The Happiness Lab with Dr. Laurie Santos - Can You Become a "Practical" Optimist?

Episode Date: April 21, 2025

There are many benefits to being an optimist - particularly when things go wrong in our lives. But we aren't all naturally optimistic, so can we learn to adopt the best and most positive behaviours of born optimists? Through treating New Yorkers caught up in the 9/11 attacks, psychiatrist Dr Sue Varma developed a concept she calls "practical optimism". She shares her tips on how we can all be more optimistic in the face of life's challenges.  Read more in Sue's book Practical Optimism: The Art, Science, and Practice of Exceptional Well-Being   Get ad-free episodes to The Happiness Lab by subscribing to Pushkin+ on Apple Podcasts or Pushkin.fm. Pushkin+ subscribers can access ad-free episodes, full audiobooks, exclusive binges, and bonus content for all Pushkin shows.  Subscribe on Apple: apple.co/pushkinSubscribe on Pushkin: pushkin.fm/plusSee omnystudio.com/listener for privacy information.

Hey everybody, it's hoda koppi and I would love for you to join me for new episodes of my podcast making space each week I'm having conversations with authors actors speakers and your friends of mine folks who are seeking the truth compassion and self discovery. I promise you will leave these talks stronger and inspired to make space in your own life for growth and change to start listening listening, just search Making Space wherever you get your podcasts

and follow for new episodes every Wednesday. ["The New World"] Pushkin. There's no way around it. Sometimes life is tough. Awful, even. Bad things happen all the time. Whether it's an unanticipated health problem, a new relationship woe, or dire news on the

job. Sometimes these nasty circumstances result from our own behaviors and choices, and sometimes they have nothing to do with us whatsoever. Every day, people become the victims of random accidents, natural disasters, or even unprovoked attacks. In the aftermath of awful events like these, it's easy to feel upset and broken. And when things are really bad, you can even start wondering whether you'll be able to pick up the pieces of your life again. It is so fabulous to be back in Miami, in this beautiful city, in this beautiful weather, with you beautiful people.

This spring, I was invited to host a discussion at the World Happiness Summit in Miami. And that gave me the chance to interview someone who's dedicated her career to helping people whose lives have been impacted in awful ways. Thank you. So much. Meet this amazing audience. I know. I was like so excited to see you.

I am so excited to be here. This is psychiatrist Dr. Sue Varma. Sue was the first medical director at the World Trade Center Mental Health Program at NYU, where she treated people caught up in the attacks of 9-11. Sue has now gathered her insights from decades of this kind of work into a new book called Practical Optimism,

the art, science, and practice of exceptional wellbeing. In the book, Sue explores strategies we can use to deal with the difficult chapters in life. And her biggest recommendation is to adopt a particular form of optimism, what she calls practical optimism. To me, optimism has head-to-toe benefits, but at the end of the day, what optimism is, is a mindset.

The World Happiness Summit, or WAHASU as we call it, is an amazing event. If you liked this podcast, you would have an absolute blast at WAHASU. But with so many speakers scheduled, I only had time to chat with Sue about a tiny part of her work. So I asked her to record a fuller interview just for you. Nice to see you. My pleasure. Looking forward to it.

So I got her back to join me on Zoom. Yeah, I'm fine with whatever works for you. I don't mind doing like a full episode. Yeah. And began at the beginning with her story of the morning of September 11th, 2001. So, you know, on 9-11, I was a medical student and I was working in a New York City hospital. And I remember getting the call to say, you know, discharge as many healthy-ish people as you can because we need to make beds for people who are going to be coming in who are injured. And we did that and we waited and waited and waited and we just simply didn't see the kind of numbers that we were thinking because the death toll was so high. Do you remember where you were when you first like heard about the towers? Like were you already

like at work and saw it on TV or something? Yes. I remember we would come in at 5 a.m. So I'd already been there for three plus hours when we were hearing the news and seeing it live as the towers were coming down as a plane crash. So it was freakish. And I remember my sister-in-law was working downtown in 9-11. So many friends and family members were somehow down and around there, and we couldn't get through to anybody. Nobody was answering the phone,

and we did lose loved ones, friends. I mean, there were so many stories of people getting caught in the dust cloud, seeing people jump out of the buildings, getting trampled on. In the days after, myself and my colleagues, we volunteered in a variety of ways with first responders, with cleanup rescue recovery at the morgue, getting trauma training. Being a New Yorker my whole life, this is a place I identified with,

but I think no matter where you were in the country or in the world, I think a lot of people felt somehow connected and traumatized, rightfully so. It was devastating. When I think of trauma, you're never left the same. There's a you before it and then there's a you after it. When I think of trauma, you're never left the same. There's a you before it and then there's a you after it. When I think of mass disasters and terrorism, it's really intended to chip away at your morale and your sense of self and

your sense of confidence and trust in the world. What I saw in this whole concept of New York strong, it really to me came from this idea that great tragedy, not always, but sometimes can bring out a sense of grit and toughness and community. It wouldn't be until years later after I'd finished my residency training at NYU in psychiatry to be recruited for this role that I really didn't feel prepared for, but felt so honored to be considered and thought of for it.

It was a massive effort. It was a new program. When I came on, I remember the early days, they're like, there's several hundred patients who are on our list, you're going to be treating first responders and civilians. And I was like, great, how many psychiatrists do we have? Like six, seven. They're like, no, it's just you. I joked, I'm like, these are big shoes to fill. And they're like, no, no, no, you're breaking your own shoes, because there are no shoes. Like, this is the first program of its kind. Incredibly daunting, challenging,

but eventually extremely meaningful and rewarding. But you had, if I understand, I have someone to look up to who dealt with difficult situations with optimism. I'm thinking about someone in your family that you talked about in your book. Tell me the story of the inspiration that your dad was giving you. My dad still is an inspiration. He's going to be close to 90 soon and he literally looks and acts and thinks 20

years younger, if not more. And one of the kindest, sharpest, and healthiest people that I know. There's such resilience. You know, he came from very little in India, and, you know, he was born in late 1930s and has seen so many decades of trauma and tragedy. And the things that I take away from him, he would always say, simple living and high thinking. And this was a big saying in my family.

And I always make fun of him. I was like, but dad, why are you always laughing? Why are you always smiling? Like, what is there to be like, especially now? Like, what is there to be so grateful for? He's like, I mean, you can laugh or you can cry. I mean, you make the choice. He's always sometimes like laughing at his own jokes

in his own head, telling himself stories, not in a delusional way, just like laughing. And I was like, but dad, you didn't have electricity, you didn't have running water. He's like, what are you talking about? We had dance parties and slumber parties on the rooftop and camel rides and hurricane lamps. I'm like, that's because you had no electricity, dad. He's like, life was great. Life is great. He's like, how do you want to look at it? How do you want to tell your story? And so I just saw him this morning and he's standing there and he's is great. He's like, how do you want to look at it? But like, how do you want to tell your story? And so, you know, I just saw him this morning and he's like standing there and he's like cutting fruit.

That's how like immigrant dads show love in the house. He's like, what do you want to eat? Like, you know, cantaloupe, I'm cutting this, I'm cutting that. I was like, wow, you spend three hours cutting fruits for the whole, like he's retired now. He's like, you know, we've got to spend our time some way. So I was just thinking about him and I'm like,

you know that saying like, you don't want to just add years to your life. You want to add life to your years. And he is like the perfect example of that of just always enjoying himself no matter where he is, he's always reading new books, always coming back and listening to podcasts and interviews and sharing things. So keeps himself intellectually stimulated. So it seems like part of his story is that even though he came from circumstances that might feel kind of negative or feel sort of harsh to other folks when they're listening to it. He seems like he's really happy and optimistic and

resilient. And this sort of seems to fit with the question that you faced when you saw your patients. I mean, talk about the puzzle you sort of experienced as you saw different patients' reactions to the trauma of 9-11. Yes. So, you know, first thing I want to say is I never want anyone to feel less than if they do end up experiencing mental health disorders, whether it's related to an event or an incident or not. Most people, 20, 30, 40 percent of folks in their life will experience a mental health disorder. And 70 to 80 percent of people will experience a life-threatening event at some point or another, right?

Well, what's interesting that when it comes to post-traumatic stress disorder, that while 80% of people will experience a life-threatening event, only about 8 to 10% of people will actually meet criteria for post-traumatic stress disorder. So what that says to me is, wow, like at least 90% of people will have really bad things happen to them in their life, big, bad, life-changing things, and yet they will move on. We had a lot of patients who were in the medical monitoring program but never met criteria for anxiety, depression, PTSD.

Our brain has a great ability to bounce back. But to me, bouncing back from adversity, that's only part of the equation. It's important part, but it's only one part. I wanted to help people thrive in the face of adversity, because which one of us will escape this world without anything bad ever happened to us? None of us. That is where practical optimism came to me,

is because I would see these folks who, a lot of these patients who never became anxious or depressed, they would still come to our program and helping other folks. They bring them to their appointments. After the math of 9-11, a lot of patients would have agoraphobia or avoidance of people, places, things. Reminders is a feature of PTSD. So is hypervigilance, insomnia, nightmares, irritability. So they don't want to leave their house. And we would have these other patients who are like, I'm fine. I'll bring you. I'll take the subway with you. Because they were so afraid of there being

another attack in the days after or just having triggers and reminders. These folks who never made it into my program, I would see them in the hallways and I literally would be like, what is your secret? I started to see common threads of specific things that they did. But resilience in my mind was

always something you either had or you didn't. And one feature of it was optimism. But there were other features like altruism, social support, moral compass, cognitive flexibility. But optimism was again, one of these things that you had or you didn't and so was resilience. But what about the rest of us?

And it wouldn't be until years later that there was a paper done with researchers from UCLA and they said, you know There is a genetic link to optimism. So that was my first question Is it genetic? Is it something you're born with? And I love it when I find signs to back up things that I'm already thinking and it said yes there is and it's this Oxytocin receptor gene and if there's some variation in it, you know, you may not be as optimistic and what did that mean? Well, if you're pessimistic or have pessimistic tendencies, then you're more likely to get depressed.

Then they looked at this gene and they said, well, what is it actually code for? It's a mindset, yes. But in addition to being a mindset, it's also the ability to regulate your emotions, to be able to ask for help. I was thinking about so many of these things that in my therapy with patients, what is it that I'm helping them with? Can I teach people optimism? Can I teach them the things that optimists do?

How do we codify this? What does this look like behaviorally in the world? And I found data in every field of medicine talking about it. People who are optimistic and do a brief optimistic intervention, recover faster from colds or have less colds or infections, or looking at exceptional longevity in this study in JAMA that was a meta-analysis of over 200,000

people and said that people who are optimistic live 10 to 15% longer, and not just longer lives but healthier lives. So the concept of health span, because lifespan may be increasing, but we're spending the last decade of our lives, especially women, with dementia, living in a nursing home or dependent on other people. So I was like, head to toe, optimists have less anxiety and depression, 30% less likelihood of getting strokes or dying from heart attacks or really all cause mortality. They're happier, they're 40% more likely to get a raise in the next year. They have more friendships, stronger and longer bonds from childhood. They are happier in their romantic relationships. I was like, why is no one talking about this? This to me is the jackpot.

This is the wellspring of health. So I wanted to talk a little bit about how people tend to think about optimism, because I think when we hear the word optimism, we sometimes get it wrong. So what is optimism? Yeah, so I think a lot of people, I know I did think of it as like this woo woo thinking

and just look on the bright side and everything will work out. And that is definitely not optimism. That is toxic positivity. Asking someone to just get over something just look on the bright side and everything will work out. That is definitely not optimism. That is toxic positivity. Asking someone to just get over something or look on the bright side. Optimism simply is the tendency to have a positive outlook in an uncertain situation to kind of expect the best possible outcome. But to me, optimism by itself is only part of the equation because it's like I can have all the positive thinking in the world, but if I'm not doing anything actionable and proactive, I'm not going to be able to translate

those positive outlooks into positive outcomes. And so in my mind, I needed something more. I needed skillset and a toolset, and that is what practical optimism is. And that is how practical optimism differs from optimism. So if you're in that 25% bucket that is born naturally with a positive outlook, excellent. But the reality is that 75% of us are not skewed that way.

We might be sort of somewhere in the middle or may skew more pessimistic. So optimism is having a very favorable outlook, but by itself, it's not sufficient. So let's walk through this sort of updated version, practical optimism. How is that different? So practical optimism helps you translate

positive outlooks into positive outcomes through action. Practical optimism is a practice like having a yoga practice, learning a new language, learning how to ride a bike, learning a sport. Some days it's five minutes, some days it's longer, but it does require effort and work. More importantly, it's a skill set. Why that was so freeing to me is like,

we can all learn skills and we all should learn skills. And the practical optimism is a practice that requires you to take chances and to put yourself out there in the world and to course correct and to continually learn from mistakes. It's time for a quick break, but we'll dive deeper into Sue's idea of practical optimism when the Happiness Lab returns in a moment.

This show is sponsored by BetterHelp. In our society, which glorifies hyper-independence, it's easy to forget that we're all better off when we have a good support system in place. Research shows that we're better able to handle stressful times if we have someone to chat with. I'm lucky to have a great support system. My husband, Mark, lots of good friends who are there whenever things feel

overwhelming, and I also have my therapist. My therapist doesn't always have all the answers, but she does help me refocus my thought patterns and my emotion. Therapy can be a source of support for any area of your life. It can help you switch your focus from doing it all to knowing when to ask for help. Plus therapy can help you learn positive coping skills. It can teach you switch your focus from doing it all to knowing when to ask for help. Plus, therapy can help you learn positive coping skills. It can teach you how to set boundaries, ones that will empower you to be the best version of yourself. If you're considering therapy, give BetterHelp a try.

BetterHelp is fully online. It's convenient and affordable, and you can switch therapists at any time for no extra cost. Build your support system with BetterHelp. Visit betterhelp.com slash lori to get 10% off your first month that's better help h e l p dot com slash lori l a u r i e. Hey everybody it's hoda khatbi and I would love for you to

join me for new episodes of my podcast making space each week I'm having conversations with authors actors speakers and your friends of mine folks who are seeking the truth, compassion and self-discovery I promise you will leave these talks stronger and inspired to make space in your own life for growth and change to start listening just search making space where you get your podcast and follow for new episodes every Wednesday. space wherever you get your podcasts and follow for new episodes every Wednesday.

In her book, Practical Optimism, the art, science and practice of exceptional wellbeing, psychiatrist Dr. Sue Varma explains that a major pillar of becoming more optimistic is facing up to our emotions and processing them. So why is that so important? When people look at optimists, they want to dismiss their happiness and say, well, they've never had anything bad happen to them. Of course, they're happy. What people don't realize is that optimists and pessimists

both experience the same number of life adversities. The difference is that optimists are better able to cope with them. The reason is because they are in real time processing their emotions. It requires more effort and more energy to suppress your emotions. And when you suppress your emotions, they say that your body expresses what your mind cannot. And so a lot of my patients will come to me and they'll say, I don't know why I'm always sick, or I have these headaches, or I have these unexplained aches and pains or ended up in the emergency room from panic attacks.

So processing your emotions is such a key pillar of optimism because it says bad things are going to happen to you, people are going to piss you off, and what are you going to do about it? And a lot of times people end up suppressing negative emotions, like when we talk about any kind of addiction or unhealthy behavior with substances, with anything. Hours of binge watching, doom scrolling, if it's meant as an avoidance, as a procrastination, you cannot escape negative emotions. They will come to haunt you.

And that's why I say manage your emotions before they manage you, because in some form or another, I see so much suffering. You know, in my practice, a lot of these people look to the world as if they have it all together. And the reality is, I know differently because I get an interesting inside perspective of what is actually going on in their lives. And so in one form or another, whether it's

their relationship suffering, whether it's their work, something is going to suffer. So we know that people who deal with their emotions are less likely to have all sorts of problems, heart disease. There's something called type D personality. We've heard of type A and type B. And type D is this kind of like angry, holding onto emotions, not expressing them. It takes less energy to express it. I think so many people are afraid of their emotions. They're afraid to be alone.

They're afraid to be alone with their thoughts. I know people who will put the music on always in the background because they don't want to be alone with their thoughts. And they're like, what would that mean for me if I actually had to confront how I feel? Which I think is so sad, right? Because our emotions are this really useful signal

about what's going on in reality and what we need to do differently. I feel like ignoring them, we do that really at our peril, right? Totally. And you know what is an interesting, Lori, is that I think a lot of times people are afraid to confront emotions because it means that they will have

to make in their mind what they perceive as massive changes in their life. And they're not ready to do that. Because if somebody confronted the fact, wow, I really can't stand my partner, and I've been resentful for so many years, and if they were to confront it, it would require something to change. And maybe they're afraid that it would mean that this would be the end of this relationship, and who would I be without it? So I get it, I understand, but I would also say that Rome wasn't built in a day. We don't have to deconstruct our lives as a result of figuring out what it means. I had a patient the other day who was sharing with me a lot of things that she was not happy about with her partner. And I was like, what do you think would be most

helpful for me to say right now? And she was like, well, I know what I don't want you to say. I know I don't want you to tell me to break up with him. She knows on some level that the way things are not working, but isn't ready to end the relationship. So that's just one example. There's so many where somebody's like, I know what I need to do in terms of changing my life or changing a job. Like they know that if they were to allow themselves to be

enveloped by the emotion either that they would be debilitated by it. And I always say to patients, think of it as like dresser drawers. to allow themselves to be enveloped by the emotion either that they would be debilitated by it. And I always say to patients, think of it as like dresser drawers. I'm not saying let's open all of them and take everything out and create an entire mess and pile in the middle of your room. I'm saying like, let's just look at one drawer at a time and I'll help you act it a little bit neater, right? But we're not saying everything, take out everything.

Because I think there's a fear of being overwhelmed. And I think that fear of being overwhelmed can also involve not just being overwhelmed by the circumstances you need to change, but this worry that you might be literally overwhelmed by the emotion itself. And that's one of the reasons I love your book. You share this sort of handy rhyming catchphrase,

which I love, for how we can begin processing our emotions. What is this catchphrase? So it's name it, blame it, tame it, and reframe it. And the naming part is just name the antecedent or the trigger, just being aware of it. And there's so much evidence that having emotional granularity, just like understanding, putting words to what you're feeling and what caused the trigger. When we look at people who have suicidal thinking, as weird as this may sound, we feel that patients who have understanding

of what the trigger was probably have a higher chance of recovery and prognosis because they can tie it back to a specific event. And if you can do that, then you're more likely to be able to address the underlying causes and prevent them from happening again. So naming your trigger and antecedents and knowing what they are is really important.

And so next up is claim it. What does it mean to claim our emotions? So when I say claim your emotions, where in your body do you feel them? A lot of times people will say that I have insomnia or I have frequent urination or frequent bowel movements or I have headaches or I have a lot of tension in my neck and my shoulders. So I say that the body expresses what the mind cannot and a lot of times our painful or forbidden emotions shows up physical symptoms. Another reason you talk about the importance of claiming emotions is it allows us to think about

what we might call our forbidden emotions. What are forbidden emotions? So I think for some people, women especially, anger might be really forbidden. I have so many patients that I work with that end up crying when they're angry. It's scary because either I think that they're afraid of pushing the other person away or that it means confronting or challenging the person and then what. I think we've all created stories in our head about, if I were to say something to someone, they're not going to like it, they're going to leave me,

they're going to be mad at me, and then what? I think it's helpful to be like, okay, yeah, and then what? There's a statistic that says that 85% of the time, the things that we worry about never actually happen. And the 15% of time that they do, we're better equipped to handle it than we think. So I think that's really important to just keep in mind.

So that's claiming our emotions, but next step is that we have to tame our emotions. And one way that you suggest doing this is to really try to tame our ruminative loops. What do you mean by ruminative loops? I think I know what you mean. I think I've experienced this myself first. Yes, I definitely have experienced ruminative loops. And it's just like you're going in circles with the same thought. And what that does is end up creating powerlessness. And it strips us away of our agency because you're repeating the same emotion, what if, or you're

catastrophizing, assuming the worst case scenario or you're projecting. But taming your emotions is like short circuiting and fading a break in that and saying, all right, I am feeling angry, anxious, helpless. What am I going to do to self soothe? And so taming is really about soothing. And what I say is pick an activity that's not going to create a negative habit on its own. Somebody may say a glass of wine helps me soothe,

then what happens when you need two or three or four to have the same effect? We don't want the soothing activity to take on a life of its own. I would say pick something that seems relatively healthy-ish. Can you make a five-minute phone call to a friend? Can you text someone that you know is going to be supportive and helpful?

Would you do a one-minute meditation in place wherever you are, just closing your eyes and taking a deep breath. For me, walking is one of the most soothing activities. I was fascinated by the science of walking, that there's something about when you're walking, your eyes have to track what's out there in the world. So you don't want to get hit by a car. All of that forces you,

those eye movements to get out of your own head. Going for a walk or any kind of exercise just gets you out of your own head and gets you out of routine. So whatever you're capable of doing, it could be a five minute stretch. So we just want to keep it simple and lower the bar. But what's soothing for you? That's the big take home point. You also mentioned this other strategy that I'm totally going to adopt myself, which is

this idea of emptying your emotional spam folder. What is this? For me, I do that in journaling and I think that there's so much value and there's so much science behind two 10-minute journaling sessions. And there's no one right way to journal. What works for you? Like sometimes it's literally for me reiterating what happened in the day, and it's getting it out of your head and putting it on paper and you're like, all right, that's it, I'm

done. You know, when I was a patient and going for my own therapy, I learned a technique called worry journaling. Somebody may say, well, that seems counterintuitive. Why would you keep a journal of your worries? What I learned is that when you write the same thing over and over again, you start to see that there's a trend in your worries,

there's a common theme, you're worried about the same types of things, and that the things that you're worried about are not actually happening. If you're willing to write down how you handled it, that creates a sense of mastery as well. So putting it on paper is one way to unload your worry spam folder. And so that's a nice transition to the last of our four tips for kind of

processing our emotions. We need to reframe them. What is reframing our emotions? Why can it be so important? So reframing is one of the best techniques to try to put a different spin on a negative situation that happened. I just want to say that there are some negative things that happen to you, that there will be no positive spin, there will be no silver lining,

and I 100 percent get that. But other than the big tragedies, ask yourself, and sometimes it may not be until you've created some distance between you and this bad thing that happened. but reframing allows us to take back some control and says, you know what, I am not going to allow myself to be debilitated by this. And one way might say, is there another way for me to look at the situation? Could I look at it from another person's point of view? Would I

understand it in the context of the larger plan for my life? So sometimes it might be a rejection and there's this catchy thing, rejection is really just redirection. There were so many things that I wanted to do at certain times in my life. And I am glad in retrospect that they didn't happen at that time because for any number of reasons

I might've thought I was ready or maybe I gained more experience later on or I was better equipped to handle the challenge. And you could say, well, that's just you trying to be an optimist. And I'd say, sure. But the point is, I couldn't control it, I couldn't change it,

so why not reframe it in a way that puts me at ease? So reframing really just is taking back control, and it's saying, I don't have to choose to allow myself to be a victim of this situation. Reframing is one of the most powerful techniques used in trauma processing therapy, but I recognize, I had 9-11 survivor patients and friends, and they would say, when we would talk about reframing,

they're like, I don't see, there's no silver lining. I'd say, absolutely. It would be later on that I would recognize that there are some things that there'll be no positive way to put a spin on it. Then I realized from my Eastern upbringing, something my parents would say to me is that, is this a problem to be solved or a truth to be accepted? And sometimes you

cannot reframe something and then it just becomes about acceptance. And I think, you know, my Western upbringing would have me believe that acceptance was resignation, surrender, passive, meek and weak. Eastern upbringing says, no, acceptance is a very strong place to be when you don't have a choice. We need to take another quick break But when we return su will explain how she's been inspired by the japanese art form of kintsugi Taking broken pottery pieces and reconstructing them to be even more beautiful than an undamaged face the happiness lab. We'll be right back Hey everybody, it's hoda katpi and I would love for you to join me for new episodes of

my podcast making space each week I'm having conversations with authors actors speakers and your friends of mine folks who are seeking the truth, compassion and self discovery. I promise you will leave these talks stronger and inspired to make space in your own life for growth and change. To start listening, just search Making Space wherever you get your podcasts and follow for new episodes every Wednesday. Treating people caught up in the destruction of the World Trade Center had a huge impact on Dr. Sue Varma's career.

Of course, Dr. Patient confidentiality prevents Sue from talking in detail about the specific cases she treated, but she wrote about one inspiring person who escaped the collapsing towers, a woman that Sue calls Shelley. So, you know, Shelley was one of the first patients I worked with and I had imposter syndrome. I was like, this is like a big job and like, how am I qualified to be here? I was scared and I was like, how am I going to help Shelley? Because Shelley in some ways represented a lot of the themes that I was seeing which was these amazing people,

many of them high achievers, many of them leaders in their community. Shelley is a mom and just like a very honest, hardworking, strong human being. She was someone who considered herself an optimist, go-getter. She's like, I'm the one always doing the 5K races and throwing the company get togethers. And so I never saw that something could break my spirit. And that was literally what she said.

She was like, on 9-11, here I am, I'm getting trampled, I'm getting caught in the dust clouds, I'm wearing heels that day, I love to look cute when I come to work. And the heel broke and then I'm walking barefoot and I'm asking heels that day. I love to look cute when I come to work and the heel broke and then I'm walking barefoot and I'm asking for help. The next thing you know, like the dust cloud, like just, there's no ways to even put words on what happened that day. You go to work thinking this is just a regular day and then you're seeing people die in front of you everywhere.

And she was like, I couldn't get home that day and my husband couldn't reach me. Like she wasn't able to go back to work in that office. And eventually when she did, she never took a day off and never asked for help. And it was really like only through the program that a lot of people were told that they're going there for physical reasons for checking up like asthma, GI problems. And then they got mental health screenings that she wasn't even thinking that like, I need to get help. And in her story, as she's unfolding it, she just starts crying. And she's like, I don't cry in front of people. And I don't think I've ever cried about this in front of anyone before. And at the end, she said, I feel broken.

That was one of the hardest things to hear because I was like, what role do I possibly even play in helping you? Because everything you're saying to me is a thousand percent legitimate. There's no silver lining. How do I get you to reframe? There's no positive spin. So the theme was the brokenness that Shelley was sharing. And it made me think of this art of broken ceramics, Kintsugi in Japanese culture,

which is preparing something to beyond its original form. It's restoring it, but bringing upon a level of beauty culture, which is preparing something to beyond its original form. It's restoring it, but bringing upon a level of beauty that is like the 2.0 version. In kintsugi, you're putting these broken ceramic pieces together with a golden glue, a golden lacquer, and it ends up being even more majestic and expensive and valuable. When she said that, it reminded me because I remember when I was in therapy and I saw this art form in my therapist's office, it's the thing that my dad had from one of his trips many years ago in Japan. I thought to myself, is this an opportunity? Could tragedy ever be an opportunity

for us to come back stronger? And so then became the journey, I think it was a parallel journey of me becoming a therapist, I think, learning so much from my patients and just going home and saying, you know what, like, I'm on this ride with them for better or for worse, and we're going to get through this together. I don't have all the answers and I don't have them right now. We're going to co-create and co-construct a new reality that hopefully will be just as good.

It's never going to be the same. I get it. That Shelley who wore the heels is the Shelley that now wears sneakers or if she wears kitten heels and she brings a book bag, duffel bag, and had a change of clothes, always anticipating in a way like what if this were to ever happen again. So in some ways, she was right. She was never going to be that person. But after the treatment ended, I sat with her and her husband and he's like, I used to be the warrior in the relationship. And I finally have my wife back and she's able to function and she was able to ask for help but it's returning back to a person that sense of self that they

lost of like that ability of I can do this. It seems like going through trauma so many people that you've worked with went through this idea of the sense of inner brokenness and you talked about this as the effect that trauma has had on people's self-efficacy. What is self-efficacy and why is it so important for mental health? Self-efficacy is your confidence in your own abilities. I think it's so interesting because it's not really saying anything about your actual abilities.

You know that saying, fake it till you make it. I think there is some truth to it, but not. The reality is nobody is saying completely fake it. You need to do the work, whatever that work is, if it's training to become a musician, you need to train, but you also have to have faith and confidence in

your ability to achieve the thing that you're working towards. There's two aspects of it. One is continuing to push yourself to develop that ability, but then eventually believing that it is going to come to fruition. We see there's so much work, like Albert Bandura had done a lot of study on self-efficacy, and he says that this sense of confidence comes from your own personal experience, from vicarious learning,

looking at role models, getting feedback from trusted people, and then also just a sense of how does it make you feel your own physiological feedback. It also seems like self-efficacy involves some specific expectations, both expectations about ourselves and outside ourselves. Explain what the research shows about that. Yes, there's two features to it. One is just the belief that you yourself have the capacity to achieve this. And then the fact that this outcome is achievable period. So I'm just going to use weight loss as an example. Somebody may say, I'm doing all the things I know, like I know what I need to do. And that could be anything. Like if somebody said, I'm trying to put on more muscle, I need to eat more protein, I know what I need to do.

If I need to wake up like better sleep hygiene. So intellectually knowing what the steps are, that's a part of it. Number two, you carrying it out. But number three, will my work in the end be impactful? Will I see results? Because there'll be people who say, I'm still not seeing the result. Sometimes the results are not in your hand be people who say, I'm still not seeing the result.

Sometimes the results are not in your hand. You may say, I'm working really hard at work for promotion. I know what I need to do, but I'm dealing in a very stressful work environment that feels unfair, that feels biased, that feels like I'm walking an uphill battle. So I think that there are two parts that you need to feel efficacious

because your environment lends itself to making you feel that way. And the environment needs to be supportive because you can do all you want. But if the system feels rigged against you, and again, it could be a matter of perception or it could be reality. So we have to entertain both. And I always try to ask my patients, I say, listen, I just want to get a better sense of your work. Tell me a little bit about your boss's personality. Give me a sense of the interactions. How do you feel? How do your colleagues feel about this?

I never want to deny that reality if somebody says, I'm trying, I am doing my best, and things are still not working for me. But both of those expectations seem to contribute to the benefits of experiencing self-efficacy. What happens when it feels like we're not able to do what we really want to do? What happens when we're not feeling so effective?

I think we end up feeling demoralized, disenchanted, disenfranchised, and we give up. It's natural to think that you're going to fail, but what you really need to be reminded of is that you can rise up again. To me, proficiency is about reminding people at their very core of their capability. They did experiments with athletes and they're

told you're not going to win against this person, They're so much better than you. What they didn't know was they were actually matched with an athlete who was at the same level as them. But when you're told in advance, you're not going to be able to do this, they can't. And when they were told the opposite, oh, this person sucks compared to you, you're so much better, you're going to win. So a lot of times our expectation really predicts outcomes. And like there's an experiment where they tell students going into a classroom, the people there are very friendly or they're not. And the success of the student going to the classroom being able to make friends really

had to do with their expectations of what was to come. So I do believe in this concept of self-fulfilling prophecy. And I don't think that optimism is at all magical thinking. So how can we fight some of these barriers that lead to a lack of self-efficacy? What can we do to become more proficient? One of the barriers you talked about a lot is sort of fighting helplessness. How can we fight our inner sense of helplessness? So I think the first thing is just understanding and recognizing it as that and

allowing yourself time to rest and to sometimes hit pause, maybe not stop. Validation is a key part of that is just to say, I had a really hard time. If you're lucky enough to have someone really loving and caring and has your best interests at heart, to say, I get it, I see you, I see how hard you're working and this was not your fault, or could you learn something from this if you did have a role in it,

and what can you do differently? I think pausing, resting, recovering, because I think so many of us just go from one project to another, to another, and it's this like sort of destination addiction where you're like, I need to get to the next place, without really thinking through, why do I continue to strive?

And sometimes to look at the helplessness and say, is this an opportunity for me to change course? Am I meant really for this? Do I really want this? Or is there another way for me to achieve this? And that really nicely gets to a second barrier. You've talked about this idea of stuckness, where it's like, I'm never going to find a path forward. I'm just always going to be stuck. How do we fight this barrier to proficiency?

Fighting stuckness is about finding flexibility. And I talk about in the book about patients who are like, oh, I must go to, I don't know, fill in the blank, like business school or medical school or whatever it is. And it was actually a patient who, she was like, I must go to, I don't know, fill in the blank, like business school or medical school or whatever it is. It was actually a patient who, she was like, I have to be a PhD in psychology. This is the only thing she wanted since she was a kid. Her parents were like, no, you're not really meant for that very long course

and we don't have the money for it. I remember talking to this patient saying, is there anything else that you can think of? One thing led to another and next thing you know, she's the head of a wellness company. Years later, she sent me a clipping of some award that she got and it said she had written, thank you and this was something you shared with me in therapy, write your purpose in pen but your path in pencil. And that was so poignant to me because I was like, number one,

I don't remember saying that but thank you, I'll take it. And then number two, wow, you know, it was something that probably I needed to hear at that time. And just this idea that we don't have to be fixated on one specific path because there are so many roads to feeling satisfied, to feeling needed, to feeling impactful. And often it's not the road that we thought that we would be, and that's totally fine. So flexibility is a big part of proficiency. You have to be nimble, you have to be quick, you have to say, I have tried, and it is okay. Giving up isn't always a sense of failure. I think a lot of times in this culture of go, go,

go and work warrior, make it happen. Too much emphasis is on the final product, on the success rather than the process, which is about making mistakes and learning and fun and creativity and getting lost. When my husband and I travel and sometimes we make plans and sometimes we don't, we don't like to have fixed structured itineraries. We like to drive and go to small villages and meet people and see where things take us. You know, and I get that that's not always reality and it's not always productive or efficient,

especially if you're traveling with young kids. But I think as much as possible, I love the idea of getting lost and just think about what feels safe and what parameters and guardrails. How do you want to intentionally and safely allow yourself to get lost? Such a nice way to reframe your perceptions, which I think is such an important part of flexibility. Those are ways we can fix stuckness. But the third barrier is also one that I relate to a lot.

It's this fatigue, this idea that I'm too tired to be proficient, like I just can't do this. What are some ways we can break through that barrier to proficiency? Laurie, I love that you share that because when I think of so many like really successful and high achieving people, I feel like we are at risk

of burnout because we hold ourselves to really high standards. And I feel like in this culture, we're often taught that rest has to be earned or that rest is wasteful, unproductive, and it's frowned upon. And I just think that rest and leisure need to be incorporated as part of the work plan and scheduled with the same type of intention and urgency in a way. So when fatigue sets in, I think that whatever fills your cup, play, I think for me, is always a way to do that. So give yourself grace and be

gentle and recognize that do you want to get to the peak or the summit of this mountain completely out of breath, weathered and worn down, demoralized, you got to the peak, but at what cost? It also sounds like it's just really recognizing our natural limitations, whether those are just kind of mental natural limitations, like we just need some rest, we need to take a break, but also physical natural limitations. I think this is sometimes why we feel so fatigued is that we're not taking care of our physical bodies too. Yes, yes. And I say like for me, like something I'm really working on right now, and it's

something I've been thinking about for a long time is like sleep hygiene. You know, I think that I've always just taken my physical health for granted. And sometimes there's consequences to that. And I've just assumed, oh, I'm a machine. It'll work itself out. I remember a friend several years ahead of me telling me that, Sue, there's going to come a point in your life when you're going to make your schedule around sleep. I was like, I don't believe you. I make my schedule around everything else but that. That just fits itself in. She's like, no, I'm very careful about it. Now I'm thinking backwards where I'm like, if I want to protect this time,

whatever it is, seven, eight, nine hours, then I'm going to work backwards. The things that I'm saying yes to and no to are going to be centered around the sleep schedule. It's about making deposits into this rest account. Sleep is one way, 15-minute naps is another way, one-minute meditations is another way,

exercise is another way, anything that'sitations is another way, exercise is another way, anything that's going to refill your cup and replenish your energy. And so all these strategies that you're talking about for replenishing your energy, fighting helplessness, feeling less stuck, these were exactly the kind of things you talked about with Shelly. What was the outcome there? Was she able to use these strategies to kind of heal that inner sense of brokenness? Yes. And it's funny because she would joke, she's like, I didn't often know where you were going with certain things. Like when I'm telling you how I'm scared about another terrorist attack happening,

or I feel like my sense of safety or calmness or hope has been changed or demoralized, you would say to me, talk to your boss about trying to get time off or sleep. She's like, I didn't understand where we were going necessarily, but, you know, I figured I'm here, so I might as well show up and go with you. And so I think a lot of times when people come in to work with me, they'll come in with one specific problem in mind and they're hoping to get an answer for that problem. And then I often say, let's back up and sort of take a 360 to approach your wellness, even

though you're talking to me about, let's say problems at work. She wanted to get a raise, she wanted to get a promotion, but she was just so afraid. She thought that if I asked for days off, if I asked for rest, even if it was like blocking off an hour for therapy, that all of these things would get in the way of promotion because she would be seen as, you're not really serious about this job. And what was interesting was by taking care of her mental health, by resting more, her boss was like, I had no idea that you were going through all of this. I am more than happy to give you PTO. No, I'm not going to Dr. Pei,

please consider it as part of the sick leave that you have, which you have tons of, you have never taken a sick day in your life. She finally felt permission to rest, permission to take care of her mental health, and she ended up getting the promotion. I mean, her life changed. A lot of it is because embracing the fact that your life is not the same. I think that's the hardest part because so many people very quickly after trauma or any kind of setback want to get back to who

they were. I mean, it's not possible because this event has transformed you and your understanding and framework of the world. But also for a lot of people, going back to baseline also doesn't make sense because your baseline might have gotten you to where you are right now and why you're in my office to begin with. So really think about when someone says I just want to be who I was, is it realistic, is it possible, and is it healthy? Because sometimes optimism really seems like it's about kind of accepting where we are and giving ourselves the grace to be in that spot. Yes, exactly. So it's interesting because when you think about optimism, it's just you think it only means one thing, which is to look on the bright side, not recognizing that it includes a practice of gratitude, of leisure,

of rest, of self-compassion, of proactivity, of challenging the way that you're thinking. So there's so much more to it. And optimists do it naturally, not to mention having healthier habits and what's involved with that. Thanks to Dr. Sue Varma and the folks at the World Happiness Summit who introduced me to Sue's work. If you want to learn more about the summit or sign up for their 2026 event, you can visit worldhappinesssummit.com. That's worldhappinesssummit.com. But my discussion with Sue at Waha Sue was so insightful that I can't help but leave you with one more of the highlights.

This was when Sue agreed to lead me and the audience in a name it, claim it, tame it, and reframe it exercise. Okay, so first of all, like just, if you wanna close your eyes, feel free. If you wanna keep them open, you know, whatever works best for you. Name the antecedent. Think of a problem, right?

Think of anything that might've happened today or in the last week that could have triggered you to feeling upset, right? And the more granular you get, the more likely you are to be able to put your finger on it and change the problem. And we see this even as far in extremist suicide, where somebody can put their finger on these

with the events that led to me feeling like my life didn't have value anymore, I didn't wanna live anymore, right? So that is a dark scenario, but just think of an everyday problem name the antecedent, right? Then I want you to feel in your body, right? So maybe you want to close your eyes for this Where in your body are you feeling the tension, right? Are you feeling it in your jaw? Are you feeling it in your shoulders? Are you feeling it in your legs? Where do you tend to hold the problem and the stress in your body?

Right? So now you've named the antecedent, you've claimed where it is in your body, because often the body will express what the mind cannot. Right? And it will take place in the form of medical problems, headaches, things like that. And then I want you, this is the taming part, and everybody has a different form of self-soothing. Some people may say that I want to take a one-minute meditation, I call these Oasis Moments, where you are shutting the world out and finding your grounded sense of peace internally, right? It could be a one-minute meditation.

Or something that I've worked on that is based off of a best possible scenario. It's an optimism intervention. It's 10 minutes, but this is a one minute version of it. So if you want to do this with me, let's go. I'd like to just close your eyes, settle in, let your shoulders drop. And I want to take you on a little journey with me. So now that I've asked you to envision a problem, right? So you've clearly defined the problem in your mind. I want you to imagine a road, a path, leading to the solution to that problem. And I want you to get very specific. What does that solution look like?

And what does the road to the solution look like? Is that road straight? Does it wind? Does it twist or turn? And now I wanna imagine that we are walking together towards that solution. We're getting closer. You're getting closer.

And this solution is the best possible outcome that you could have envisioned. And you're starting to feel the anticipation of excitement, of delight, of success, of satisfaction, of personal gratification. You're getting closer and now you have arrived at the best possible outcome of your solution. And I want you to feel all the feelings that come with success, with mastery, with resolution. Peace, happiness, and success are enveloping you right now. I want you to take a deep breath to the count of five, inhaling gently through your nose, and exhaling slowly through your mouth.

You're feeling relaxed, hopeful, successful. And just know that this feeling is always at your fingertips. Success is accessible within you through a positive mindset that you have chosen. And take a deep breath and open your eyes. Pretty good, right? That's pretty good. Thank you. This podcast is supported by BetterHelp, offering licensed therapists you can connect with via video, phone, or chat.

Here's BetterHelp head of clinical operations Heshew Jo discussing who can benefit from therapy. I think a lot of people think that you're supposed to be going to therapy once you're having panic attacks every day. But before you get to that point, I think once you start even noticing that you feel a little bit off and you can't maintain this harmony that you once had in relationships, that could be a sign that maybe you wanna go talk to somebody, there's always a benefit

in talking to someone, because we can all benefit from improved insight about ourselves and who we are and how we behave with other people. if you're human that's like a good indicator that you could benefit from talking to somebody. Find out if therapy is right for you visit better help dot com today that's better h e l p dot com.

Everybody it's hoda khatbi and I would love for you to join me for new episodes of my podcast making space each week I'm having conversations with authors, actors, speakers, and dear friends of mine, folks who are seeking the truth, compassion, and self-discovery. I promise you will leave these talks stronger and inspired to make space in your own life

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