalize that. Like saying the word repression instead of depression when you mean to...

That might have been a variety of slip on your part. I'm not nervous. I'm excited. Yeah. Yeah. I really, really like it. Tracy, let's bring this home. Where should people go if they want to check out the stuff that you do? Dr. Tracy PhD.com. I love it. The book will be linked in the show notes below as well, Future Tens.

I really like this. There are a number of different science communicators that seem to be converging on this similar sort of reframing slash, you have control over your in a state place, and it's not woo and it's based in science and I very very much like it and I'm looking forward to seeing what you do next. Thank you so much for the pleasure to speak with you. you