Ten Percent Happier with Dan Harris - Can Anxiety Be a Gift? | Dr. David Rosmarin

Episode Date: November 27, 2023

This guest says you can thrive with anxiety. And the trick is learning to get comfortable with discomfort.Dr. David H. Rosmarin is an associate professor at Harvard Medical School, a program director at McLean Hospital, and founder of Center for Anxiety, which services over 1,000 patients/year in multiple states. His most recent book is Thriving with Anxiety: 9 Tools to Make Your Anxiety Work for You.In this episode we talk about:The difference between anxiety and stressHow anxiety and distress can, paradoxically, improve our relationships with ourselves and othersWhy he’s a proponent of exposure therapyHow anxiety can be transmuted into loveWhy we often use anger to cover up fear and anxietyAnd the spiritual benefit of thinking the worstSign up for Dan’s weekly newsletter hereFollow Dan on social: Instagram, TikTokTen Percent Happier online bookstoreSubscribe to our YouTube ChannelOur favorite playlists on: Anxiety, Sleep, Relationships, Most Popular EpisodesFull Shownotes:https://www.tenpercent.com/tph/podcast-episode/david-rosmarinSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

This is the 10% happier podcast. I'm Dan Harris. Hello, my fellow suffering beings, how we doing? Of all the interviews I have done recently, this one, the one you're about to hear, has lodged in my cranium more prominently than perhaps any other interview. Dr. David Rossmarin is an associate professor at Harvard Medical School and he's the founder of the Center for Anxiety, which side note sounds like a super fun place. Dr. Russ Maren's thesis is that anxiety is, and these are his words, a gift and a blessing. He contends that it is possible not only to manage your anxiety, but also to thrive with it. His view is that a major contributor to the current epidemic of anxiety that we're seeing in our culture is that we have grown increasingly uncomfortable and

intolerant of discomfort. But discomfort, of course, is a non-negotiable part of being alive. So how do we get more comfortable with being uncomfortable? How do we thrive with anxiety? We're gonna talk about all of that with David Russ Maren, plus the difference between stress and anxiety, the role of medication in all of this,

how anxiety can be transmuted into love and the spiritual aspects of anxiety. David is just out with a new book called Thriving with Anxiety. Nine tools to make your anxiety work for you. I got an enormous amount out of this conversation and I suspect you will as well. A heads up before we get started that Dr. Russ Maren's audio quality is not quite at the level you might be used to, but I promise you, this will not detract from the truly incredible insights that he has to share. Time for BSP. Blate and Self-Remochen. I want to remind you I just started a new newsletter.

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You might know that I adventure around the world while recording this podcast. And over the years, I've learned that where I stay when I travel can make all the difference. Airbnb has been my go-to place for finding the perfect accommodations. Because with hotels, you often don't have the luxury of extra space or privacy. Recently, I had a bunch of friends come down to visit in Mexico. We found this large house and the place had a pool, a barbecue, a kitchen, and a great big living room to play cards, watch movies, and just chill out. It honestly made all the difference in the trip.

It felt like we were all roommates again. The next time you're planning a trip, whether it's with friends, family, or yourself, check out Airbnb to find something you won't forget. I'm Rob Briden and welcome to my podcast, Briden and we are now in our third series. Among those still to come is some Michael Palin, the comedy duo Egg and Robbie Williams. The list goes on. So do sit back and enjoy Brighton and on Amazon Music, Wondery Plus or wherever you get your podcasts. Dr. David Russ Mare and welcome to the show.

Thanks so much for having me. So you have a really interesting thesis. Your argument is that we should see anxiety as, and these are your words, a gift and a blessing. Please explain. Sure. If you take a step back, the reason we have an anxiety epidemic is because we are terrified to feel anxious. In truth, this is a normal human emotion, something that we all experience from time to time,

and the more we try to squelch it, the more we try to get rid of it, the worse it gets. By contrast, when we embrace this, there are many opportunities that come our way, because this is just part of life. An anxiety is gonna happen, and the question is, what do we do when it happens? We'll get to the opportunities that come our way allegedly. But let me just pick up on some of the points you made there about, I think you called it

the anxiety epidemic. Do you believe that it's being overdiagnosed at the same time? We're seeing an over-prescription of drugs? Yes and no. The truth is, anxiety in our society is out of control. The reason for that is because we are allergic to even the low levels of anxiety. And the minute we start to feel anxious, we interpret that as a sign that we're weak, as to sign us something's wrong with us,

and that interpretation of threat means we're going to dump more adrenaline into our systems, which then creates a cascade of anxiety, and then that actually creates an anxiety epidemic. So in some ways, the reason why we have so much anxieties because of diagnosis, and because of, as you mentioned, we're trying to medicate it away all the time. But at the same time, there is some truth to that because we've really created an actual anxiety at the clinic. It's not a fake thing. It really does occur today. We are super anxious. But the root of it is this unwillingness to be uncomfortable. So we get a little pan of anxiety, which is normal. As you've said, if you're not anxious, you're dead. That is part of the human

condition. We're all going to worry, feel stressed, anxious. This is quite normal. But there's something about the modern society that we then tell ourselves this story, this what you call a cascade that this is unacceptable, and we go down the toilet. Correct, and I agree it's a culture as opposed to a modern condition.

There are many cultures where individuals and societies don't believe that you have to feel good all the time time and they actually are very a lot better. So I can imagine some people might feel little triggered. Are you saying we shouldn't be taking medication for our anxiety? You know, I know plenty of people who feel like I can't live without my Xanax, I can't live without other forms of benzodiazepines that would fit in the Xanax family. Similarly, there's Zoloft, which I know

is a very different drug. Before we get into the meat of your thesis, let's just clear this off the table. What's your take on medications? I want to make it abundantly clear. I am not against medication. And medication has a very important place in the management of anxiety and the treatment.

However, often medication is sold as the solution to anxiety and the goal of those medications that people are given, especially benzodiazepines, which you mentioned, is to get rid of anxiety. When people are told this will get rid of our pain, this will get rid of how we're feeling, they expect to feel calm and to feel okay all the time. Inevitably, though, we're going to have breakthroughs.. We're gonna have pops of anxiety that occur during tense moments, sometimes when we're not expecting them at all.

And usually what happens is when people especially benzos are taking them, their anxiety tends to worsen over time. If it's used as an anxiety squelcher, other medications, you mentioned Zoolov, or other medications, non-benzoid-yazapines, I think are a little better because they can tamp down people's anxiety in general,

as opposed to stopping it in the moment. So that gives us some opportunity to practice tolerating anxiety. So it depends on how the medications are used. But in general, I'm not against them. I just think we have to be very cautious. Yeah, so I'll say a little bit about how I use the medications just to normalize this for everybody. So I have a panic disorder and it's shown up on camera quite famously or infamously and also in

situations where I might feel claustrophobia. I will use a benzodiazepine like a clonipin or an adivan as a kind of bridge You know, I don't use it much now, but when I was in a really heightened state of panic disorder around getting on planes and things like that, I would use it as a way to like get me on planes I had to get on. And then concurrently, I was doing exposure therapy,

which we're gonna talk about today, which is just learning slowly to get comfortable with the discomfort of the claustrophobia. So spending hours riding an elevator with my discomfort of the claustrophobia. So spending hours riding an elevator with my shrink at the Westchester Mall. So I use the Benzo's as a bridge. Now I don't use them when I get on a plane, although I have them and it's like an escape hatch if the anxiety gets too strong, but I haven't had to use them. So I'm just getting comfortable with the discomfort. Simultaneously, I also use Zoloft on a standing basis, very, very low dose, just as a kind

of protective measure. So anyway, how does all that sound to you and is that potentially a model for how people could think about it in their own lives? I mean, it sounds perfect and it's what I was trying to convey before. I don't know if it came across. Basically, for what I understand, you're taking the anxiety down to a manageable level, which enables you to face it. So it doesn't become completely overwhelming in the moment, but your goal isn't to get rid of your anxiety. It's to bring it down to a point. It's kind of like a mortgage where I can't afford to

pay the entire house at once, but I can pay it off in chunks, but I'm going to pay it off. If you stop making your payments, then that's a different story. It's not a substitute for dealing with anxiety by facing it, but it does make it tolerable so you're able to manage it. Is that fair? So the non-negotiable here is that we need to deal with it. So what do you think is going on that so many people seem unwilling to deal with it?

Well, the medical community in many ways, and I think other institutions that we have, has sent a problematic message that we need to feel even killed and happy and healthy, mentally healthy all the time. And that's just not realistic. Part of being a human is that we're going to have days that it's hard to get out of bed, or it's hard to have conversations with people, or we're, you know, feeling just pummeled by our emotions sometimes. This is such a human characteristic. And I just think we're missing the boat.

You have written that part of what may also be happening here is that we have a society that is in your words obsessed with control. Definitely. We have these amazing devices today, right? You know, these electronic appendages that can give us all sorts of information. And this morning I was communicating with people in three continents in the span of a couple hours.

We have such a sense that we can accomplish things and do things. And our emotions we expect that those will follow suit, like the machinery that we're dealing with today, is just not going to happen. I mean, human beings just not going to happen. I mean, human beings are not built that way. We're built to think fast and also to think slow, you know, have multiple emotions occurring even at the same time, complex emotions. That's part of being human.

That's part of the beauty of being human is that we're not machines. We're not even capable of time. Another point you've made, and I'm staying at a high level here before we get into this argument you make about anxiety being a blessing, which I just for the record agree with. You point out that there's this interesting thing that's happening right now that anxiety, and I see this in my personal conversations, and I feel like sometimes I get in trouble from making the point that you make in your book, which is that anxiety is at record levels, and yet by most objective measures, personal security, financial security, access to information, access to education, we've never had it better.

And now, you are very careful to argue that that doesn't mean that climate change isn't a massive problem, bigotry, inequality. These are all huge problems. Definitely. And yet, looked at from 10,000 feet, things are objectively better. So what do you think explains that delta and is it possible that people like you and I find this argument resonant because we're upper middle class white men? It's definitely possible and it could be my bias of privilege. At the same time, I'm also looking at global data.

If you look at middle-income countries, the levels of anxiety compared to upper-income countries is half. If you look at lower-income countries, compared to middle-income countries, it also, it's half. There could be detection factors, of course, but if you look at levels of suicide, objective behavioral measures of mental health, if you look at levels of suicide, objective behavioral measures of mental health, if you look at levels of people going in disability, in the middle of the 20th century, where there

were world wars, where people were facing Korea via NAMM, the Cuban Missile Crisis, these were massive national crises that we faced. Things are so much worse today, today emotionally than they were back then. So I don't think it's just my bias. You know, maybe there's an aspect of that, but I don't think it's only my bias. I think that this is an objective reality that in some ways, certain challenges that we have as a society actually make us less likely to experience an anxiety epidemic. What explains the Delta?

When you live in a middle-income or lower lower income country or where you've been through challenges in life, you expect to feel unmoored sometimes. It's part of life. And when you speak to your friends, it's not an impression management. Oh, I'm feeling great today. Oh, I'm looking great today. No, it's a tough day. It's a tough week. And that gets part laid into actual emotional wellness, ironically over time. We expect to be totally, like I said before, even killed, never to have a bad day. You know, late is in general, that is just not going to happen. That's not human. It's just a really comes down to expectations.

If you expect everything to be rainbow-barfing unicorns, then you're in for some nasty surprises you are going to suffer. If you see suffering as a part of life, well, then you're more resilient. Exactly. I might say if you see pain as a part of life, you're less likely to suffer. Right. I might even say that. Is it also that there's something about modern, wealthy countries where we have lost

a sense of community, where isolated, where individualistic, and that could contribute? Certainly. I also see that as a symptom of the larger problem. Relationships are messy. And the closer relationships that you have, the more messy they are. I mean, people today, in teens, even 20s,

are less likely to date than ever. A lot of the relationships are pixelated, because it's so much easier to deal with two dimensions than the three-dimensional person who like has gaps and stuff comes up. And when we want to have a clean, predictable smile all the time, it's a lot harder to have those relationships. So I think our individualism is actually coming from this place of needing to be in control all the time and needing to feel good all the time. So interesting. I tend to agree. What about mental health awareness?

I read an interesting quote recently from some public health official who was saying yes to a certain extent. Obviously, it's great that the stigmas around anxiety, chemical dependency, depression, loneliness that the stigmas have eroded massively. So that's all great. but this person was saying, when I see mental health awareness day, I wince a little bit because we're too aware of it at this point, and we're too focused on it.

Does that resonate with you? It does to some degree, you know, if think of one positive thing came out of the pandemic, it's that people actually started revealing their emotional variability, if you look at Simone Biles. She's a real champion of being able to say, like, hey, I'm just not gonna compete here because of how I'm feeling today.

So in some ways, I see that as a win. And in fact, in many ways, I see that actually as a win. I think that we do have to combat this general approach in our society of having to feel and look good all the time. And when we accept that distress is a part of life and we're able to talk about that, I actually think it makes us stronger. And yet do you worry at all about the kind of fetishization of our mental states that it as soon as we feel anxious, we make a distraught tick-tock post about it?

And is there a downside to awareness? To some degree, I think the pendulum does have to swing before we're going to get to a place of regulation. And maybe we're seeing the pendulum swing, which might be a little bit too far in some cases. You know, one thing that does distress me is when people are involved in things like self-injury online, because there's a contagious effect. And we know that when people are exposed to that, then that can sort of give people ideas of what to do.

So modeling the behaviors, I think, is different than modeling a vulnerability of speaking about how we feel. Like if someone's on TikTok or any social media platform speaking about the fact that they're anxious, what you did was so heroic. Even today, just speaking about panic disorders openly, I see that as such a positive, healthy, embracing a pure humanity, which makes you, somebody who's human, somebody who's so relatable. I wish more people would do that.

I appreciate that. Thank you. Okay, we're going to dive into the three-part argument of your book. But let me ask one more foundational, definitional question, which is, how do you define anxiety? Anxiety shares the same brain circuitry as fear, which means that anxiety is the fight or flight system in action. And adrenaline goes through our blood.

We have a cascade, a whole series, a host, rather, of physical symptoms that occur. Everything from dilation of the pupils to muscle tension, increased breathing, increased blood flow through the body. And all of that is intended to prepare us just like a fear response. The only difference between fear and anxiety is that fear is a response to a real threat, a present threat. Anxiety is basically a fossil arm. It's when the fear system gets triggered, but it didn't need to. There wasn't actually a saber-to-tiger, so to speak.

There wasn't actually an imminent threat. So, yeah, anxiety is unnecessary, but it's not dangerous. It just means that your fear system is working. In fact, if anything, it's an indication that you're neurologically and otherwise well and can respond to threat if you need to. Well, that leads us nicely into the three parts of your argument that anxiety is a gift. Your thesis is that working with anxiety can enhance our lives on three levels. And the first level is that it enhances your connection with yourself that it teaches you about your own strengths and areas where growth could be called for. Can you just say more about that part of your argument?

Sure. One more point before getting into the meat of it. I'm not saying anxiety is fun. I certainly have a reasonable amount of anxiety that I experience. And the days and the moments where I'm feeling panicked, when I'm feeling uncomfortable, when I'm feeling even a little faint, it's not pleasant. Those are not the moments when I'm feeling even a little faint. It's not pleasant. Those are not the moments that I'd want to write home about. But when I respond to myself and when I respond with others and when I try to use it in a

constructive way, I find that it immeasurably enriches my life. I mean, ways that I would actually prefer to live with that distress than without it. So that's where we're going here. I'm not making a light of anxiety in any way. And I've worked in acute psychiatric settings, and I have a visceral sense of how bad it can be. But that doesn't mean that we can't use the word parlay again, that into something positive in our lives.

Point well taken. Cass, you a question? Of course. The therapist in me wants to ask, since you started to experience panic, would you say you're more self-aware? Yes, by necessity, because from my first, not my first panic attack, my most public panic attack back in 2004 on television, I knew I needed to deal with it in order to continue working, and that just got me to therapy. So yes, I am by necessity

more self-aware. Okay. Fine. Granted by necessity, but you became more self-aware person. Yes. I can't tell you how many of my patients say the exact same thing. Almost all of them. We'll say that they're more self-aware because of it. Do you think you're more self-compassionate? For sure. But it really took me a long time to get to that piece of it. That's a late development. It makes sense.

I think in our society, we're really hardest on ourselves, maybe giving more than others. In almost all treatments for anxiety, whether it's CBT, which I practice, or DBT, which I also practice, or even dynamic or other forces of psychotherapy, are often about becoming more aware, more self-compassionate, and recognizing that we just have these limits, and we're gonna have these feelings, and that's totally okay, that's a part of it. It's such a healthier way to live.

Well, would you say that anxiety's in-hands to your relationship with yourself? Yes, 100%. You know, it's something that we often miss, because when you're going through anxiety, it's painful, and it just sucks, but often miss because when you're going through anxiety, it's painful and it just sucks. But often people look back and they're like, whoa, I'm just a different person. Here I am several years later in my connection with myself as to this.

Isn't that like, I think about Joseph Campbell and the hero's journey that we are designed to over the course of our lives, face challenges and grow as a result. I think we are equipped to face challenges. Often we shy away from them because of the way that we feel. And if we try to squelch our anxiety and just get rid of it, then in addition to it being futile, it usually doesn't work.

Usually makes our anxiety worse. But in addition to that, I think we miss out on the opportunity to really know ourselves. Coming up, David Russ Marene talks about the difference between anxiety and stress, how anxiety can actually, and this is counterintuitive, improve your relationships with other people and yourself, and why he's a proponent of exposure therapy. What a life these celebrities lead. Imagine walking the red carpet, the cameras in your

face, the designer clothes, the worst dress list, big house, the world constantly peering in, the bursting bank account, the people trying to get the grubby mitts on it. What are you all about? I'm just saying, being really, really famous, it's not always easy. I'm Emily Lloyd-Saini, and I'm Anna Liang-Grofi, and we're the hosts of Terribly Famous from Wondery, the podcast which tells the stories of our favorite celebrities from their perspective. Each season, we show you what it's really

like being famous by taking you inside the life of a British icon. We walk you through their glittering highs and eyebrow-raising lows and ask, is fame and fortune really worth it? Follow terribly famous now wherever you get your podcasts, or listen early and ad-free on Wondry Plus on Apple Podcasts or the Wondry app.

Psst! Hey you! Yeah you! I'm gonna let you in on a little secret. Psst, hey you, yeah you. I'm gonna let you in on a little secret. Jiffy is the fastest and easiest way to get jobs done around the house. Just hop on the Jiffy app, choose from the 40 plus services, and bam, you'll be matched with a reliable pro in seconds. Windows and eaves cleaning, check, yard cleanup, check. Plumbing, you guessed it, they've got it all.

Plus all jobs come with a satisfaction guarantee. Download the JIVI app or sign up at jiffyondemand.com and don't forget to use the code first for $25 off your first job. 40% discount until December 1st. Get this deal before it ends by going to 10%.com slash 40. That's 10% one word, all spelled out.com slash 40 for 40% off your subscription. So what's the difference between anxiety and stress? Yes, so stress can resemble anxiety and that some of the symptoms are the same.

Often the muscle tension and difficulty breathing. The heart rate doesn't quite go as high, but it can be elevated in general. The difference though is that you're not dealing with an immediate threat, you're dealing with a low grade chronic threat. I mean, the simplest definition of stress is when you have two few resources to deal with the demands that are in front of you. You can find 10 minutes away from somewhere and I have to be there in five minutes. I'm gonna be five minutes stressed.

The difference between my resources and demands equals them to stress that out. And wait, I understand that as being the definition of stress, how does that differ from anxiety? So the symptoms are similar because it's activating a similar set of processes in the body. And also the relationship is that when I feel anxious about something, essentially I'm perceiving that I have a threat in my life and I don't have the resources to be able to deal with it.

So there's a similarity between anxiety and stress. The difference is that with stress, it's only due to that difference. With anxiety, it could be like a perceived thing. Like I'm really nervous about something that just isn't gonna happen. So if we think about whether we're experiencing stress right now, which is mathematical, you know,

and measurable, it's the difference between our resources and our capacity and anxiety, which may simply be a problem with our perception of the events. Yeah, I think that's a great way of thinking about it. Often people who have chronic stress will take on more things in order to avoid recognizing how stressed they are. The type of people who will take on those extra projects at work, take on additional financial commitments,

be volunteering in their community, doing all sorts of great things. When they're already completely tipped in terms of their level of resources is substantially less than the existing demands. I think many people do this, myself included sometimes, in order to avoid that feeling that I'm not control. It's hard to accept that there's only so much that we can do. So, there's a lot of similarities between stress and anxiety, although there are differences as well. I imagine you're often comorbid, because as I hear you're talking here, I mean, it feels like, yeah, I personally have a lot of stress, often self-created, and it may be that I'm

creating it because of my anxiety. Sure. like, yeah, I personally have a lot of stress, often self-created, and it may be that I'm creating it because of my anxiety. Sure. It's much easier to focus on your due list than whether it's panic or OCD or generalized anxiety disorder and lots of worries, you know, clipping through your head. Some people find, I wouldn't even call it soulless, it's distraction. It's just sheer distraction by piling on the list of things to do, as opposed to dealing with what we really got to do with.

Joseph Goldstein was a great meditation teacher, was staying at our house recently, and he and I were talking about, this is a conversation he and I have been having for a long time when he goes into Uncle Joseph mode and points out that I do too much stuff, even though I have, as I often say, seriously divested myself of various careers over the years. His point is like, you're still working seven days a week, and I think at the root of that is anxiety or an irrational fear of being homeless at some point, and I think clinging to the various trappings of late-stage capitalism that I've been able to accumulate and an unwillingness to say,

you know what, I'm not sure it's worth all of the energy to maintain. Yeah, I've definitely been there myself. Having an academic position at Arbor Medical School can be a tough environment and having to keep up with my colleagues in terms of productivity and then also having a clinic

which grew into a string of now seven offices and 80 staff, plus the case load and I had certain points along the way. I definitely had to really take inventory of my own feelings and what am I doing and like why am I taking on so much. And I guess it's not only capitalistic, I'm also trying to advance the world and we are dealing with a mental health crisis. So I have, you know, it's not only capitalistic, I'm also, you know, trying to advance the world and we are dealing with a mental health crisis.

So I have all those, you know, good reasons to be doing this and maybe there are excuses though at some level. Reckoning with that was just such a good process for me personally. I'll tell you. And I think it actually made me a more effective administrator, a more effective academician. So one of the reasons I'm doing this book, which is more public-facing, because I just see I want to have a bigger impact. I have to scale back from other things in order to do that. So you said reckoning with that was really helpful. So what did that reckoning look like and where did you net out?

Pairing down. Thinking this is not going to be my responsibility. I'm going to delegate it. And watch other people struggle with this and deal with it. There's a great phrase that I came across recently. Apparently it's a Polish proverb, not my circus, not my monkeys. That great. It's just not my problem. And I can't be dealing with everything.

Had a certain level, I'm not just had a certain level. I am simply human. I have to accept that and focus on what I really want to focus on without anxiety and never would have come to that. So this essentialism as it's been called of like pairing down to what you view as essential to be your priorities, I can imagine it requires some sacrifice in terms of control, but did it also require any material sacrifice? It certainly required confronting that possibility along the way,

which was scary. I'm sure you've had to do the same thing. Well, yes, I quit quite a lucrative career as a news anchor, and yet I still think there's more reckoning to be done. I'm curious, what does the reckoning look like for you? How do you work with your own anxiety? Do you have a therapist yourself? Are you applying what you teach to your patients? You mentioned CBT and DBT.

People may not know what that is. Yeah, I mean, in some ways, the book that I wrote is my own toolkit of what I do in order to handle not only anxiety, but, you know, any number of struggles and stressors coming along the way. And also tools, of course, that I've used with countless patients over the years. And also tools, of course, that I've used with countless patients over the years.

And many examples of that, I'm a runner. I'm a long-distance runner. And that keeps me sane, you know, meet with my trainer once a week. A very blessed to be able to do that. My family spend, you know, a lot more time these days than I used to with my family, which is amazing. And I try to just be myself if I'm struggling.

You know, I'll talk to my wife about it. Use those as opportunities to connect as opposed to just pretending everything is okay. I think spiritually, which is a piece of the book, but not the main piece. That's also an aspect for me, just coming to terms and accepting my humanity, my very small pace in the universe, my lack of control. And what I really want to accomplish in this world is opposed to a lot of the,

I love that word, essentialism, what you said before, but getting down to that. Like, who am I? What can I do? I think without distress, I just wouldn't have any of it. Yeah, that'll land for me.

And like you, I personally would not place myself at the end of that process. It's just ongoing. Well, let's learn a little bit more about the nitty-gritty tools you use with your patients and that you describe in the book, especially in this first part of the book and the thesis of the first part of the book, is that anxiety and distress can help us improve our relationships with ourselves. You've mentioned self-compassion. What specifically do you recommend for people in this regard? Yeah, when you're feeling anxious, don't take on a new project that day. Don't run away from it. Be kind to yourself. Try to get a little more rest. Try to do something that you enjoy. Those are days for self-compassion.

If you're having a tough time, that's not a day for fast food. That's a day to go out somewhere nice or to actually spend the time making yourself dinner. Go for a run. Do what you like. Go to a movie. Call up an old friend. Hang out with them. I mean, there's so many.

I'm just giving random examples here. But like I said before, like both of us have before, when we're feeling anxious, sort of just plow ahead in order to stop thinking about the anxiety in order to pretend that we're still in control, as opposed to just letting a wash over us, accepting it, and being kind. I can imagine people hearing this and saying themselves or shouting out loud, well, I can't be kind to myself today. I can't cook a dinner, go for a run, call a friend. My boss keeps calling me, my kids are crying.

I don't have a choice. There's no let up. Yeah, that's why there are multiple skills in the book. You know, if it's an interpersonal thing with the boss, there might have to be a hard to heart conversation that they're like, hey, I'm having a really hard time right now. And I need to know what I really have to get done because all of this is not going to happen. It takes a lot of guts and a lot of courage to be able to do that.

And I recognize not everybody can do that and to keep their jobs. That's also another factor, which is genuinely challenging and there have to be other tools that we use in such circumstances. But more often than not, I found that when people are adding value to a company, especially in this climate, there's some degree of, I wouldn't not going to call a job protection,

but people want to keep them and work with them. And if they're gonna have a tough couple of weeks and then they're gonna be back in full swing or whatever it is, better to have that conversation and I often encourage my patients to just be up front or at least to talk to someone else at work. If you can't talk to your boss, then a work colleague, you know, I'm having a hard time, can you cover for me, can you help me out? There are strategies and ways to manage it, but it doesn't come from pretending that everything's okay and searching forward That's not the strategy. You mentioned earlier CBT and DBT. That's cognitive behavioral therapy and dialectical behavioral therapy

What are some basic tools? I know you go into greater detail and you're one-on-one sessions with patients and in the book But just some things the kids can try at home listening to this podcast Exposure therapy is a cognitive behavior therapy tool. In some ways, it's the CBT tool for anxiety. And as you've spoken about before on this podcast, and personally involves facing your fears and not shying away from them. But it's amazing about exposure.

Firstly, it's very real. It's very raw, and it's very painful. I'll tell you as a therapist, it's so hard to watch your patients going through exposure therapy. They're confronting their fears and so viscerally uncomfortable. Not to mention, I don't ask my patients to do anything I wouldn't do myself. You mentioned claustrophobia before, so I've been an ulcerist in Nuxencrannies. When people have OCD, patients have obsessive compulsive disorder, there's a lot of gross stuff that I'd prefer not to talk about on the air that there certainly had to do alongside

my patients in order to help them habituate and expose themselves, so to speak, to the anxiety. But I actually wanted to get your take on this. Do you think that going through exposure therapy and facing your fears has made you more resilient in general? Not just for panic, but more broadly in life. A thousand percent, not just 10 percent and not just a hundred percent, a thousand percent. Yeah, yeah.

How so? I mean, this is a part of being alive is just to go back to Joseph Campbell. Maybe we're not built for this, but we're equipped for, and I think it is a great way to infuse meaning to go through hardships and learn from it and come out stronger on the other side. And I have found that staring down the barrel of a resurgence of panic where I thought, okay, well, this just proves that I'm a fraud and a failure. And I cannot imagine getting back on a plane to slowly and gently systematically confronting

the fears and seeing that I could do it. Just gave me so much confidence in my own strength and in the power of my mind and the human mind generally that yeah, it's made me better able to tolerate lots of life's slings and arrows. And I want to emphasize, I'm a complete wimp in many, many ways. I'm just maybe a little bit less than I used to be. So I see we still have to work under our self-compassion. Okay. Well, I just want to oversel. I'm just thinking of all the examples of I used to be. So I see we still have to work under our self compassion. Okay.

Well, I just want to over sell. I'm just thinking of all the examples of like, how much whining I was doing to myself just today an hour or two ago, but I feel like overloaded on another thing on my list. And I'm always working on it. And I suspect I'm not the only one. Yeah, that's the difference between

thriving and flourishing, which I'll maybe get to in a minute or two. But I just want to ask you another question. Would you have started 10% happier if you hadn't overcome aspects of your anxiety with exposure therapy? Would you have had the guts to leave as an anchor and launch this new project? No. I wouldn't have known there was a project to start outside of facing the news.

That's fair. So, any of my patients who go through exposure therapy have a renewed cartage and strength to be able to face any matter of life. I mean, it's going to make you nervous when you're starting something brand new, and habitually eating ourselves to anxiety is just a good, healthy, life skill that exposure therapy teaches, and it just makes it so much easier to achieve our goals and dreams. What's the difference between thriving and flourishing?

So flourishing is when people are doing well in their careers, things are going great in relationships, you know, health-wise, things are fine, and monetarily things are going great. Often that's because of external circumstances, right place, right time, markets are good, right. It's the economy stupid, as they say. Thrive in can occur, whether you're flourishing, whether you're languishing, whether you're distressed or even severely distressed. I've worked on inpatient psychiatric units within the Harvard Medical System at McLean

Hospital. I've seen moments of thriving on the inpatient units, where patients who are severely distressed have moments of connection. They have an aha moment. They face their fears. They open up about something that's really on their mind to a therapist or to somebody else on the units. They're moments of bravery, they're moments of light in a day that's otherwise very dark. I said it before and I'll say it again, dealing with anxiety and thriving with anxiety is not always fun, but it is so worthwhile. And over time, when we learn to do this, you look back two, three, four, five years later

and you're just a different person. Coming up, David talks about how anxiety can be trans-bearded into love, why we often use anger to cover up for our fear and anxiety, and the spiritual benefit of thinking the worst. Everyone leaves the legacy. I like Mr Gorbachev. We can do business together. Everyone leaves a legacy. For some, the shadow falls across decades, even centuries. But it also changes. Reputations are reexamined by new generations who may not like what they find. Picasso is undeniably a genius, but also a less than perfect human. From Wondering and Goldhanger podcasts, I'm Afwahirsh. I'm Peter Frankertpern.

And this is Legacy. A brand new show exploring the lives of some of the biggest characters in history. To find out what their past tells us about our present. Spina Simone was constantly told to sit down and shut up. You're the angry black woman. The name of Napoleon still rings out in the petter of the guides who thrive on the tourist trade. Binge entire seasons of legacy add free on Amazon music.

All listen weekly wherever you get your podcasts. Hey everybody, it's Dan on 10% happier. music or listen weekly wherever you get your podcasts. Hey everybody, it's Dan on 10% happier. I like to teach listeners how to do life better. I want to try. Oh hello, Mr. Grinch. What would make you happier? Ah, let's see. And out of business sign at the North Pole

or a nationwide ban on caroling and noise, noise, noise. What would really make me happy is if I didn't have to host a podcast. That's right, I got a podcast too. Hi, it's me, the Grand Puba of Bahambad, the OG Green Grump, the Grinch. From Wondery, Tis the Grinch Holiday Talk Show is a pathetic attempt by the people of O'Vill to use my situation as a teachable moment. So join me, the Grinch! Listen as I launch a campaign against Christmas cheer, grilling celebrity guests like chestnuts

on an open fire. Your family will love the show! As you know, I'm famously great with kids. Follow Tiz the Grinch Holiday Talk Show on the Wondery app for wherever you get your podcasts. Let's move to the second and third parts of your argument for anxiety being a gift. The first, as we've just discussed, is that it can improve your relationship with yourself, can improve your confidence and resilience.

The second is that it can improve your relationship anxiety can with other people. How so? Yes. Now, I want to clarify, it does not always do this. In fact, many times when we feel anxious, the last thing we want to do is to show that to other people and to open up to them. And often when relationships do make us anxious, we do one or two things. We fight or we flee. There's an activation of the fight or flight system. Humans or social beings were meant to be social beings. We thrive when we're social. Because of that, our relationships matter a lot.

And I would also say because of that, when we feel anxious, there is something so emotionally intimately connected about speaking to someone else about how you feel. Now whether that's a friend, whether it's a therapist, whether it's a romantic partner, opening up about how you feel being vulnerable, taking the risk that someone might reject you or judge you, allowing them to be there for you and creating that secure connected bond. It's almost like anxiety is the tool that we can convert into love. I would go as far as to say that in our interpersonal relationships. How does anxiety get transmuted into love? What's the mechanism there?

So I'll explain it like this. Let's say you have a couple and just take a romantic scenario and they're arguing over, I don't know, a financial matter. You spend too much, you know, you're too cheap. So the recriminations go on for years and years and nobody gets anywhere until they actually start having conversations about their anxieties. Why am I so scared that you're being cheap?

Often when I'll come out and this actually did, I was a current example of a couple of them dealing with now. He was afraid about her being cheap was because he didn't want to lose her and felt like if I'm not providing, if we're not materially comfortable and able to enjoy what we have, then maybe this relationship is something

you're gonna get fed up with and actually leave. Finally, like after months, that fear was expressed. The root of the anxiety came out. It was such a naha moment in therapy because he was able to get this reassurance, like I'm not going anywhere. Like this isn't about the money it never has been. And then mutually, when she explained to him,

like we're just spending too much money, what came out was, and he knew this, so he kind of should have figured it out beforehand, but her parents had financial struggles when she was a kid and almost split because of it. And it was very painful for her to watch them struggling, so she really needs to see a bank balance with a certain amount, otherwise she'd bannocks.

But again, it was all about love and the relationship, and once they communicated that they were afraid of losing each other, it settled things down so much. It takes the time to get there though. So just to get into the algebra of this alchemy, if you can, in your interpersonal relationships, be open about the shit that scares you, that can lead to a thriving of the relationship.

And that's how anxiety leads to love. Yes. As long as it's expressed in a vulnerable way, it's received by the other party as you be vulnerable because if you've done this after years and years of criticism, they're not going to hear it as a vulnerability, they're going to hear it as a criticism. So you might have to do it for a long time. Like it could take six months if it's just saying it and being consistent. You know, you mentioned alchemy. In some ways it is, but in other ways,

to actually get the formula right, you know, you have to wait for a lot of weather to pass and it can be complicated, depending on what's going on in the background of the relationship. However, notwithstanding all that, yeah, when we explain our vulnerabilities, when they received his vulnerabilities, and when that person is able to be there for us, which usually, although

not always, they are, sometimes they might not be there, by the way, they might actually decide to go, which is terrible when it happens, but then at least you know where you stand. But when they want to be there and you show them that you need them, and they hear that you need them, that's called secure attachment. It's a straight out of Sioux Johnson's emotionally focused therapy and it's a very powerful technique. Is another mechanism by which anxiety can lead to improve relationships that once you have more self-awareness, it can inexorably lead to you understanding that other people

have their own minds and lives and interior ups and downs, and therefore you have some empathy for them. There is something about experiencing our own emotional plane that makes us more into the feelings of other beings. And I think it's also reflexive. Like sometimes being more empathic and being more compassionate towards others can help us to be more compassionate and empathic towards ourselves and even more in tune with our own feelings. So these two can build on each other in a positive way. Yes, I mean, that's what I us to be more compassionate and empathic towards ourselves and even more in tune with our own healings. So these two can build on each other in a positive way? Yes, I mean, that's what I sometimes jokingly refer to as the cheesy upward spiral that,

you know, as you get cooler with yourself, you get cooler to other people, your relationships improve. Because the relationships are probably the most important variable in human flourishing and thriving, you get happier and then your relationships get better. And so like, yes, you can access the spiral from either side. You can start by being self-compassionate or you can start by being of service. And either one of them can, in the right circumstances, lead to a positive, self-reinforcing upward spiral.

No, I'm not. So, at the beginning of this part of the discussion, however, you did say anxiety doesn't always lead to better relationships. And I suspect what you were pointing at there is that if we're unwilling to accept our anxiety, if we're going to shut it down through denial, compartmentalization, polypharmacy, shopping, whatever it is, then we may end up being closed off to other people's emotions. And that's the opposite of the GZ upwards spiral. Yeah, we're going to be closed off to other people's emotions and also our own.

And if you're not willing to be anxious, it's very difficult to have a close-reloving relationship. If you're more likely to blame the other party as opposed to saying, I need you, it's so much easier to say, why are you doing that? That's dumb. As opposed to, hey, when you do that, it really makes me nervous. Like it actually raises my heart rate. It makes me uncomfortable because of X, Y, and Z factor. Would you mind changing your behavior? Not because you're doing anything wrong.

I'm not blaming you. I'm just sharing my need. That's the difference. But it's not easy to do that. And sometimes when we feel anxious, we're more likely to blame, we're more likely to get into a fight or flight. Sometimes we're less likely to see other people's feelings because we're so wrapped up on our own. But if we're ready to accept that anxiety is here to stay, we just have to use it in a positive, constructive manner, then that opens up these doors. And any of those doors can lead to just new vistas for relationships, emotional connection

and intimacy. Physical intimacy. I've seen people transformed over this. Back to the negative side of the equation, you write about the connection between anxiety and anger, and you can close to the notion just a few sentences ago. And I find that very resonant because I remember being on my high horse about something in some therapy session pissed off, self-righteous in some way, and the therapist said, well, sometimes we think of anger as a secondary emotion,

that usually there's something underneath it that you're covering up with the anger, and for me, I find that's usually fear anxiety. You've got a great therapist. I'll tell you, I was not really tuned into the relationship between anxiety and anger until the pandemic. And the Harvard Gazette called me up and they're like, what's with all the seething anger that we're seeing in this world? Do you have anything to comment on it? I had to think long and hard before I took that interview, but I did.

They published a piece and this is exactly what I came to and what was written about in that interview. I think you said it so beautifully before Ed. Like, when we feel anxious, it's much easier to convert that into anger. Hey, you're doing something wrong. What's wrong with you? Like, you know, as opposed to really what's going on at a fundamental primary level, which is I'm very uncomfortable with something and our relationship matters, which means I'm

kind of locked in here. I'm not going anywhere, you're not going anywhere, so I'm kind of stuck. So I'm trying to get you to change through showing anger as opposed to showing my vulnerability that like, hey, I really kind of need a hand here. So what do you think is the move if we're doom scrolling and feeling all this rage at people we disagree with or throwing our shoe at the television or whatever it is. Is there some sort of inward move we can make that might make those moments a little different and potentially could scale up to a healthier society?

Yeah, I think there are a lot of moves we can make. First is, I think we have to be kind ourselves and recognize that we're going to be frustrated and it's for damn good reason because there's a lot of stuff happening today which is on both sides, any sides, whoever you are, that is just bona fide frustrating and crazy. And I think we have to accept that as opposed to trying to get rid of it, speaking with other people and talking to them about how it makes us feel vulnerable, that there are certain people doing certain things, and what the implications might be, and what I'm really afraid of, as opposed to the anger. I think the more we speak about the primary emotion of fear, as opposed to the secondary emotion of anger, that's the key one. The biggest one, though, relates to kind of part three of my book, which is accepting our humanity.

Like, throughout all of human history, there's only so much that we can do. You know, I'm not saying we shouldn't vote, I'm not saying we shouldn't fight climate change, I'm not saying we shouldn't do what we can. But at the end of the day, I'm one person. And I'm not going to give up in my area, in my area of specialty, in my unique struggle, but at the same time, there are many fights that I'm just not my circus, not my monkeys. I don't have a dog in that fight. And accepting that is so hard.

It's so hard in an ear of history where we seem to have so much control. So I think we need to accept it. I just think we need to recognize our very small place in the world. And I think that makes us better people when we do that. You reference the third part of your book, which you entitled enhancing your spiritual connection. And so by spiritual in this sense, you mean like in the sense of a positive smallness that can be a feeling of awe in the face of the unfathomable,

hugeness of the universe. Definitely. Also, it's not a religious matter. For me personally, I'm a religious individual and that informs my spirituality. I think there are many paths to the realm of the spiritual life. Ultimately, it's recognizing the fact that we're human. There's another aspect of spirituality in the book, which is self-actualization.

Bringing forth your unique potential, seeing what has to be done in this world, what are my unique skills to be able to make a difference in the world and having the guts to go for it. Anxiety is going to be part of that. You're going to be out of the limb if you're pursuing your real dreams. It's going to feel terrifying and that's great. And when people get hooked on that, I think that's when a lot of the magic happens. Also in this part of the book where you're talking about the spiritual benefits of anxiety,

you have a phrase that I like, you say the spiritual benefit of thinking the worst. What do you mean by that? What's the benefit of thinking the worst? This is a page out of exposure therapy, actually, cognitive behavior therapy, for dealing with chronic worry, otherwise known as generalized anxiety disorder. And one of the techniques which was developed, I think initially initially by Tom Borkavek, is to learn to think the worst as opposed to low levels of worry on a chronic basis. When people worry, they're like, what if I get sick? What if I lose my money? But they don't actually delve into like, no, really, what would it look like the next

day after you got abandoned? What would it actually look like to pull up your bank account and see a zero? What would you do next? What would you feel like? How would that impact your relationships? How would that impact everything else? And people don't want to go there in exposure therapy for worry, for GAD. We encourage people to go there because once we accept how little control we have, we can tolerate uncertainty better, we can tolerate not knowing what's going to happen next. I mean, it makes us more resilient to be able to handle live stressors. So I do think there's a spiritual benefit to this as well, sort of accepting our place

in the universe that like, how much can I really control? It's hard to think about, but it's so humbling and very uplifting, ironically, in a certain way. People want to try this exercise at home. I believe it basically is catching yourself in low-level worry and just asking systematically, I believe the words you use are, if so, then what would happen? And so just keep going with that to its logical conclusion. Yeah. If it gets really amped up and really tough on your own, it might be the kind of thing to speak about with a therapist or at least with a friend or family member.

Sometimes it's easier to think the worst when you're not alone. So I'll just throw in that one piece of caution. But yeah, I do think we have to learn to accept those aspects of potential reality. Your fellow Bostonian, Dr. Robert Waldingerer came on the show, fellow Harvard guy too, and used a phrase and may not be his, but never worry alone. And absolutely love that.

Absolutely love that. Just one more question on the spiritual tip here. You talk about the power of prayer. What do you mean by that? Yeah, that's a good question. So some of this is informed by my own theology coming from the Jewish faith, but I do think and I hope I speak about it in a way that's accessible to people of it. What I like to say, all faiths are none, whether they do prayer or don't.

Now in the CBT world, especially people think of prayer as a compulsive act that people do in order to cope with uncertainty. That's not the way it was taught to me. And I often think that it's not used in that way within religious communities. Prayer is an act of, well, I mean, at least the request prayer is, hey, I'm in trouble. Can you help me out? And yes, there's an act of sort of trying to manipulate the heavens, if you will, and trying to cope with a Wednesday anxiety.

But there's another subtext, which is, I am accepting that I'm not in control of the situation. That yeah, I'm going to do whatever I can. People talk about it in psychology and psychoancology. A lot of some colleagues who do spiritual research, John Petit is one of them at Harvard Medical School and Dana Farber Cancer Institute on this type of work in Tracy of Albony is another individual, her wonderful husband Michael Bologna, and you know some of their work has taught us that there's something that when people are going through a

cancer diagnosis where they will go to treatments, do the best that they can, but there is a letting go of control, which can be facilitated through prayer and other means, which is very healthy for dealing with the situation. People are engaged, they're tapped into reality, but they're also letting go. And when prayer is used in that way, to facilitate acceptance, it can be very positive positive experience and anxiety can be parlayed into that to actually interact and give a person, if you will, a spiritual boost. I've definitely seen that.

You keep pointing to right from the beginning here, this issue of control being maybe at the root of our anxiety epidemic, and Buddhism, we probably say clinging. If prayer is not on the menu, for example, for me, as I call myself a friendly agnostic, what are the practices that I could do that would help me let go, see my smallness, see my lack of control, and ease into it? I think contemplating the vulnerability of one situation, one circumstances, thinking if it's once a week, how bad things could really go and really getting to a place of acceptance around that.

I could see that being a positive experience both for emotional resilience and for spiritual growth and whatever way you want to. Yeah, that's probably, that's what's coming to mind. Yeah, I try to do that to play it all the way out and think, all right, so how, if I lose it all, what's that really going to mean? I try to do that somewhat regularly and I always come to like, yeah, you'll be fine. I know my wife will stay with me and I know my son's still going to love me and we'll figure it out. I don't know if I always believe that in my molecule, so I'd

like sometimes add a little, the aforementioned Joseph Goldstein likes to teach in phrases, little mantras, little slogans you can use when you need them. This does not come from him. This is just something that I started saying to myself, which is, you're good. You're gonna be fine. You know, you may lose a bunch of stuff that you're clanging to, but you're good, you're fine. Just to stop this spiral and really pound the intellectual conclusion of, it'll be fine at the end of this shitty rainbow into my felt sense. Any of what I'm saying makes sense to you. Yeah, it sounds good.

You know, I'll only add that, even if we have moments of clarity around this and we can't carry it into our day-to- day life, I think it still works. It's sort of like we're in the dark and then a lightning bolt goes off and you can see everything clearly for a fraction of a second, but at least you know you're in heading in the right direction. So yeah, if it's a practice once a week, once a month, sounds like you have a lot to teach. I don't know about that. But I've learned a lot have a lot to teach. I don't know about that.

But I've learned a lot from you, speaking of teaching, don't be surprised if you see me quoting you a lot going forward. I really love what you're talking about here. Before I let you go, can I just push you to shamelessly plug your new book and any other resources you've put out into the universe? You're very kind. Thriving with anxiety, nine tools to make your anxiety work for you. thriving with anxiety, nine tools to make your anxiety work for you. I feel very blessed to have written the book with Harper Collins as an awesome publisher and it'll be available October 17th wherever books are sold. All right thank you very much. Appreciate it. Great job. Thank you. Thanks again to Dr. David Russ Marin as you know he had some incredibly practical things to say about Thanks again to Dr. David Russ Maren.

As you know, he had some incredibly practical things to say about anxiety. If you want to take a deeper dive on this topic, we will put in the show notes a slew of links to previous episodes we've done on anxiety, including interviews with TPH favorites like Dr. Judson Brewer, the meditation teacher Leslie Booker, and the actor and singer Sarah Bareilles. 10% happier is produced by Gabrielle Zuckerman, Justin Davy Lauren Smith and Tara Anderson. and Brewer, the meditation teacher Leslie Booker, and the actor and singer Sarah Burrellis. 10% happier is produced by Gabrielle Zuckerman, Justin Davy Lauren Smith and Tara Anderson. DJ Kasmere is our senior producer, Marissa Schneidermann is our senior editor, Kevin O'Connell is our director of audio and post-production, and Kimmy Regler is our executive producer,

Alicia Mackie leaves our marketing and Tony Magyar is our director of podcasts, Nick Thorburn of Islands, the Rodar theme. We'll see you all on Wednesday for a fresh episode with Orin J. Sofr, the great Dharma teacher. If you like 10% happier, I hope you do. You can listen early and add free right now by joining Wondery Plus in the Wondery app or on Apple Podcasts.

Prime members can listen to add free on Amazon music. Before you go, tell us about yourself by filling out a short survey at Wondery.com-survey. Hi there, I'm Guy Ross. And I'm Mindy Thomas. Wait. And we're the host of the number one podcast for curious kids and their grownups. Wow, in the world! Join us as we discover the wonders in our world.

Or as we like to call them, wow. The wows of science, the wows of new technology, innovation, and the people changing the world as we know it. Wow, now I kind of want wanna listen to the show, guys. Exactly. Join us on our next scientific adventure every Monday wherever you get your podcasts. Or, add free and one week early on Wondery Plus Kids.

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