Jeff Hrusko :
0:08
Hello, and welcome to another episode of COG podcast where we explore why we learn why we don't and what makes the difference. But in this episode, we're going to do something a little bit different. We're going to explore how we can unlearn something specifically anxiety. I'm Jeff Rosco, instructional designer and technologist and today I'm so excited to be joined again by Swati Sharma, who has a master's in psychology. She's a practicing rational behavioral therapist. She also does art based therapy and a couple other things and my fiance, I Swati so Swati, tell me a little bit about how anxiety develops and a person some people and in full disclosure I have an anxiety issue myself. So some people are plagued with anxiety.
How does it happen? And what are the different types of anxiety disorders people experience?
Swati Sharma :
1:11
Yes, Jeff, you're shifting into the right direction because anxiety does have a biological and evolutionary aspect to it. So of course, we all have mechanisms that are designed to alert us when there's a perceived threat.
However, some of us are more predisposed to having that mechanism set off much earlier or much of more often than for some other people.
Jeff Hrusko :
1:46
When you think of when you think of from an evolutionary perspective, again, and this is where a false positive is not a bad thing, right. So the ancestors that survived reacted to things.
Something's in the bush, something's in the bush, right? But we have a lot of people say, you know, we're no longer in the bush, we're no longer in the jungle but I've I've crossed Mumbai traffic with you and I need all my instincts there 100% but is still there and it serves like a very important purpose, but because it seems like there's not a penalty or there was an evolutionary penalty for false positives. Is that one of the reasons why you think some of us are prone to having an overstimulated anxiety system for lack of a better word.
Swati Sharma :
2:39
There are many theories on why people would have an overstimulated you know, anxiety predisposition, and, you know, and I'm not sure which one of them would actually fit rightly. But what's more important to know is that besides having a predisposition to also depends upon your environmental experiences and maybe traumatic situations that you may have passed through. And yes, what you say is right, that you know, this is like erring on the side of safety.
But this mechanism which is supposed to bring us to a fight or flight mode is supposed to switch off after a period of time, say, you know, in a matter of minutes, once the threat is over, but with this one overdrive, we are in a state of chronic stress and anxietyit is like it gets stuck.
Jeff Hrusko :
3:50
Yes, back in the old days when we had throttles and cars, I remember I had actually had a car that the throttle got stuck in the open position. So the thing just revd like crazy, and it was very scary, because it's tough to stop. And it's kind of it seems kind of like that. And again, I speak from first person experience, it's like, seemingly out of nowhere. And I know there's different types of anxiety and maybe you can talk about the different types of disorders. But the one that I've experienced personally is just going from zero to 60 or 100 kilometers in no time flat, just and for no good reason. There's no Tiger in the bush. So can you tell us about the difference? And so what I described there that that is called a panic disorder. Is that right?
Swati Sharma :
4:43
Right. Right, a panic disorder is so exactly what you were talking about, like, seems to come out of nowhere. It hasn't really manifested because something happened and you know, Seemingly, it's just happened out of the blue therefore it feels like because of all that symptoms as well, it feels like if you look at the person feels and the person is having a heart attack or some real physiological medical emergency, and even the person going through it is sensing a feeling of doom, there is a, there's an emotional experience that this is it. Or I'm going to die or I'm going to go crazy or I'm having a heart attack and it's fatal.
Jeff Hrusko :
5:33
For the for those of you that and before I had experienced it, that's kind of a hard concept to get your head around. I remember hearing about it. But when it happens to you, you know exactly what a sense of Doom is. You just feel like you're gonna drop dead in the next minute. It's very frightening. Beyond panic disorders, what are the other types of anxiety disorders that people mostly suffer with,
Swati Sharma :
5:58
right? We have a lot of incidences of generalized anxiety and social anxiety. These are the most common forms. generalized anxieties, basically, of anything that might be happening on our day to day basis can cause you to react in an extremely anxious manner of social anxiety. Of course, a lot
Jeff Hrusko :
6:27
Before you get into that one, just so I can make the distinction there. So when we said a panic disorder, like I have, you know, that's zero to 60. But are you saying that a generalized anxiety disorder is more likea constant simmering of anxiety? Would that be accurate?
Swati Sharma :
6:48
yes, yes. Not only that, that's constant. The constant simmering is, I think, part and parcel of a lot of different types of anxiety issues. But also, it won't be, you know, focused on a certain aspect of your life. Now, if you understand social anxiety, for instance, then you would see that that's more of what we call an ego anxiety. Or what anxiety I'm sorry. Oh, it's a it's called an ego anxiety you
Jeff Hrusko :
7:20
OH I thought you said evil, which I think is evil.
Swati Sharma :
7:23
It's not evil. Oh, it's all anxiety is evil.
Jeff Hrusko :
7:29
Except when it's protecting you from actual tigers, or actual drivers in Mumbai?
Swati Sharma :
7:35
Oh, yes. Oh, yes. So anxiety in Mumbai near the zoo.
Jeff Hrusko :
7:42
is the only place you're allowed to be anxious. No, but But seriously, I mean, that is I know my own treatment. That's one of the things that they had to clarify. It's like we're not going to try to get rid of all anxiety becomes healthy enzymes in there is such a thing. And correct me if I'm wrong, if I'm changing any of the terms. There's a health anxiety there's normal, a certain amount of anxiety. And maybe anxiety is even the wrong word with a certain amount of stress, healthy stress. Yeah, there you go. That's a better way to put it. Say before you're, before you're giving a speech or whatever it is, it helps you stay focused, without the right to say.
Swati Sharma :
8:26
That's, that's so anxiety is so crucial for us because that's our survival mechanism. Hey, we cannot do without it. Right? That's what helps us to stay alert. I mean, it comes from our alertness, our awareness, our sense of scoping around us. And, you know, anything that's sudden anything that's not fitting in, needs to then come into our conscious awareness because Because of those things, so our attention to detail comes from there, therefore, and like you beautifully said focus and attention. Yes. So it's important mechanism.
Jeff Hrusko :
9:11
And I don't want to lose. So we sort of have what, what a panic disorder is with generalized anxiety disorder is and then the last one you mentioned as one of the most common Oh, just let me make a footnote like it I think around the world, but I know for sure in the United States, anxiety disorders are the number one mental issue with people a large percentage, so you're not alone. If you do suffer with this from time to time, I forgot exactly what the stats are all posts in some place, but something like five to 10% of the population at least, covers and so can you tell us what social anxiety is?
Swati Sharma :
9:48
Oh, social anxiety is like like its name. It's related to how you experience discomfort and your anxiety. He's focused only on the social interactions that you're expected to conform to. And you might not be comfortable with that, you might think that you are not good enough for it, you are constantly sensing, you know, in your own mind that you're being judged. You are being evaluated, rated and ridiculed for for that matter, or just criticized, for instance, even though that might not be happening, but that's that's the, you know, state of awareness that it brings you,
Jeff Hrusko :
10:39
You focus on that and kind of ruminate on that. I think when people are like this, because it's like, the other side of that is, yes, people do judge, but who cares, right and it's never usually as much it's not their main focus of you know, it's not cuz people make micro judgments about people, and you make micro judgments about other people too. But so what does that mean? That'd be fair to say or
Swati Sharma :
11:11
Completely. It's a beautifully put. And of course, it's part of all the more comprehensive therapy, learning, because this is what our podcast is about today. So how do we learn to bring that kind of thinking? That then pushes back on the anxious thinking, the anxious rumination and you know,
Jeff Hrusko :
11:37
That's a great trends transition. So now we have the basics of the just the outline of the various types of disorders here. And so yeah, comes to all these are learned responses. Is that accurate to say?
Swati Sharma :
11:52
Yes, yes, all responses are learned responses besides your genetic predisposition and evolutionary mechanisms which might be you know, structurally here and there. So, besides the biological aspects of it, I would say, you know, I would want to focus on what you said about this being a pandemic already. And it's a pandemic, nobody's gonna talk about pretty much soon and it's a pandemic, we're not going to look for a vaccine for but it's it's everybody.
Jeff Hrusko :
12:33
Yeah, everybody to a certain degree. And then there just comes a point when, what let's talk about some of the things that it does and then we'll get into what we can do about it. So when you are anxious, Ryan, tell me what what happens in the body, what happens in the mind.
Swati Sharma :
12:56
The anxious state is, you know, When you've started feeling something physiologically forced, most more often than not even though the activity starts in your mind. That's not what you notice first, what you notice is that you're, you're not feeling the same. And usually the first awareness is towards your chest tightening or your breath shortening, or a feeling of, you know, being stiffened. You know, you know, feeling stuffy, you know what I mean? And,
Jeff Hrusko :
13:39
Yeah, I know exactly what you mean. And let me just just kind of add on that just a bit. It's like, okay, you feel butterflies in your stomach, you feel warmness in your chest, right? makes it hard to think about anything else. Am I describing anxiety? Or am I describing love? I mean, I think is like our reaction to what's happening in the body. And this was a tough thing for me to, to learn makes a big part of it, how we frame that. Yeah. Because you look at what's going on there, and we're bringing to it this. And I think this might be the Learn part and correct me if I'm wrong. We're bringing what we bring to it. Is that the fear and the emotion?
Swati Sharma :
14:33
Yes, yes. And the entire sympathetic responses activated. And there is a sense that you don't want to be there. And there's a sense that you are not going to be able to handle this. There's a sense of urgency that I can't be in this place. So there's a restlessness because there's a it this stress responses basically spiking up your, you know, motor psychomotor instinct. And then you there's, there's a, there's an impulse to run or it's not manifesting as an impulse to run in the current times, but it's more like choice to keep
Jeff Hrusko :
15:20
or freeze.
Swati Sharma :
15:22
Absolutely, absolutely. Yeah.
Jeff Hrusko :
15:24
I have a friend of mine actually also suffers with panic disorder, said it beautifully. He said, it's like being trapped in your own body and you have nowhere to run.
Swati Sharma :
15:40
Absolutely. This is such a beautiful way of describing what happens. You have no better run.
Jeff Hrusko :
15:48
No words. Yeah, it has nothing to run from.
Swati Sharma :
15:51
Yes. And you know, it though this is excruciating. What is even more excruciating, probably. Here's what's happening in your head. Because there is almost, you know, what you can call exhausting. And, you know, overwhelmed.
Jeff Hrusko :
16:18
And it feels like and I guess it depends to is like where we consider the the I or the ego there that we're the logical part of the mind the logos or whatnot. In my experience when I'm anxious gets very small, right? And so it's almost like you're being, you know, you started out a walk and you have two dogs with you and they start out as puppies and all sudden they turn into werewolves, and then you go along and taken away. Everyone's like, wait, wait, no, he'll he'll stop No.
Swati Sharma :
16:54
Right, right. Precisely, precisely, and it's Very difficult to be able to hold your ground at that time. Your body is losing. You know, your body has a mind of its own and your mind has a body of its own. And like you're just completely helpless between a rock and a hard place.
Jeff Hrusko :
17:20
All right, so we've now talked about what it is. And let me review some of the symptoms or how it feels right. We said it's very hard to concentrate. Specifically, I mean, for job performance. If you're in an anxious state, it's difficult to think clearly. And depending on the level of anxiety, there could be physical manifestations, racing heartbeat, if you only plan the sense of doom all around, not fun. Alright, so now we're going to get to the crux of it. What can you do and we'll talk about what can you do about it into in two aspects one, what can you do if it's happening? And then the second is what can you do as lifestyle changes or as maintenance? To sort of manage it? Does that sound fair Swati?
Swati Sharma :
18:18
Yes, yes. Almost by. Yes.
Jeff Hrusko :
18:21
Okay. Yeah. And you could swap, whichever one you want to go first with. So, Swati, you tell me what can we do about anxiety?
Swati Sharma :
18:30
Yes. In fact, I was faced with this question today when I was in session with my client, and he wanted to know what can one do when anxiety strikes so hard and so sudden, that there is no time for all the stuff that you have learned in therapy, and probably that's as good a place to start as any other so if you're in the throes of anxiety attack, it would mean that you're already having very short breath, your chest is hurting, you are sweating you have a, you know, or sort of a palpitation or literal palpitations. And maybe like Jeff, you said, some discomfort in the stomach. So, if you are already there, it would be likely that your mind would take over and start having a lot of scary worst case scenario thoughts, which then trigger even more anxiety.
Jeff Hrusko :
19:40
Yes, it's a feedback loop despair,
Swati Sharma :
19:44
Feedback of despair and you know, the vicious cycle. It's called a secondary emotion response. And that's, that's one of the most unfortunate parts of anxiety or maybe even though you know, it's maybe Also, you know, brighter side or good news because most of what you're experiencing is just extra layers that you put on yourself because you were listening to carefully to what was happening in your head and believing buying into it. So if that has happened already, and now everything is really out of control, shocking your senses, your five senses is a good way to try bringing it down. So the idea is to, you know,
Jeff Hrusko :
20:36
this is making a bad joke.
Swati Sharma :
20:39
Sorry, I missed that. He says,
Jeff Hrusko :
20:40
Shocking your system and like, Well, you've put a fork in a socket, right? Okay. No, not wrong. Anybody to ever do that. Ever. And if you have little kids, you know, make sure you put those covers in. I'm sorry. Go ahead. How do you snap yourself out of it then when you're in the throes of it so
Swati Sharma :
20:56
I was saying the idea of doing that is to take the attention Off the anxious mind from the thing that is bothering it and diverted towards something more external and in the present moment so take something very very cold like ice cubes and you know have something really hot go for a very cold shower or a very hot shower you know stuff like that or you know just hit yourself pinch yourself but of course like I said not not severely did this is one of the things what know that another thing that's really helpful
Jeff Hrusko :
21:40
Let me just comment on that a little bit because I you know, I've been through all of this so I can get feedback on it. Yeah. And and those techniques because you are activating different parts of your nervous system, different parts of your brain. They can help on in a pinch, you know, in in an emergency. You know, over These things though, like one of the things that I'm sure you'll get to it too is acceptance that sometimes you will feel feel anxious. And that takes away some of the secondary emotions. I'm sorry, go ahead, then.
Swati Sharma :
22:14
Yes, I must come back to acceptance. That's so important. Thank you, Jeff for pointing that one out. So the other thing that we can do is called diaphragm breathing. And since we spoke about the chest and the butterflies in the belly, then I could probably point out that diaphragm is between these two spaces just above the place your belly starts, but just where your chest ends, and the idea is to use your inhalation to inflate your diaphragm. So you're like almost pushing your belly out, or your What do you call the space above the belly, like the upper belly out, and when you're exhaling, you pull it in as much as you can. As if you're really intending to take it all the way back to the spine, which of course you can. And in between that inhalation and exhalation you have a small pause. So usually it goes to account of inhalation 1, 2, 3, 4. Pause for 1, 2, 3, 4 and an exhalation going 1, 2, 3, 4, 5, 6 and probably seven. And you do that for a number of times to kind of bring your sympathetic response down.
Jeff Hrusko :
23:43
Yes, yeah, that that is helpful. And just to the listeners, not not anything is a magic bullet. And we'll talk about that. But from personal experience, this is something that that's helpful. It's also oxygenating your system so your brain can get to little little more oxygen with that, I think is doing that. And it's also good, because we were talking about one of the main symptoms or shortness of breath and taking shallow breaths. So actually by taking deep breaths, you're signaling to your system that it's okay. You're okay.
Swati Sharma :
24:19
Right, right. And the other thing is, you know, a dirty little secret about our mind is that it cannot multitask. It cannot think of two different things or be doing two different tasks at the same time. And therefore, another thing that works very well is to count backwards from hundred jumping, jumping seven, so it's hundred minus seven minus seven minus seven. That is pretty preoccupying, and then it takes your mind away
Jeff Hrusko :
24:48
it is that a decision from personal experience again, triggering that part? You You will fight against it. Like if you were trying these things, and I've done different things like Sudoku. Things that take mental energy concentration and mental energy and it will be tough, it will be tough. But the more you do it and this isn't instantaneous because you think about it, you've just flooded your system you know with all sorts of hormones when they call it cortisone, cortisol, you know, anywhere stressful and they will take a while to dissipate but all this does, again can be effective from personal experience. Like I said, not everything works for everybody but just from my own experience. Just one more thing that worked for me at times again, this is for cute acute anxiety, which is not very cute at all. Unless you picture your demons a little cute fuzzy guy. They wouldn't be so much of a demon anyway. Um, so one thing that I did to kind of shock myself out of this and kind of incorporates a lot of this is I would tense up muscle All groups tense up my face like face, tense, tense, tense, you know, my chest and my arms and then do that with my neck and legs and go through the whole body thrice and then start the deep breathing exercises and then between each round of the breathing, I would look left and right. Because I read somewhere like I said, I don't work, but somewhere that like seeing like it somewhere you you're in a lower reptile brain is looking saying, oh, there's no lion. Okay, chill, maybe. So that that is something that has helped alleviate acute anxiety for me. Right. Does that sound right, Swati?
Swati Sharma :
26:51
Yes. Yes. Um, so the the relaxation exercise that you were talking about. That's, that's very Very helpful for anxiety. And not only during the time when you're right in the middle of one attack, but also usually, usually before bedtime. The more you do it, the better. In fact, we're going to talk about it and the remedies, you know, the sensitization exercises, then we are doing them This helps a lot tightening and loosening of muscles.
Jeff Hrusko :
27:27
Well, let's get into it. Let's talk about how to unlearn your anxiety response.
Swati Sharma :
27:35
So, one interesting thing about how we disturb ourselves is how we make ourselves anxious or depressed is very existential in nature. Because we are you know, as we grow into adults, we have you know, developed understanding of a lot of social norms and rules. Then, you know, we just followed the toed the line, but we really haven't figured out who are we supposed to be? And what is the point of being at all? And a lot of anxiety comes from misplaced ideas, misplaced belief systems that are formed when you've had experiences that did not leave a good taste in your mouth, or that you did not interpret correctly though they were very fairly harmless or they just scared you. So, yes, fear is on the basis of it.
Jeff Hrusko :
28:38
Well, that's it. That's a lot there. Let me ask some questions about it sounds like you're kind of talking about existential type questions. Like, it makes me think of Frankel's
Unknown Speaker :
28:52
What's his name? Franco
Swati Sharma :
28:53
Viktor Frankl
Jeff Hrusko :
28:55
Thank you. Yeah, yeah. Yeah, he has a beautiful philosophy about the search for meaning and how that is such a cause of people's anxieties and if anybody wants to read a moving book is, is I think it's called Man's Search for Meaning and I don't remember exactly, but I could link to it about his experiences and finding meaning in a concentration camp. So that's so you're saying as part of it, my rephrasing it too much or is that it like, this is
Swati Sharma :
29:27
absolutely it. And and the whole idea of who am I What am I supposed to be and what is supposed to be the essence of what defines how I lead my life, everything, the whole, the whole confusion that keeps working parallely to all the things that society constantly tries to, you know, beat us into becoming or learning and
Jeff Hrusko :
29:56
deep thing I could, I never really made that connection before, but I could certainly see it, just from my own experience being raised, Catholic, and just my relationship to the concept of God and religion and everything else like that. And when it's something that's so part and parcel, to your sense of being your sense of any philosophy that you know that that is whether it's your party or religion or nationality, but when that is somehow changes or challenged, I think that causes such a visceral reaction in people. I mean, it's still something I struggle with him think about myself. Is that kind of what you're talking about with this?
Swati Sharma :
30:40
Yes, yes. Yes. And so, here's how we build the belief systems that cause anxiety. And we are very, very important for us to function through life. Most of our belief systems are very, very functional and really helped Our brain to figure things out, but some of them have caused serious anxiety or even depression or anger. And we want to talk about so so right Yeah,
Jeff Hrusko :
31:11
and I just read Uh oh, now I forget which book it was, but I think it was Brian Greene. He said we we didn't evolve to know the truth we evolved to survive. Exactly.
Swati Sharma :
31:25
Yes, we so we are going to talk about some belief systems that create environments that might make you anxious, and pro, you know, give you anxious thoughts, for instance, achievement and strong absolute, absolute aesthetic demandingness for achievement, which assembly is called achievement anxiety where you have definitive must that you need to make it in Certain things that you want to achieve, it might be a sport or academics or job. And that's also called performance anxiety. It might be a presentation of business deal. And you tie yourself up not either, you know, situationally, or overall. So I've heard lots of lots of my clients talk about the word success, and they take the word success, and then they put whatever they want into it because it's such a fluidic kill board. And then they stopped themselves, because they have kind of defined their idea of success, but they think they don't really they don't realize that it's them who have given it that idea. It wasn't given to them by anybody. And then they they're like, I'm a failure, because that didn't happen.
Jeff Hrusko :
32:55
Oh, you know, it's interesting, when you were saying that it reminded me of a life A song and this is one of those cases where the child is a father to the man, you know, something I thought of when I was a teenager, but then you know life, life and conditioning gets in the way. And it was this line in the song that just said success and failure what ridiculous notions.
Swati Sharma :
33:21
Exactly.
Jeff Hrusko :
33:21
They it made much sense to me when I was 15. And then you kind of lose, then you kind of drink the i hate saying , drink the Kool Aid, you buy into what society and other people are telling you, you must, must, must, must have.
Swati Sharma :
33:39
Right and probably, you know, it's, it's not a very overt message, clearly defined overt message of expectation that you must do a certain thing and become successful, though when many times it is, especially with brown parents. But so, so many times you've shown Given that idea yourself, like I said, and here's the thing with all the forms of, you know, anxiety provoking with belief systems is that you'd forget that you have a choice, you have a choice to think in a certain way, which doesn't provoke anxiety. But you're still trapped. You're trapped. And you continue to think the same way that you're thinking and you do not want to change your patterns. But once you come to the general epiphany that you have that choice, which is also part of the existential theory, your person of choice and you can analyze what your thinking is not healthy and what you're thinking is not even logical or real. And you can slowly work towards changing your thinking patterns which is why we are calling this conversation How to unload anxiety. And we're not and definitely not saying that it's easy. And that really reminds me. And when I was in situations in my life where I felt very trapped, I just thought of Tennessee Williams, The Glass Menagerie, and then the main character there had to well felt that he had to take care of his mother and his disabled sister.
Jeff Hrusko :
35:25
And he went to see a magic Act and the magician, put himself in a coffin, and then nail the coffin shot and escaped. And, and then he came home drunk, and he said, How do you get out of a coffin without moving one nail? And so some belief systems, I think, are like that there's a cost, right? Isn't there Swati to changing a belief systems the cost of how it will affect other people?
Swati Sharma :
35:55
Yeah, yes, yes. I get your point. So, you know, just to differ a little bit on that. Sure. That's a cost and Sure, it's very difficult, but it's a process, it takes time it takes effort it takes work. It takes a lot. Having said that, the time, effort, pain, trouble difficulty that you encounter while remaining in it is incomparably like a lot more. So short, it's it's kind of very tricky, and you definitely need a lot of insight. You need a lot of health, maybe even medication. But yes, I've got some very good instances. And I think given you Jaffe, so many people have overcome this and it's definitely you No, something not really imperceivable
Jeff Hrusko :
37:04
How do you identify? How do you identify beliefs that are causing you anxiety? Sometimes it doesn't seem that clear to them that a belief system is causing you harm in some way.
Swati Sharma :
37:22
See, um, I have a shortcut, but that's because I'm lazy. And here's what I asked myself or so I feel. Say for instance, you're feeling anxious. You're feeling uncomfortable, or you're really feeling just plain Shetty. Whatever it is, once you realize that your feelings something like that. Quick question is, what am I demanding over here? That I have no control over. Right. And, more often than not, you might find yourself You might be able to analyze the situation situation much, much faster.
Jeff Hrusko :
38:04
What do you mean by that? What am I demanding that Oh, what am I doing that I don't control? controlling? Let's
Swati Sharma :
38:10
Yes, say for instance, you have a very important meeting tomorrow or you know, you're just walking towards it and you are anxious. And you might ask yourself, What am I demanding over you that I have no control over and you would be able to see that I am saying I must not come across as a fool. I must not come across as a failure. Or I must not stutter or fumble in front of these kinds. And I agree with my you know, presentation,
Jeff Hrusko :
38:47
and I think sometimes that's like saying, Don't think of the white elephant. Ah, you might
Swati Sharma :
38:56
fumble you might or make mistakes. You might Also get asked questions that you are not prepared for, or you might get clients or audience that are not very friendly or supportive. These things are not in your control. What is in your control, however, is whether you think you feel like a fool. That's where I feel that we perceive, working on our own mental processes as excruciating ly difficult and a lot of hard work, but actually, we're just holding too tight to them. And once we understand that, these are the things that are and actually are not control, it's even more difficult. In fact, it's literally in impossible to will for external situations to change.
Jeff Hrusko :
39:47
So what else do we have this and this is huge. I mean, and can you give me some, you know what Swati gave me some resources that I can link to from the Show page and the notes on this So, you know, this could just go on and on digging on this particular topic and like looking at your belief systems, but the takeaway, and I think it was a beautiful takeaway, like one way to separate the wheat from the chaff. I don't even know what chaff is, but I guess there's no good. There's a sort of cafe chappies Cafe navigate is to look at, look at what you're demanding for yourself and look at what you can control and what what is out of your control and accept what isn't as something that you don't have control over. I say control too many times. I think.
Swati Sharma :
40:41
Yeah, I think I think it could be said many more times and still fine.
Jeff Hrusko :
40:46
Okay, okay. focus and it's like that Serenity Prayer. Lord, give me the grace to accept what what I can I can't think of the surrender. For
Swati Sharma :
41:01
me the courage to change what I can accept what I cannot. And to make the main difference. Yeah,
Jeff Hrusko :
41:12
we got it. So can you talk to me about some maintenance things that people can do that aren't acute but like lifestyle changes to maybe lesson
Swati Sharma :
41:27
we were talking about the thoughts which were which are anxious thoughts. Yes. So, what are the thoughts that we will learn Should we go on that?
Jeff Hrusko :
41:37
Sure, sure. Sure.
Swati Sharma :
41:41
So, yes, one is the need for achievement. And then there are some that come under the umbrella of ego anxiety like one of them which which we spoke about social anxiety but another one is the need for Constant validation or constant approval, either by everybody or by people who are close to you. And which is coupled by an intense need not to be criticized. And that can keep you really anxious
Jeff Hrusko :
42:18
to videos but
Swati Sharma :
42:21
I am a senior I'm raising my hand to a lot of us actually. Yes and my favorite for which both my hands are raised the need to be perfect and make no mistakes that can keep me anxious till the last day and so many others like general need to have things in order. You know. So one of the forms of anxieties of separate compulsiveness.
Jeff Hrusko :
42:55
Yeah, and I know we we didn't talk about that, but I know from our past conference That there is, um, there's a relationship between anxiety and OCD. Is that right?
Swati Sharma :
43:08
Yes. Yes.
Jeff Hrusko :
43:11
And what do you think that relationship is,
Swati Sharma :
43:13
is that they all upset obsessive thinking is one kind of anxious thinking of. So when I when we were talking about what the mind does when it's in an anxious state, that's a very tiresome activity. In fact, with chronic, persistent anxiety. You might have a phenomenon where your mind is fixated on two or three cards, or two or three matters or issues. And you have repetitive thinking it goes in a loop and it continually stays and keeps triggering you all the time. It's very tiresome.
Jeff Hrusko :
43:54
That's almost like a version of
Swati Sharma :
43:59
you Yes. And you know, it's it's frustrating beyond our ability to, you know, sustain it because it's like day after day after day. And obsessive thinking is more specific to probably one thing. And it has a lot of it could be in a thought or image or an idea. And it has to be something that really jars you. Worst case thinking is part and parcel of all anxious thinking, but obsessive thinking will give you something that will really charge you. I had a client who had had a newborn baby was a new mother, and she constantly thought about how she would kill her baby. And it it breaks you It scares you It terrifies you It makes you very vulnerable. It makes you extremely guilty. It cannot live with yourself. So not not all obsessive thoughts make you either guilty or anything you could also be scared about burgers or about getting assaulted again. The important part is the other side of it, which is the compulsive behaviors. So, the compulsive side is what you do, which you have to do as a ritual as a routine, because that is the only thing that will come for the thoughts and come them down for a limited period of time.
Jeff Hrusko :
45:39
So is it almost like something you have control over whether whatever it is stalking, folding laundry, I don't know what it is. Although I wish I had some compulsion about cleaning up. That would be probably not so bad, but is it you think it's a matter of doing something you can control
Swati Sharma :
46:00
Yes You feel it gives you the idea of control. But it doesn't really leave you with that feeling. It's not like you say, Okay, I have checked the door seven times. So now I feel I'm going to be safe. You still feel vulnerable, you still feel uncomfortable your thoughts to come back, but at least they shut up for a period of time before they're back, and then you know, the seven goes to eight, it goes to nine.
Jeff Hrusko :
46:38
So what's the what's method of breaking out of these obsessive thoughts?
Swati Sharma :
46:42
There are lots of different therapeutic methods. But for the cognitive theorists, the favorite thing we go for like we spoke last time, I think we spoke about this
Jeff Hrusko :
46:56
exposure right? Oh, yeah. therapy.
Swati Sharma :
47:02
In fact, I think Yeah, it is. It is very powerful. Even exposure and progressive relaxation, the exercise, we were talking about some time back, or tightening and loosening of muscles. That's also very powerful. And for specifically obsessive thinking, to be able to acknowledge that you have the obsessive thought and it is terrifying you the way it does, but you hold your ground and you do not and do not respond without compulsive. Sorry, yeah, compulsive behavior. And I do this in sometimes broken parts, because I try to create it, like take it in levels. So I say instead of doing this for seven times, can you try to do stop at three?
Jeff Hrusko :
47:57
Oh, that's actually I didn't think
Swati Sharma :
48:00
Count. Yes, that's really when you're counting you count very loudly. So that you say one and then you say, two, and I've checked it and it's locked. Then you say three and checking it. It's locked for the third time. And then you leave it and see how it goes. And then you take it down from there. Hmm.
Jeff Hrusko :
48:23
I think that's I think that's beautiful. Because I was thinking how, again, you know, when something is there, like there's a big red button in front of you and you say, don't touch the red button becomes very hard. But if you say don't touch the red button 10 times you can touch a nine it seems like that's a little easier of a lift.
Swati Sharma :
48:45
Yeah, Jeff, that only happens to four year olds.
Jeff Hrusko :
48:48
me. I'm just not a button.
Oh my god. I just had about a minute. To the memory. Say real quick since I thought about it, I was a teenager and I was in a grocery store and for some reason, I had a desire to touch the cash register. I wasn't stealing anything or do anything that I just I don't know. And yeah, I toasted of course the thing would be like crazy and I just ran I store. I'm sure everybody thought that I was trying to do something but no, I just wanted to Yeah, that was.
Alright, so let's try to summarize because I think we have so much here. Summarize and give some last minute tips about what people can do and some lifestyle changes they could make. So if you could summarize some of the the ways the main ways to unlearn our anxiety response, what are they
Swati Sharma :
50:00
Yes. So there are a lot of techniques and challenging our thinking, first of all by writing down identifying what are what are those very primary anxious thoughts that preoccupy your mind? Most often and challenging their illogic, unrealistic nature and complete irrationality, right. And in fact also the irony of it because some of those expect to save you and prevent you from some untoward situation or unwanted situation. But actually, they make the whole thing much worse because you're more likely to you know, do it like you said, don't touch the red button, which is more likely to screw up a situation if you're getting really, really nervous about it. But I really want to talk About acceptance, Jeff, because I think that is at such a fundamental level of all the treatment, what are you going into treatment with? What is that demandingness that you are holding, when you are sitting in therapy working on demandingness in your thoughts, are you actually even coming with the entire intention of a demanding this demanding is that I must not have anxiety. In fact, this is also This was also discussed in the session today. Where, because this client I was with today has, you know, done very well in therapy is sharply self aware. And he had this anxiety attack and he said that I could see where the actual anxiety stopped and the secondary anxiety to cope were the anxious It for oh my god is this COVID stopped stopped as it doesn't didn't cease but where it kind of happened and then where it kind of propelled into another level because oh my god, I have an anxiety attack I thought I'm fine I thought I'm going to never have an anxiety attack again.
Jeff Hrusko :
52:22
Yes I have been there and you know this too like when I first started treatment or rational behavioral therapy you know and I said yes I of course I demand Are you out of your mind I demand I don't want to feel like this. That's my two cents and you know, what's the
Swati Sharma :
52:41
most or you know, heart rate, you know, what do you call it like painful part heart wrenching part is that if you have own period of time where you've been anxiety free it is so delicious. That Your secondary emotions about getting an anxiety experience again. It's like very, very heartbreaking. It's disappointing and it's like, I cannot believe this is come back. You were so you were so free and light headed, you know, light hearted. And now it's back and this is what today's client described to me and he he was kind of he had a you know, his heart sounds Why am I feeling this feeling again?
Jeff Hrusko :
53:33
It's like you finally get rid of the in laws. Oh, you're back. Oh,
Swati Sharma :
53:40
okay. That's not going down very well with me.
Jeff Hrusko :
53:43
Okay, sorry.
Swati Sharma :
53:47
Just kidding. Just
Jeff Hrusko :
53:48
Just a little joke. But yeah, and then and then from, from my personal experience, so I've gotten gone through exactly that. And that, for me started a whole nother round. Round of anxiety, and then it only became the you know, like you were saying the secondary thing, the secondary thing became the primary thing. Fear of fear.
Swati Sharma :
54:10
Yes. Piano fear.
Jeff Hrusko :
54:13
So, we're talking about excepted
Swati Sharma :
54:16
Yes. To the acceptance of it is. Again, for the end time, I'm going to mention my client today. I think I really am so proud of him actually. And he also spoke of acceptance, right when he was describing all of this and he said, then I came to a point of acceptance. And the idea is like, you know, like, sometimes you get gassy and sometimes you don't get gassy for a really long time. If you can be that matter of fact about anxiety, having the possibility of coming back and understanding that it's temporary understanding, it's going to eventually go and it's not life threatening. It's just uncomfortable. It's, I mean, uncomfortable is really toning it down. It is not fun, like you mentioned earlier, but that's technically what it is. It will cause you discomfort, but it's not harming you, it's not life threatening. And if you can bring yourself to a point of accommodating ate like, okay, hang around as much as you want to, I don't want to get rid of you. You can sit here for the rest of my life and, and here's again the paradoxical thing that the moment you show loss of interest in whether it stays or both, is the moment from where you can probably see recovery,
Jeff Hrusko :
55:42
it will start to dissipate and getting there and maybe some people get there faster. But getting to that level of acceptance is is tough, so it was tough for me. Definitely. So I still you know, with my own journey through the good days and bad But more and more that that power of acceptance is like a feeling little off today. Okay, tomorrow will be better. And if not the day after will be. It's not easy.
Swati Sharma :
56:11
But it's
Jeff Hrusko :
56:13
it's not easy. No, but that's like the the, the acceptance of it is the hardest, but the most powerful, paradoxical way to beat it is almost like passive resistance.
Swati Sharma :
56:28
Yes, yes. So, there's some other ways that we can talk about are some really simple ideas. So one was challenging your thoughts. And this is also a methodical thing that we have in therapy, where we counter each irrational thought with its rational counterpart and question our own selves. So you have to kind of get into a dispute with your own mind every time and the trick, you know, initiate or trigger but initiate plasticity process where you are reframing how your brain things then there are other options like positive visualization where you think not like pollyannish but you think positive, closer to reality but positive because anxiety so much about negative thinking. So you kind of balance that out modeling nice utopia
Jeff Hrusko :
57:31
the one time that I should carry out a counter or something else like that or you are just a tick mark and just listen or look for every negative thought. Yes, just to see the impact of them.
Swati Sharma :
57:45
Yes, that's that's your birthday gift for next year.
Jeff Hrusko :
57:49
Ah, thanks for that.
Swati Sharma :
57:54
photo.
Jeff Hrusko :
57:55
Swati, I think we're going to wrap this up because we had a So much rich, rich stuff here. And this is for some people, maybe the beginning of the journey. And we've mentioned a couple things here that would be helpful. One that I found very helpful was feeling good by David Burns, inexpensive book and a lot of these techniques that we discussed here that walks you through. Another thing would be to find a therapist to help you through this. And just in all fairness, I will say that Swati Sharma is available. Throughout this crisis, we're doing things entirely online. So if you want to go to mindscapes therapy, and her contact information is there along with some resources. Is there any any last minute advice you would like to give our listeners
Swati Sharma :
59:00
I'd like to recommend a book if I might have your permission. Sure. I think it's quite real you know user friendly and I like to suggest this for clients. It's called How to control your anxiety before it controls you. It's by the DVD founder don't Yes.
Jeff Hrusko :
59:23
Good old lb He's my bro because we're tight.
Swati Sharma :
59:30
Yeah. Thank you so much. I always enjoyed talking to you and I think
Jeff Hrusko :
59:36
this we will we will talk about it is we can keep going and going on this. I think we covered a lot and I know this will be helpful. Some people how to unlearn anxiety. It's life changing. It really is. So please listeners. We gave you some good resources to Go nurse Hill found through this loss of support. And the good news is that although anxiety disorders are considered like a mental disorder and mental illness, they are the most curable of just about only the mental illnesses out there. If you're dedicated and with a, find a therapy that works for you, you can overcome it, or for at least manage it to the point where you're, you will live a happy and productive life. All right, thanks very much.
Swati Sharma :
1:00:38
Thank you. Bye bye bye.
0:08
Hello, and welcome to another episode of COG podcast where we explore why we learn why we don't and what makes the difference. But in this episode, we're going to do something a little bit different. We're going to explore how we can unlearn something specifically anxiety. I'm Jeff Rosco, instructional designer and technologist and today I'm so excited to be joined again by Swati Sharma, who has a master's in psychology. She's a practicing rational behavioral therapist. She also does art based therapy and a couple other things and my fiance, I Swati so Swati, tell me a little bit about how anxiety develops and a person some people and in full disclosure I have an anxiety issue myself. So some people are plagued with anxiety.
How does it happen? And what are the different types of anxiety disorders people experience?
Swati Sharma :
1:11
Yes, Jeff, you're shifting into the right direction because anxiety does have a biological and evolutionary aspect to it. So of course, we all have mechanisms that are designed to alert us when there's a perceived threat.
However, some of us are more predisposed to having that mechanism set off much earlier or much of more often than for some other people.
Jeff Hrusko :
1:46
When you think of when you think of from an evolutionary perspective, again, and this is where a false positive is not a bad thing, right. So the ancestors that survived reacted to things.
Something's in the bush, something's in the bush, right? But we have a lot of people say, you know, we're no longer in the bush, we're no longer in the jungle but I've I've crossed Mumbai traffic with you and I need all my instincts there 100% but is still there and it serves like a very important purpose, but because it seems like there's not a penalty or there was an evolutionary penalty for false positives. Is that one of the reasons why you think some of us are prone to having an overstimulated anxiety system for lack of a better word.
Swati Sharma :
2:39
There are many theories on why people would have an overstimulated you know, anxiety predisposition, and, you know, and I'm not sure which one of them would actually fit rightly. But what's more important to know is that besides having a predisposition to also depends upon your environmental experiences and maybe traumatic situations that you may have passed through. And yes, what you say is right, that you know, this is like erring on the side of safety.
But this mechanism which is supposed to bring us to a fight or flight mode is supposed to switch off after a period of time, say, you know, in a matter of minutes, once the threat is over, but with this one overdrive, we are in a state of chronic stress and anxietyit is like it gets stuck.
Jeff Hrusko :
3:50
Yes, back in the old days when we had throttles and cars, I remember I had actually had a car that the throttle got stuck in the open position. So the thing just revd like crazy, and it was very scary, because it's tough to stop. And it's kind of it seems kind of like that. And again, I speak from first person experience, it's like, seemingly out of nowhere. And I know there's different types of anxiety and maybe you can talk about the different types of disorders. But the one that I've experienced personally is just going from zero to 60 or 100 kilometers in no time flat, just and for no good reason. There's no Tiger in the bush. So can you tell us about the difference? And so what I described there that that is called a panic disorder. Is that right?
Swati Sharma :
4:43
Right. Right, a panic disorder is so exactly what you were talking about, like, seems to come out of nowhere. It hasn't really manifested because something happened and you know, Seemingly, it's just happened out of the blue therefore it feels like because of all that symptoms as well, it feels like if you look at the person feels and the person is having a heart attack or some real physiological medical emergency, and even the person going through it is sensing a feeling of doom, there is a, there's an emotional experience that this is it. Or I'm going to die or I'm going to go crazy or I'm having a heart attack and it's fatal.
Jeff Hrusko :
5:33
For the for those of you that and before I had experienced it, that's kind of a hard concept to get your head around. I remember hearing about it. But when it happens to you, you know exactly what a sense of Doom is. You just feel like you're gonna drop dead in the next minute. It's very frightening. Beyond panic disorders, what are the other types of anxiety disorders that people mostly suffer with,
Swati Sharma :
5:58
right? We have a lot of incidences of generalized anxiety and social anxiety. These are the most common forms. generalized anxieties, basically, of anything that might be happening on our day to day basis can cause you to react in an extremely anxious manner of social anxiety. Of course, a lot
Jeff Hrusko :
6:27
Before you get into that one, just so I can make the distinction there. So when we said a panic disorder, like I have, you know, that's zero to 60. But are you saying that a generalized anxiety disorder is more likea constant simmering of anxiety? Would that be accurate?
Swati Sharma :
6:48
yes, yes. Not only that, that's constant. The constant simmering is, I think, part and parcel of a lot of different types of anxiety issues. But also, it won't be, you know, focused on a certain aspect of your life. Now, if you understand social anxiety, for instance, then you would see that that's more of what we call an ego anxiety. Or what anxiety I'm sorry. Oh, it's a it's called an ego anxiety you
Jeff Hrusko :
7:20
OH I thought you said evil, which I think is evil.
Swati Sharma :
7:23
It's not evil. Oh, it's all anxiety is evil.
Jeff Hrusko :
7:29
Except when it's protecting you from actual tigers, or actual drivers in Mumbai?
Swati Sharma :
7:35
Oh, yes. Oh, yes. So anxiety in Mumbai near the zoo.
Jeff Hrusko :
7:42
is the only place you're allowed to be anxious. No, but But seriously, I mean, that is I know my own treatment. That's one of the things that they had to clarify. It's like we're not going to try to get rid of all anxiety becomes healthy enzymes in there is such a thing. And correct me if I'm wrong, if I'm changing any of the terms. There's a health anxiety there's normal, a certain amount of anxiety. And maybe anxiety is even the wrong word with a certain amount of stress, healthy stress. Yeah, there you go. That's a better way to put it. Say before you're, before you're giving a speech or whatever it is, it helps you stay focused, without the right to say.
Swati Sharma :
8:26
That's, that's so anxiety is so crucial for us because that's our survival mechanism. Hey, we cannot do without it. Right? That's what helps us to stay alert. I mean, it comes from our alertness, our awareness, our sense of scoping around us. And, you know, anything that's sudden anything that's not fitting in, needs to then come into our conscious awareness because Because of those things, so our attention to detail comes from there, therefore, and like you beautifully said focus and attention. Yes. So it's important mechanism.
Jeff Hrusko :
9:11
And I don't want to lose. So we sort of have what, what a panic disorder is with generalized anxiety disorder is and then the last one you mentioned as one of the most common Oh, just let me make a footnote like it I think around the world, but I know for sure in the United States, anxiety disorders are the number one mental issue with people a large percentage, so you're not alone. If you do suffer with this from time to time, I forgot exactly what the stats are all posts in some place, but something like five to 10% of the population at least, covers and so can you tell us what social anxiety is?
Swati Sharma :
9:48
Oh, social anxiety is like like its name. It's related to how you experience discomfort and your anxiety. He's focused only on the social interactions that you're expected to conform to. And you might not be comfortable with that, you might think that you are not good enough for it, you are constantly sensing, you know, in your own mind that you're being judged. You are being evaluated, rated and ridiculed for for that matter, or just criticized, for instance, even though that might not be happening, but that's that's the, you know, state of awareness that it brings you,
Jeff Hrusko :
10:39
You focus on that and kind of ruminate on that. I think when people are like this, because it's like, the other side of that is, yes, people do judge, but who cares, right and it's never usually as much it's not their main focus of you know, it's not cuz people make micro judgments about people, and you make micro judgments about other people too. But so what does that mean? That'd be fair to say or
Swati Sharma :
11:11
Completely. It's a beautifully put. And of course, it's part of all the more comprehensive therapy, learning, because this is what our podcast is about today. So how do we learn to bring that kind of thinking? That then pushes back on the anxious thinking, the anxious rumination and you know,
Jeff Hrusko :
11:37
That's a great trends transition. So now we have the basics of the just the outline of the various types of disorders here. And so yeah, comes to all these are learned responses. Is that accurate to say?
Swati Sharma :
11:52
Yes, yes, all responses are learned responses besides your genetic predisposition and evolutionary mechanisms which might be you know, structurally here and there. So, besides the biological aspects of it, I would say, you know, I would want to focus on what you said about this being a pandemic already. And it's a pandemic, nobody's gonna talk about pretty much soon and it's a pandemic, we're not going to look for a vaccine for but it's it's everybody.
Jeff Hrusko :
12:33
Yeah, everybody to a certain degree. And then there just comes a point when, what let's talk about some of the things that it does and then we'll get into what we can do about it. So when you are anxious, Ryan, tell me what what happens in the body, what happens in the mind.
Swati Sharma :
12:56
The anxious state is, you know, When you've started feeling something physiologically forced, most more often than not even though the activity starts in your mind. That's not what you notice first, what you notice is that you're, you're not feeling the same. And usually the first awareness is towards your chest tightening or your breath shortening, or a feeling of, you know, being stiffened. You know, you know, feeling stuffy, you know what I mean? And,
Jeff Hrusko :
13:39
Yeah, I know exactly what you mean. And let me just just kind of add on that just a bit. It's like, okay, you feel butterflies in your stomach, you feel warmness in your chest, right? makes it hard to think about anything else. Am I describing anxiety? Or am I describing love? I mean, I think is like our reaction to what's happening in the body. And this was a tough thing for me to, to learn makes a big part of it, how we frame that. Yeah. Because you look at what's going on there, and we're bringing to it this. And I think this might be the Learn part and correct me if I'm wrong. We're bringing what we bring to it. Is that the fear and the emotion?
Swati Sharma :
14:33
Yes, yes. And the entire sympathetic responses activated. And there is a sense that you don't want to be there. And there's a sense that you are not going to be able to handle this. There's a sense of urgency that I can't be in this place. So there's a restlessness because there's a it this stress responses basically spiking up your, you know, motor psychomotor instinct. And then you there's, there's a, there's an impulse to run or it's not manifesting as an impulse to run in the current times, but it's more like choice to keep
Jeff Hrusko :
15:20
or freeze.
Swati Sharma :
15:22
Absolutely, absolutely. Yeah.
Jeff Hrusko :
15:24
I have a friend of mine actually also suffers with panic disorder, said it beautifully. He said, it's like being trapped in your own body and you have nowhere to run.
Swati Sharma :
15:40
Absolutely. This is such a beautiful way of describing what happens. You have no better run.
Jeff Hrusko :
15:48
No words. Yeah, it has nothing to run from.
Swati Sharma :
15:51
Yes. And you know, it though this is excruciating. What is even more excruciating, probably. Here's what's happening in your head. Because there is almost, you know, what you can call exhausting. And, you know, overwhelmed.
Jeff Hrusko :
16:18
And it feels like and I guess it depends to is like where we consider the the I or the ego there that we're the logical part of the mind the logos or whatnot. In my experience when I'm anxious gets very small, right? And so it's almost like you're being, you know, you started out a walk and you have two dogs with you and they start out as puppies and all sudden they turn into werewolves, and then you go along and taken away. Everyone's like, wait, wait, no, he'll he'll stop No.
Swati Sharma :
16:54
Right, right. Precisely, precisely, and it's Very difficult to be able to hold your ground at that time. Your body is losing. You know, your body has a mind of its own and your mind has a body of its own. And like you're just completely helpless between a rock and a hard place.
Jeff Hrusko :
17:20
All right, so we've now talked about what it is. And let me review some of the symptoms or how it feels right. We said it's very hard to concentrate. Specifically, I mean, for job performance. If you're in an anxious state, it's difficult to think clearly. And depending on the level of anxiety, there could be physical manifestations, racing heartbeat, if you only plan the sense of doom all around, not fun. Alright, so now we're going to get to the crux of it. What can you do and we'll talk about what can you do about it into in two aspects one, what can you do if it's happening? And then the second is what can you do as lifestyle changes or as maintenance? To sort of manage it? Does that sound fair Swati?
Swati Sharma :
18:18
Yes, yes. Almost by. Yes.
Jeff Hrusko :
18:21
Okay. Yeah. And you could swap, whichever one you want to go first with. So, Swati, you tell me what can we do about anxiety?
Swati Sharma :
18:30
Yes. In fact, I was faced with this question today when I was in session with my client, and he wanted to know what can one do when anxiety strikes so hard and so sudden, that there is no time for all the stuff that you have learned in therapy, and probably that's as good a place to start as any other so if you're in the throes of anxiety attack, it would mean that you're already having very short breath, your chest is hurting, you are sweating you have a, you know, or sort of a palpitation or literal palpitations. And maybe like Jeff, you said, some discomfort in the stomach. So, if you are already there, it would be likely that your mind would take over and start having a lot of scary worst case scenario thoughts, which then trigger even more anxiety.
Jeff Hrusko :
19:40
Yes, it's a feedback loop despair,
Swati Sharma :
19:44
Feedback of despair and you know, the vicious cycle. It's called a secondary emotion response. And that's, that's one of the most unfortunate parts of anxiety or maybe even though you know, it's maybe Also, you know, brighter side or good news because most of what you're experiencing is just extra layers that you put on yourself because you were listening to carefully to what was happening in your head and believing buying into it. So if that has happened already, and now everything is really out of control, shocking your senses, your five senses is a good way to try bringing it down. So the idea is to, you know,
Jeff Hrusko :
20:36
this is making a bad joke.
Swati Sharma :
20:39
Sorry, I missed that. He says,
Jeff Hrusko :
20:40
Shocking your system and like, Well, you've put a fork in a socket, right? Okay. No, not wrong. Anybody to ever do that. Ever. And if you have little kids, you know, make sure you put those covers in. I'm sorry. Go ahead. How do you snap yourself out of it then when you're in the throes of it so
Swati Sharma :
20:56
I was saying the idea of doing that is to take the attention Off the anxious mind from the thing that is bothering it and diverted towards something more external and in the present moment so take something very very cold like ice cubes and you know have something really hot go for a very cold shower or a very hot shower you know stuff like that or you know just hit yourself pinch yourself but of course like I said not not severely did this is one of the things what know that another thing that's really helpful
Jeff Hrusko :
21:40
Let me just comment on that a little bit because I you know, I've been through all of this so I can get feedback on it. Yeah. And and those techniques because you are activating different parts of your nervous system, different parts of your brain. They can help on in a pinch, you know, in in an emergency. You know, over These things though, like one of the things that I'm sure you'll get to it too is acceptance that sometimes you will feel feel anxious. And that takes away some of the secondary emotions. I'm sorry, go ahead, then.
Swati Sharma :
22:14
Yes, I must come back to acceptance. That's so important. Thank you, Jeff for pointing that one out. So the other thing that we can do is called diaphragm breathing. And since we spoke about the chest and the butterflies in the belly, then I could probably point out that diaphragm is between these two spaces just above the place your belly starts, but just where your chest ends, and the idea is to use your inhalation to inflate your diaphragm. So you're like almost pushing your belly out, or your What do you call the space above the belly, like the upper belly out, and when you're exhaling, you pull it in as much as you can. As if you're really intending to take it all the way back to the spine, which of course you can. And in between that inhalation and exhalation you have a small pause. So usually it goes to account of inhalation 1, 2, 3, 4. Pause for 1, 2, 3, 4 and an exhalation going 1, 2, 3, 4, 5, 6 and probably seven. And you do that for a number of times to kind of bring your sympathetic response down.
Jeff Hrusko :
23:43
Yes, yeah, that that is helpful. And just to the listeners, not not anything is a magic bullet. And we'll talk about that. But from personal experience, this is something that that's helpful. It's also oxygenating your system so your brain can get to little little more oxygen with that, I think is doing that. And it's also good, because we were talking about one of the main symptoms or shortness of breath and taking shallow breaths. So actually by taking deep breaths, you're signaling to your system that it's okay. You're okay.
Swati Sharma :
24:19
Right, right. And the other thing is, you know, a dirty little secret about our mind is that it cannot multitask. It cannot think of two different things or be doing two different tasks at the same time. And therefore, another thing that works very well is to count backwards from hundred jumping, jumping seven, so it's hundred minus seven minus seven minus seven. That is pretty preoccupying, and then it takes your mind away
Jeff Hrusko :
24:48
it is that a decision from personal experience again, triggering that part? You You will fight against it. Like if you were trying these things, and I've done different things like Sudoku. Things that take mental energy concentration and mental energy and it will be tough, it will be tough. But the more you do it and this isn't instantaneous because you think about it, you've just flooded your system you know with all sorts of hormones when they call it cortisone, cortisol, you know, anywhere stressful and they will take a while to dissipate but all this does, again can be effective from personal experience. Like I said, not everything works for everybody but just from my own experience. Just one more thing that worked for me at times again, this is for cute acute anxiety, which is not very cute at all. Unless you picture your demons a little cute fuzzy guy. They wouldn't be so much of a demon anyway. Um, so one thing that I did to kind of shock myself out of this and kind of incorporates a lot of this is I would tense up muscle All groups tense up my face like face, tense, tense, tense, you know, my chest and my arms and then do that with my neck and legs and go through the whole body thrice and then start the deep breathing exercises and then between each round of the breathing, I would look left and right. Because I read somewhere like I said, I don't work, but somewhere that like seeing like it somewhere you you're in a lower reptile brain is looking saying, oh, there's no lion. Okay, chill, maybe. So that that is something that has helped alleviate acute anxiety for me. Right. Does that sound right, Swati?
Swati Sharma :
26:51
Yes. Yes. Um, so the the relaxation exercise that you were talking about. That's, that's very Very helpful for anxiety. And not only during the time when you're right in the middle of one attack, but also usually, usually before bedtime. The more you do it, the better. In fact, we're going to talk about it and the remedies, you know, the sensitization exercises, then we are doing them This helps a lot tightening and loosening of muscles.
Jeff Hrusko :
27:27
Well, let's get into it. Let's talk about how to unlearn your anxiety response.
Swati Sharma :
27:35
So, one interesting thing about how we disturb ourselves is how we make ourselves anxious or depressed is very existential in nature. Because we are you know, as we grow into adults, we have you know, developed understanding of a lot of social norms and rules. Then, you know, we just followed the toed the line, but we really haven't figured out who are we supposed to be? And what is the point of being at all? And a lot of anxiety comes from misplaced ideas, misplaced belief systems that are formed when you've had experiences that did not leave a good taste in your mouth, or that you did not interpret correctly though they were very fairly harmless or they just scared you. So, yes, fear is on the basis of it.
Jeff Hrusko :
28:38
Well, that's it. That's a lot there. Let me ask some questions about it sounds like you're kind of talking about existential type questions. Like, it makes me think of Frankel's
Unknown Speaker :
28:52
What's his name? Franco
Swati Sharma :
28:53
Viktor Frankl
Jeff Hrusko :
28:55
Thank you. Yeah, yeah. Yeah, he has a beautiful philosophy about the search for meaning and how that is such a cause of people's anxieties and if anybody wants to read a moving book is, is I think it's called Man's Search for Meaning and I don't remember exactly, but I could link to it about his experiences and finding meaning in a concentration camp. So that's so you're saying as part of it, my rephrasing it too much or is that it like, this is
Swati Sharma :
29:27
absolutely it. And and the whole idea of who am I What am I supposed to be and what is supposed to be the essence of what defines how I lead my life, everything, the whole, the whole confusion that keeps working parallely to all the things that society constantly tries to, you know, beat us into becoming or learning and
Jeff Hrusko :
29:56
deep thing I could, I never really made that connection before, but I could certainly see it, just from my own experience being raised, Catholic, and just my relationship to the concept of God and religion and everything else like that. And when it's something that's so part and parcel, to your sense of being your sense of any philosophy that you know that that is whether it's your party or religion or nationality, but when that is somehow changes or challenged, I think that causes such a visceral reaction in people. I mean, it's still something I struggle with him think about myself. Is that kind of what you're talking about with this?
Swati Sharma :
30:40
Yes, yes. Yes. And so, here's how we build the belief systems that cause anxiety. And we are very, very important for us to function through life. Most of our belief systems are very, very functional and really helped Our brain to figure things out, but some of them have caused serious anxiety or even depression or anger. And we want to talk about so so right Yeah,
Jeff Hrusko :
31:11
and I just read Uh oh, now I forget which book it was, but I think it was Brian Greene. He said we we didn't evolve to know the truth we evolved to survive. Exactly.
Swati Sharma :
31:25
Yes, we so we are going to talk about some belief systems that create environments that might make you anxious, and pro, you know, give you anxious thoughts, for instance, achievement and strong absolute, absolute aesthetic demandingness for achievement, which assembly is called achievement anxiety where you have definitive must that you need to make it in Certain things that you want to achieve, it might be a sport or academics or job. And that's also called performance anxiety. It might be a presentation of business deal. And you tie yourself up not either, you know, situationally, or overall. So I've heard lots of lots of my clients talk about the word success, and they take the word success, and then they put whatever they want into it because it's such a fluidic kill board. And then they stopped themselves, because they have kind of defined their idea of success, but they think they don't really they don't realize that it's them who have given it that idea. It wasn't given to them by anybody. And then they they're like, I'm a failure, because that didn't happen.
Jeff Hrusko :
32:55
Oh, you know, it's interesting, when you were saying that it reminded me of a life A song and this is one of those cases where the child is a father to the man, you know, something I thought of when I was a teenager, but then you know life, life and conditioning gets in the way. And it was this line in the song that just said success and failure what ridiculous notions.
Swati Sharma :
33:21
Exactly.
Jeff Hrusko :
33:21
They it made much sense to me when I was 15. And then you kind of lose, then you kind of drink the i hate saying , drink the Kool Aid, you buy into what society and other people are telling you, you must, must, must, must have.
Swati Sharma :
33:39
Right and probably, you know, it's, it's not a very overt message, clearly defined overt message of expectation that you must do a certain thing and become successful, though when many times it is, especially with brown parents. But so, so many times you've shown Given that idea yourself, like I said, and here's the thing with all the forms of, you know, anxiety provoking with belief systems is that you'd forget that you have a choice, you have a choice to think in a certain way, which doesn't provoke anxiety. But you're still trapped. You're trapped. And you continue to think the same way that you're thinking and you do not want to change your patterns. But once you come to the general epiphany that you have that choice, which is also part of the existential theory, your person of choice and you can analyze what your thinking is not healthy and what you're thinking is not even logical or real. And you can slowly work towards changing your thinking patterns which is why we are calling this conversation How to unload anxiety. And we're not and definitely not saying that it's easy. And that really reminds me. And when I was in situations in my life where I felt very trapped, I just thought of Tennessee Williams, The Glass Menagerie, and then the main character there had to well felt that he had to take care of his mother and his disabled sister.
Jeff Hrusko :
35:25
And he went to see a magic Act and the magician, put himself in a coffin, and then nail the coffin shot and escaped. And, and then he came home drunk, and he said, How do you get out of a coffin without moving one nail? And so some belief systems, I think, are like that there's a cost, right? Isn't there Swati to changing a belief systems the cost of how it will affect other people?
Swati Sharma :
35:55
Yeah, yes, yes. I get your point. So, you know, just to differ a little bit on that. Sure. That's a cost and Sure, it's very difficult, but it's a process, it takes time it takes effort it takes work. It takes a lot. Having said that, the time, effort, pain, trouble difficulty that you encounter while remaining in it is incomparably like a lot more. So short, it's it's kind of very tricky, and you definitely need a lot of insight. You need a lot of health, maybe even medication. But yes, I've got some very good instances. And I think given you Jaffe, so many people have overcome this and it's definitely you No, something not really imperceivable
Jeff Hrusko :
37:04
How do you identify? How do you identify beliefs that are causing you anxiety? Sometimes it doesn't seem that clear to them that a belief system is causing you harm in some way.
Swati Sharma :
37:22
See, um, I have a shortcut, but that's because I'm lazy. And here's what I asked myself or so I feel. Say for instance, you're feeling anxious. You're feeling uncomfortable, or you're really feeling just plain Shetty. Whatever it is, once you realize that your feelings something like that. Quick question is, what am I demanding over here? That I have no control over. Right. And, more often than not, you might find yourself You might be able to analyze the situation situation much, much faster.
Jeff Hrusko :
38:04
What do you mean by that? What am I demanding that Oh, what am I doing that I don't control? controlling? Let's
Swati Sharma :
38:10
Yes, say for instance, you have a very important meeting tomorrow or you know, you're just walking towards it and you are anxious. And you might ask yourself, What am I demanding over you that I have no control over and you would be able to see that I am saying I must not come across as a fool. I must not come across as a failure. Or I must not stutter or fumble in front of these kinds. And I agree with my you know, presentation,
Jeff Hrusko :
38:47
and I think sometimes that's like saying, Don't think of the white elephant. Ah, you might
Swati Sharma :
38:56
fumble you might or make mistakes. You might Also get asked questions that you are not prepared for, or you might get clients or audience that are not very friendly or supportive. These things are not in your control. What is in your control, however, is whether you think you feel like a fool. That's where I feel that we perceive, working on our own mental processes as excruciating ly difficult and a lot of hard work, but actually, we're just holding too tight to them. And once we understand that, these are the things that are and actually are not control, it's even more difficult. In fact, it's literally in impossible to will for external situations to change.
Jeff Hrusko :
39:47
So what else do we have this and this is huge. I mean, and can you give me some, you know what Swati gave me some resources that I can link to from the Show page and the notes on this So, you know, this could just go on and on digging on this particular topic and like looking at your belief systems, but the takeaway, and I think it was a beautiful takeaway, like one way to separate the wheat from the chaff. I don't even know what chaff is, but I guess there's no good. There's a sort of cafe chappies Cafe navigate is to look at, look at what you're demanding for yourself and look at what you can control and what what is out of your control and accept what isn't as something that you don't have control over. I say control too many times. I think.
Swati Sharma :
40:41
Yeah, I think I think it could be said many more times and still fine.
Jeff Hrusko :
40:46
Okay, okay. focus and it's like that Serenity Prayer. Lord, give me the grace to accept what what I can I can't think of the surrender. For
Swati Sharma :
41:01
me the courage to change what I can accept what I cannot. And to make the main difference. Yeah,
Jeff Hrusko :
41:12
we got it. So can you talk to me about some maintenance things that people can do that aren't acute but like lifestyle changes to maybe lesson
Swati Sharma :
41:27
we were talking about the thoughts which were which are anxious thoughts. Yes. So, what are the thoughts that we will learn Should we go on that?
Jeff Hrusko :
41:37
Sure, sure. Sure.
Swati Sharma :
41:41
So, yes, one is the need for achievement. And then there are some that come under the umbrella of ego anxiety like one of them which which we spoke about social anxiety but another one is the need for Constant validation or constant approval, either by everybody or by people who are close to you. And which is coupled by an intense need not to be criticized. And that can keep you really anxious
Jeff Hrusko :
42:18
to videos but
Swati Sharma :
42:21
I am a senior I'm raising my hand to a lot of us actually. Yes and my favorite for which both my hands are raised the need to be perfect and make no mistakes that can keep me anxious till the last day and so many others like general need to have things in order. You know. So one of the forms of anxieties of separate compulsiveness.
Jeff Hrusko :
42:55
Yeah, and I know we we didn't talk about that, but I know from our past conference That there is, um, there's a relationship between anxiety and OCD. Is that right?
Swati Sharma :
43:08
Yes. Yes.
Jeff Hrusko :
43:11
And what do you think that relationship is,
Swati Sharma :
43:13
is that they all upset obsessive thinking is one kind of anxious thinking of. So when I when we were talking about what the mind does when it's in an anxious state, that's a very tiresome activity. In fact, with chronic, persistent anxiety. You might have a phenomenon where your mind is fixated on two or three cards, or two or three matters or issues. And you have repetitive thinking it goes in a loop and it continually stays and keeps triggering you all the time. It's very tiresome.
Jeff Hrusko :
43:54
That's almost like a version of
Swati Sharma :
43:59
you Yes. And you know, it's it's frustrating beyond our ability to, you know, sustain it because it's like day after day after day. And obsessive thinking is more specific to probably one thing. And it has a lot of it could be in a thought or image or an idea. And it has to be something that really jars you. Worst case thinking is part and parcel of all anxious thinking, but obsessive thinking will give you something that will really charge you. I had a client who had had a newborn baby was a new mother, and she constantly thought about how she would kill her baby. And it it breaks you It scares you It terrifies you It makes you very vulnerable. It makes you extremely guilty. It cannot live with yourself. So not not all obsessive thoughts make you either guilty or anything you could also be scared about burgers or about getting assaulted again. The important part is the other side of it, which is the compulsive behaviors. So, the compulsive side is what you do, which you have to do as a ritual as a routine, because that is the only thing that will come for the thoughts and come them down for a limited period of time.
Jeff Hrusko :
45:39
So is it almost like something you have control over whether whatever it is stalking, folding laundry, I don't know what it is. Although I wish I had some compulsion about cleaning up. That would be probably not so bad, but is it you think it's a matter of doing something you can control
Swati Sharma :
46:00
Yes You feel it gives you the idea of control. But it doesn't really leave you with that feeling. It's not like you say, Okay, I have checked the door seven times. So now I feel I'm going to be safe. You still feel vulnerable, you still feel uncomfortable your thoughts to come back, but at least they shut up for a period of time before they're back, and then you know, the seven goes to eight, it goes to nine.
Jeff Hrusko :
46:38
So what's the what's method of breaking out of these obsessive thoughts?
Swati Sharma :
46:42
There are lots of different therapeutic methods. But for the cognitive theorists, the favorite thing we go for like we spoke last time, I think we spoke about this
Jeff Hrusko :
46:56
exposure right? Oh, yeah. therapy.
Swati Sharma :
47:02
In fact, I think Yeah, it is. It is very powerful. Even exposure and progressive relaxation, the exercise, we were talking about some time back, or tightening and loosening of muscles. That's also very powerful. And for specifically obsessive thinking, to be able to acknowledge that you have the obsessive thought and it is terrifying you the way it does, but you hold your ground and you do not and do not respond without compulsive. Sorry, yeah, compulsive behavior. And I do this in sometimes broken parts, because I try to create it, like take it in levels. So I say instead of doing this for seven times, can you try to do stop at three?
Jeff Hrusko :
47:57
Oh, that's actually I didn't think
Swati Sharma :
48:00
Count. Yes, that's really when you're counting you count very loudly. So that you say one and then you say, two, and I've checked it and it's locked. Then you say three and checking it. It's locked for the third time. And then you leave it and see how it goes. And then you take it down from there. Hmm.
Jeff Hrusko :
48:23
I think that's I think that's beautiful. Because I was thinking how, again, you know, when something is there, like there's a big red button in front of you and you say, don't touch the red button becomes very hard. But if you say don't touch the red button 10 times you can touch a nine it seems like that's a little easier of a lift.
Swati Sharma :
48:45
Yeah, Jeff, that only happens to four year olds.
Jeff Hrusko :
48:48
me. I'm just not a button.
Oh my god. I just had about a minute. To the memory. Say real quick since I thought about it, I was a teenager and I was in a grocery store and for some reason, I had a desire to touch the cash register. I wasn't stealing anything or do anything that I just I don't know. And yeah, I toasted of course the thing would be like crazy and I just ran I store. I'm sure everybody thought that I was trying to do something but no, I just wanted to Yeah, that was.
Alright, so let's try to summarize because I think we have so much here. Summarize and give some last minute tips about what people can do and some lifestyle changes they could make. So if you could summarize some of the the ways the main ways to unlearn our anxiety response, what are they
Swati Sharma :
50:00
Yes. So there are a lot of techniques and challenging our thinking, first of all by writing down identifying what are what are those very primary anxious thoughts that preoccupy your mind? Most often and challenging their illogic, unrealistic nature and complete irrationality, right. And in fact also the irony of it because some of those expect to save you and prevent you from some untoward situation or unwanted situation. But actually, they make the whole thing much worse because you're more likely to you know, do it like you said, don't touch the red button, which is more likely to screw up a situation if you're getting really, really nervous about it. But I really want to talk About acceptance, Jeff, because I think that is at such a fundamental level of all the treatment, what are you going into treatment with? What is that demandingness that you are holding, when you are sitting in therapy working on demandingness in your thoughts, are you actually even coming with the entire intention of a demanding this demanding is that I must not have anxiety. In fact, this is also This was also discussed in the session today. Where, because this client I was with today has, you know, done very well in therapy is sharply self aware. And he had this anxiety attack and he said that I could see where the actual anxiety stopped and the secondary anxiety to cope were the anxious It for oh my god is this COVID stopped stopped as it doesn't didn't cease but where it kind of happened and then where it kind of propelled into another level because oh my god, I have an anxiety attack I thought I'm fine I thought I'm going to never have an anxiety attack again.
Jeff Hrusko :
52:22
Yes I have been there and you know this too like when I first started treatment or rational behavioral therapy you know and I said yes I of course I demand Are you out of your mind I demand I don't want to feel like this. That's my two cents and you know, what's the
Swati Sharma :
52:41
most or you know, heart rate, you know, what do you call it like painful part heart wrenching part is that if you have own period of time where you've been anxiety free it is so delicious. That Your secondary emotions about getting an anxiety experience again. It's like very, very heartbreaking. It's disappointing and it's like, I cannot believe this is come back. You were so you were so free and light headed, you know, light hearted. And now it's back and this is what today's client described to me and he he was kind of he had a you know, his heart sounds Why am I feeling this feeling again?
Jeff Hrusko :
53:33
It's like you finally get rid of the in laws. Oh, you're back. Oh,
Swati Sharma :
53:40
okay. That's not going down very well with me.
Jeff Hrusko :
53:43
Okay, sorry.
Swati Sharma :
53:47
Just kidding. Just
Jeff Hrusko :
53:48
Just a little joke. But yeah, and then and then from, from my personal experience, so I've gotten gone through exactly that. And that, for me started a whole nother round. Round of anxiety, and then it only became the you know, like you were saying the secondary thing, the secondary thing became the primary thing. Fear of fear.
Swati Sharma :
54:10
Yes. Piano fear.
Jeff Hrusko :
54:13
So, we're talking about excepted
Swati Sharma :
54:16
Yes. To the acceptance of it is. Again, for the end time, I'm going to mention my client today. I think I really am so proud of him actually. And he also spoke of acceptance, right when he was describing all of this and he said, then I came to a point of acceptance. And the idea is like, you know, like, sometimes you get gassy and sometimes you don't get gassy for a really long time. If you can be that matter of fact about anxiety, having the possibility of coming back and understanding that it's temporary understanding, it's going to eventually go and it's not life threatening. It's just uncomfortable. It's, I mean, uncomfortable is really toning it down. It is not fun, like you mentioned earlier, but that's technically what it is. It will cause you discomfort, but it's not harming you, it's not life threatening. And if you can bring yourself to a point of accommodating ate like, okay, hang around as much as you want to, I don't want to get rid of you. You can sit here for the rest of my life and, and here's again the paradoxical thing that the moment you show loss of interest in whether it stays or both, is the moment from where you can probably see recovery,
Jeff Hrusko :
55:42
it will start to dissipate and getting there and maybe some people get there faster. But getting to that level of acceptance is is tough, so it was tough for me. Definitely. So I still you know, with my own journey through the good days and bad But more and more that that power of acceptance is like a feeling little off today. Okay, tomorrow will be better. And if not the day after will be. It's not easy.
Swati Sharma :
56:11
But it's
Jeff Hrusko :
56:13
it's not easy. No, but that's like the the, the acceptance of it is the hardest, but the most powerful, paradoxical way to beat it is almost like passive resistance.
Swati Sharma :
56:28
Yes, yes. So, there's some other ways that we can talk about are some really simple ideas. So one was challenging your thoughts. And this is also a methodical thing that we have in therapy, where we counter each irrational thought with its rational counterpart and question our own selves. So you have to kind of get into a dispute with your own mind every time and the trick, you know, initiate or trigger but initiate plasticity process where you are reframing how your brain things then there are other options like positive visualization where you think not like pollyannish but you think positive, closer to reality but positive because anxiety so much about negative thinking. So you kind of balance that out modeling nice utopia
Jeff Hrusko :
57:31
the one time that I should carry out a counter or something else like that or you are just a tick mark and just listen or look for every negative thought. Yes, just to see the impact of them.
Swati Sharma :
57:45
Yes, that's that's your birthday gift for next year.
Jeff Hrusko :
57:49
Ah, thanks for that.
Swati Sharma :
57:54
photo.
Jeff Hrusko :
57:55
Swati, I think we're going to wrap this up because we had a So much rich, rich stuff here. And this is for some people, maybe the beginning of the journey. And we've mentioned a couple things here that would be helpful. One that I found very helpful was feeling good by David Burns, inexpensive book and a lot of these techniques that we discussed here that walks you through. Another thing would be to find a therapist to help you through this. And just in all fairness, I will say that Swati Sharma is available. Throughout this crisis, we're doing things entirely online. So if you want to go to mindscapes therapy, and her contact information is there along with some resources. Is there any any last minute advice you would like to give our listeners
Swati Sharma :
59:00
I'd like to recommend a book if I might have your permission. Sure. I think it's quite real you know user friendly and I like to suggest this for clients. It's called How to control your anxiety before it controls you. It's by the DVD founder don't Yes.
Jeff Hrusko :
59:23
Good old lb He's my bro because we're tight.
Swati Sharma :
59:30
Yeah. Thank you so much. I always enjoyed talking to you and I think
Jeff Hrusko :
59:36
this we will we will talk about it is we can keep going and going on this. I think we covered a lot and I know this will be helpful. Some people how to unlearn anxiety. It's life changing. It really is. So please listeners. We gave you some good resources to Go nurse Hill found through this loss of support. And the good news is that although anxiety disorders are considered like a mental disorder and mental illness, they are the most curable of just about only the mental illnesses out there. If you're dedicated and with a, find a therapy that works for you, you can overcome it, or for at least manage it to the point where you're, you will live a happy and productive life. All right, thanks very much.
Swati Sharma :
1:00:38
Thank you. Bye bye bye.
