How to Flourish with Anxiety with Dr. David Rosmarin

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Welcome to Where Parents Talk. My name is Lianne Castelino.

David Rosemarin is also an associate professor of psychology at Harvard Medical School and director of the McLean Hospital Spirituality and Mental Health Program. He is a global thought leader in the treatment of anxiety and depression. A father of six and an author.

His latest book is called thriving with nine tools to make your anxiety work for you. Dr. Rosemarin joins us today from Boston. Thank you so much for taking the time.

Thanks for having me.

I wonder if we could start with what is your assessment of what underpins or what is the root cause of the increased prevalence in our society today of anxiety?

Sure. There are a number of different factors.

One of the pieces that I think hasn't been talked about enough is how our society expects to have an anxiety free life and that just isn't possible. How many people do you know who have zero anxiety?

None.

None.

Yet when we start to feel anxious, we judge ourselves that something's wrong, that we're sick, that we're weak, that we're feeble, that everybody else is feeling fine. Why am I feeling this way? And that process happens. It spikes that low level of anxiety to something that's actually out of control.

So we have set up this strawman, this false expectation of having an anxiety free life. And I think that in many ways is at the epicenter of the anxiety epidemic today.

So following up on that, are there any statistics that you could use to illustrate just what that looks like in terms of Western or North American culture?

Sure. But today it's kind of scary.

20% of healthy university students in the United States are engaging in self injury on an annual basis, destroying bodily tissue because of high anxiety or depression or other similar symptoms. So that's one shocking statistic.

Yet if you look in it, underdeveloped countries, if you look in it, if you look in low income countries and middle income countries, what you find is that not only are levels of anxiety less, but levels of self injury are less, levels of suicide are far less. And when in those societies people don't have this expectation that you're going to have an anxiety and stress Free life. But we do.

And I think that that intolerance of anxiety is really not doing us any favors.

What's interesting about your story is that you come at it from multiple different perspectives, obviously as a medical professional and in sort as an entrepreneur as well. But also you have lived experience in this space and anxiety during the pandemic.

I wonder if you could take us through the highlights of what that looked like for you and how it changed your relationship with anxiety.

And then the pandemic hit and I myself started to struggle pretty significantly, primarily because we had at that point center for anxiety had about 500, 600 patients. And I was panicked as to what was going to be with these individuals who were under the care of myself and my staff.

It turned out that my anxiety was not founded, that our patients actually did extremely well. We ended up publishing a paper on this subject which was published in Plus One back. It was last year, in 22 years ago.

What I learned from that experience is that not only my own anxiety, but sometimes the anxiety that people have in a clinical setting can actually inoculate us and help us to become more resilient, more connected, more self aware, and maybe even more spiritual in some regard. And all of those assets can actually be helpful for dealing with anxiety for the future.

So that that radically shifted my entire perspective on this subject, which is what I've been writing about and speaking about the last couple of years.

Now, speaking of your patients and of the clinical setting, what made you decide more than 12 years ago now to start up the center for Anxiety?

That's a great question. Often I wonder that for myself. But there was an opportunity that came up.

I had my faculty position here in Boston, which is where I am with my family, where we live, and a philanthropic opportunity came up to start this center in the middle of New York. And after much soul searching, I took it. So that was the origins.

Well, and here we are, Fast forward almost 13 years now into this, and you've had the pandemic and so many other. Just a confluence of factors contributing to people's mental health.

In your research and your clinical work, what Would you say has surprised you most about the individuals and families that you see in terms of how they experience and manage anxiety?

That finding from the pandemic really shifted my perspectives on this. I was always taught anxiety is a disorder, it's a disease, it's something you have to get rid of.

Here is your toolkit as a clinician to help people eliminate anxiety, to help beat it, to help conquer it in their lives and overcome it. So it's not an issue. I don't think that narrative is correct.

It's partially correct in that sometimes people have clinical anxiety, it interferes with their life. They need clinical tools or medication to be able to deal with it.

But there's always going to be a residual amount of anxiety and that's not a bad thing. That can help us if we learn to use it in a constructive way to face adversity, stay connected to others, become more self aware.

That's where the opportunity of anxiety lies, on the lower end. Not when we try to get rid of it, though. When we do that, we're sunk. That's. That's the end.

So along those lines then, how would you say that your approach has evolved as it relates to how parents, of which you are one with six kids, as we mentioned, how parents manage anxiety.

Sure. Yeah. I think it has a huge implication for families. Often parents will call me and say that their child is English. I say, how old are they? Two.

Okay, so it's possible to have severe anxiety in a two year old, but it's highly unlikely.

More likely what's happening is that they are having a normal stress response, anxiety response and emotional experience that is going to give them fortitude. The best analogy I can give you is going to the gym. Do you work out?

I do. I try to.

Great. Are you a sweaty mess by the end of your workout or is it just me?

Usually y.

Great. And is that a good thing or a terrible thing?

It's supposed to be a good thing.

It is a good thing. The worse you feel, the more, in some ways, pain you feel when you're doing whatever workout you're going through builds your muscle tone.

That builds your response pattern. It builds even your cognitive abilities in some regards. Well, emotionally. I don't think we're viewing anxiety in the same way.

We view it as something's wrong with my child. Not necessarily. Maybe your child's having a normal stress anxiety response and this is part of their normal growth and development.

It could be something more serious if it's happening more than 30 days.

If they're keeping them up at night, if they're not being able to function during the day, go to school, go to playdates, that's called clinical if it's actually causing dysfunction.

But most of the time, most of the time the anxiety is just a distressing experience that's part of life and part of our body's mobilization of our resources in order to grow to the next stage and where we need to be.

So then what would you say to a parent to have them maybe pivot their mindset from anxiety being seen as a burden to anxiety now being seen as a potential asset?

Great. First thing I'll tell parents is that there are two types of anxiety.

There are clinical anxiety disorders which interfere with life, and then there is normal anxiety which is positive, healthy and can be used for growth. If anxiety is getting in the way, then we can have a conversation.

But if it's just distressing, if it's something that's upsetting, that's called life.

I think we need to reset our expectations for an anxiety free life to understand that yes, clinical anxiety is a problem, but non clinical anxiety is going to happen. I would even go as far as saying if a child doesn't have any anxiety, something might be wrong. I'll prove it to you.

Neonates, upon birth, they have the moro reflex. It's actually a startle response.

If a child doesn't respond to either a sound being emitted or being shaken a little bit by a nurse shortly after birth, that's a sign that something's neurologically problematic. A healthy baby will scream and cry immediately after birth.

So that anxiety, that startle response, the fear response, it's part of the process of growth for humans. I think we need to respect that, we need to understand it and we need to respect it more.

Now, in your book Thriving with anxiety, you outline nine tools. I wonder, Dr.

Rosemary, if you could take us through one tool in particular that you believe would be effective for parents to know about and potentially practice in their own homes.

Perfect. So parents who are blessed to have a partner who they're co parenting with, I'll speak to that.

There's an interpersonal dimension of anxiety where we can share our fears, our anxiety, with our loved ones. And doing so, it's uncomfortable, it's a bit raw, it's vulnerable and it's hard and it creates amazing closeness when we do so in the right context.

The conversation shouldn't be rushed, shouldn't be. When stress is really high, you have to pick the time.

Well, but there's a Time to really open up and say what you're afraid of, experience those raw, uncomfortable emotions and receive the comfort that we all need, proverbially, we all need a shoulder to cry on.

And I think that, you know, if you think in your own way, I certainly, this is the case for me that the people I'm closest to are those I can actually open up to about what's really on my mind and heart and the depth of our relationship. I mean, with my wife, I'll say, you know, I didn't always express my anxiety to her. I sort of put it away. You know, that's clinical.

So that's, that's one of the tools. It's in chapter six.

Now, with respect to children, I'm curious as to what that looks like in your household. You've got six kids, the oldest being 21 years old, all different ages and stages of development, et cetera, et ceter.

What does helping them manage their anxiety look like in your household?

Firstly, I'm going to tell you that having six kids is anxiety provoking and stressful. So there is already a baseline of understanding that, you know, a certain level of stress and anxiety is just going to be part of life.

I like to joke that it actually gets easier after two, because at that point you realize, like, you're outnumbered. It's going to be intense, it's going to be tough.

And once you resign yourself to that fat, as opposed to protecting yourself from it, things go a lot easier. Six is ambitious, I will admit. And two are not home at this point. Two have already moved out of the house. But, yeah, you know, our kids get anxious.

Our kids have sad days, they have scraped knees. They have struggles with their, you know, their normal kids who have, you know, social struggles and academic stuff.

And thank God, you know, they're not perfect and we're not perfect parents. And I think part of the blessing of anxiety is that we can actually talk about that and be authentic in our home.

And something we try to inculcate is that it's okay to not be okay and to struggle. It doesn't mean that you're broken, doesn't mean that something's wrong with you. And even if you need professional help, that's fine.

But there's an acceptance of the journey, which we try. So that's something. That's something we try to do now.

You'Re also a proponent of integrating spirituality into mental health practices. And I wonder, how can parents strive to incorporate spiritual principles to help their families navigate stress and anxiety?

Yeah. So first I'll say that not everybody's so partial to spirituality.

It happens to be part of my personal life, and I've been blessed to be able to weave that into my professional life.

And that actually was driven by the patients who I saw who wanted to speak about spiritual matters and heard about my interests and sort of, you know, surmised my. My spiritual leanings. So I learned through that process that spirituality is relevant to about 80% of individuals with. Who come in for. For services.

But it's not everyone. It's not 100%. So for parents or anyone who wishes to do this, I would give people permission to go there.

And I think it's often the type of thing that in clinical settings, we don't talk about. It's really for a variety of reasons, going back to Sigmund Freud.

Spirituality and religion certainly are something that are really left at the door of therapy and not integrated. And I think that's a shame because many people do seek something spiritual in the context of anxiety or anything else.

One of the things spiritual messages that I think is very important, that really cuts across different religious faiths or none, is the concept of letting go. As humans, we are limited in our scope of control. What we can accomplish, what we can do.

We're bound by time, we're bound by place, we're bound by geolocation. We don't, you know, we have to sleep at a certain point. And I think accepting that and leaning into it and sort of letting.

Letting things unfold as opposed to having to be in control of everything. I think it's an important message that we inculcate first in ourselves and also in. In our children.

Different religious traditions have different language for that and idioms and phrases and customs and, you know, practices to inculcate those values. But I think regardless of how one goes about that, it's an important human message and one that's very much related to anxiety.

If there was one piece of advice, Dr.

Roseman, that you would want to share with parents about how to not only better manage their own anxiety, but certainly that of their children, what would.

It be to sum it up in one sentence? Embrace your anxiety. Embrace your children's anxiety. Don't try to shut it off. Don't try to squelch it. Don't try to get rid of it. Embrace that.

It's part of the journey.

And once we do that, then it's only a matter of figuring out what we need to do in order to thrive with it, as opposed to letting it get the better of us.

Dr. David Rosemern, thank you so much for taking the time to share your insights with us today.

Thanks so much. What a pleasure.

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