A Better Way to Worry

The transcript below may be for an earlier version of this episode. Our transcripts are provided by various partners and may contain errors or deviate slightly from the audio.

Shankar Vedantam:

This is Hidden Brain. I'm Shankar Vedantam. When you build a home or design a building, there are many alarms you might want to install. We have devices that beep and blare. When something is wrong, they notify us about problems, they alert us to threats. In the long course of evolution, nature has built similar alarms into us. Warnings go off inside our heads when we are about to do something that can be dangerous. Our internal alarm systems can also get activated by situations that are not dangerous, but are still stressful, like performing at a piano recital or public speaking, or going to a party where we don't know anyone. The paradox, of course, is that the alarms meant to help us can also sometimes destabilize us, especially when they become deafening. This week on Hidden Brain, learning to listen differently to the alarms inside your head. Life is full of adversity, challenge and uncertainty. Think back to the last time you had a child come to you in tears, or a friend who had just received a difficult medical diagnosis. Think back to the last time you were worried about something, so worried you could barely think straight. At City University of New York Hunter College psychologist and neuroscientist Tracy Dennis-Tiwary studies these voices of alarm inside our heads and how to deal with them. Tracy Dennis-Tiwary, welcome to Hidden Brain.

Tracy Dennis-Tiwary:

Thank you, Shankar. It's great to be with you.

Shankar Vedantam:

Tracy, some years ago you found yourself teaching your son how to ride a bicycle. I understand you were in upstate New York. Can you describe what the day was like and your hopes when you set out?

Tracy Dennis-Tiwary:

That's my son, Kavi, and he was about nine years old at the time. And we're raising our kids in Manhattan. And so he's a city kid and we had not gotten around to teaching him how to ride a bike. Now we were upstate. And so I just thought, "Now is the time." And I said, "Okay, Kavi, let's go out and start learning." And he seemed game for it. Our friends, Raj and Laura had lent us an old Gremlin BMX, so we had this big old clunky bike. I took him to a gravelly hill. I just started trying to teach him and he was doing great. He was riding and he was really doing it, but he started to say, "I'm afraid I'm going to fall." He really wanted to throw in the towel.

Shankar Vedantam:

He's staying upright on the bike, but he's also very nervous. And unbeknownst to you, your phone happens to be recording while you're giving him a pep talk about his ability to ride this bike. Now, it was a windy day, but I want to hear some of the exchange that you had with your son. And I think it's fair to say that you were frustrated.

Tracy Dennis-Tiwary:

All right, let's go up. Kavi, you know what, I'm going to start giving up. I'm doing my best to be supportive and you're nothing but a grouch.

Kavi:

I'm trying.

Tracy Dennis-Tiwary:

No, Kavi, you're doing great. You're just complaining every second of the way.

Kavi:

I'm really trying.

Tracy Dennis-Tiwary:

You're doing amazing. Why are you so negative about it?

Kavi:

I don't know.

I'm scared.

Tracy Dennis-Tiwary:

You are not scared. There's nothing to be scared about. You did it perfectly. You haven't fallen once. I should knock you down so you fall. Get over it, Kavi. Honestly, there's not... You're just talking yourself into being scared.

Kavi:

You're right.

Tracy Dennis-Tiwary:

And I don't know why- You're crushing it. You're so good. You're so good at it, and you're just talking yourself into this crazy like, "I'm scared." No, you're not. You're doing awesome. You haven't even fallen. You haven't even gotten a single bruise.

Kavi:

I know.

Tracy Dennis-Tiwary:

Son, come on. I have to give you a little tough love here. You got to get your head together, man.

Kavi:

I really don't want to-

Shankar Vedantam:

So at one point, Tracy, he says, "I'm scared" and you say "You are not scared." I want you to put yourself back in your shoes that day. Now, I know you may have revised how you were thinking after you heard this clip, but I want you to put yourself back in your shoes that day, in that moment, paint me a picture of how you were trying to help your child deal with his fears.

Tracy Dennis-Tiwary:

Oh yes. And that was very painful to listen to. When he was working on riding the bike, it was so puzzling when in the face of success, he kept on expressing fear and anxiety and wasn't able to track the gains he was making. And the more fear and anxiety he expressed, the more anxious I was becoming. And I think I felt like this was a sign that, "Oh gosh, is he going to have a hard time persisting through other challenges or things that make him scared?" And so I think essentially I was anxious that his anxiety learning to ride a bike was going to reflect or play into some larger vulnerability in his life. So like any parent, I felt concerned for his well being, and I think that was driving my frustration and my strong reaction to him.

Shankar Vedantam:

As we were researching this episode, we came by the work of the author Julie Lythcott-Haims. She's a former dean at Stanford University, and one of her best selling books is titled, How to Raise an Adult: Break Free of the Overparenting Trap and Prepare Your Kid for Success. Here's something she once said.

Julie Lythcott-Haims:

If the world is less safe, which it really is not, statistically, but even if it was, don't we need our kids to be stronger and more capable to face what awaits them outside of our homes? If things are less safe out there, we need to be raising warriors, not fragile weak pieces of veal who will be slaughtered by what the world brings to them.

Shankar Vedantam:

Tracy, I heard you trying to do this for your son. He was telling you that he was scared and you were telling him "Be a warrior."

Tracy Dennis-Tiwary:

That's exactly right. Her words really resonate, I think with me thinking back to how I was feeling in that moment. I think it resonates with many of us parents who see that the world is very different in many ways from the world we grew up in. And we're deeply concerned that we can help launch our children into this new world in a way that sets them up for success and happiness and wellbeing.

Shankar Vedantam:

So this is one way in which our culture recommends dealing with the alarms that go off inside our heads. We say, "Be brave, ignore the alarms full speed ahead." But there's also another way, and you've come by this yourself in your work as a college professor. I understand Tracy, starting a few years ago, you noticed a change in your students in terms of how they were handling challenging situations. Can you talk to me about that?

Tracy Dennis-Tiwary:

I've been a professor moving up on 20 years now, and really I think it was just maybe over the past 5, 6, 7 years, there seemed to be quite a shift in how students were reacting to challenges. And especially with our graduate students and especially in the field of clinical psychology, that is people who are becoming our future therapists and clinical researchers. When I was getting my degree, there was this idea that you throw yourself into these challenging situations, whether it's science or therapy, and you have to push through and you have to show that there's a level of grit and determination that you can build on and slowly become a professional. And what I noticed in this era of students is there was less belief in their ability to cope with some of these challenges that were being thrown their way. I think you see this trend really being crystallized in the idea of safe spaces.

One way that students have tried to create a more comfortable environment for themselves is to really argue that, "Well, if there's an offensive opinion, if there is upsetting content, if..." We see this on campuses all over the country, that there are speakers who might come to campus and have some, for some, really offensive opinions, or there's a very vigorous debate that a speaker or a number of speakers might be taking part in, I see students much less prepared or interested or motivated to actually go and take part in these debates, in these difficult conversations and these uncomfortable experiences and emotions and instead really ask to be shielded and protected from them.

Shankar Vedantam:

At one point, Tracy, I understand that a professor at your university was alleged to have engaged in inappropriate behavior and he eventually resigned. Can you tell me what happened and the effect it had on students?

Tracy Dennis-Tiwary:

It was a very painful experience for our community. Part of the pain of that experience was that there was awareness and there was not enough advocacy and protection of the students. As we were processing this as a community and really tried to engage in those conversations, one thing that I noticed that surprised me in some ways is that there were direct requests from some students to not give them information without first filtering it for them. For example, there was an article that was published and some students felt very let down and unsupported because we faculty did not tell them that this article was coming out or help them process it before they were able to read it themselves. This really struck me because it occurred to me that what students were asking for was a way of processing emotions so that they didn't have to actually process it out of the social support net. It seemed to me that the emotions they might experience in reading this article and being exposed to uncomfortable and painful information, that they felt that those emotions might do them harm.

Shankar Vedantam:

So the students were looking essentially for a trigger warning?

Tracy Dennis-Tiwary:

In a way it was a trigger warning. And of course, trigger warnings began as a way to really help folks who were struggling with post traumatic stress disorder, who had a trauma in their past. And when they were exposed to trauma-related information, the thought was, "Let's give them an opportunity to prepare and avoid the information if necessary."

Shankar Vedantam:

But even as her students were asking for safe spaces and trigger warnings, Tracy had one eye on the scientific research on the effects of these accommodations.

Tracy Dennis-Tiwary:

The data are still coming in, but in one study from 2021, people were brought in and they were asked to actually read about a scenario that may have been emotionally challenging or upsetting for some people. And half of that group, they gave a trigger warning about it, that "You might be reading about something that will upset you" and the other half did not receive that warning. What you found in this study was that people who received the trigger warning actually showed higher levels of anxiety, especially if they held this belief that emotions can do them harm.

Shankar Vedantam:

Doesn't that raise questions about the efficacy of trigger warnings?

Tracy Dennis-Tiwary:

It certainly raises questions and there's a very strong possibility that by giving trigger warnings, the message we're actually sending to people is that there's something upsetting coming up. We don't think you can necessarily handle it. And if you feel difficult emotions, they might do you harm. The very fact of trigger warnings is creating this narrative, this story around difficult emotions that most emotion science and clinical science will actually say is counterproductive.

Shankar Vedantam:

American culture, and increasingly cultures around the world are torn between two competing narratives. One says, if you're frightened about something, the way to get your fears under control is to eliminate the thing that's frightening you. The other narrative says dismiss your anxiety. If you feel anxious, tell yourself "I'm not anxious." Get over it.

When we come back, Tracy explores the science of how we should deal with the alarms inside our head. You're listening to Hidden Brain. I'm Shankar Vedantam.

This is Hidden Brain. I'm Shankar Vedantam. Tracy Dennis-Tiwary is a psychologist and neuroscientist at CUNY Hunter College. Like many other observers, Tracy has noticed two schools of thought when it comes to dealing with our fears. One says, "Let's keep people safe. The anxieties people have point to the threats they're confronting. If we want to reduce the anxieties, we should reduce the threats." The other school of thought says, "The problem is not with the world. The problem is with you. Your alarms are too sensitive, you should ignore the alarms." Now, there's no question that many people suffer from anxiety-related mental disorders, but Tracy's focus was less on clinical conditions and more on the way we think about anxiety as a culture.

So you started to do a lot of thinking and research about these two models, and you came to an important insight about whether anxiety was a character of law as one school of thought would have you believe, or it was an unbearable trauma as another school of thought would have you believe. What was your insight, Tracy, about the nature of anxiety?

Tracy Dennis-Tiwary:

Emotions are fundamentally functional. They have adaptive functions and we actually, this is not a new idea... It so happens that a third of Darwin's theory of evolution is actually devoted to emotions. The third book in his trilogy is called The Expression of Emotion in Man and Animals. Think about the double-edged sword of both positive and negative emotions.

Shankar Vedantam:

When you apply this functional model to the study of anxiety, how did it change the meaning of anxiety for you?

Tracy Dennis-Tiwary:

It changed it radically because I'd fallen into this language trap that I think many of us have, which is that when I say, "Oh, I have anxiety," or "This person has anxiety," I'm actually communicating that someone has an anxiety disorder. I'm completely conflating the emotion of anxiety with a disorder. And this was really the moment of my big insight because the emotion of anxiety is not a disorder. Anxiety is an emotion, and it can vary along a spectrum from butterflies in our stomach to strong feelings of panic.

An anxiety disorder is only diagnosed when our ways of coping with anxiety over time are causing functional impairment so that the actions we're taking to handle that anxiety are causing more harm, causing us to have problems at work, have problems in our relationships, and are affecting our health choices. Maybe you're self-medicating with drugs, you're doing a series of things to cope with anxiety that's really causing more harm and is getting in the way. That's when we're diagnosed with an anxiety disorder. When we say we have a crisis of anxiety in our society right now, what we really mean is that we have a crisis in the ways that we're coping with anxiety.

Shankar Vedantam:

Tracy came by some research that asked "What happens if you stop thinking about anxiety exclusively as a disorder and start thinking of it as an emotion to be worked with?"

Tracy Dennis-Tiwary:

And this is the work of Eli Lebowitz and his colleagues at the Yale Child Study Center. It's this idea that when we have a child in our family who's anxious, there is a strong tendency, I think upwards of 97% of the time, we will try to accommodate that anxiety. And that means we want to reassure that child, we want to help them avoid the anxiety-provoking situations because of course, we parents, except apparently when we're teaching a kid to ride a bike, if you're me. We parents, we just want our kids to feel better. We want to comfort them, we want to reassure them. But this accommodation when it comes to anxiety, has a price tag.

Shankar Vedantam:

Instead of making kids less anxious, the accommodations seem to make the children more anxious. So the researchers tried something new.

Tracy Dennis-Tiwary:

And so Eli Lebowitz and colleagues created a new intervention called SPACE, Supportive Parenting for Anxious Children. And they did something really elegant, they had a group of kids with anxiety disorders diagnosed, and to half of that group, they gave them gold standard cognitive behavioral therapy, which is one of the best therapeutic approaches for anxiety disorders. To the other half of the group, they gave the kids no therapy and instead they taught parents to stop over accommodating their children's anxiety and to start helping their children work through anxiety. What does that mean? Accommodation for a child who's socially anxious and doesn't want to go to school anymore or doesn't want to sleep alone at night, You say "Ah, the school makes them so upset, let's let them stay home today" and "Oh, they're scared of the dark, let's let them sleep in the parent's bed tonight." And this accommodation is repeated over time. And so what parents in this space intervention were taught to do was to stop the accommodation and instead slowly and steadily help their kids to engage with these anxiety-provoking situations and slowly work through them, so that slowly the child is helped to get back to school, slowly the child is helped and supported to sleep in their own bed alone at night.

And at the end of this study, when you compared the children's anxiety severity, if you compared the group that the children received CBT directly versus the group of kids who received no therapy, but their parents received the SPACE intervention, those kids showed exactly the same level of gain in terms of reduced anxiety symptoms. The parents felt less stress and the parents did indeed show less over accommodation of childhood anxiety.

Shankar Vedantam:

Our stock responses when we hear a blaring alarm is to do one of two things, turn it off or run in the opposite direction. Tracy said, "Instead of trying to suppress it or flee from it, what happens if you engage with your alarms with curiosity?"

What happens if you tell your anxiety, "I see you are trying to tell me something important. I really want to hear you out. Help me understand you." In other words, Tracy asked, "What happens if you treat anxiety like a friend?"

Tracy Dennis-Tiwary:

That's right. Anxiety is apprehension about the uncertain future. Now it feels like fear and we often equate the two, but while fear is about really certain knowledge, that there's a present threat you're facing, anxiety and contrast has nothing to do with the present. What it does is it makes us into mental time travelers into the future where something bad could happen, but something good could also happen. It's still possible. I might have anxiety, maybe I'm out camping and I know that there are bears that have been sighted in this part of the wilderness. And so anxiety would actually give me the information that there could be danger, but also safety. And then it primes me with that information. It primes me to prepare and to do something about that potential danger and to optimize the chances that I can be safe from that bear and that I don't wander into a cave where there's a bear with her cubs.

Shankar Vedantam:

I'm reminded of that adage from former Intel CEO, Andy Grove. He says, "In business only the paranoid survive." And to some extent it's the same idea, isn't it? Which is that anxieties keep you focused on both threats but also want possibilities. And turning off your anxiety is in some ways like dismantling your smoke alarms because they feel upsetting to you.

Tracy Dennis-Tiwary:

That's right. Anxiety actually has to feel bad to do its job because it has to make us sit up and pay attention. And the smoke alarm analogy you bring up. If we hear a smoke alarm go off in our house, it really wouldn't be wise to put earplugs in or to just ignore the signal and move to another part of the house. What we do when we hear a smoke alarm is we make sure there's not fire. We might even check the batteries to make sure that's not off, but we don't ignore it. And anxiety is an emotion that wants to be heeded, that wants to be honored. It's telling us that there's this future uncertainty that we're facing and "I'm here to help you navigate it. I'm going to prepare you with information about what's coming and to do everything you possibly can to make sure that those outcomes you hope for become your reality."

Shankar Vedantam:

Tracy was reminded how anxiety could be her friend when she was pregnant with her first child, her son Kavi.

Tracy Dennis-Tiwary:

I went in for the mid-pregnancy ultrasound and we found out that my son was going to be born with a congenital heart condition called Tetralogy of Fallot. And this condition requires open heart surgery to repair it. And with this disease, you can have genetic abnormalities that go along with it. You have very disparate kinds of outcomes. Children do survive this, but sometimes it can be very risky. And of course, anytime you're doing open heart surgery on an infant, it's very frightening.

We found this out and I just crawled into bed. I felt such anguish, anxiety, and a little despair was starting to creep in honestly. And then being a scientist, after I had a good cry, I got onto PubMed and I learned within the space of a few hours as much as I could about this disease. I then followed that with more information gathering. My husband and I called up every doctor we knew, a couple of them happened to be cardiac specialists, and they helped us figure out that, "You need to get to this surgeon and this practice." What I started to realize as I was information gathering and I was already preparing, we were really receiving a blessing that we found out about this disease before my son was born so that we could have things set up as well as possible to get him the best care we could.

Shankar Vedantam:

And in some ways, you now credit your anxiety with helping get you and Kavi and the family through the surgery and its aftermath?

Tracy Dennis-Tiwary:

Oh, a hundred percent. We needed to make sure at every stage that we had the proper care setup that we were monitoring. Once he was born, he was going to go into heart failure that was guaranteed. And he did like clockwork, actually about a month in. He then had failure to thrive. He wasn't strong enough to be able to breastfeed or take a bottle, and so we had to give him food through a tube that was put down his nose. It was a very challenging time, but it was my anxiety that kept me really focused on this future where I knew that if we did everything we could, that we had a very strong possibility that he would be just fine.

Shankar Vedantam:

So this is the same kid who a few years later you were telling you need to be a warrior and stop being afraid?

Tracy Dennis-Tiwary:

Well, our cardiologist did tell us that after the surgery that we should never treat him like a sick child. So there you go. I took it to heart.

Shankar Vedantam:

I understand that researchers have found empirical evidence of the same phenomenon among adult patients with heart failure. What is the role of anxiety here, Tracy?

Tracy Dennis-Tiwary:

It was Madan and colleagues who, as doctors, as medical professionals, they were very interested in how to really promote positive health outcomes for people who were in line to receive a heart transplant. And so common sense suggests that if a patient has higher anxiety or depression, their health outcomes might be worse and they might not respond as well to the heart transplant. But they found something very interesting. Patients who had higher levels of anxiety and depressed mood actually had better health outcomes and were more likely to receive a transplant than patients who had lower levels of those emotions. What they really interpreted this as reflecting was that particularly those patients with higher levels of anxiety, they adhered to treatment recommendations more. They saw their doctor more regularly as they were waiting for the heart transplant. They were a little more anxious and persistent in taking care of themselves and following all the recommendations of their doctors.

Shankar Vedantam:

And in some ways it makes perfect sense, doesn't it? I'm anxious about something my doctor says, "You need to do A, B, C, and D to make sure this bad outcome doesn't happen." And it's because I'm anxious that I listen super carefully when my doctor tells me to do those things and I actually follow up and do them. If I didn't have the anxiety, presumably I might not have the motivation, the executive control to actually do those things that my doctor is recommending.

Tracy Dennis-Tiwary:

That's right. But when we talk about anxiety, the first thing we think is, "Oh, we better soothe it. We better immediately make it go away." But when we listen to anxiety as information, we can use it to say, "Focus more, persist more, know that this is important." Instead of avoiding what makes us uncomfortable, you can see immediately how anxiety is going to be a helpmate in these kinds of arenas.

Shankar Vedantam:

There's something of a paradox here, Tracy, the feeling that drives many of us to want to flee from anxiety, which is the excruciating discomfort we feel when we're anxious. I think what I'm hearing you say is that it's this discomfort that is also the feature of anxiety that prompts us to reap its benefits.

Tracy Dennis-Tiwary:

That's right. And that's why anxiety has to be uncomfortable. Not only do we have to sit up and pay attention to it, but there's what's called a negative reinforcement cycle in anxiety too. When we tune into anxiety, it's priming us to prepare, to focus. Once we're on the right track, once we're in the conversation or maybe we've done a little preparation ahead of time, anxiety naturally diminishes. That is a very reinforcing experience. The discomfort of anxiety, it rises, and then when we're doing the right things to take actions based on the information anxiety is giving us, then anxiety naturally diminishes. And that tells us that when we take action in response to our anxiety, we feel better and we're going to keep doing and taking those actions.

Shankar Vedantam:

It's almost like a compass, isn't it? It's actually giving you a sense of direction to say you are off course or you are on course.

Tracy Dennis-Tiwary:

I love that because we're only anxious when we care. We're not anxious about things that don't matter to us. Anxiety is a wonderful compass for pointing us to things that matter to us, that have implications for our lives and the lives of our loved ones. It tells us that it's also something in the future that we believe we can still work towards. Anxiety from that perspective is not only important information, it's essential and crucial information.

Shankar Vedantam:

All of us have voices of alarm inside our heads, but not all of us have learned how to properly listen to those voices. That's when we come back. You're listening to Hidden Brain. I'm Shankar Vedantam.

This is Hidden Brain. I'm Shankar Vedantam. When a smoke alarm goes off in your kitchen, the intensity of the alarm can be upsetting. In fact, the intensity of the alarm is designed to be upsetting. It's trying to make you stop whatever else you're doing and investigate if there is fire behind the smoke. At City University of New York Hunter College, Tracy Dennis-Tiwary has found that if we are to reap the benefits of our anxieties, we need to find ways to manage the intense discomfort they generate.

Tracy, you've written that anxiety wants to be our friend. It wants to be recognized and acknowledged and listened to and cherished and heeded. It feels terrible because it's trying to tell us something important that we'd rather not hear as a good friend often does. We talked earlier about how one school of thought in our culture says you should ignore anxieties and another says you should eliminate threats from your life that make you anxious. In important ways, the emerging scientific picture that you're painting would suggest that both schools of thought are wrong in important ways. Can you elaborate on that, Tracy?

Tracy Dennis-Tiwary:

As usual, any black and white propositions are not quite right. I think that's especially the case when it comes to anxiety because this whole you have to be a warrior, pull yourself up by your own bootstraps approach, ignores the fact that before we can do that, we have to listen to anxiety. We have to tune in and leverage it. And so really the metaphor here is that anxiety and other difficult emotions are like waves. And when you have a wave, it's pushing us forward. But you can drown in a wave. So you have to learn to swim. You have to build skills and the ability to work with these emotions, with these feelings. And so when we talk about anxiety as dangerous or when we put it, the emotion of anxiety, in the category of disease, we now are primed to avoid and eradicate those feelings. But we know that anxiety and negative and difficult emotions only are amplified when we avoid it or we steamroll over them.

Shankar Vedantam:

I love what you said a second ago, which is that we need to learn to listen to anxiety as a source of information. But of course there are ways of doing that and there's a way of thinking about this kind of response as a skill that is to be learned. And I want to try and look at some of the different elements of the skill. You recently had the opportunity to listen to your own anxiety after having an argument with your daughter and then waking up in the middle of the night replaying the argument in your mind. Tell me what happened in the middle of the night to you, Tracy.

Tracy Dennis-Tiwary:

This was one of those early morning worry, wake up calls that I think all of us have experienced. It's usually around 4:00 AM for me. And I woke up with just a yucky feeling. When you apply this idea that anxiety is actually information, it primes you to do what I actually tried to do in the moment. I took a breath, I had these free floating thoughts and worries, and I just waited for a moment. I waited for something to rise to the surface. And what I found when I took that breath and gave anxiety moment is that this disagreement, this fight really that I had with my daughter the night before was on my mind. She'd been upset about something and did something I really wasn't happy about and I'd yelled at her. It was bothering me.

When you listen to anxiety, the great thing about this information is that it can prime you to take action. And so I decided right there as I'm half awake that I was going to say two or three things that I felt would really address the mistakes I'd made the night before. And once I made this plan, even though I was half asleep, I noticed that my anxiety immediately started going down. I started to relax. It was a signal to me that I was on the right track, that this is the action that I need to take. And yeah, this was the worry that woke me up.

Shankar Vedantam:

And in some ways, your experience is demonstrating, I think, the importance of making a plan when we're dealing with anxiety, not just simply thinking about it, worrying about it, but actually coming up with concrete positive things that we can do.

Tracy Dennis-Tiwary:

That's right. And that's really how we leverage anxiety. Because if anxiety is information and preparation, we need to then put that preparation into action. Once you've either taken an action or maybe figured out there's not that much action you can take, we can in those moments do something that can allow us to be back in the present moment, whether that's taking some deep breaths, try to relax a little bit, or taking a walk, speaking with a therapist, exercising. These are all things that, in this cycle of anxiety, in this learning how to ride the wave of anxiety, these are skills that we can build even when we're struggling with very strong or debilitating anxiety.

Shankar Vedantam:

Another thing that can help us listen to anxiety without allowing it to destabilize us, in other words, as in your metaphor, to ride the wave or swim the wave as opposed to being drowned by the wave, is social support. Can you talk about this idea that we can help others listen to their alarms and others can help us listen to our alarms if we are giving and receiving social support?

Tracy Dennis-Tiwary:

It may surprise people to find that anxiety and our social instincts are actually very closely bound. One way that anxiety is linked up with social connection is that when we're anxious, it actually increases levels of oxytocin in our bodies. And oxytocin is the social bonding hormone, which primes us to seek out social connection. And so our brains actually evolve to outsource emotional challenge to draw on the tribe, on our social networks to actually cope with anxiety and stress and all these things. And we do better when we're in social groups. So in some ways, anxiety with this beautiful fractal symmetry almost contains some of its own solutions within itself.

Shankar Vedantam:

There was a study out of the University of Wisconsin some years ago, I believe, where volunteers were told they were about to receive electrical shocks as they were put into a loud claustrophobic MRI machine. But some of the volunteers were allowed to hold the hands of their loved ones and others were not. Tell me about that study and what it found, Tracy.

Tracy Dennis-Tiwary:

They have three conditions where people were assigned to either be alone during this difficult and anxiety-provoking task, to hold the hand of a stranger or to hold the hand of a loved one. And then what they did, because they were already in the MRI machine, is they imaged the activity of the anxiety-related circuits in the brain. These areas of the brain that are activated when we're trying to cope with this challenge and monitor threats.

Folks who were alone, that circuit in the brain was working very hard. It was lighting up when you looked at the fMRI read up. And then you had the people who were holding the hand of a stranger. And what you saw is that this circuit in the brain seemed to be somewhat soothed. It was actually less active, a little more efficient. And then of course, what you saw in the group that was allowed to hold the hand of a loved one is that the anxious brain, so to speak, the circuit that should have been highly activated, was much calmer, was well regulated, and was really operating very efficiently. And I think they also found in this study that the closer your relationship or the more satisfying your relationship, the stronger this effect was, of holding the hand of a loved one.

Shankar Vedantam:

I understand that in your own life, your family experienced a crisis that called upon you to exercise what you had learned about the science of anxiety. Your husband's career faced a sudden challenge some time ago. Tell me about that, what happened to him and how you responded, Tracy?

Tracy Dennis-Tiwary:

My husband is a Broadway producer as well as across other platforms. And he had spent the past decade launching, with his whole team, bringing to Broadway, Alanis Morissette's Jagged Little Pill. And this was really this huge achievement. It was a highly anticipated and wonderfully received musical. And about four months later, the pandemic happened. And so this decade of work, this passion project was now closed down. And of course, it was very much out of our control as we all experienced during the pandemic these kinds of changes. As he was struggling, I found that I myself was struggling really a lot with handling my own anxiety about what the future held for his career, for our family, but also struggling with how to help him work through this very real uncertainty and anxiety.

And one thing that I did is I tried to just be a listening ear to what he was going through and to suspend judgment really. As a psychologist, maybe just is my personality, I'm a problem solver. I like to go in, I like to fix it. That's also a great anxiety management tool. But here I am and I know that there's not really anything we can do right now. There's some things that are uncontrollable. And right now what he needed to do was process what he was going through before he could take any action. And so really my task was to suspend judgment, suspend this impulse to solve problems. And when we got through those early stages of worry and loss and all of those feelings, he ended up actually going in a different professional direction that has been immensely beneficial and satisfying to him.

Shankar Vedantam:

But it's also the case, I think your response to him was different than your response to your son. And I'm trying to understand how and why that happened. And I think what I'm hearing in some ways is that when your son was expressing these concerns, in some ways you were catastrophizing about how his concerns about riding a bike might affect him later as an adult. You were spiraling. And instead of simply listening to your anxiety and saying, "Let me take in this information and see what to do with it," you were trying to get rid of the anxiety as quickly as possible by telling him that he shouldn't be afraid. And with your husband, it sounds like you were better able to say, "Yes, it's uncomfortable. Yes, this is anxiety-provoking. Yes, I'm a problem solver and this is a problem I cannot solve," but you are patient enough to sit with the discomfort. Surprisingly, this was actually what your husband needed.

Tracy Dennis-Tiwary:

I think it's just what you say, my anxiety for my son was so great, but it was prefaced on this idea that he was fragile in some way that I couldn't control. I think I had a level of belief and faith that my husband had what it took to go through this, that I think allowed me to do better as a partner to my husband in that moment than I did for my son.

Shankar Vedantam:

So Tracy, I can imagine that there are people who have anxiety disorders, clinically-diagnosed anxiety disorders, who would say, "Hang on a second, what I have is a medical, biological, psychiatric problem. And that's not going to get fixed. By merely following Tracy's advice, to listen to anxiety as information." What would you say to these people?

Tracy Dennis-Tiwary:

I really honor that perspective because what we do know about anxiety is that there are many, many causes of anxiety disorders. There are many biological and medical causes that can make our struggles with anxiety much, much worse. And these vary from nutrition, lifestyle choices, and even the overprescription of medications, including benzodiazepines, which over time we know can actually increase baseline levels of anxiety, unfortunately.

I acknowledge that there are many, many determinants and factors of anxiety disorders. At the same time, by being curious and open to anxiety, understanding that it's information to listen to and to leverage, and then to gain skills and letting go, that stance can actually help us tune into when there might be these biological and lifestyle factors that are leading to debilitating anxiety. It can help us benefit more from therapies when we do receive them. And I think it can help us also have more hope and believe that anxiety and feeling anxiety, it doesn't indicate that we're broken or that we have a malfunction or failure, but rather that it's really part of this messy work of being human. And we can gain skills and we can find solutions. So I think this stance, if taken in the spirit that I hope it's received, it can really be empowering to people even who are suffering from debilitating anxiety.

Shankar Vedantam:

I understand that you have a story of how you once initially pursued this tough love warrior model that you pursued with your son. You also pursued it with your daughter Nandini, before recalibrating. Can you tell me how you initially responded to her fear of insects and how that changed over time, Tracy?

Tracy Dennis-Tiwary:

This was after the bike riding incident, you think I would've learned but... This was, I think, within that first year of the pandemic. She was about seven or eight at the time. And my daughter, Nandini was a girl who loved being out in nature. She had taken part in these eco science camps where she just had bugs crawling over her all the time. And now here we are in the pandemic and all of a sudden she's expressing a lot of concerns and anxieties about insects. In particular, flies and ladybugs were her bugaboos. I knew that around ages eight and nine, a lot of kids actually start to develop new fears. And so I even had this framework, "Okay, this is expected."

But one day we were in the bathroom and I think she was brushing her teeth and there was a fly, a big fly, that got stuck in the bathroom and she screamed at the top of her lungs. And so I, in my mind, decided, "Okay, now's the time to expose her to this fear of bugs and we'll work through it and I'm going to be a great parent." So I closed the door and locked it. She's banging on the door and I'm trying to talk to her, saying, "No, we need to... Let's catch the fly and put it outside." And she wasn't in a low or moderate state of anxiety, she was really panicking. And she'll tell me this now to this day, that she actually thinks that was the moment that she became really scared of bugs because mama locked her in the bathroom with the fly.

No, luckily it's not the end of the story. And I acknowledged that this was not the most productive way to work through her anxiety. And so what I started doing, and really again in collaboration with her was talk about her anxieties, her, what was it about insects? I think I should have gotten a little more Freudian and thought, "Huh? We're in the middle of a pandemic where there's this virus which we think of as a bug, and it's put the entire world off kilter and she's developed a fear of bugs." But anyway, I really... As I of course corrected, I tried to talk with her more and make a plan to say, "Listen, we're going to be around bugs. They're inescapable. How can we get you gradually to be more comfortable with bugs?" And so we'd spend a little time in that area where we saw some bugs. We talked about strategies she could use to calm herself when she felt anxious about those bugs. And we took this gradual exposure approach.

And then just this past summer her heart was set on attending a camp with some of her friends up in Maine. Now this would be in the middle of the woods on a lake in Maine, which equals bugs, many, many bugs. But now she had this real passion and motivation to try to figure this out. And so we talked about, "Okay, there are going to be bugs there. What kinds of bugs do you think you'll see? How do you think you might feel? If you feel anxious, how do you want to work with that anxiety? How can you cope with it?" And we made this plan.

But then she went and she wasn't... She was feeling nervous. Once she got there, she wanted to be part of the fun. And she soon realized that if she was too afraid to get into the lake because of the bugs that might be there, she would be missing out on getting badges and swimming and being with her friends. And so she literally just started working on it very actively. And pretty soon she was the one who was first in the lake. And when we picked her up a few weeks later, she said, "Oh, why would I ever want to swim in a pool? Pools are boring lakes. I'm a lake swimming girl."

Shankar Vedantam:

Tracy Dennis-Tiwary is a psychologist and neuroscientist at CUNY Hunter College. She's the author of Future Tense: Why Anxiety Is Good for You (Even Though It Feels Bad). Tracy, thank you for joining me today on Hidden Brain.

Tracy Dennis-Tiwary:

Thank you so much, Shankar.

Shankar Vedantam:

Hidden Brain is produced by Hidden Brain Media. Our audio production team includes Brigid McCarthy, Annie Murphy Paul, Kristin Wong, Laura Kwerel, Ryan Katz, Autumn Barnes, and Andrew Chadwick. Tara Boyle is our executive producer. I'm Hidden Brains executive editor.

For today's unsung hero, we turn the mic over to you, our listeners. This segment is brought to you by OnStar. OnStar Advisors are now with you everywhere, on the app in your car and at home. Today's story comes from Alexandra Middlewood, she's a professor of political science at Wichita State University. During the fall 2021 semester, Alexandra began hybrid teaching with some of her students in masks in front of her, others on Zoom.

Alexandra Middlewood:

Wearing a mask for a 75 minute lecture while wearing a microphone, while trying to make sure that my students who are on Zoom are engaged, my students who are in the classroom are engaged while also trying to navigate PowerPoint and my own lecture notes and writing key concepts on the board. I don't know how I'm going to do this all semester. I don't know how I'm going to try to navigate teaching to two classrooms essentially.

Shankar Vedantam:

One Monday morning, three weeks into the semester, Alexandra was feeling especially overwhelmed.

Alexandra Middlewood:

I was lecturing on the material. I had just finished writing something on the whiteboard, and I turned around and I looked up and I have this room full of students. Most of them are maybe not as engaged as I would like. And I notice there's this one student who is nodding along with what I'm saying and looking directly at me. And not just nodding in a way to signal that he's paying attention, but nodding emphatically in a way, at least that it seemed to me that what I was trying to teach was resonating with him and his life experiences and that he was understanding these concepts. And then I felt really reinvigorated and it was the most excited I had been to be there in a classroom for a really long time.

And I remember thinking to myself "This. And I've really missed this. This right here is why I love my job." And I hope that students will now be able to do that for their professors and even those of us who we sit in meetings for work all the time, we can now think about what little gestures like nodding may mean to someone who's presenting material to us or who's leading a meeting or whatever that situation may be.

Shankar Vedantam:

Political science Professor Alexandra Middlewood, she lives in Wichita, Kansas.

This segment was brought to you by OnStar. OnStar believes everyone has the right to feel safe everywhere. That's why their emergency advisors are now available to help not only in the car, but wherever you are, on your phone, in your car, and at home. OnStar, be safe out there.

If you like this episode and would like us to produce more shows like this, please consider supporting our work. Go to support.hiddenbrain.org again. If you find our work to be useful in your life, do your part to help us thrive, go to support.hiddenbrain.org. I'm Shankar Vedantam, see you soon.