Ep.34: Understanding and Coping With Anxiety

Episode Transcript
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Colette Fehr (00:00):
Laura, welcome back to insights from

(00:03):
the couch. We've got a greatepisode for you today where
Laura and I are going to divedeep into anxiety, how women
experience anxiety, thedifferent types of anxiety, what
causes it, and how to best copewith it. So this is one you
won't want to miss, becauseanxiety affects as much as 20%
of the population. So Laura, I'mexcited to talk about this

(00:25):
today, because you specialize intreating anxiety, and I kind of
specialize in having it,even though, obviously I have
some experience treating it aswell, especially in the past
when I did EMDR, but I thinkthis is a great topic to dive
into. You

Laura Bowman (00:44):
know, it's so interesting. You say that
because, like, I am an anxiousperson also, but I have, like, I
don't think it's as noticeable,because I think my tendency when
I'm anxious is avoidance. Do youknow what I mean

I do, but is this You telling me my anxiety is
noticeable?

I mean, you are like, you're out front about it,
right? Like, if you're worriedabout something, but the thing
about you is your your anxietyreally works for you, yeah,
because it propels you to act.
It propels you to problem solve.
It's the right kind of anxiety.
I'm actually a little jealous ofyour brand of anxiety. Thank
you. I sometimes want to dolike, a whole blog about wanting

(01:23):
to like the want to be type A,because I am such a. Want to be
type A. I'm not type A, but Ilike, kind of aspire to be, how

do you define type A? Because I think we want to
today talk a little bit tooabout the different variants of
anxiety in women, and let mejust set the stage before we
answer this question, thatanxiety is the most common
health disorder. It's estimatedthat as much as nearly 20% of
the population struggles withanxiety. It's twice as common in

(01:58):
women as in men, and and thatmay be for a variety of reasons,
some of it may be misdiagnosingbased on gender norms, but
regardless, those are thecurrent numbers. And there is a
difference between anxiety,which is a natural emotion and
can be extremely useful, right?
Situationally, anxiety isletting you know that something

(02:20):
is dangerous and you need toact, but that it really becomes
problematic for people when it'spervasive, it interferes with
functioning, right? And itreally can derail people. So
that's the stage to set, butwe're going to talk a little bit
about like the type a sort ofhigh functioning, anxious Woman
versus the crippling,debilitating body is in a state

(02:43):
of alarm, regardless ofsituational variables. So with
that said, I want to hear yourdefinition of type A. I'm so
curious, not clinical, just likehow you think of it,

I see type A people as being driven and
uncomfortable with leavingthings undone and and having to
act whereas and they'recompelled. So I know it's
uncomfortable. It can be reallyuncomfortable for people. This
is me. I'm kind of more of abeta person to begin with, so I

(03:18):
look at it enviously, because Ihave a tendency to take
something and be like, Oh, I I'mgreat at compartmentalizing.
Like, this is a little specialskill I have, and I think some
people might be jealous of thatability, but I can be like, Oh,
I'll deal with that one later.
And then I will get into like, amoment where every like, the
anxiety is too heavy and I haveto act all at once. So when I

(03:41):
see people who are always gotthat drive to act like, I'm
going to work out, I'm going tosend the email, I'm going to do
the project, I'm going to startearly, I'm going to get it done
early. I'm like, oh, what wouldit be like to just have the
ability to act all the time?
Okay,

okay, so you're talking about it as a driver
rather than an avoidance. Andit's interesting, because I
think anxiety can lead to bothmanifestations, and I can
actually do both. I can get veryprocrastinatory and very quickly
narrate reasons why somethingthat feels too overwhelming, or

(04:22):
I feel it feels too overwhelmingbecause I feel like I don't know
how to do it right, I don't knowhow to get it done. Then
sometimes I just want to stickmy head in the sand and just
say, like, Fuck it, la, la, la,la, la. And then I'll be like,
Oh, well, I deserve a day off.
And, you know? And of course, Ideserve a day off, but that's
procrastination, yeah. But

how do you deal with fear, like when you're
really afraid? Well, it dependswhat to act. Does it most often
lead you to act?

Not necessarily.
It depends the way, yeah, theway I think of it is so my
personal brand of anxiety andand truly, even as. A clinician,
and before I started onlyworking with couples, I did work
with a lot of people withanxiety, and I predominantly
treated it with EMDR, which isEye Movement Desensitization and

(05:09):
Reprocessing, and had some goodresults with that. But I saw
many different flavors andmanifestations of anxiety,
including a lot of I had manymale clients with anxiety that
they mostly tried to suppress,mask and bury and like, alcohol
consumption, yeah, you know,yes. So, and they have these

(05:30):
high achieving careers, andthey're not standing there going
like this, like I'm so worriedon the street corner, like I am,
right? So, right. So it's not asnoticeable. I the way I
approach, the way I experienceanxiety, is that I don't live in
a state of body alarm. I don'tlive in a state of activation.

(05:53):
My anxiety does tend to beprecipitated by something that's
happening. I'm afraid of thatsaid, I'm afraid of a lot, like
a lot, I'm extremelyclaustrophobic. I'm afraid of
heights. I'm afraid of beingmurdered to like, a quasi
irrational degree. I walk aroundwith a lot going on up here now.

(06:16):
Am I anxious, or am I justneurotic? Or am I just a very

what does it feel like to you?

What it feels like to me is that I'm just a
warrior. I think my selfassessment, after 51 years of
exploring this and trying towork on it, is that I have a
very sensitive limbic system, avery hypersensitive amygdala,
which is the fear center, andthe limbic system is your

(06:48):
emotional brain, so it's part ofwhat makes me creative, and it
helps me attune to people, andhelps me Intuit what's going on.
But as a result, if I'm walkingdown a road and somebody feels
shady to me. I've already, in 10seconds, narrated my murder,
where I'm going to be buried.
Will it be solved? How can Ileave evidence? What will I do

(07:09):
to fight back like that? Cause,my god, yeah, I mean, I'm
exaggerating, but only a little,a little so,

Unknown (07:18):
yeah. So like, let's talk. Because I think that most
people I always see, like,anxiety is like the dormant
volcano, and that by the timeyou're really getting symptoms,
it's erupting, right? But like,people are always like, Why do I
have anxiety? And it to me, it'slike, it's all these like things
underneath the volcano that youdon't see. So, like, it starts
with our culture. I think wehave a very anxiety producing

(07:40):
culture. It's capitalistic, it'scompetitive, it's fast paced.
It's not designed to make youfeel great about yourself. So I
think that it just grinds on thehuman system. And then on top of
that is like, what you'retalking about is like your
temperament that you're bornwith, yeah, you know the shy
child, the sensitive child? Imean, I'll never forget your

(08:00):
little shoe story at the circusand how worried you were your
mom would not get her shoe back,like those kinds of like I
thought somebody was gonna climbin my window and kill me as a
kid. Like I was sensitivefearful.

So I was sensitive and fearful, but not shy. Yes,
yes, yes. And very sensitive andvery always going into my
parents room and being like,like, if we saw a movie, the
movie would be in my head forlike, three years, same so I
really have gotten better atprotecting my brain from certain

(08:36):
things, but not enough. Because,like, I know what I should keep
out of my helmet, but, like, I'mstill completely

Unknown (08:43):
go for it. Now all your like, murder stories, you
totally I'm still

compulsively watching Dateline because I'm,
like, drawn to the dark. Butwhat I wanted to say to you
about fear that I think is soimportant, the way I see fear,
regardless of anxiety, is thatif I want what's on the other
side of the fear, then I'm goingto push through the anxiety and
take action. That's interesting,yeah, so, like, I'll give you an

(09:11):
example. I'm afraid of heights.
Okay? I don't care that I'mafraid of heights. I have no
desire to go up high. I don'twant to ski. I did it once. I
was like, never again. I'll gofor the appreci ski. But like,
No, I'm not doing it. I'm notgetting on a chair. Let's value
it. No, I don't value it, butI'm scared of getting up in

(09:33):
front of an audience. But I alsolove public speaking, and want
to do it and enjoy it and thinkI'm good at it so that fear is
actually extremely potent andactivated, and not unlike
getting on a chair lift, but I'mwilling to get up and do it
because I want what's on theother side.

I love that you said that and like, let's put a
pin in that, because I thinkthat's one of the ways. Ways
that we treat anxiety, becausethere is stuff that isn't worth
tackling, and then there isstuff that you really do value,
and you want to get to the otherside of fear, and that's where
exactly really begin to thinkabout treatment.

So let's come to that when we talk about treating
it. Yeah, okay, but

like in my little dormant volcano, we have
culture, we have temperament,and then you go a rung above
that, and it's like, what? Howis your caregiver with your
temperament? Did they exacerbatethat? Did your environment
exacerbate your temperament? Orwas it, you know, great with
your temperament and you hadgreat experiences. What are your
aces? You know, adversechildhood experiences. How much

(10:39):
trauma lives in your body?

Yes, you know?
Yeah, I know. And for somepeople, it really is more, I
think it's always, for everyone,a combination of what's happened
to you and your inborn geneticnervous system. And then I see
even differently from that isyour personality and your
disposition, right? There's howyour nervous system runs, right?

Unknown (11:06):
Yeah. Like, place it even thinner, right? Like, if

we look at disposition and personality,
which are also slightly,slightly different, but let's
lump that together for a second,it's almost like, if you look at
two different cars, right? Like,like, a Ford, I don't know this
where I'm gonna, like, lose mymetaphor, and f1 50, okay, I
don't even know if that drivesfast, but that's that big truck
with, like, the open back,right? And then I know, I don't

(11:31):
know my trucks. And then youlook at like a Ferrari, right? I
mean, a Ferraris engine is notgoing to do the same thing as an
f1 50, even if they're both onthe highway being chased

Unknown (11:43):
exactly right? But then you like your metaphor. Thank

you. Thank you. I just wish I knew, I don't know
why I picked a truck when, like,I don't even know anything about
trucks, but you get it, but thenyou have what happens to you.
And I do think there are manypeople, and I know this as like
someone who used to work verydeep into the ocean with trauma.
Some people, regardless ofnervous system, what they have

(12:08):
experienced is so intense thatthat is still living in their
body, and they're living in apermanent state of alarm. And
anyone who's even been throughsomething shaky, where you sort
of face death, or a brush withdeath, or something really scary
happens. You know? You know howyou sometimes your body just

(12:28):
can't work through it rightaway,

right? And then you get somebody who is like a
fragile temperament, and thenyou put them in a highly
traumatic situation that's amess. We also see people who
live through awful things andhave very like, resilient,
hearty temperaments that areable to kind of get through it.
One of the things I see all thetime in women with anxiety is

(12:52):
that they've had to be likepremature caregivers to parents.
That is, like, a trend, Oh, youthink, or like, or like a
chronically ill parent, yeah, ora psychic, you know, psychiatric
issue with a parent that willcue and wire in that anxiety
into the system pretty

quick, right? And also can often produce, I think,
one of the one of the commonpresentations of anxiety and
women, is women with anarcissistic mother, who have
who are intelligent andsensitive, and they because
their mother has emotionallymature deficits and mental

(13:33):
health struggles, they are theone who calibrates to that
mother. They are on thereceiving end of a lot of
criticism withholdingperformance based love. And so
they learn to really perform, toachieve love and validation. And
that can turn into its ownvariant of type A where the

(13:55):
driver is really if I'm notdoing and I'm not achieving,
then I'm going to feelworthless, yes, or empty or
unloved,

yes. So there's, like, all kinds of things, and
we didn't even talk about, like,the presence of epigenetics and
like the intergenerationaltransmission that exists in all
families where you have, like,maybe alcoholic fathers for four
generations, or, you know, likeHolocaust survivors, and what
gets passed through the DNA,just in the fiber of the being,

(14:30):
yeah, but Okay, so you'repicturing my dormant volcano,
right? Like people are like, I'mfine, you know, I'm fine, but
like, you've got all thesethings that are putting down
pressure on you. And then what Isee is that some precipitating
event occurs. Usually it's likea betrayal, a loss of a
relationship, a humiliation,something that causes deep

(14:53):
shame. It's like something justor deep, deep fear. Somebody
gets sick, something happens,and. Then you're symptomatic.
Your volcano is erupting. You'recoming in and you're saying,
like, I just don't know what'swrong. I'm I'm having panic
attacks. I'm flooded by anxiety.
I've never had that before, butyou have all these, you know,

(15:15):
risk factors that have precededit.

Yeah, the volcano is a good metaphor. You know
what I've seen? First of all, Isee a lot at how anxiety and
anxious partner, or two anxiouspartners, can really affect one
another, you know? And ofcourse, there's relational
anxiety, but I'm thinking backto when I was working with
individuals more and how therewere just some people that

(15:45):
there, they were just sort ofconstantly elevated heart rate,
jumpy, jittery, like whetherthings were happening or not.
You know, their legs bouncingand they're tapping and they're
worrying, and they can't sleepbecause there's thoughts and
then, ironically,coincidentally, whatever the
accurate word would be, they'rein these high stress jobs, like

(16:06):
they're attorneys with these,like, insanely high pressure
cases, and they're like, anabsolute train wreck internally,
but it's not visible on theoutside, and again, often
medicated with alcohol. And thenI'd see a lot of people more
like you, where, you know, maybethere's some kind of low level
anxiety that exists, and it'skind of manageable, and then

(16:29):
something happens that hits atipping point, and all of a
sudden, the symptoms are reallytaking over, and the functioning
goes down. And that would betrue for what happened with me,
I think, where I never thoughtof myself as anxious, as a young
person, but I think I kind ofpushed aside and stayed away

(16:56):
from the things that pushed mybuttons and let other parts take
over. And I really firstexperienced symptomatic anxiety
after I had my first daughter,Charlotte, and I probably had
postpartum anxiety. It was notlike anything I'd ever
experienced before. I was soworried about everything that

(17:16):
would happen to her, I could notrelax. You know? I was like, I
remember breastfeeding her, andyou know, anything you read
about that could go wrong. I waslike, this could go wrong. This
could go wrong. This could gowrong. And I had a very
traumatic birth, so that mayhave played a role in it, but
your hormones go haywire and youdon't know what they're going to

(17:36):
do. And postpartum anxiety ismore common in women that
already have an anxiousproclivity, yeah, and I remember
taking her to like the theAdvent health had the booby
buffet. It wasn't even Adventhealth, it was Florida Hospital
2024,

years, like a lac tation consultant. So

you'd go with your newborn, and because you never
knew how much breast milk theywere getting, and I had all this
anxiety that she wasn't gettingenough food, and that she was
like under fed, and what if Iwasn't making enough milk? And
it was triggered by the factthat she would own, you know,

(18:18):
they'd say 20 minutes on eachboob, and Charlotte would only
eat for like, three to fiveminutes on each boob, and I'd
be, like, shoving my boob andher face, like, eat for 20
minutes. Okay, and so I go tothis booby buffet, and I'm and
basically everyone came who hada baby at Florida Hospital.
Maybe you didn't even have to doit there, and you sat around and

(18:40):
talked about it, and you hadsupport, and then you breastfed,
and you you weighed your babybefore you breastfed, and then
you weighed your baby after youbreastfed, and then you could
see how many ounces

Unknown (18:52):
they got. Oh, my god, yeah, but it, it

told you if your kid was getting enough food. So
this is where anxiety, though,this is how it shows you how
much it can distort yourmindset. Charlotte was born six
pounds. She literally, like,like, porked up, like a balloon
overnight. She was just a rapid,efficient eater, and I had a ton

(19:16):
of milk, so she was getting,like, the maximum quantity,
ounces, just in like, fiveminutes. But I didn't know that.
Meanwhile, if you looked at her,it was very obvious that the
child was being fed. And Iremember sitting there sobbing
while I was breastfeeding her,going, like, I can only get my
baby to eat for five months.
Like, I don't know what's wrong.

(19:40):
I've tried everything and, like,just sobbing, yeah. And then I
put her on the scale, and Idon't remember if it was like
three ounces or five ounces. Shewas really little, but everyone
was like, holy shit. Your

Unknown (19:53):
kids, like, like, Fine, having like, a 711 like, Big
Gulp, but

you're. Perception was that it wasn't working. You
weren't doing it right. Thingsweren't going well. Yeah,

am I starving? Was gonna die,

yeah? But, I mean, we're all like, so like, that's
the other thing about why womenare diagnosed with anxiety. So
much more is these we've talkedabout in other episodes, these,
like, ledges of hormones, youknow, like after I had Anna, and
I, like, nearly died in mydelivery, I went through like a,
like a postpartum anxiety whereI would, like, fly out of bed in

(20:31):
the morning, like with just likedriving anxiety, like fear, and
I'd have to walk, like, around,like a three mile loop just to
sort of discharge the stress Ifelt in my body. And I got,
like, obsessive about cleaning,in a way where I was like,
obsessed with, like, the smellof Clorox. Like, don't even ask
me what that was about. But itwas so weird, and it was

(20:55):
definitely what it what it showsyou is that hormones drive
anxiety, and this, you know,this biological and mental piece
is so, so tightly wound, andanybody can find themselves
there

absolutely so let me ask you this before we talk
into how you cope with it andhow you can make anxiety work
for you. What do you how do youexperience anxiety to the degree
that you do today. Because firstof all, everyone gets anxious at
certain moments. Like nobody'sanxiety free. I

think that everybody has specific pain
points, and they always say thatanxiety will tackle the things
that you value the most, orplaces where you've had, like,
previous experiences with fear.
I bar none, can get like, I canbe okay with almost anything,
like I have space to cope withalmost anything other than
health. And there I have health,no margin, no margin. Like, I

(21:49):
can get wound around the axle soquickly with fear. And I think
that's understandable. Like, Imean, I know I went to the
hospital when I was like three,and nobody went with me. I have
no idea that live that probablylike lives in my body. Why? Why
did that happen? What happened?

(22:10):
I had a PD of my mypediatrician, I was really sick,
said to my mom, she needs to goin, into the hospital. You need
a break, go home. I was sent bymyself. I have no idea what that
how that lives in my body, but Ihave a feeling it was abject
fear. I was a very clingy baby,very fearful baby. So I just, I

(22:33):
don't know what three year oldme experienced, but I have a
feeling my body says, hell no,yeah, around that my my
grandfather got sick withlymphoma in 1987 I was nine. I
thought the worst thing thatcould happen was cancer in a
hospital. I had an ectopicpregnancy where they like, you
know, you get the sonogram andthey say you're going to surgery

(22:55):
right now, like that feelingwhere the floor drops out and
your safety is real, so nothinggets me, like, help, okay, and
to me to watch people who arelike, Yeah, I'm getting tests
run. I'm like, aren't you like,a master? Like, yeah, well, I'm
just, you know, gonna wait andsee what, what's what? I'm like,

(23:16):
I would be hard to talk to if Iyou know when I'm in those
situations? Yeah,

no, I think health anxiety is powerful, and
definitely I see and hear aboutthat from a lot of clients, and
I can relate to that. I thinkit's scary, but my variety is a
little more the like thepainful, shocking, violent death

(23:44):
more than the getting sick,believe me, I'm terrified of
getting sick and dying, but Idon't get as activated by those
stories. But if I hear a storyof someone who died in a
horrific, unusual way, it willreally permeate my
consciousness, and it will keepcoming up. And then anytime

(24:04):
something is remotely like that,I'll think of it. Now, it may
not necessarily activate mybody, but I think of it. I mean,
to the degree I walk around thelake here in Baldwin, and I do
not ever go around the lakewithout thinking about an
alligator coming out. I

Unknown (24:23):
need me. I've seen videos like that, yeah.

And because I've seen videos like that, it's not
like the whole time I'm walkingaround like this and I'm in
fear, but the thought is there,or the places in the lake where
the shoreline is sort of lappingup, I'm like, wow, I could just
see, like, what would I do?
Like, fuck, I don't want to beone of those videos where, like,

Unknown (24:45):
I know my she's like, her leg is sticking out of the
water

and, oh, my god, yeah. So that's more my, my
variant that really like creepsin. I

think that we all have. This, right? Like, and
this is the difference between ahighly anxious brain and a we
all have thoughts that rollthrough like tumbleweeds, right?
Like our kids are on the highwayand we're like, oh my god, what
if they get in a car accidentdie, or a fam loved ones on a
plane? And you're like, what ifthis is the time a plane
crashes? But the thought rollsin the head, you know, through

(25:19):
the brain, and it we talk to itpretty quickly, yes, like, okay,
look, you know, it's fine, it'sfine, and that is

what I do, yeah,

but that's because you're like, normal functioning,
but when you are in a cornerwith anxiety, you cannot put
those feelings down. You cannotput those thoughts down, yeah,
and they get bigger and theyruminate and they spin, not

to mention OCD, where there's really anomalies
that per in the brain thatprevent you from being able to
discharge the thought, yeah, butI also think that when, okay, so
let's say, you know, I don'tthink, and I've looked at this
many times, I don't think I meetthe criteria for generalized

(26:02):
anxiety disorder, but I have hadsituational bouts of anxiety
where I have the samesymptomology as generalized
anxiety disorder, and where partof it is the thing that I'm
feeling fearful and activatedabout is so Big that I can't
discharge it, the thoughtsbecome ruminatory. I'm cycling

(26:24):
through the same thing I may,rationally know fully well that
the thing I fear most is notlikely to happen, and I still
can't get out of it, and my bodyis activated by it, like when
people say, Oh, don't worryabout what you can't control.
Like, fuck off. Okay, yeah, Imean, sure that'd be great. And

(26:46):
then there would be notherapist, and everybody would
be out living their best life.

What helps you when you're in that space,
getting

a lot of exercise, getting my heart rate up so I
can balance with endorphins,being outside in nature, being
able to talk to people. For me,it's helpful to externalize and
talk about my fears, and it'salmost like pulling out weeds
from the garden of my mind whenI can just say like I'm scared

(27:17):
and validating that I feel theway I feel, and also shifting
into a little bit of inner partdialog where, you know, what's
helped me is befriending anxietyand seeing it as mostly a
positive, whatever you want tocall it. You know, I do jump out

(27:38):
of bed and like, tackle the dayand some of it's motivation and
excitement, and some of it'slike, oh my god, I gotta get
this done, and I want it to begood. You know, you don't really
want somebody to go do aperformance and not feel any
nervousness, because then you'retoo like you're supposed to
care. So I think accepting thatI feel the way I feel, but then

(28:01):
doing the things that help thosefeelings to stay manageable and
keep me in my window oftolerance. Yeah.

I mean, I think everything you just said is
exactly how you do cope. I mean,one of the things that I think
is so an underutilized strategyis like completing that stress
cycle, like you have to movethat nervous energy through your
body, yep. So, I mean, I have aguy that has is high, high
anxiety, and he, I mean, he'salmost disabled by his his level

(28:29):
of anxiety. Rides his bike forhours a day. That's how he
manages, because there's so muchtension in his system, yeah. But
a run, a walk, anything out innature is even better, right?
It's like you get just the thatsensation of, I don't know,
nature is so healing,

yeah, and that, they have done studies around
people walking and seeing water,and some studies have shown that
it's more powerful, that seeingwater for 10 minutes is more
powerful than medication. Now, Imay not be quoting the research
exactly right, but it issomething very close to those

(29:10):
lines. So we know that there iswe're designed for that to be a
healing bomb. And you're right.
You gotta get that theactivation. Move the activation
through. And some people needmore than others. Where I see
clients go wrong, people gowrong for themselves is trying
to fight it, trying to talkthemselves out of it, fine,

(29:34):
right? Or like, I'll justsuppress this, compartmentalize
it, mask it with marijuana,alcohol, workaholism,
pornography, television, Doom,scrolling and eventually it'll
go away. I mean, we knowdefinitively that those things

(29:55):
do not help your nervous system.
No,

it just makes it worse. And I mean, I think all
anxiety is sending the signal ofthat you're not okay, because
it's such a body sensation, likeespecially clinical levels of
anxiety, so in the body and thatyou cannot handle it. So that's
the that's the signal it'ssending. You're not okay and you
can't handle it. So if you giveinto the urge of masking all of

(30:23):
that and numbing that and tryingto, you know, distract from
that, you are making that, thatfeeling stronger. So we know
that, like, the way to handleanxiety is to confront it and to
learn that it is okay and I canhandle it. Yep, that's all
anxiety treatment. That's a hugepiece of anxiety treatment,

yes, and this is why, back to fear. And you know,
talking segue into talking aboutcoping with anxiety. This is
why. And I know you do thiswork, exposure Response
Prevention is the gold standardfor anxiety, because there
really is no other way to letlet's say there's something

(31:07):
you're fearful of that you haveto do or want to do, right then
there's no other way to lowerthe anxiety around that activity
than to do it and to teach yourbody Not by trying to convince
yourself intellectually, but byexperientially showing your body
I can do this, and I'm okay, Ican do this, and I survived,

(31:29):
right? You know, yeah, I have togo for my mammogram tomorrow.
And does it give you anxiety?
Oh, hell

yes, really, oh yes. I have a feeling in there
that I want to run out into theparking lot and drive away, like
I just always feel that way. Imean, I'm telling you, I have a
feeling of, like, Do not tell methat I'm dying, right? Like it's
just like, it's just terrifying.
But I I go, and this is whereit's like, you know, you talk to

(31:59):
your part, right? I have likemyself energy that's going to
hold that little girl's hand andbe like you can do this. This is
you. You value back to yourvalues. I value taking care of
myself, right? Value being alivefor my kids and myself. You
know? I value being proactiveabout my health, so all of that

(32:21):
you know, my wise adult isgonna, like, drag me in there
and, like, talk me through it,and say, like, you can handle
whatever happens, and

it's okay to feel how you feel. And I do find this
to be the most effective way betaking the action anyway, and
the inner talk between parts ofself to cope with, at least, you
know, normal bouts of anxiety,right? That I do the same thing.

(32:57):
I'm very validating. I'm notlike, what's wrong with you?
This is no big deal. Get yourshit together ever I'll do this
every day. Yeah, yeah. Whocares? I now know I'm a very
quirky, fearful little bird, andI'm also a super strong,
powerful, very bold women. Andthere's stuff I'm not scared of,
that everybody else is terrifiedof, that I do on a regular

(33:20):
basis, and nobody else feels aslike confident in those areas as
I do. And then there's thingsthat other people do every day
that I'm absolutely terrified,and it's okay, I'm me, so I talk
to the little girl too, and say,You know what? It's okay that
you're terrified. I know you'rescared. I'm here with you,

(33:41):
meaning me, adult Colette, andwe're gonna do this because this
is, like, good for you, and

you care about this. And you know, this is
where people, like, begin tolose their power. Is like, if I
were to let that little girlpart win and be like, I can't
handle this today. I can't doit. I'm gonna call. I'm going to
reschedule. We'll do it later,right? And then the next time I
go back to do that mammogram,again, my level of anxiety is

(34:10):
now up above the old level ofanxiety, exactly. And then the
likelihood I give into that partagain and say, I just can't
handle this right now, exactly.
And you see this, people do thisall the time, and they are their
anxiety about, you know howscary things are, intensifies,

right? And it becomes crippling. And this is
how people end up, where the thephobia, if you will, takes over,
and they can no longer do it atall. And in fact, I learned this
the hard way before I was atherapist, really with flying,
because after, I had a really,really terrifying two bad

(34:48):
flights in a row, one of thembeing on 911 and being up in the
air while the thing washappening at New York airport.
And it was just do it right,yeah. It was very powerful. Very
scary. And I had had a badflight before that. And really,
until that point, I had neverhad a bad flight experience. My
dad used to fly little planes.
I'd go up with him and like atwo seater little thing. And I

(35:11):
mean, I had no fear of flying atall. This also was during what I
now look back was still thepostpartum period. Charlotte was
five months old when 911happened, and I got off that
plane, and I was like, I amnever, you know, I mean, I saw
it happen out the plane window.
So after that, and then we flewaround for almost an hour with

(35:34):
no information on what washappening, if our plane was
okay, where we were going toland. So when I got off the
plane, I had not smokedcigarettes in seven years. I
went and bought a pack ofcigarettes, sat down on the curb
and smoked like, 10 of them in arow. And I was like, I'm never
getting on a plane again. Andthus began a period of time of

(35:56):
like, if I went to New York, Imean, one time I took the Amtrak
for Yeah, it got really bad,because as I it was too much. It
did not feel like I could handleit. There was too much fear in
my body, spending all that timein the air, not knowing if I was
going to die or not, overwhelmedmy resources, and for years

(36:21):
after, when I did get on aplane, because I did it so
infrequently, like I only did itwhen I absolutely had to, I
would start shaking on the planelike this. I'd start crying
before we took off on takeoff. Iwould hold my, then husband's
hand, and, like, sob. And peoplewere like, well, I mean, it was
like, hardcore, yeah,

but I did, what that example shows is, like, how
quickly something benign, right,can be become so, like,
hardwired as intolerable, like,you know, you can drive for 30
years, get in a car accident,and then never be able to drive
again. Or you are a driver, youknow, been driving forever, but

(37:03):
you have a panic attack over abridge, and then you can't ever
drive over a bridge again. Sothese things get wired up in one
second. Yes,

exactly. And it doesn't even have to be such an
extreme thing. It can be, youknow, someone swerves and almost
hit you, and your body goes intolike just an instantaneous
experience of what it might belike to die, and your body's
like, No Never again, neveragain. That's dangerous, but my
point, too with the flying isthat I did the exact wrong

(37:36):
thing, and I see why, because Iwas so overwhelmed, but by
reducing the amount of flying Idid and getting on the plane
only when I absolutely had to, Iactually, really ensured that
the fear intensified and lastedfor longer, and I'm much better

(37:57):
now. The minute there'sturbulence, I turn into like,
Yeah, I kind of decompensate,but I'm no longer sobbing on
takeoff. I used to be if I knewI had a flight for five days
before I Was A Rat a mask, andnow I can actually fly without
Xanax, without alcohol,sometimes massive exposure,

(38:19):
massive exposure. And also theluck of massive exposure with
uneventful flights, like nonturbulent flights, you know, it
taught my body like, okay, yeah,it could happen, but most of the
time it's gonna be okay. Andit's one of the reasons now that
I'm so claustrophobic, I stillforce myself to get on elevators

(38:41):
occasionally because I have toomany friends and family. And
like, New York City, like, Ican't never get on an elevator,
right? And if I avoid, if Istart, I already avoid it a
little, but like, if I startavoiding it completely, I'll
never get on an elevator again,exactly.

And that's a like a message is that if you have
something that you avoid becauseyou're fearful the how, how
quickly can you begin toapproach that and expose
yourself to that and slice

it really thin?
Yeah, so if it's an elevator,don't go to the top of the
Empire State Building, becausethen your body is going to go,
Fuck no go one floor on anelevator every day for a couple
months, and then go two floors,right? If it's public speaking,
get up and talk in front of agroup of 10 people for two

(39:28):
minutes, right? You've got tobuild a window of tolerance,
yeah, right, right, and thenkeep the frequency

Unknown (39:37):
up. Like, I know people who are afraid of escalators,
like, you know, then you know.
See, can you daily hit anescalator somewhere, or can you,
like, ride the escalators at themall, you know, right, just to
expose yourself and to to, like,send the signal like, I can
handle this. You have time. Youwant to avoid. I want to shout
out to people who are listeningto this, who've had really
crippling you. Levels ofdiagnostic anxiety, yeah, and if

(40:00):
you have been, if you've everbeen caught in that where you're
having panic attacks everywhereyou go, or you're just like, you
can't do anything, you know,medication is really kind of the
thing that we need to, like,give you to dampen that level of
anxiety just to begin to be ableto work on it. There is a there

(40:22):
is anxiety that's too high towork with. I mean, that's my
feeling. Maybe, maybe somebodyelse would say, No, well, I'm

sure there are people. But I one of the saddest
things that I think you and Iboth sometimes see and have to
work with people through a lotin therapy is there still, even
though mental health has gottendestigmatized, there's still so
many people who believe thatsomehow medication is bad. It's
a weakness, it's bad for you.
And there are a lot ofmedications that really they're

(40:54):
not addictive. Doesn't sayanything about you. It's just
turning down the volume on whereyour system set, and you'll
still have to it's not apanacea. You still have to learn
those other coping skills. Butit is so hard as a therapist
when you see someone strugglingso hard with something that they

(41:15):
can't will themselves out of andI've seen so many people shift
when they finally do trymedication and go like, Oh my
God, right. Just doesn't have tobe so hard, right,

right? And that's like, a part of it, you know,
that's like one piece. It'smaybe not where you stop,
because then you get the otherexperienced clients is like,
this is all a biologicalprocess, and, like, I just need
a pill, and as long as I have mymedication, and then it's like,
no, you know, the the dormantvolcano, or the volcano has all

(41:50):
these layers you really have, ifyou were somebody who has
clinical anxiety or deals withOCD, I mean, there's all
different types of anxietydisorders, Right? It's a signal
you have to take great care ofyourself. You have to take
better care of yourself than theaverage person.

Yeah, yeah. And I think to use the volcano
metaphor again, you know theactivation the sim, the signal
in the body that you're indanger, that you need to be on
high alert, that something'sgoing to happen. Some systems,
whether it's from past, trauma,genetics, a combination thereof,
are set where the volcano isactive and there's lava right to

(42:32):
some degree, regardless ofwhat's happening, yes, and then
there's other people that all ofthat's in there. And if there's
a fault line that cracks, thenit may start to activate, right,
right? So you've got to reallyfigure out which is for you. But
I think we're both saying that,you know, if you feel in an
anxious, activated state a goodportion of the time, which,

(42:54):
let's face it, people reallymedicate most in society through
alcohol, yeah, yeah. Andmarijuana these days, right? And
marijuana, which is raising thefloor of anxiety, if nobody
knows that, like you know, itmay suppress anxiety, but you
come back above baseline,exactly, making yourself more
net, exactly over time. Andjust the cultural, stigmatized

(43:16):
part of this. I was justthinking about this. I remember
in the worst phase of my divorce20 years ago, when I just felt
in a constant state of anxiety,like, how was I going to make
money, a job, manage the kids? Ihad a very adversarial situation
with my ex husband. At the time,it just felt like Whack a Mole

(43:37):
all day, every day, with likestress. And I always thought of
myself as so capable andtogether that the therapist I
was seeing at the time I had notbecome a therapist yet, was
like, you know, maybe this wouldbe a good time to just take a
little medication. Help yourselfcalm down a little for now. And

(43:58):
I was like, I don't needmedication. Like, I'm not a
person who takes medication. I'ma very healthy, strong, capable
person who does not takemedication, who could use the
medication, right? And then shewas like, well, you are telling
me how, like, every night afterthe kids go to bed, you sit
outside and smoke cigarettes anddrink two or three glasses of

(44:18):
wine. I was like, Yeah, I toldyou, I'm fine. That's how I cut,
motherfucker. So the reality is,you know, those to me at the
time were, I didn't see that asmeanwhile, that's so unhealthy.
But like, those were the copingmechanisms I thought were normal

(44:40):
20 years ago, and I had thisidea about medication. I did end
up realizing that I wasn't doingmyself any favors, and seeing
that I had an idea that reallywasn't serving me and wasn't
true, and I ended up taking.
Medicine for six months, ithelped tremendously. I was able

(45:04):
to go off it after a littlewhile. It really helped me to
get through a crisis. Ratherthan chain smoking and, you
know, drinking every night bymyself and just I'd be out there
ruminating like, what do I needto do? What do I need to do?
What do I need to do? You know,and I was the best thing.

Yeah, I'm glad you said that, because I think that
we are all there. It's probablyinevitable that most of us will
be at an inflection point wherewe will be that ruminatory, that
fearful, that kind of out of ourskin with anxiety, that we may
have to consider that right? Andit's, oh, that's life, guys,
yeah, yeah. I'd also be remissif we didn't talk about the rate

(45:46):
at which women somaticizeanxiety. This is just such a
huge thing that I see is thatwomen pull anxiety and stress
into their body and they becomeit becomes physical symptoms,
then do this too. Yeah, women, Imean the fibromyalgia, you know,
all of the like, sort ofnebulous pain disorders that we

(46:10):
see and sensations in the body.
I mean, women pull stress intotheir body in a way, and this
is, this speaks to why it's soimportant to learn to be
assertive in your communicationand stand up for yourself, and
is that your body will speak ifyou can't speak for you, your
body will speak for you, because

this is energy.
This is energy imagine topersonify anxiety that there is
a crisis happening outside ofyour house and you're asleep,
anxiety is coming to the door,banging on your door, saying,
there's danger, there's danger.
Wake up. Wake up, wake up. So ifyou keep going, it's going to

(46:56):
bang louder and it's going tobang louder, and if it can't get
you to pay attention at thefront door. Then it's going to
go to your window and it's goingto try to open. So it's it's
going to that energy and thatalarm that's saying pay
attention you're in danger. Youneed to act, whether it's true
or not, that there is an activedanger outside your door. It's

(47:19):
going to present somatically, ifthat anxiety can't get your
attention emotionally, 100%

and we know women, that's another piece too, is
that women have thesevulnerabilities in hormone
health, thyroid health, thereare all these things that makes
women's bodies prone to anxiety,depression, like, you know, you
I have people clients come in,and I have one woman that always

(47:48):
says, I'm in a deep luteal whichmeans, like, her luteal phase is
like popping off, and she's, youknow, miserable, because, you
know, the, you know, because aprogesterone and estrogen And
the whole thing, and we arealways dealing with that stuff
as women, so it makes us moremore vulnerable to, like, all
kinds of sensations in the body,headache, you know, all, all

(48:11):
sorts of things,

yeah, and not to mention, you touched on this at
the beginning. But as women,something men don't understand.
And it's not just me and mylittle Dateline, fear based
stuff. Women are constantlytargeted, sexually assaulted,
yeah, murdered. I mean, it's areal thing. You know, I've seen

(48:34):
those, those memes, or wherethat whatever, where they say,
like every single woman has atsome point felt unsafe walking
by herself. Now I feel unsafeevery time I walk by myself, but
like we are so much violence andperpetration is done to women,

(48:54):
and then at midlife, we've gothormonal factors. So I think
what we're saying is that, firstof all, anxiety is so common to
varying degrees, and thedisorder, I hate that word, but
Right, like the clinical anxietyaffects as much as 20% of the
population. So you're not alone.
Explore if medication could bean alternative for you. And if

(49:16):
you have ideas about medication,we're urging you to challenge
those because there's nothingwrong with it. The right
medication for the right personis helpful and additive and a
positive and it doesn't sayanything about a person or who
they are, and also that thereare some very regular things for

(49:38):
general, normal daily anxiety oranxious periods that really help
talk through that

let's go through like, the things that are just
universally helpful, likehelpful for healing, for anxiety
and and coping and coping, andthen people like, talk. Out,
there's a difference betweenmanaging anxiety and healing
anxiety. Like, I know RussellKennedy is, like, very big and,
you know, he has his, he hasanxiety. Yeah, he has terrible

(50:10):
anxiety. But it's he believesthat his comes from, like, a
complex PTSD. He had a wet like,a skit schizophrenic father

or bipolar father, but, yeah, I can't remember,
yeah, yeah, yeah. So he

has, like, the gut love, like the body level, sense
of not being safe. And he, hehas great healing kind of
mechanisms, if you're interestedin that kind of trauma based
anxiety, and it's all, it's allabout bypassing the mental story
and going to the body. Yeah,it's all about the body, and
that's where a lot of thehealing is. These days, I agree.

(50:45):
In the body we go, we try toargue too much in the mind with
anxiety, why am I feeling thisway? I've got to understand why
I'm feeling this way. It's likebypass that that will get you
nowhere.

It's true. Yeah, regardless of what is really
causing your anxiety, your headis not going to help you resolve
your anxiety, your way out ofanxiety, right? But I, what I
don't like is when people, and Ihope is coming through in this
because there are differentversions of anxiety and
different causes. And for somepeople, what I would see on

(51:17):
EMDR, if there were variableseven Complex PTSD, right? Like,
if you had a very traumaticchildhood, pervasively abusive
parents and activated home, youknow that can be stored in the
body in a way that you canreally work through by bringing
your body and your brain intoprocessing. That was then and

(51:39):
it's over, this is now, and I'msafe, and if you can get your
system to recognize that,there's a lot of relief. But not
everyone's anxiety is thatvariety. And you know, I think
EMDR worked really well forwhich is trauma therapy, for
some of that kind of stuff. Butsome people's systems are set at

(52:01):
a higher level, and they're notgoing to be able to just work
through what happened in thesame way. So you got to really
figure out what that is. And Ithink these coping mechanisms
that we're about to talk to arehelpful for everyone, but some
may need more than just this,right? Exercise is one of the

(52:22):
best things you can do foranxiety,

feeding that stress cycle, like, whether it's
like shaking or, you know,discharge, discharge the stress,
yeah, uh, weight lifting. Imean, this is people don't
realize this, but like,contracting the muscles and
release, that's what progressiverelaxation is, yep, and you get
the same discharge from like,lifting heavy weights. I mean,
you get even a better dischargeof stress through that. So

(52:50):
that's another thing. And noneof these things are like silver
bullets, but this is a holisticway of addressing anxiety. I
think diets another one that'sunderutilized. Yeah, we do know
that gut microbiome and thebrain are, you know, on the same
access. Don't connect it, right?
So if you're like, you know,medicating with alcohol and
sugar and, like, simple carbs,you are not going to feel good

(53:13):
and your anxiety is going to getworse,

right? So that's so many people go that route.
Yeah, sleep is another thing.
Sleep should be a religion.

Thank you. Yes, and, and, really, like, if
people get proper sleep, anxietygets can get cut in half

if people get sleep and I believe even a
burst. I mean, I love whatyou're saying about muscles, and
I can't wait till I start myweight training that was
supposed to happen in October,because I'm going to be so
relaxed. But getting whenever Iget my heart rate up, even for a
short period of time, there's areally long effect of a mood

(53:55):
boost that's been that's beenresearched and proven to be
true, and that can really justcounter a lot of the ruminatory
thoughts and the tension.

Yep, yoga, like anything that, like is
increasing breathing andpresence that can be great. You
know, it's like, the thing thatI always hear is get out of your
head and into your body, yeah?
So whether that's walking or oryoga or massage or anything
that's like helping you juststay present in your body and

(54:26):
getting out of your head.

Walking outdoors, I think, is huge. And I even
think going for walks where youdon't have music, not talking,
just walking and being still andexperiencing nature and
mindfulness meditation. Youknow, I mean, every it's become
such a cliche, almost in a way,but it really helps a lot if

(54:55):
you're willing to develop apractice what I personally. Will
never be. And I've been throughthe Mindfulness Based Stress
Reduction training twice in apretty intense way, and I fought
it, fought it, fought it. I waslike this. I hate this shit at
first in grad school when I tookit, and then eventually I came

(55:16):
to see the benefit. But I'm notsomeone who wants to spend 40
minutes of my day meditating,even though I think that would
be wonderful, but I make sure Ido at least five minutes. It's
very short. Sometimes I do 10minutes where I'm just still and
I'm noticing whatever's there,accepting it with non judgmental

(55:37):
awareness, right? And letting itgo like I visualize my thoughts
like lotus flowers, and I'mplacing them on a river and
letting them flow. I love that.
I love that imagery. I've hadthat vision for almost 20 years.
Yeah, it's it's so calming tome, and it just keeps my brain
in a little kind of baseline offitness to to ruminate less, or

(56:00):
to notice when I'm gettingpulled into thoughts that don't
serve me. And to be able to say,oh, there's that thought again,
it's okay. And now I'm going tojust, I love, let it, let it go.
And

then another one is anything that increases
presence. So like they say,playing with animals, playing
with children, doing anythingcreative, you know, like arts
and crafts, literally, this iswhy there's adult coloring
books, you know, anything thatcan, just like, let your brain
kind of slip into flow. Or

if you're Laura, doing a puzzle. Did

you see that there is now puzzle Olympics, where
everybody gets a puzzle, thesame puzzle, and then they set a
timer, and then it's like a raceto see who can build it first.
Is this gonna be like, ruin itfor me, honestly. But I was
like, oh my god, I have a sport.

Oh my god, that is hysterical. I know I'm

Unknown (57:00):
gonna send you the video. Oh

my god, so maybe you'll be in the puzzle of
books. Okay, I hate puzzles. Itry. I

make some people anxious. They

just make me annoyed. I have a low tolerance
for boredom. It's too manypieces that like look the same.
I like my word puzzles as

you know. I know, I know. I like word puzzles too,
but there's something aboutpuzzles for me, is about the
sorting, like the quick sorting.
That's why I like to clean, too.
It's like, okay, I love to

clean. I love to organize. I love to throw things
out. Oh, I get high of throwingthings out. So go for a run and
then throw out everything inyour house except, you know,
like Marie Kondo says, Whateversparks joy. So, okay, so in
wrapping up, you know, we'resaying everyone has anxiety.

(57:56):
There's some things that canhelp. And some people have
anxiety to a different degree.
It can be biologically wired. Itcan be trauma based. It can be
both. Don't judge yourself, youknow, figure out what's good for
you. And if you think you'resomeone who has anxiety, you're
not sure, and maybe you've nevertalked to a therapist at all

(58:17):
like it's really worth it to toconsider doing that, because
there's so it can be so muchbetter than it is. Yeah, and I
don't want

to sound like proprietary over anxiety
information, because No,certainly a lot of therapists
are well trained, but anxiety isone of these things that you
have to do, or really throwintake of people's lives, you
have to understand how behavioris functioning for people, how
people are doing safetybehaviors to keep themselves

(58:50):
safe in situations and likestopping themselves from getting
well. There are, like, a ton ofanxiety disorders. There's
specific phobia and OCD, whichis its own social anxiety,
right? Social Anxiety thesethings, they require somebody to
do a really thorough intake andthen design really, really

(59:13):
targeted approaches for you getbetter. So don't go to somebody
who doesn't know what they'redoing with anxiety, because a
well intentioned person can,like, make it worse, because
there's an urge, you know,there's this, like, tendency to
want to reassure, like,Absolutely, it's going to be
fine. You don't know if it'sgoing to be fine, right? You
don't know. So it's like thatthe way some people want to

(59:34):
intuitively deal with anxiety isnot always what's helpful,

yeah, and for people who are listening in
different parts of the countryand the world. You know, it's
what you're saying is verysimilar to the way I feel about
couples therapy and reallyanything that you're treated,
not that there aren't greatgeneralists, but find somebody
who really knows about anxiety.
There's so much in mentalhealth, and you. Go to somebody

(59:58):
that this is something they'retreating often. You know, they
are using evidence basedmodalities like ERP right,
cognitive behavioral therapy isalso validated for anxiety. It
doesn't really work for me, butit works for many, many people.
Yeah, you know, EMDR, eyemovement desensitization,

(01:00:20):
reprocessing is very helpful formany people, but not for
everyone. Same thing withmedication, you've got to find
the right thing for you. But ifyou are going to get
professional help, find somebodywho's experienced an anxiety,
ask them, how much of yourpopulation do you treat with
anxiety? What approaches andeven if you don't know what

(01:00:41):
these approaches are, ask themand look them up, because you
know you don't want someone hateyourself. Yes, yes, yes. And,
and you know, if you're in adifferent place you don't know
how to find a therapist, you canalways start by looking at
Psychology today.com. You canenter your zip code, and you can
search for therapists who treatanxiety, but do your homework

(01:01:02):
beyond that, because some peopleput they treat everything under
the sun,

Laura Bowman (01:01:08):
yeah, that's a sign, guys, if they treat
everything under the sun, theytreat nothing, yeah, you know.
And and also educate yourselflike nobody is going to direct
your healing, like you are goingto direct your healing. So we
will. I will list my favoriteanxiety books, one of that and
so that you can begin to lookand see what's what's good out

(01:01:28):
there. One of the newer onesthat I like is the anatomy of
anxiety by Elder, she's aholistic psychiatrist, so she
really breaks down anxiety intoall of the bins and like shows
how all the physical stuff canlead to anxiety. So there's so
many

Colette Fehr (01:01:46):
components. Say it again. Say it again, the knee

of anxiety. Okay, I haven't read it. I'm gonna
read it for I'll list all thisstuff. I'll list my favorites in
our on our website and put

in there too, even though it's not specifically on
anxiety, feel the fear and do itanyway. By Susan Jeffrey, yeah,
that's my favorite book, andit's really about those things
in life you want that you aregoing to have a lot of anxiety
around because it's scary andhow to cope with it. It's
amazing. She's now deceased.
I've read it like five times,and I never reread books. It's

(01:02:20):
so good.

Love it. Love it,

all right. So thanks everyone for listening.

Like, 10 more episodes on this, maybe we will,
but

yeah, and I want to do, like, let's do one soon,
where we talk about OCD. Yes,

Unknown (01:02:36):
that it's its own huge topic, because

I'm like, almost OCD, but I'm not. I see

a lot of OCD, actually one of my favorite
things to work with. Yeah, it's

definitely not mine. But I keep feeling like I
have OCD, and then I keeplooking at it, I'm like, Ah, I
just don't think I do. But like,I'm so close on the

Unknown (01:02:57):
edge I'm not hearing

All right. Thanks everyone for listening. Check
out our website, insights fromthe couch.org. For a list of
great books to read. And also,we'll list Psychology Today
there too. Can we do that sothat people can find a

therapist the things that you want to look for
when you're looking for anxietycare? Beautiful. We

appreciate you all so much, and if you're enjoying
our show, please leave us a fivestar review to help us spread
the word and share this episodewith any friends you have. You
think this might help as well.
We will see you all next time oninsights from the couch.

Unknown (01:03:36):
Bye, guys. You

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Ep.34: Understanding and Coping With Anxiety

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