Modern Wisdom - #475 - Tim Clare - The Crippling World Of Modern Anxiety

Episode Date: May 19, 2022

Tim Clare is an author, poet and creative writing coach. Anxiety rates have skyrocketed over the last decade. After spending hours every weekend wracked by crippling panic attacks, Tim decided to contact every anxiety expert he could to hear their suggestions for potential strategies to reduce it, and then he did all of them. Expect to learn why people are turning up to A&E believing they're having a heart attack, how the gut-brain connection plays a role in mediating our mood, why exercise is as effective as an anti-anxiety drug, how early childhood can influence our anxiety levels, the most effective tactics Tim has implemented to improve his mental health and much more... Sponsors: Join the Modern Wisdom Community to connect with me & other listeners - https://modernwisdom.locals.com/ Get 20% discount & free shipping on your Lawnmower 4.0 at https://www.manscaped.com/ (use code MODERNWISDOM) Protect yourself from identity theft online with Aura. Try 14 days for free at http://aura.com/modernwisdom (discount automatically applied) Get 10% discount on your first month from BetterHelp at https://betterhelp.com/modernwisdom (discount automatically applied) Extra Stuff: Buy Coward - https://amzn.to/3FHA31R  Follow Tim on Twitter - https://twitter.com/TimClarePoet  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

What's happening people? Welcome back to the show. My guest today is Tim Claire, he's an author, poet and a creative writing coach. Anxiety rates have skyrocketed over the last decade. After spending hours every weekend racked by crippling panic attacks, Tim decided to contact every anxiety expert he could to hear their suggestions for potential strategies to reduce it, and then you did all of them. Expect to learn why people are turning up to A&E, believing they're having a heart attack. How the good brain connection plays a role in mediating our mood, why exercise is as effective as an anti-anxiety drug, how early childhood can influence our anxiety levels, the most effective tactics Tim has implemented

to improve his mental health, and much more. I really appreciate how open and vulnerable and honest Tim is with this. There's something extra specially shameful deep down about being a man and a father and a husband and dealing with this. It's typically not what society expects of men and the fact that this is across all genders, it's across all two of them and affecting people of all different age groups as well is something that we need to focus on. It's something that needs a lot more research and the fact that Tim went to read thousands and thousands of papers and went to see all of the biggest experts in the world. He's done the hard stuff for you.

If you enjoy this, his book's linked in the show notes below and you should go and check it out. But now, ladies and gentlemen, please welcome Tim Klaer. What is your expertise? What gives you license to write a book about anxiety? So the awful truth is, is that I was sitting down having written sort of a couple of novels and thinking, what can I write about? And I'd written nonfiction before. And I was like, what am I an expert?

Because let you say, like when you're pitching something, whether it's like an article or a book, one of the four pitch lines units, like this is a story about this, or I wanted to look into this, the reason why I'm the person to do this, and you shouldn't get a better known celebrity to do it instead is because this is my area of expertise. And I was like, what am I an expert on? And it was like, well, I'm mentally ill, like, again, it's like I'm really, I'm just like, I was like,

at the time, I've had a two-year- old daughter. She's still, she's just older now. I still have a daughter, she's just older. But I was really struggling with like severe anxiety and panic that was like, I was having panic attacks every week. Sometimes I was having multiple ones a day that would like put me on the floor and that have several a day over like a three day period. And I was like, this is taking, this is just like, this is unlivable. And also, you know, in my work I do doing like a creative writing podcast, I'd started to have like neuroscientists on. I'd started having psychologists on. I studied like four years of psychology back in school,

but I'm not qualified. My background is in writing, but I'd spoken to these guys and had some really interesting beginning talks about the brain and the differences when they put writers in an MRI scanner and stuff like that. And so I was like,

and then we signed my daughter up to a developmental study where they started studying her brain and the development of kids at different ages. And I got to take her in and see they put this thing called an F-nears on her, which is, it's like a portable scanner in a kind of skull cap, it looks like a Medusa right wig, they stick it on her head, she looked like, well, she looked like a cross between Medusa and this is like a very deep-cut nerd reference, but like when Patrick Stewart plays like Lucutius out of the Borg, she looked like one of the Borgs, she had like one eye-red eyepiece sun, the Traxer vision. And I was seeing on a computer different parts of her brain lighting up because of something called the bold response,

the blood oxygen level, dependent response, showing different parts of her brain as different levels of demand wanted more or less oxygen. And I was like, I'm watching my daughter think, we are at a level now where psychology and neuroscience, we can like look inside people's heads. And I'm like, there's got to, like I only get access to this because we've signed up

to this study, but I'm like, there's got, I now know there's research that they're willing to speak to me for some reason. And I guess the thing was I just wanted to get well. And I was like, well, if I say I'm writing a book, these people are going to open their doors to me. And I'm going to be able to be able to grandfather myself in to speak to all these people.

And then I'm going to go like, and at the same time, I've like, you know, like if you've got hay fever, everyone in your family will like send you emails going, hey, I just read this article with this like their home spun remedy on how to be hay fever. And you get it. Manuka honey, yeah, you need to spread the Manuka honey over your nasal, nasal cavity or something. Exactly. And you'll never be sure of suggestions. Well, obviously, people knowing that I was really scared. I was never sure of people making suggestions, send them the articles and you see all these articles saying, there's new treatment has been found. So I was like, I keep reading that we're like five years

away from this treatment that's going to blow it open, whether it is a new drug, a new open, whether it was a new drug, a new sort of, a new strategy that people were doing, you know, like, I think it's you social prescribing people going for walks, forest bathing, dice, bars, things like that. And I was like, what if I just go and speak to the people, there are people who are spending their lives studying this in all different disciplines. Why if I go and speak to them and then I try and do everything? Because the other thing was, I'd also read all the studies on the effect of mental illness, appearance, mental illness on children,

and how that stuff starts early and it gets passed down and how across a whole range of profiles, it makes kids outcomes worse. And like stuff you'd expect, like their chance of mental illness being worse, but also crazy stuff, like their chance of having asthma. And I was like, it's this, I want my daughters to have the best chance

in life she can. And like some of us can be like, really down on ourselves and go like, I can't do this, I'm not worth it. But like the bottom line was, do I think it's worth having a go at this for my daughter's sake? If I don't care about myself, do I care about her?

The answer was like, yeah. That's one hell of a motivator, yeah. I know, yeah. And so that's how I... So, the short answer to your question was when I started out doing this in terms of my qualification. I was quite smug. I was like, I've been... I've been, I've been really anxious

for ages. I have the worst panic attacks out of anyone I've ever encountered. I've read a lot of articles. My nan has sent me a lot of clippings. I was like, I'll go and speak to a couple of, I'll speak to a couple of scientists, right? And they'll kind of sprinkle like a little bit of legitimacy, pixie dust on the top of it. They'll just quote stuff that I kind of already know. I'll go, yeah, yeah, I thought I'd sit in there. I'd get into their labs, I chat with them, and they tell me stuff and I'd go, because of course it's this, isn't it? I'd go, it's the amygdala, right? And they'd go, oh, you know about that. Oh, you're a colleague. And we'd kind of like nod and they'd

see that I was an expert. And then I'd go and write my book, and it's only when I went out and started speaking to people, and they're going, nut him, it doesn't matter at all, and I was like, I'm in deep trouble. I'm in really deep trouble. And then I just went down this rabbit hole, read over a thousand peer-reviewed studies, end-to-end, spoke to dozens of people, including like every expert that I could find in all sorts of disciplines. And by the end of it, like at least what I can say is I know how little I know, if that makes sense.

Like I know how dumb I am,, I know what the edges of my knowledge in any given discipline are. Well, the difference is that you've got that in the trenches experience, you know? Like, even if it wasn't medical understanding originally, you were able to appreciate it from an experiential standpoint, right? So what... For the people that haven't had one, how do you describe what a panic attack feels like?

So I went to the, I mean, you can get a technical answer, right, which is you go to the DSM-5 and there's a list of symptoms, right, and you have to have like X number from a list of symptoms, and then it's officially diagnosed. A psychiatrist could say, yeah, you've had a panic attack, and I think it's just like a hair under 8,000 possible, it's acceptable combinations of symptoms you can have for a panic attack. So they're incredibly diverse.

But reading the explanation of what a panic attack is, it's kind of like licking a photograph of an ice cream, right? Like describing a panic attack. I can tell you that it feels like it can feel like you're going mad. Like you, a lot of people, especially men, don't know they've got panic disorder until they present at A&E, saying they're having a heart attack.

They think that they're having a heart attack that they're having cardiac arrest. They go to A&E and the doctors like, no, you're having a panic attack because so many of the symptoms are the same breathlessness, what they call like air hunger, but also a feeling of like de-realization, which is really difficult to describe

until you've been through it, but you can feel like nothing's quite real, this sudden feeling that you're in a dream, which is also why a lot of people who are having a panic attack think they're going mad or insane, your airways closing up, your airways closing up, dizziness, racing heart, sweating, trembling, you might start getting pins and needles in your extremities, your extremities might start, they call that pins and needles and your extremities might start going into claws, which they're called tetany, which is to do with calcium deficiency as you breathe so hard. You might obviously

like feelings of dread and fear, often terror. I mean, my panic attacks, but all of this is like, if I described, like, you know, they call it, you know, they'll call it in the literature They'll say a panic attack is like this feeling of sudden dread and fear accompanied by extreme physiological symptoms Which is a bit like calling like being kicked in the balls like a sudden extreme pressure to the testicles, right? Like it's a very very different thing to go through it And you're like, hey hang on And even after I've had one, I'd look back and go, yeah, but that's not so bad. And then you're going through it. And you you feel like you're dying. And it's ridiculous, you know, since it is ridiculous because you're not,

but there's various ways and various elements that I would later learn speaking to like pulmonary biologists and psychiatrists about the physiology that makes it actually very difficult to think straight while you're having one. It's not just a failure of character. So that's what it is, but I would say like they can present very differently. Some people have talked to me having, we talk about the fight, flight or freeze response, right? Those kind of three things. And panic attacks, I would say, you can can split them into those three categories. Some people, you wouldn't necessarily know that they're having a panic attack.

They just go completely frozen up. I've had a friend I talked to who said he had a panic attack on stage while doing a stand-up gig, right? And he's at the mic and he starts having a panic attack. Now people, all the people saw was him going completely silent, completely still and staring out like warlied over this, it looked like stage fright, right? From his perspective, he's having a panic attack, he can't breathe. There are other people like me that like honestly, it looks like a toddler having a

tantrum. Like I'm like on the floor, I might be screamer, I might be saying, I can't breathe. I'm like sweating. I might be like convulsing. You might think I'm having a heart attack. It was super embarrassing. It was like the least dignified thing you could, the only way I think you could have been worse if I was doing honking thoughts while I was doing it. I was literally about to say the only thing you could have done was shit yourself at the same time. That would have been some harm, maybe.

It's like you're emotionally shitting yourself. That's how it is. It's that complete incontinence of emotion and terror. Which would, when we see them in, the panic attack is preserved amazingly well over like millions of years of evolution. You can get very similar reactions from, you know, like, voles and stokes. Why does it exist? How is it adaptive to have a panic attack? Okay, so that's a great, that's a fantastic question and there's loads of, like, people have

jumped on this like, why. And there was a psychiatrist called Donald Klein who in 2003 wrote a paper where his theory was he sees it as a kind of he called it like a suffocation false alarm. So he's going back to like we know that panic attacks can be reliably triggered by something called the CO2 challenge, right, where you give someone a mask and they breathe in a mix of air that's got 25% CO2 in it, carbon dioxide, right, that reliably gives people like smashes of a panic attack, like it's the grimace thing, it's quite, and I've spoken to a psychiatrist who, you know, did it himself before he used it in his experiments, but we know that

people who are vulnerable to panic attacks are much more likely to have bigger and worse panic attacks when they do that challenge. And it's one breath, by the way, like you put this mouse on, you take one denouc- Right. It's, I, I, people who've done it have like said, you can't, I, I should say like there's, there's a, there's a famous patient called patient SM who had her, her amygdala, both her amygdala's removed, they're amygdala, they're, these parts of the brain that have, have often been thought by kind of like, when they talk about them in magazine articles, they call it the brain's fear center. Now's not but it is definitely implicated in our threat circuit she'd had this rare genetic condition that meant she lost both of her amygdala were eaten away by calcium

deposits she couldn't feel fear she had like a gun held to her head and someone threatened to kill her she didn't even realize that they were threatening her. They've done all these tests on her. They have her held, they had her held snakes. They took her to like a fun house and there was a guy dressed up as like pinhead out of the hell-raising movies and apparently she made him jump because she went up and grabbed one of the nails coming out of his mask just to find out what was going on. She's been beaten up, she's been assaulted at no point as she felt fear. Not all of these were in an experiment. No, no, no, they're super. Actually, the experimenters, all of them that talked about her, were really sort of protective and tender about her. She wasn't some weird, like, caged

of... Well, the problem that you have with someone that doesn't have any fear is that they're pretty bad at looking after themselves. Yes, you're not able to do threat response or threat detection very well. You're unbelievably vulnerable. Yes, and that's been a case studies from her life where a really sketchy guy just rolled up in his car and said, she want to get in and come with me and she was like oh yeah, hi, yeah, and he took her to a abandoned barn and assaulted her like she's had that throughout her life trusting people. But then she does the mask thing.

Yeah, yeah, and then this is the thing is like she's just not able to she so she does this She did this CO2 challenge is 25% and she had the worst panic attack they'd ever seen With that so even somebody who can off your fear in their life Had a panic attack a terrifying one when she had it now the difference with her is afterwards They said do you want to do it again? She was like, you're right. She wasn't able to learn from the experience, but during it, she was screaming, I can't breathe. She was grabbing for the... So the theory is that these chemo receptors in the brain are there, developed from when we were kind of like

borrowing animals. You go to sleep in a burrow, it collapses. CO2 levels will start going up because you're going to suffocate. You want something that will just flood the body during sleep with adrenaline, quarters, I'll get the heart hammering and go just move, scrabble, thrash around, try and get out. That's the that's Donald Client's theory that it's preserved because there was a time when it was adaptive to wake up suddenly because you and it kind of still is right like we know that children who have seizures during the night. the seizure reaches the amygdala, they are capable of just stopping breathing. In fact, they've had problems, you know, this has been one of the problems with COVID. There have been COVID patients who stop breathing, have incredibly low oxygen levels and just aren't aware. They call them happy hypoxics, right? Like the infection, this kind of neuro might reach the amygdala and these chemo receptors are somehow affected in the same way that people

will report sort of problems with taste and smell and they don't know that they're not breathing. I'm that little alarm that says shit like you're suffocating, you've got to breathe now and sort of jolts your wake doesn't go off and people can just sit there and pass out. So that's one of the theories. Another theory is that a panic attack is like the last resort of the fight flight of freeze, the most primal response to being attacked by a predator. Like if everything else has failed, if you've frozen

and they still find you, if you try to run away and you still get caught, if you try to fight, the last thing is just to flood the body with adrenaline. And so you thrash, you scream, you fight in the hope that like basically it drops you, that, you know, or it like it. So it's like this last ditch effort, which is why, which is, you know, one guy I spoke to John Wemy who's like a psychiatrist and he does like pulmonary biology and things like that, and he performs this CO2 test. His position was like, he said, when the amygdala is removed, what the amygdala might do is help us decide

which of the fight flight of freeze options. You've got to choose right when you get this blood of adrenaline, it might help us decide it. And when that's removed, we might just always default to the to the worst thing, which is like panic attacks, right? So the amygdala is almost like a kind of spiger that chooses how much water you want, and if you hack the spiger off, it's just going to jet water. So that's one theory of panic attacks. Why some of the elements of them might be adaptive, that it's a chemo receptor in the brain. There's very well, actually, there's various areas that might have chemo receptors. The amygdala might have them, but also peri-acquaductal gray, kind of like around the back, you might have these over- oversensitive chemo receptors. And actually, when they've done ambulatory monitoring of people who have panic attacks,

where they monitor their breathing, as they walk around throughout their daily life, they find that a lot of people who have panic attacks have a tendency to over breathe, right? So they're breathing a lot, they're washing out carbon dioxide, they're taking in a lot of oxygen. And so as they do that, they're slowly training this kind of like this canary in the mind shaft, these chemoreceptors to be more and more acutely aware of the tiniest bit of CO2. And so all you need then is a period where people frequently with panic disorder will wake up in the night having a panic attack. So there's been no trigger. It's not like they're in a shopping centre and they feel claustrophobic, they're in bed and they wake up thinking they're having a heart attack,

right? And so there may be some dist... it happens, panic disorder correlates with like sleep up near and like respiratory problems, people who have them, so there may be some dysregulation of breathing. And then of course what happens if you're having a panic attack, which we often think is part of it, but it's sort of almost a second stage, is then you over breathe, you hyperventilate, which I mean, I don't know, like if you hyperventilate, it has all these crazy effects on. I mean, and this is what I didn't realize I didn't get was like, and it also explains the very traditional method of stopping someone having a panic attack, right? Where you see them on the old movies where they breathe into a paper bag, right?

And that's not really dealing with panic attacks so much as the effects of hyperventilation, which are like an over correction afterwards, right? Someone breathes and breathes and breathes. It washes out all the CO2. And then with all that lack of CO2 and as a response it you get vasoconstriction in the brain. So the capillaries, after about a minute of hyperventilating, the capillaries are about 50% of their previous capacity, right? And then, and this is all really complicated, it took the ages to get my head round this because you're like, well, the bloodstream's full of

more oxygen, surely your more's going to your brain. Well, the body is a homeostatic system and it's constantly trying to make sure different areas are getting what's needed. And if your body thinks it's in a fight flight off-rease and there's your brain thinks it's getting too much oxygen, it'll go, right, we don't need this, right? We're going to restrict the blood vessels so the rest of the body presumably we're being chased

or in a fight, right? So I'm going to save the rest of that oxygen for the mitochondria and the cells in sort of my legs so you can run away, right? So we're right here and that's a mistake that the brain makes. At the same time you get this thing called a leftward shift on the hemoglobin dissociation curve, which basically means that hemoglobin, the protein transports of oxygen around the blood stream, cling onto that oxygen more tightly when you get a carbon dioxide washout.

So it doesn't, they don't deliver those oxygen molecules as readily. So not only does your brain get 50% of the blood flow, but all of the oxygen that's flowing through, the bloodstream is not letting go of. So your brain, like within a minute, your brain has been massively starved of oxygen. So you start feeling dizzy, you can't think straight, you start getting that de-realization, you start thinking you're going mad, you can't take logical steps because your brain is shutting down. And this is why people will regularly, you know, like I say, they will present thinking they're having a heart attack, they'll

present thinking that they've gone in, that they've lost their mind. And it's all to do with respiratory function, which is like, which is mad for me, right? That it's something so simple as like that dysregulation and then over breathing can lead to people thinking, I'm going insane and I'm dying, and it's just a breathing rhythm thing. Looking at the techniques that you went through in an effort to try and discover what can help anxiety disorders, what did you find out about exercise? So exercise is a really interesting one. I thought exercise was the first thing I tried right, because I was like, well, this is a slam dunk.

I mean, I was really, really unfit, like incredibly unfit. My job is three meters from my bed. My favorite activities are like video games and sleeping. Like, I was not, it's no exaggeration to say. I was, I know like I was a dad with a two-year-old, right? So, like, my sleep patterns were all out of whack. I was comfort eating because of the anxiety and because of, you know, I'd often get my daughter to bed at a crazy time. And then I'd just like, get a take away because the idea of then cooking for myself

was seemed like the least appealing thing and I thought, I'm fancy, you know, I deserve to treat. So, but I thought exercise, I was like, everyone's always telling me to do exercise. It would be a shoe in. And I went and started looking at the literature. I went to see a trainer called Dave Thomas who owns a gym in London who's got like 20,000 hours of like one to one sessions under

his belt to talk to him about like sports science and stuff like that. And I started digging into the literature. And what I was surprised to find is the relationship between exercise and reducing anxiety is by no means clear. It's a really interesting paper by a psychologist from Liverpool University called Peter Salmon, who looked at a load of studies on anxiety and exercise. And what he found is that most of the studies that you will read like in the paper, in magazines that say, you know, 15 minutes a day will reduce anxiety and whatever. The people they get to do, though, the sample that they use for those are generally, and they should be obvious for us, but like people who sign up to those studies are not generally people who hate exercise. They

need volunteers, right? And the people who tend to sign up to exercise studies tend to people who quite like exercise. So for a start, there's a skewed sample in that the people who tend to sign up to exercise studies tend to people who quite like exercise. So for a start there's a skewed sample in that the people who are doing them are people who generally don't hate exercise. Secondly, the samples that are used, and this is another weird one that surprised me, are often not people who are clinically anxious. They will get people who are just, you know, everyday people and they will study them and then they'll give them a survey at the beginning and a survey at the end and they'll go, do you feel less anxious now than you did before and often people do? But they weren't clinically anxious to begin with, they just feel more relaxed.

Does that mean it works with someone with PTSD or panic disorder? That study doesn't have anything to say on that necessarily. Secondly, a lot of studies don't, thirdly, I should say, a lot of studies don't really distinguish between what type of exercise. Like, there were a lot, you know, exercise is a big, that's like just saying, you know, books, is it reading a book good for you? Well, what kind of book, what kind of exercise is walking the same as sprints or farleck or hit, are we talking like marathon running? Are we talking about swimming? What duration are we talking relative intensity to someone's fitness level or absolute intensity, how many days a week for over what period? So all of these questions are ones that are not often well addressed in the current literature. And of course

one of the things that I got from talking today is like, you know, if you start an exercise regime, the first thing it's going to start doing is at least transiently raise your quarters old levels, your adrenaline levels, you know, your your testosterone levels as well, which is like more ambiguous when it comes to how that affects anxiety, but your stress hormones are going to go up initially, right? So the and it's going to be unpleasant, right? When I started running doing this book, I fucking hated it. It was grim. I did not like start running down the street,

whistling to myself, going, I feel so alive. I, I, I got a hated life. So much, I could taste blood in my mouth. I was limping. I would like, I was aching next I couldn't get up and down the stairs. I was so angry.

And I was like, why am I doing this? I hate doing this. But and there is there is a butt coming here, right? Like despite all that. So those are all the caveats, right? Despite all that, if you then look at the body of literature, there are some great results. Like one thing I'd say, like let's imagine that you did a bunch of exercise, right? And it did nothing for your anxiety, but you started an exercise regime. Well, we already know you're going to live longer. You're going to have more energy during the day. You're going to be your risk profile across a range of diseases is going to drop dramatically. So, the worst case scenario is that you live longer.

You're a healthier, better, leaner, sexier version of the person you were yesterday, you just still have anxiety. Yeah, exactly. So, it's not like, we're asking someone to put their hand in a meat grinder. It's something that's already good for you. I think it's sort of unambiguous across the range of literature, but can it help anxiety? Well, there are some suggestions that there are ways

it can do, when we look at athletes and some studies of people who exercise regularly and do intense exercise, and they've done some of this with bodybuilders as well, actually in response to a threat. And in the lab, this tends to be something like a shock protocol, so they'll literally wire someone up and give them unpredictable electric shocks. That's how they find out someone's stress levels and they'll check their cortisol with a swab. When you look at these people, actually, their fight flight or freeze response, their hormone cascade, is generally more pronounced than people who don't exercise. However, it tends to normalize more quickly as well.

So they have almost like more of an adrenaline boost in response to a stimulus. But then they return to baseline faster and this is something actually we see a lot across a lot of anxiety that it's not so much someone has a bigger. It's not like someone has a bigger startle reflex or that that can be part of it but they're worse at responding to safety cues and return to baseline. Let's actually on the other side of it. Exactly, yeah. Like, and it was true of me that like a can of beans could fall out, a cupboard. And that would be me, gone for the rest, that would be my nerve shot for the morning. I'm just like, I've got to take to my bed now with a case of the vapors and fan myself saying, what shall become of us? Because like that was it. Like my, I was just

jittery. So it's going to normalize that. The other thing is, and I'm sure, you know, you'll be thinking about this as well, but like your blood sugar levels, like when in response to a shock, you know, your body is going to release glucose, there's various hormones that release glucose into the bloodstream, anticipating a threat. So it's going to be available to the muscle so you can start running and whatever. So it releases these sugar stores. If you don't immediately use that up, then your body is going to release insulin to reabsorb it. So you get these big crashes. So that's why often people with

anxiety have this horrible up and down thing where you get the shock and then you drop into like the equivalent of a sugar crash afterwards where you feel sluggish, you can't think. And then of course you it's tempting to like have a sugary support string or something which will sort of briefly bring you back up and normalize, but then you know, you start this kind of like your day is this series of peaks and troughs. Exercise can help down-regulate some of the kind of cortic cord like some of your receptors that deal with things like cortisol to make them sort of slightly less responsive and they can put you in a situation where those kind of like

sugar spikes are less pronounced. They help with things like insulin resistance as well and that's of course, you were shading into diet now but exercises part of that as well. So what about that? Because I've always heard that there's more serotonin released in your gut than there is in your brain and that there's a good brain connection

when it comes to anxiety and the inflammation is something that you need to watch out for because you can eat some gluten and you'll have an anxiety attack. What's the lessons to be learned there? Yeah, so it's really important. And it's what that serotonin receptors in that you've got that idea of having loads of serotonin receptors in your gut.

You're like serotonin, five hydroxy-triptamine. Most of it is doing stuff around in different things all across your body. It's also the reason why you can't just take a serotonin pill, right? Because it doesn't cross the blood brain barrier to get into your brain. It's not won't be available in your brain. You've got a blood brain barrier that stops like nasty's getting into your brain. Obviously your brain sort of like very, very, that's one of the reasons why you get kind of like cerebral vasoconstriction so quickly, why it has these crazy responses is because it's really, really conservative.

Finally, too. Yeah, yeah, because it doesn't, you know, because getting a virus into your brain is much, much worse than getting one into your stomach, like if it's in your stomach, you can just diarrhea it out, which is one of the functions of serotonin. In the gut is what they call, it contributes to gut motility or peristalsis, which is why if someone takes like an SSRI, selective serotonin, reuptaking inhibitor to increase the availability of serotonin, one of the side effects is diarrhea. It's also one of the reasons why, like taking like a real strong serotonin agonist like psilocybin can give someone gut cramps and

extreme cases like diarrhea because it is that you've got all these serotonin receptors in the gut. Yeah, but they do something different crucially to what they might do in the brain. Mostly they're, you know, they're flushing out nasties. Yeah, peristalsis is like the motion of worm makes, and they make your gut do that to kind of force stuff through quicker. So what you eat, I'd say like one of the key areas for me, I spoke to a couple of people, I spoke to a microbiologist called Simon Carding

at the, in Norwich. He deals with, I'll be honest, the real reason I spoke to him, is because they do these fecal microbiota transplants, these FMTs, and they've been using it to deal with people who've got C-differceal infections, right? Really serious life threatening infections in their microbiome. And what they do is they take a cocktail, they take, basically they get a fecal transplant from someone else. They, someone donates their poo, that who's got a healthy microbiome, they kind of whisk it up and then they sort

of syringe it into the patients by the way they're re-arend or that you can swallow it in something that they call a crapsule and it will like restore your microbiome. Yeah, I know, right? And there's all these beautiful stories that are like my dad's poo saved my life and stuff that you see in the papers. So that's like well evidence for C. difficile, but they started to find these other things where took the micro biome from the quote unquote brave mice,

these, these, this one strain that I know to be more likely to explore a maze, and they'll jump down from a raised platform quicker and they injected the microbiome from their gut into well from a little pouch and some of that mice have called the Seacum and they took that and they injected it into the timid mice, these ones that are a string called Balb C that come from like a they're traced all the way back to like a 1913 pet shop dealer in like Ohio and they've just been bred and bred and bred and then known to be very sort of, with the mouse, the equivalent of nurse, right? And so they're inject that microbiome into

those mice and those mice become braver, They become quicker to jump down from a raised platform. So people are like, what the hell's going on here? You can give one microbiome to another type of mouse that is like genetically that is like known to be, have a hereditary cowardice and it changes. They don't become as brave as the other mice, but they become more brave, right? What's going on here? So they've been looking at it in humans. Can we give people, can we change people's gut microbiome, and make them braver? So the sort of disappointing answer is like, at the moment, probably not. Like we've looked at it, phages, and it seems to work with mice, but mice have got like three inches of gut. We've got like three meters.

Like there's a reason, like we are, it was funny speaking to Simon Cardin because he was like almost like pinching his nose. Like the number of times he'd had to tell journalists, mice and humans are different. And it's like almost surreal to like have that conversation over and over and go, mouse is not a person, it's not a little person.

Like they've got all sorts of differences in their guts. They can't, like my son rats can't be sick. They don't have a gag reflex, so they've got massive differences in what they can and can't do. But in terms of like your diet, there's plenty of epidemiological studies. A big, big studies where they take huge numbers of people that suggest there's a mild association with a Mediterranean diet and lowered risk of anxiety and depression. It's not like a huge one, it's like for one in every 45 people who switched to a Mediterranean diet will avoid depression or anxiety that would have otherwise gone. But there's like a smallest, but you do that over a population, right?

And suddenly you are reducing, you're getting hundreds of thousands of fewer people hitting the mental health system with anxiety and depression and hundreds of thousands and that's only clinical level as well But hundreds of thousands of people potentially who aren't having their life like ruined by this so you know It gets to big numbers if you look across a population But I did speak to you you asked about inflammation. I spoke to a An in me she called her a self-unite immuncardra, so she called herself, that was her job title. She's at the University of Southampton, Dr. Rihwahu, and she told me she looks exclusively at the links between inflammation and depression and also anxiety. And she said that there are, you know,

what we're finding a bi-directional link between anxiety and chronic inflammation in the body. Now, it just so happens that being sort of like chronically over a weight, creases inflammation in the body. It just so happens that doing lots of exercise reduces inflammation in the body. It just so happens that doing lots of exercise reduces inflammation in the body. So if there is a bi-directional link between those two things, we can kind of put the pieces together and I'm kind of like speculating slightly, although she felt that this was reasonable, that eating, you know, a good diet and that would be one Mediterranean style diet full of plant-based polysaccharides,

lots of fiber, things that are going to increase that gut mortality and stuff. It's going to reduce inflammation and reduce your risk profile. I think it's fair to say reduce your risk profile of anxiety rather than immediately cure your anxiety. She also mentioned things that I thought she was taking the mickey to be honest when she told me them because she said, oh, that's like, what's the other things you can do? She said, oh, like, be religious. And I was like, that can't be right. And she was like, being religious is reduced with lowered inflammation, lowered this CRT,

this marker of inflammation, people who are religious and part of religious communities have lower levels of that. I was like, so I ended up looking into the research of that. And it is true. It doesn't specify what religion. So if you want to start your own cult, apparently that will reduce your chances of anxiety as well. But I suppose, you know, the takeaway from all of this is anxiety is not just one thing. It's not, it's a bit more like a headache, right? It's a symptom

that could have many causes and it may be that there is a subgroup for whom their chronic anxiety is arising from chronic inflammation, from a kind of feedback loop, from poor diet, lack of moving around, and sort of lowered hormone profiles across a range of things. There's other things that exercise boosts like this neuropeptide. Why is this one particular peptide that's associated

with lower anxiety in people who have it, lower rates of PTSD in people who have like high levels of neuropeptide white, that is produced by the only lots of exercise. So there is a good chance that there is a subgroup of anxiety sufferers who may be, you know, when we've looked at the depression, profiles with inflammation, we can see that there are some people who respond really well to just taking anti-inflammatories for their depression. There is like a subgroup who seems, that seems to like, they seem to. So that's the crux of their depression,

that's one of the reasons that their depression manifests. Yeah, but I would never want to get into this. You can get sucked into these sort of arguments where people are going, so are you saying that anxiety exists in the brain, or are you saying it's just about information, or are you, surely if someone's having a stressful life,

that's going to contribute. And then there'll be other people who say, it's only their environment, and you can't ever say anything about neuroscience, even though like clearly all the thoughts we're having, all the experiences we're having, are, you know, in some way instantiated in the brain. Like there was a brain is one of the pieces

in this puzzle, right? And sometimes when I get sucked into those, I feel a bit like I'm watching two people have a brutal fist fight over whether Kermit is a muppet or a frog. You know, like it's just like these things can all be contributors. And for me, like, inflammation is definitely sort of a reasonable culprit, but it may not be everybody's sort of primary boogeyman kind of behind what's giving them anxiety. What about childhood trauma and bullying and stuff like that? How does that contribute?

Well, I spoke to a, I spoke to a brilliant neuroscientist called NIMT Tottenham, who has done lots of studying of like childhood adversity and particularly how it affects brain development and how when people have had very traumatic childhoods, either because of like a single traumatic incident or because of like lots of different things that have happened, it affects the suggestions that it affects brain development in a way that's not always immediately

apparent at the age of the trauma, but happens later abnormal development of, I've mentioned the amygdala before, but also the hippocampus, which is associated and implicated in parts of memory. We try to get away from this idea that one part of the brain is kind of like one department for doing one thing, but certainly hippocampus is important in forming memories. And specifically for anxiety, it seems to be to do with associating certain environments with safety or threat, which is why there seems to be a lot of dysregulation in the hippocampus in soldiers with PTSD, people coming home who can't...

I'm not sensitive to it somehow. Yeah, you know that kind of like, the kind of classic thing is like a car back firing and they think they're kind of under gunfire. But like that, the brains inability to differentiate between a theater of war and a safe zone. You know, the hippocampuses almost certainly implicated in some level in that. But Nim Tottenham looked at how the brain, often those, she did this great paper that showed that like often our study suggests

that the brain starts to change in adolescence, but as the result of things that happen much, much, much younger, and we might get a sort of upregulation of, when we, if you're looking at, I guess, what they call like neuroanatomy, you might get much bigger or much smaller. The one thing I'd say at the moment is the literature is really ambiguous over whether an area like the amygdala, whether I'm having a bigger amygdala is worse because you're going to be more anxious or whether having a smaller one is worse because you have less regulation over anxiety. It's not entirely clear what the relationship is between sort of size and function. Did they say what sort of age this could begin from?

Are we talking about before stuff that we could potentially even remember, sort of toddler age that they could have been things that have impacted on our brains from then? Absolutely, I mean, some of the, I was looking at one study that was suggesting that we can't start forming coherent autobiographical memories that we're able to retell to people

until about two and a half. So they could be things that you don't remember, but certainly from the moment you're born, you are learning your threat circuits are active, right? Like babies are not great at certain types of threat perception, but you come out of the womb with sort of like flint responses to say like being dropped or pain or things like that. Babies for a while,

they've done these great studies where they get babies to crawl out over a Perspex floor that suddenly underneath, like goes is a cliff, like drops away, and you know, a crawling age, they will just crawl happily out over the edge. On this Perspects thing, they don't know that they're on a see-through kind of like ledge. And then there'll be a certain developmental point where they'll go, I'm afraid of heights now. So we know that some fears are required. Some are developmental steps, like it's good when a child starts to get a little bit of stranger fear. There'll be a moment where a child gets a bit more clingy. Well, they're starting to differentiate between faces.

That's quite good. Obviously, it can be pathological, but it's a neuroanatomical and neurodevelopmental milestone that's actually pretty great, right? to neuro anatomical and neurodevelopmental, a milestone that's actually pretty great, right? They're learning to go this face is safe, this is a stranger. But yeah, from really early on, they chipped Nim Tottenham, did a great study in mice

where they played the music when they were born, like they play a particular song, and then they found, most don't normally like to nest around any noise at all, like they're naturally timid. But then, if this song was played when they were adult mice, they would want to go, they prefer to go and make their nest when this music was playing. So they tried it with, I'm adults, they got butt people in and they played them songs. They did this very stressful test where it's like notorious test called the trias

where basically you're made to do a maths test that is rigged, that you're always gonna fail. It's gonna be too hard. And the answers come too quickly. There's like a loud horn sounds every time you get one wrong. You can see a bar that supposedly how other people who've done the test before did and you're always doing much worse than that bar, right? People report doing this trires as like the most stressful thing, more stressful than like noxious thermal stimuli where their hand is burnt, more stressful than seeing like graphic photos of like corpses, the the trires is what people find the most

stressful and don't want to go back and do again. And she did this test where they they would be made stressed by that and then they'd either be played some random music, or one group were played music from this watch, they call the critical period, which is like around five and six. And if you're played, if she found that when people were played the music from five and six, I mean, it reliably reduced their stress levels more than the control music. So they went back to the time when these people

would have been five and six, looked at the typical songs that were playing in the region, Phil Collins or whatever the fuck. Yeah. So everyone will have like a critical period. So she think, her theory is this is a critical developmental period when we are learning safety because people who had had a trauma around that age,

their critical developmental period was shifted earlier to about three or four. So as if the brain just goes, we're not going to have time to fully develop, we need to get things going, right. So they tended to respond better to music that was what was the response. The response was down regulated what happened. Yeah, so it's the it's lowering of cortisol levels. So they're like cortisol swabs. It's also things like they'll do galvanic skin resistance. So they'll check the sweatiness of skin and things like heart rate as well. They'll also just get people to, because we can, I got quite like obsessed with all these kind of like objective measures of like anxiety, but they'll also just ask people, what is your subjective, how stressed

are you feeling right now, which is always like a useful thing to do, because sometimes you can get a lot of studies they've done on neuroscience and stuff. They'll get parts of the brain that are supposedly associated with threat, flashing up and they'll go, this person must be scared. But then when you ask someone in the scanner, are you feeling scared? They'll go, no. And actually some of those studies, I spoke to one neuroscientist, Alexander Shackman, who was like, you know, actually one of the problems we have is the tests are kind of

boring and people fall asleep in the scanner. So clearly we can't be studying anxiety if like someone's like fall in a sleep because they're so bored and you got, you're going, these people are scared of these things. So yeah, like the response was people were having, they were like moving into that kind of parasympathetic rest and digest state of kind of going, it's like almost like those songs are safety cues for them. Okay, so is the lesson, what's the lesson to take from that when it comes to childhood trauma and adult anxiety? Well, like, there's two and like one of them is like the obvious ones that like we've got to like really protect children and make sure they grow up in the best environments possible because these things can have disproportionate effects on how they grow up. But I would also say, you know, as an adult, you can, if you've been through difficult

things in your childhood, it can be the most, most depressing thing in the world for someone to go, I am afraid you're screwed. And here's like 50 studies proving it. By all it, like like we're seeing more and more like neuroplasticity is still a thing. So what I would say is there is clearly an effect from that critical period of music and you might find that listening to songs from that period help you but I'm not convinced that that having like looks across the literature that effect is necessarily bigger than just listening to music that you love, right?

I'm not sure it might be an effect, but whenever we find an effect in research, we've got to ask compared to what? And I'd say probably those songs do work better than random songs. Do they work better than like your favorite songs? I don't know. But in terms of like what we can do about it, the takeaway is that yeah, you may have had experiences early on that have predisposed your brain to go not in a nasty way, it's not even pathological, it's gone, okay, the world is a dangerous place. I'm going to, we are going to be on the lookout for stuff and we're going to look around and make sure that we spot this early.

So, I, you know, someone might have social anxiety, right? They might like constantly think, does this person hate me? They might be on a train and there's a couple of people are drinking and you start getting anxious and you're well, and I'm part of your brain is thinking, is it going to kick off? Are these people going to be a couple of drinks down the line and going to start like getting Larry? And I'm going to be going to get in a fight? Well, all of that is actually quite compassionate and rational of your brain if you grew up in an environment

where don't piss off dad. If dad comes home and he's had a few, just get out of the weight, spot the early warning signs that someone might be not safe to be around, like, and try and spot the moments where they're, you know, the shift in the tone of voice. If you've grown up around that, there's like a little note of warning in someone's voice, and that is the time you're going to get, you're going to get hiding if you don't get out the way, your brain's going to go cool. Well, that's cool. We're going to apply that. That's an adaptive lesson.

Yeah, that's a useful thing. It is. Yeah, like if you have a soldier like in a theatre of war who's just prepared to like walk down sort of walk through an urban environment where there are like installed snipers sort of whistling and like twiddling an umbrella around their finger, you wouldn't go, oh, that's great. That's like a healthy human being who has no anxiety disorder. These things are contextual.

They're deeply contextual, right? That you would think that person is rightly, I think you would think that person has lost their mind. Their behavior would be maladaptive, to be non-anxious and to not have any threat perception in a dangerous environment is in some cases fatal, as we've sort of said before when people are unable to tell if someone's trustworthy or not.

The question is, and I think the question that anyone's got to ask is, is this, how's that working out for you, basically? is this still serving me? If it's not, there is no indication that the brain is not plastic. The brain is changing all the time, which is why I got a lot of neuroscientists laughing at me when I was going, I read a study that said eight weeks of meditation couldn't change the shape of the brain. And they're like, yeah, like taking a shit changes the shape of the brain. Like if you do that in the same lieu every day, like in like every action we do changes the brain, every action we do is making new connections, strengthening connections, wrapping these myelin sheaths around neurons. What this is, you know, what they call hebspostula,

what fires together, wires together. You cannot do a thing in your life that isn't changing your brain. So, I would, you know, I think it's a really important takeaway is to say like, you know, of course, there are neurological conditions. You can get, you can take a brain injury that affects your brain. But in terms of a childhood experience, meaning that you are destined to put all your life to, and you can't get better, you can't improve, I'd say there is, the research simply doesn't support that at all. It's the good news. Like, is the research doesn't support the idea

that you can't change the brain. I'd say it's almost impossible not to be changing the brain with almost every action and decision you make, which is its own kind of existential crisis. You're like, what habits am I laying down? You don't get to not make a habit, man. You only get to choose which type of habit you want to make. That's what people need to remember.

Like every action that you take moves you towards a tomorrow that is more likely for you to do that thing again. You know, you want to eat the cookie or not eat the cookie. It's not just a case of eating the cookie, is not not eating the cookie. It's also ingraining the eat the cookie module. So one of the things, talking about identity, our sense of self growing up and being an adult and stuff like that, something that I'm really, really interested in, given the fact that you're a man, you're a professional, you have an identity, you have people that

follow you online, you've got this big course that lots of people have done about coaching them to write and stuff, father, husband, masculine purpose in the modern world, all this sort of thing. Something that I'm really interested in is how you have dealt with the sense of self-referential feelings around being someone that has panic attacks. Did you struggle with masculinity, with your identity, with what you feel your place in the world is, given the fact that you're doing something that traditionally is not seen as that protector provider stereotype. I mean, so yeah, you're absolutely, and I think that, of course, you want to part of

you's, like, what was, imagine that you're above all that, and you kind of go, well, I don't really, you know, I don't, I'm confident enough in my own masculinity to not feel threatened by that. But when you are on the floor, like having shoved like a towel in your mouth to try and cover the sound of you screaming, so your baby daughter doesn't hear because you don't want her to be afraid in sort of two rooms away when your wife looks after her and you're just because you're scared of nothing. Also, you're just in your house, right? There's no threat. It's, I think it's impossible for anyone, no matter what their relationship to masculinity, to feel diminished by that. We know actually from some really interesting studies I read that

people who have more of a sense of what we might think of as traditional masculine values. Now I want to be careful how I say that because that's a bit loaded. But the idea that men shouldn't get anxious, that men should be sort of self-sufficient, that men shouldn't get anxious, that men should be sort of self-sufficient. The consistently have worse and more likely to get PTSD and have worse symptoms when they do. Why do they do that? I think if you can't, what we know, the ability to, it's going to sound so like, it's absolutely, it's simply simple, but the ability to talk to someone about what you're feeling and have it validated and be heard, it's like I think fundamental

to getting over anything, to be able to go like partly because it means you've got to be able to articulate yourself, so it requires some level of self insight. And if you can't, if it shatters your identity to go, at the moment, I'm really anxious, I'm not coping. So you can't let that in. You're going to constantly have an incongruence between your daily experience and the person you want to be. And you'll know that you're not living up to what you want to be, right? Like, you can say it all the time, but you know. And so you constantly feel like a failure, right? You continually do. Also, if you can't go to a doctor or, you know, or just a friend, right?

And say, I'm behind the shitiest time. I'm getting like stressed. I like getting keyed up. I like, I can't sleep at the moment. I'm like, keep thinking this, someone in the back gun going to break in, I was up at two o'clock, like with a flashlight, but all of these things, if you can't speak to someone and they go, yeah, what I was talking about earlier that sounded like a throwaway line about religiosity, reducing inflammation, well, one of the reasons that might be is just people having supportive

communities who they can go to where it's normalized to go I'm having a shit time. I've just been bereaved, you know like in a religious community if you loop if you lose someone in your life They die. It's expected that you'll be able to talk to them about it and That is in itself like has such It may even account for many of the instances of the placebo effect that sort of sober devil psychological research in that just going to someone. In fact, when we look across all types of evidence-based therapy, it doesn't matter what the modality is, right? It doesn't matter what type of therapy is, they all perform about the same,

and a lot of that I think is just being a room with someone who listens. We are a social, gregarious species. We are, which is why I think like so many people found like lockdown and I don't think you could have done anything worse for people's mental health than stop people being able to meet up with each other. It's such a terrifying thing, especially and then people dying outside, right? Those two things in combination terrible for people's mental health. And I think

that I think there's loads of great aspects to masculine values. You know, there's one of the things I talked about with Dave Thomas about exercise and stuff, setting and meeting challenges is is one of the things that helps my anxiety the most, like pushing myself, not going, oh, I need to sort of back away from this. The more you back away from challenges, I think it's understandable that we want to, and everyone around you will say, we should, you should rest, you should give yourself a break, but actually the stuff that's always helped is been like, I'm going to train to run a marathon.

Yeah, it's not like I'm... You know, like I'm... Yeah, it's not like I'm... You know, like I'm... I mean, into it, man. This is one of the things that kind of recursive self-loop that I see. And I've seen it myself, so throughout my 20s, I was struggling with low mood depression. I don't know whether it was being clinical.

I went to a GP when I was 21, and this, they gave me a single printout, and sort of, or should me on my way. So I'm hoping that the NHS has improved a little bit since then. But throughout all of that time, when I was suffering with low mood and stuff like that, so much of what happens is you become increasingly less able to lean into discomfort. The difficult thing happens, or there's a challenge that's placed in front of you, and you get to the stage where getting out of bed seems like an insurmountable task. You think, like, I simply can't go and have a shower. I simply can't go and make myself some food, or even be bothered to go and get myself a glass of water. And then you do it, and you come back and you go, oh my God, like that was that for me for today, that's me done for the day.

And then what you see when you're in a good place is that that reverses, you see that you're more able, you're more anti-fragile, you go into the gym and you're putting more weight on and there's this sort of, it is a masculine value, right? You sort of grit your teeth and get through this very, very difficult thing that you're doing. And it's not out of some sense of fear, it's out of a sense that you know that you can and that you're going to do more in your motivated, but both of these spiral either down or up the same way, you know. Well, what's so fascinating about that is that I actually ended up having that confirmed

the bit where that part clicked for me was when I was speaking to AI scientists, right, this whole field of psychology now called computational psychology, where we started making like self-piloting drones that would become neurotic, that would stop leaving the that would stop leaving the factory, right? And we started having AI's that were acting a bit like people with anxiety disorders, right? They're self-driving cars, really interesting speaking to a friend who like works, you know, as a research of a self-driving cars, and they had all these problems with the self-driving cars in Milton Keynes, where they were so... they were, they were, they were, you know, these cars are made to not crush into people, right? And the public

realized that the cars were really conservative in how they drive. So they just start walking out in front of them. And it got so self-driving cars couldn't, would like, be stopping and starting and just creeping along because they get, because people adapt their behavior around them. Well, what we see with the AI is is we started to notice that some AI's would sort of sort of would would would would would travel less and less far in like root finding and then eventually just wouldn't go anywhere. And what it was is they were learning about threats, taking avasive action and then maybe that threat was only temporary, maybe a seagull was flying through that area at that one time, but because they never try that route again, they stop updating their data on that.

Because when we do anything, and this comes from computational psychology and this kind of AI science, we're actually serotonous doing two things, right? We're doing the action, we're doing the behavior. We're also collecting data on the results of that behavior. Well, when you're depressed, if you stop leaving the house, you stop receiving data on the results of that behaviour. Well, when you're depressed, if you stop leaving the house, you stop receiving data on what it's like to leave the house. And your whole schematic of what threats are in the world, and what the world is even like, is gets more and more skewed.

It gets more, your data becomes more outdated, and you get a data set from a tinier and tinier cluster of behaviours. Well, as soon as you start doing the opposite, I wouldn't even say to people you have to get to the stage where you believe I can smash this, I can get fit, I can go down the gym and I can bench my personal best. All you have to do is be a good scientist and go, should we test this? Should we do a test? Because depression is sitting on your shoulder, it's like, or anxiety or whatever, it's going to like, okay, that is a good hypothesis,

I can't do this. Let's try out. Let's see what happens, right? We can do this. Let's do four trials. Let's do this properly, right? Because if you're so convinced, you're not going to be scared for me trying this, right? Because you're going to be proven rapturously, right? So let's let's try it out. And then of course, what happens is you go, shit. Oh, I did that. What the what's get? So if I was wrong about that, that one localized misbelief, what other things could I be wrong about? And then the whole spiral again, that's that recurs other things could I be wrong about? And then the whole that spiral again, that's that recursive spiral that I'm talking about, the problem and the point at which I've been at staring at the ceiling of a bedroom for more days than I can remember,

trying to break the inertia between those two worlds, trying to break the inertia of, I can't do this, to, let's try and do this. And that is the point at which I got stuck in awful lot, and I think a lot of other people do. And now, you know, many years hence and a lot of self work and stuff like that, it's increasingly difficult for me to think about that. And it's increasingly easy for me to find equity when something bad happens and increasingly easy for me to lean into discomfort when I need to as well. I know you know, I might relapse at some point in the future or whatever, but every single time that even anything difficult does happen, it seems to happen less. And that spiral makes me feel empathetic for the previous version of me that I used to be because I know how far that person was from having that

positive reinforcement, from overcoming something and knowing that we'll be okay and getting out the other side and it's fine, it's just for now, it's not forever and all of that stuff. That learning process is very meaningful. Yeah, and it's also, I mean, that feedback as well, the, it goes back to kind of like the old, kind of like classic or conditioning that Pavlov was doing with the dogs where, his lab where he was testing these dogs, you know, where he was ringing,

he was sounding a buzzer or having the ticking of a metronome and showing them like a bowl of meat powder and they would salivate and he would measure that, that they would learn to associate the buzzer or the ticking of the metronome with food and they'd salivate just at the noise, right? Well, he had a flood in his lab one night and all the dogs had to be rescued and it was very traumatic for them, like the water was coming up to the, because it was in a basement area, right? And the dogs had like a pretty shit life under Pavlov anyway, but like this was particularly bad. But afterwards, they found that all the dogs they had in the lab were no longer,

they couldn't do that classical conditioning after that. They did something had frozen in them, and they couldn't learn new associations. And this has been like in the work of, in the work on learned healthlessness where a dog gets sort of like one area of the floor will be electrocuted and another won't and it will be, it will be shown in light and has to move from one to the other and eventually they make the task impossible for the dog. Eventually it will just lie down and let it self be electrocuted. And the only way that you can retrain the dog that has been through that is that the experiment has like literally go in and drag the dog onto the safe area of floor to show that it's assumptions about what isn't isn't safe, once they make the test possible to win again, the dog won't bother to learn that it can win it because it's just learned that life is impossible.

But the dogs inertia around its own world view is so high that it on its own can't overcome it. And an experimenter has to come in and literally draw, I mean, it's hot, don't do that to dogs. Like, I could have told you that a dog would be depressed if you're electrocuted repeatedly. But nonetheless, the lesson from this is they, you know, that you drag the dog onto the safe area and you do that repeatedly. And eventually it's like, I gave my assumptions about the world or wrong, but it is not going to do that itself. And that's what we can end up like basically in this kind of metaphor is,

it is like a, we just stay on that electrocuted part of the floor. And I saw this in other experiments, this guy Peter Loverbond did one where people would be getting an electric shock just before a sort of blue square would be flashed up on the screen. And they'd be told, there's a button right, and can press it and if you press it like within a second of the blue square coming up the electric shock won't happen. And what they found is that the button could be wired to nothing right and they just tell people that's what's going on and they learn to press the button and they think they're stopping an electric shock but there was actually never going to be one. And then,

when they're shown a blue square, people who had that button to press will get a jolt of anxiety, you know, all those kind of like physiological signs of it, even though they've never been electrocuted by that blue square. And people who weren't given a button to press, who didn't think that there was any sort of the safety behavior, who actually then had the moment of going on because it would be electrocuted. Oh, oh, no, there was no electric shock. Unlearn that association and don't find it scary anymore. And this is something they call safety behaviours like our ability to people thinking, I can't, I'll have a panic attack on the bus unless I sit, I have to sit like one of two seats by the driver. And this is the second bit I wanted to get on really quick

based on what you were saying about like facing up to stuff. As I spoke to this amazing researcher from Oxford University, called Dr Andrea Reynaker, who I heard about, someone told me about her and I thought that can't be true, where she was solving, uh, hearing people of their phobias and anxieties, like claustrophobics by locking them in a cupboard, in a dark cupboard, while giving them this thing called, uh, de-cyclocerion, which is like increases neuroplasticity and saying, you won't be let out. Like, I'm going to put you in there and I'm not telling you when I come back. Can't call for me, don't scream, don't do anything. And these are people with like chronic,

like really bad, claustrophobia. And you just have to trust or come back. And you also, you can't do any safe behaviors, no taking, you know, a rescue remedy or a pro-pranol, you can't like do rosary breed beads, you can't pray, you can't tell yourself rosary breed beads, you can't pray, you can't tell yourself the nice lady would be back soon, you just gotta sit there and just like bathe in it.

Now the fuck is it? The article. Well, it had people's, they had their informed consent, there was a pretty reasonable dropout rate, a lot of people don't want to go through it, right? It's rough. The trick, one of the tricks was actually she came back in 15 minutes. People would have like cleared the whole day. They thought they might be shutting their whole day. She came back in 15 minutes. Her like cure rate is one of the highest I've seen out of any treatment. We know that

like phobia is probably one of the best, most amenable to treatment out of anything we can do, but these people would have their amygdala response and their phobic response normalized. I think it was something like at least two thirds. That was it like 15 minutes and their phobia was cured. And their claustrophobia was cured, which is nuts. Why? What's happening there? Is it the drug? So, Dyscyclocerin is a controversial drug to use in this situation. I read one paper that was called, so you will have already guessed what the problem with giving something that increases neuroplasticity is if you put them in a very traumatic situation.

And the paper was called Dyscyclocera in making good exposures better and better exposures worse. Right. If the person panics in there and starts doing safety behaviors, the neuroplasticity breaks that trauma and they're in harder, which is why they're, you know, they're looking at some other possibilities because it's a risky thing to use.

It's no good sitting down to someone and saying, the spider isn't going to bite you. It's how many times you've been bitten by a spider, how many people do you know have been killed by spiders in your friendship circle in the UK? None, right? It's no good telling someone that it's not getting to the parts of the brain that are making them feel like they're going to die and they're going to get out there. Your brain does not believe in hearsay. It doesn't care about that. It's got to experience it.

And what going in that cupboard gives is like a cast iron experience. You have just gone up against everything you feared and it had jack shit. Like you turned round to the axe murderer who's chasing you in the dream and you stood and it turned out they were just a phantom, right? And there was something, I mean of course like on a like conscious level, the idea of facing your fear, we can all understand how invigorating that must feel, but just on a neurological level, and again, I'm talking about, I spoke to several neuroscientists who are like, their names are in. I got a copy of the manual neuroscience out of the library. And I looked up the last living name in the

history section on anxiety. And then I emailed him and he was like, yeah, I'll speak to you. And I got to speak to this guy, Joel, who's like amazing neuroscientist who deals with anxiety. And like undoubtedly the most famous in the world. And he said that what you've got to do is let these parts of the brain, he talked about the amygdala and the hippocampus, just like to learn that the threat is not a threat, but you can't do that consciously. It's got to happen non-consciously. It's got to go through it and go, yeah, oh, I can stand down everyone, like turns out, we were worried about nothing. You can't talk to that part of the brain, theoretically. So having gone through all of these different strategies, tons of different techniques

for trying to reduce anxiety, what is it that you've come to believe on the other side of it as someone who had a lot of first-hand experience But also has now done a good bit of research with a thousand papers that you've read What have you come to believe about what doesn't doesn't help anxiety? How's this changed the way that you deal with it in your daily life? Well anxiety makes us crave certainty, right? I think anyone who's dealing with anxiety us crave certainty, right? I think anyone who's dealing with anxiety wants, like, I don't mind saying I wanted easy answers, right? I just wanted someone to say this is what you need to do. Anxiety crave certainty. It's a mix to authority. You want people just to tell us what to do.

And the way out, and it sucks, is uncertainty. It's exactly what you were talking about when you were saying that moment of doubt where you go, what if my beliefs about the world are wrong? There is something much more terrifying behind anxiety and I think the key to it is in people who have been through childhood traumas and yet blame themselves somehow. And I spoke to one guy who did like psychedelic therapies and worked with people who've been through really, really grim shit, doing psychedelics and doing therapy while they were under the influence. And I said, why do people, why would someone think that was

there for? And the key thing is, if it's not your fault, then it wasn't under your control. If it wasn't under your control, there actually is no sequence of things you can totally do to stop bad things happening again. That is the horrible truth about being a human alive in the world that we are asking anxious people to embrace when we ask them to come out of the woods, right? And I think that's where we've got to start, right? It's, there's a reason to hold on to the destructive beliefs of anxiety and panic and it is that if I can just hate myself enough, I can like, and set the algorithm up, the fear algorithm, I can actually predict any threat and I can actually make my life safe. You can't. You just can't. We can do sensible things. I'm not saying you should drink a quarter of whiskey and go dance on the motorway,

but you cannot structure your life to avoid pain, threat, like it's just not possible, and that is a bitter pill to swallow in the midst of anxiety. But it's also where liberation lies. And that is, I mean, if you told me that at the beginning, I would have been so angry, I've been like, you don't understand.

And I'd say, no, I don't understand. So let's talk about it because the other thing is all of this stuff about, oh, this is how, you know, the cardiopulmonary system works. This is the hormone cascade. It's all for naught unless someone feels understood. This is what a anxiety therapist, 25 years this guy, he's also an author, Mike Shell told me.

He said, he used to go in, he said, like talking to people about the fight, flight response and telling them all the literature and just dumping it on them. And he said, he realized that you can't get anywhere until you feel like you've been understood, until someone has heard you. like you've been understood, until someone has heard you, and you go,

because that was the breakthrough moment for me, and you go, that's right. Are you get it? That's exactly how it is. And then the other, and it's almost like when you accept that, and when you've been heard, all this other stuff is like,

actually all this other shit is relatively easy because we know like oh people are going, I know I should do exercise. I know I should eat better. I know I should challenge myself but I can't and that thing about the impossible task you were talking about. You can't like put your people are going we actually we need to like the world is very stressful and we need to campaign for sort of a more just world. Well, I agree with that, but at the moment, I can't like bring myself to like have a wash. So can you understand why I'm not in a state to like upend the current system? Like that's not helpful to me.

Well, like one of the things that unlocks that ability to start doing things that are in your best interest is in the moment where the message of anxiety feels like it's delivered, like the little carrier pigeon of your anxiety has like delivered that message to someone and they've heard you and they've gone, that is shit and you've explained it to them and you hear yourself say it as well and you hear them say it back to you and you go, fuck, that's actually now I say all that loud, that's pretty bad isn't it? I've been through a lot, I'm quite courageous, then like a whole bunch of stuff melts and then a whole bunch of energy that you've been using to be anxious, you can start like redirecting that. Like adrenaline's fucking great.

You can use that to like, I started doing like boxing, one to one lessons and it like beat the shit out of me. I went to the guys like, can you, I just want to learn how to get punched in the face. And he was like, yeah, let's do this. And it was great. And I'm like, it is scary. It's not great.

I don't enjoy particularly having like someone swing at me and punch me in the head, right? But it's funny. Yeah, it is funny in a boxing contest, context, to do all that stuff. And I'm like, oh, I've got all this adrenaline and energy. I can use this to like just rant it on like a step machine or a bike or doing sprints or like getting the kind of like

battle ropes and you're and it's knackering you and you're like this oh like adrenaline feels good so ultimately I think like none of it none of it I think can start until you have felt understood. And if you can't find someone else to do that, then being able to write it down, and at least for you to come to terms with it, you know, I think I think everything else comes out out of that. And that's why some of this stuff about all the other stuff that we know we should do, but we can't bring ourselves to do. That falls into place when that kind of like the core part of you inside, which is just like this kid that is freaking out, feels like someone has got the message. And then they're like, okay, stand down, alarms off. Now, what were you saying about like eating some vegetables? I can do that now

because I've like delivered my message. Tim Claire, ladies and gentlemen, if people want to check out what you do online where should they go? You can follow me on Twitter at Tim Claire poet or you can just go to my website TimClearPart.co.uk. And coward as well your book will be linked in the show notes below Tim. I appreciate you. Thank you. Thank you very much for having me. you