Dr. Tracy Dennis-Tiwary

Welcome to the Puck Venture Capital and Beyond, a show that examines the changing landscape of our world. We'll have candid conversations with VCs, entrepreneurs, and thought leaders grappling with our current challenges and providing solutions to key problems we face as a nation. I'm Jim Beer, president of CMBG Advisors. This podcast brings change makers to the table to discover the inner workings behind their decision making strategies and ultimately to how they got to where they are today. Sometimes it's too overwhelming, and that's when we have to find balance.

And, you know, in a way, we have to be alchemists. Right? We have to work with all these aspects of ourselves, and we have to figure out a way to turn lead into gold. And for me, with anxiety, what that is is we have to know and to let go of that future tense. Anxiety makes us into these mental time travelers into the future.

Sometimes we have to let go of the future tense and use tools that we have at our disposal to bring ourselves back to the present. I am excited today to have Tracy Dennis Tawari to join us on the Puck, and she is the author of Future Tense, Why Anxiety is Good for You Even Though It Feels Bad. So, Tracy, I wanna welcome you to the POC. And before we get started, do you wanna tell us a little bit about your background and how you came to write Future Tense? Yes.

Great to be with you, Jim. I am a clinical psychologist by training, but I went right into research. So I run a research lab at the City University of New York. I am also a neuroscientist researcher, so I do a lot of research on anxiety in the brain and other topics. I'm also the cofounder of a digital therapeutics company called Wise Therapeutics, where we leverage science to create gamified mobile interventions for health.

And I'm a writer of this new book, my first book out there called Future Tense, Why Anxiety is Good for You, even though it feels bad. So what brought you to write a book on anxiety? Well, as a researcher in anxiety, it's something that I've devoted my life to trying to understand. And I actually have been a researcher for it's funny. I I have to talk in decades now.

That's how old I am. So I've I've been doing research for a couple decades now. And I actually defended my dissertation when I became an official psychologist on 09/11/2001. 2001, meaning Wow. I was defending my dissertation as the towers were falling, I'm afraid.

So this was a moment in our our collective history that really shined a light on the need to focus on mental health as a crisis. And and so when I started doing research, I really had a sense of mission, right, I was going to really contribute to solving this problem. And you know fast forward twenty years, I put my head down, did all the research, we have great science, we have great solutions, but I wrote this book starting really just a few years ago because when I looked up from my research I realized that the mental health crisis was worse than ever before. Even though we'd made great advances in science, in understanding the neurobiology of anxiety and other mental health problems, we even have great wellness, science based wellness practices out there and mindfulness and all these things, Yet, we were suffering more than ever before, especially our kids, especially the younger generation. So that's the mystery.

I wrote the book as an attempt to grapple with that conundrum and to try to put out some possible explanations for why we're in the place we're in. Right. Well, so let's go with that for a second. Why do you think we're in the place we're in? I think that right now, we have great understanding that mental health is health.

Right? So we've made advances in in prioritizing mental health as important. But we're stuck in this dichotomous binary way of thinking about mental health. There's sort of two poles of the argument. Either it's chemical imbalance and mental health makes us so fragile that we have to take great care of ourselves at all time and really feel vulnerable and that we have these diseases that weaken us.

That's sort of one pole of the argument. Or mental health disorders don't exist, just pull yourself up by your own bootstraps. And of course, like any extremes, neither of those are really true. And I think they're setting us up this misunderstanding of what mental health is. And in my case, I think anxiety is with this book.

It's the prime example of this misunderstanding, That this misunderstanding, this binary view is setting us up to do all the wrong things when it comes to managing and living with our anxiety and managing and living with mental health challenges. So that's, you know, I think the biggest barrier we have right now to making good choices around mental health is that we have the wrong mindset. We're telling the wrong stories about mental health and anxiety, again, as a prime example of that. So fitting into that narrative, is it relevant to focus on the difference between what we see as fear versus anxiety? I think it's really relevant.

I think it's also relevant to make the distinction between anxiety and an anxiety disorder. So I called this book Future Tense because that's actually one way to explain how anxiety is different from fear. Because fear, we know what that is. It's, you know, we are facing a clear and present danger. It's certain.

It's in the present tense. It's right there in front of us, it's someone holding a knife to our throat. That is fear and it primes us to respond in kind of adaptive ways. So we fight, we take flight, or we freeze, the three f's. But anxiety, although it feels a lot like fear with you know, the racing heart and butterflies in your stomach and all those feelings that come, it has nothing to do with the present tense.

And it only really is involved and interested in the future. So anxiety is apprehension or nervousness and worry about the uncertain future, things that haven't happened yet. So, you know, we're waiting for those medical tests to come back. We're anticipating that big job interview or that podcast I'm going to do tomorrow or whatever, you know, whatever it is. So we know that this future in front of us contains possible threats or possible negative outcomes.

But when we're anxious, what we don't think about when we think about anxiety anxiety actually also primes us to know that there's something good that could happen instead. So anxiety, yes, it's about threat and potential danger, but it's also about hope and possibility that we still have the possibility in the future to make that good outcome into reality. So anxiety is the emotion we've evolved to have that primes us to work to make that good outcome happen. So if I understand what you're saying, you're making a distinction between a lion in the road, which generates real fear because we really should, from flight or fight perspective, do something. Whereas anxiety is something that can be our friend because it's alerting to us that there's something that's gonna happen in the future, and we have an opportunity to take action to appropriately plan for what that future is gonna be.

And instead of seeing it as kind of a bad thing, in a sense, do we make it our friend essentially? Yes. And that's right. And I I love that example of the line in the road because when the line's in the road, you just need to deal with it right there. You need to save your life.

Right? But what if the lion's in the cave, but maybe it's in the cave, but maybe it's not in the cave. Right? So, when the lion's in the road, that's fear. When there's something we hear in the cave and it could be a lion, that's anxiety.

It allows us to anticipate what's there, plan for it, prepare, and it relies on this triumph of human evolution, which is our prefrontal cortex, our simulation machines, that thing, that part of our brain that allows us to imagine in exquisite detail things that have never happened before but might happen and to make plans to deal with them. So that's also, as you say, it can be our ally and friend because it's helping us prepare for this future and do the best that we can to optimize those outcomes for ourselves. Historically, I think, you know, at least with respect to religions, one antidote to anxiety has been faith, for instance, that tomorrow will take care of itself. And, you know, we've hear that people that are depressed tend to think about the past and people that are afraid about the future tend to be anxious. How do we kind of get to a healthy balance?

That's a great question and I love that question too because it is about balance. So that instead of saying, oh, I'm feeling anxiety or sadness or depressed mood, I should just eradicate it. That's that sort of disease model that is just, oh, if it's like a disease, what do we do? We eradicate cancer. Right?

We kill the infection. But that's not what we do with anxiety and depression and anger and all these difficult emotions. We find balance. Right. You know, it's interesting you brought in faith sometimes in all sorts of faiths you you sort of give up control and you and you trust in God or something.

Also present in those faiths are like in Islam. I don't know if I actually know if this is real. I'm not sure where in Islam this is. It might be cultural, but trust in God but tie up your camel. Right.

So I think as you as we think about finding balance, it's this shift in mindset about, well, what is a difficult emotion? Maybe instead of being a dysfunction, it's this thing we've evolved to have to prepare us for the world. And what anxiety prepares us for best of all is uncertainty. As I talked about before, it's not that there's just a threat in the future. It's that there's threat and reward in the future, but it's uncertain.

And uncertainty is the great human challenge, is the great, you know, sort of bugaboo of all living creatures. And with humanity being, you know, right there on the top of the heap in terms of how do we navigate moment to moment the fact that anything could happen and we really fundamentally can't control it. And anxiety is our helpmate, is our ally in figuring that out. And the only way to do it is to not reject it, but to engage and find balance and realize that in working through those feelings rather than making them go away, that's the way we get the information anxiety is telling us. Soothe it when we need to, work with it, but then try to use it like a wave of energy that can take us forward and channel it and figure out what's the information, what's the plan, and what can I do that's useful with this feeling?

And as people are struggling in our society more and more with anxiety, do you feel that we're medicating people too much? It's a very timely question you ask. I don't know if you're on Twitter and seeing all the Twitter battles or anywhere on social media about this new meta analysis that was just released. It essentially framed itself as debunking the chemical imbalance model of depression. It was a meta analysis, meaning it took all sorts of studies out there and it looked across them and asked the question, do any of these studies overall taken together support the idea that people who are more depressed have a disruption in the neurotransmitter serotonin in their brain?

And so the answer was there's really no direct relationship, so it's not that all depressed people have the same disruption And so it was sort of put out into the popular media as debunking the chemical imbalance theory of the brain. And it was taken and kind of run within all sorts of media outlets. I mean, everything from, you know, Fox News to CNN to, you know, the Twitterverse. And the fact of the matter is no academic or or medical professional for decades and decades and decades, no one has even believed the chemical imbalance model of mental illness or mental health problems because we know that any mental health struggle which we are people are having is multiply determined. It's never as simple as a neurotransmitter.

But the chemical imbalance idea gave people something to say to say, you know, I'm struggling with anxiety. I'm struggling with depression. Don't just tell me to pull myself up by my own bootstraps because there's more going on here. I need support. I need help.

And so by now saying, Well, it's not just a chemical imbalance. Some people are coming in saying, Oh, you know, these people, they should what are they saying? They don't really have a disease. And it's it's just not true. People really are struggling with valid mental health disorders and problems.

But when it comes to medication, what we can conclude is that it's never just a solution to give someone a medication. It's sort of like if you want someone to eat, you don't just give them a fish for a day, you teach them how to fish. So medication has always been, and if you just look on any indicator on the medication from these pharmaceutical companies, if you actually look at what the indications are, they're meant to be used in a short term way and in combination with other therapeutic approaches like cognitive behavioral therapy, psychotherapy, that can be synergistically helpful to a person who's struggling and feeling debilitated. So I I'm not one of those people that says no one should ever take any medication ever, but I am one of those people who says that we seriously over medicate in this country especially. Medication should not be the only solution, and we should really think about how we can best use these medications in a short term way that gets us to a point to benefit from other treatments and solutions that we want to use in our lives.

When you look at people, it's easy to look for a quick fix to things. Popping a pill sometimes is that, you know, fantasy approach that, hey, if I just do this, it's gonna solve everything. And so talk therapy and other things you can do to obviously deal with these issues can be helpful. But what about the nature of our society right now? Are we more anxious because of Twitter and because of twenty four hour news and because we're on our iPhones all the time and that we're inundated with too much information?

And so even though in a healthy situation, the brain can kind of deal with the unknown future, but it's manageable. Is part of the challenge here that we're just inundated with so much information that our brains are overloaded? Yeah. This is the classic question. Right?

And as usual, we love to shift to the extremes to these, to the binaries. Right? The two poles of the argument that technology has either destroyed us or, ah, there's nothing to worry about. And, of course, I'm sorry. I'm sorry, Jim.

I'm always in between somewhere because yes and, you know, it's like yes and. It's always a yes and answer. Clearly, these digital infrastructures, social media, the way we interact with technology, none of these technologies were designed to support human health and well-being. They were only designed to serve the bottom line of these companies, which means that they need to keep us hooked in. They need to optimize things like, you know, fuel the outrage machine, get people clicking, get people engaged.

What does engagement mean? Oh, it means for the most upsetting and incendiary and negative kinds of content and the most shallow content possible. So that's not good for us. But I don't think that we're necessarily more anxious today just because of social media or technology. I think it's an amplifier.

I think another big factor that's going on is that we mental health professionals have convinced people that mental health equals the absence of emotional discomfort. That somehow unless we're always performing at peak, We're always, you know, optimal. We're the perfect weight. We're like we're doing every diet on the planet. We're perfect specimens of physical fitness.

We're mentally strong. We could, you know, it's just this unrealistically, punishingly high bar of being almost robotically perfect that we've implicitly and explicitly in some cases convinced people that unless they're happy all the time, they're mentally unwell. Right. And so what that does is that takes away the opportunity for us to do what we really need to do when it comes to anxiety in particular, but any difficult emotion. What we really need to do with anxiety is we need to work through it rather than around it.

We can't be constantly avoiding and suppressing and eradicating it as our go to strategy. But when we think that mental health is only happiness all the time, of course, that's what we're going to do with this uncomfortable emotion. We're going to treat it like a disease and eradicate it. How does a person know though whether or not they are just being in a sense overly sensitive and they need to kind of bear the discomfort for their own growth versus an anxiety disorder where they really do need treatment because there's a problem? We can be anxious every day, significantly anxious, and even struggle with it and not be diagnosed with an anxiety disorder.

The only time a disorder is diagnosed is when the ways that we cope with that anxiety, things like avoidance, like not going to work anymore because you're so anxious about your performance anxiety, being so obsessive about something that you can't get anything done because it's never good enough, not having any social connections anymore because you're so socially anxious. Those are ways of coping with anxious feelings. You just you check out. You avoid. You get into these patterns.

It's when those patterns disrupt our ability to love and work and create that an anxiety disorder is diagnosed. It's not the anxiety severity itself. So that is one good way for us to gauge, okay, where am I on the spectrum and remembering that anxiety is on a spectrum. It's not a light switch. You have it or you don't.

Again, this disease model doesn't work in that sense because you either have cancer or you don't. It's It's not how anxiety is. We can be everything from just a little nervous on a daily basis to really, you know, kind of having to manage some of our feelings because maybe, you know, look around, maybe the world has fallen apart or maybe something bad has happened to you or maybe there's a trauma. But I don't think we have to take the approach of, oh, I am now broken and I have a malfunction and I need to go to someone to fix it. We can seek support from a psychologist, from a psychiatrist, from a spiritual advisor.

We can seek that support and still have this attitude that being anxious is part of the messy work of being human. We can work through it. It doesn't mean it's a bad emotion because it's uncomfortable. We can actually do something with this. And when we shift our mindset in this way, we'll do many more of the helpful things when it comes to anxiety, the productive and helpful things, and many fewer of the unhelpful things like avoidance and suppression and dulling our emotions so we don't feel anything anymore.

So how do you when you're talking about this, for instance, as a professor as opposed to an author, do you discuss this with your students and what have you learned from their perspective on this? I love talking to students about these ideas and and some of it we're doing research on and some of it is just me, you know, getting on the soapbox and kind of talking about the bigger implications of research. And what students come back to me with is it's always so inspiring and really fascinating because they feel that emotions are very dangerous right now. They have taught and really learned chapter and verse that mental health is something to be alarmed about. And they've started to doubt themselves and to feel very vulnerable.

So when I start sharing ideas like, you know, anxiety is a feature of being human. It's not a bug. Or when you're anxious and struggling, that's the only way you can ever figure out how to work with anxiety, and there is a right way to be anxious so you can build those skills. They kind of light up. They kind of say, oh, so no matter what happens in my life and even when I fall down, it doesn't mean that something inside me is malfunctioning.

It means that now's the time to bring it. Now's the time to, yes, seek help, seek support. You know, you don't have to go it alone or white knuckle it, but you can believe in yourself that no matter what happens around you, I won't be shaken. I had one young woman say that to me. She said, when I realized, and this was not me teaching her anything, this was her realization, When I realized that even though life is uncertain, I'm gonna get knocked down, that who I am inside cannot be shaken, that changed everything for me.

When you're working with students or talking to people about this, do you find that things like meditation or yoga or mindfulness help people on this journey? I think that this is completely in sync with mindfulness techniques. Well, a lot of the great wellness practices, the positive psychology practices that are out there. And why? Because there's two big reasons, I think.

One is that all of these approaches take at their core the idea that we have to, with every experience, no matter how difficult it is, to at first at least accept it, Which means not that we think it's okay or that we don't do anything with it, but we create a space between our the thing, the feeling, the experience, and our reaction to it, and we become curious about it. We listen to it. We engage and accept. And then, with that acceptance, that's when you can start doing something with that experience. You own it so that it doesn't own you.

So I think these, the whole series of practices out there, mindfulness being a great one, you know, there's many organically Christian and Jewish and Muslim versions of these kinds of practices. Prayer can be this for people. So it's really not just Eastern practices, although they have great traditions and ones that I'm particularly very interested in, But I think all of these spiritual practices, we should not look down on them. We should actually really look to that wisdom because what they also do is help us link up to a sense of purpose or something greater than ourselves. So when you're talking about, in a sense, making anxiety your friend and and seeing it as a positive thing, do you get a lot of pushback from people?

You know, it's funny. I do. And then on another level, I don't. So I have gotten pushback, especially from people who really suffer from anxiety disorders. And I like to take the time to really I noticed to entitle a book, Future Tense, Why Anxiety is Good for You Even Though It Feels Bad, is going to be controversial.

But I put it out there not to diminish the suffering that actual anxiety disorders cause, but to say even when you have an anxiety disorder, to shift your mindset to consider anxiety, the emotion, as an ally rather than an enemy. One, you need to negotiate with, like any ally. Right? You don't just get along perfectly. You negotiate with that ally.

If you can take that stance and be curious and open to your anxiety, you will be set up to do many more of the helpful things when it comes to coping with even debilitating anxiety. You will find new solutions. You will break the destructive avoidance cycle that happens in anxiety disorders, and it's actually what most therapeutic approaches try to break that cycle. When we feel anxiety, we just start avoiding it chronically. That's literally what therapy tries to disrupt.

So you will be better able to benefit from those therapeutic approaches if you shift your mindset and consider that anxiety is a part of the human condition, not a debilitating disease. It's interesting when I think about my own anxiety and how I've dealt with it over my lifetime. One of the things that I think has been challenging is that when you're anxious, it's very easy to become the anxiety and to develop the ability, that third eye, to witness yourself and realize that you are not the same thing as your feelings is a skill that I think I've developed. It doesn't always work. There are times when you get triggered and that reptilian brain just reacts quicker than the frontal cortex.

But from a scientific perspective, how do you help people understand that there is a part of their brain that's separate from their anxiety so that they can kind of learn to witness it? Yeah. And it's a great thing you're doing where for yourself, you've developed these metaphors of ways for you to understand that to engage with anxiety, I have to first have a break between that you know, it's not me, so I cannot react immediately to it. I think the first piece of advice I I really give to people is if you are open to the possibility that anxiety is not a malfunction, then you will be able to find that right metaphor for yourself. And what it should involve is a new mindset.

And what is a mindset? It is a set of beliefs, but it's also a set of practices. So if your mindset about anxiety is that, listen, I hate anxiety, it feels terrible, but it's going to happen. It is part of how human beings handle uncertainty in the universe, but it has advantages and disadvantages. I like for me, I like the metaphor that I've used to do what you're saying is physical fitness.

So I'm going to think of anxiety kind of like I think of a muscle. And not just in a terms of, like, you work it and it grows stronger, but as, in the concept through the concept of antifragility that Nassim Nicholas Taleb wrote about in his book, Antifragility. The idea of antifragility is not that we're just resilient to hard things in life, but that hard things in life are often what's required to make a system perform at its best. Whether that system is a society, muscles, the immune system. So muscles are a great example because if we don't stress and strain and work our muscles, they won't strengthen and they may even atrophy.

And so when I think about anxiety in my life and how I figure out that balance, I think, well, if I'm gonna work my anxiety muscle, so to speak, I need to build skills and endurance and strength. So I need to find ways that I can listen to and experience anxiety and really like an energy, like a like a kind of a, you know, strength to channel it in ways that get things done for me in life. And not just like this, oh, it's this baser part of me and I have to manage it and I need space to manage it. Every time we talk about anxiety, it's like, oh, what can I do to soothe it? I actually like to go even further and ask myself, what can I do to use it to my advantage?

Meaning, I know anxiety can make me wanna reach out to my social network more. So anxiety increases oxytocin, which is the social bonding hormone. Well, I know that about anxiety, so it makes me seek out rewarding human connections. Let me when I feel anxious, let me remember to reach out to my support system. I know that anxiety actually makes us more creative when it's, you know, not when we're in full blown panic, but when it's even pretty intense.

What it does is it helps us persist through obstacles. It actually makes us there's been great studies done by DeDru and colleagues back in 2013, and they found that when you make someone feel anxious, you make them prime these anxious feelings by thinking about a past thing that made them anxious. They actually are more innovative in their solutions. They persist through obstacles longer. They come up with a higher quality of solutions when you give them a problem solving dilemma.

So I know this about anxiety, so I'm not just going to manage it, I'm going to channel it. And for me, the metaphor that I like to use is this antifragility kind of muscle metaphor. So everyone can do that in their life and they can practice building these skills. The first step is to shift the mindset to even make that a possibility. So there's a continuum and you have people that have these anxiety disorders or PTSD and really severe reactions to stress, for instance.

And then you've got, you know, Nabelker, a great group in the middle. Is your book primarily aimed at the group in the middle that is catastrophizing something that otherwise should be manageable? I think it targets the whole spectrum, including anxiety disorders, although this is not a treatment book for anxiety disorders. The reason I say it targets all of those the full dimension is because the sole purpose of my book is to ask people to consider, to shift their mindset about what anxiety is so that they can start to benefit more from the things they're already doing and find different solutions to the dilemma that anxiety gives us, which is that we don't wanna feel anxious. We need to work with it.

So I actually think that in a way, perhaps this book could be even more effective or helpful for people with anxiety disorders. Because what happens is we when we have an anxiety disorder, we really get stuck in these vicious cycles of overwhelming anxiety and avoidance. And you need something really from multiple angles, you need multiple ways to disrupt that cycle. For some people, it can be the temporary use of medication. For some people, for a lot of people, it can be cognitive behavioral therapy.

Some people, it can be exercise. I think we need to add to that repertoire a mindset shift, where now we actually start before we even fully engage in feeling all that anxiety, we're open to it and we're curious. There was a great study that was done under the Yale Child Study Center just a handful of years ago, Ellie Leibovitz and colleagues, and they develop interventions for childhood anxiety disorders. So these are disorders. And typically kids would get CBT and they do a six or eight week course of therapy and it often helps kids reduce their symptoms and it helps take anxiety disorders quite a bit.

In their experiment, what they did is they took half of this group of clinically anxious kids and they didn't give them any therapy. Instead, they give their parents therapy. But what was the therapy? They taught them a very simple a hard thing, but a very simple thing. They taught the parents to stop over accommodating their kids' anxiety.

What does that mean? A socially anxious kid who is starting to no longer go to school because they can't leave the house, they sleep with their parents every night, they're really struggling, and it's totally disrupting their life, most well intentioned parents will have the impulse to let them stay home from school, to comfort them, let them sleep with them every night. But that is not the helpful thing to do when you're struggling with an anxiety disorder. Again, you have to go through the anxiety rather than around, so you have to stop avoiding it by not going to school, by not sleeping in your room alone. So parents were taught to gradually and supportively stop, you know, keeping their kids home from school and and stop accommodating all of that avoidance really.

And they did this for six weeks and they learned to do this in multiple ways with their whatever their struggles were that their child was struggling with. And don't you know it, at the end of that six weeks, if you compare the kids who received therapy themselves to the kids who only their parents received therapy, they were doing equally well. They showed clinically significant reductions in anxiety disorder symptoms and the kids had never gotten any therapy themselves directly. And what that teaches us, it's not that we should be blaming parents all the time. I'm a parent.

I I know that impulse to support and help our kids. But what it should teach us is that when those parents shifted their mindset about their kids' anxiety, not as something that was dangerous or that needed to be soothed, but as something they could support their kids in working through and building skills in, everything changed. And they started doing the right things that set their kids up for success. So that's why I say I think a mindset shift, figuring out how to be anxious in the right way instead of eradicating it, that can help all of us wherever we are on the spectrum of anxiety. You know, I think you're saying something very profound, and I don't wanna put words in your mouth, but it's my takeaway from what you just said, which is that the kids are picking up the parents' anxiety.

And what you're doing is by giving the the parents these techniques and essentially getting the parents not to catastrophize and overly protect their children, The kids then, instead of looking at their parents and kind of unconsciously seeing what mom and dad think there's a problem, there really is a problem. When the parents become less anxious, the kids are able to take on that and they start to feel better. I a 100% agree with you. And I think that as a parent and, you know, in my book, I actually tell some stories about my major parenting fails that were really all about what you say. I was anxious about my kids' anxiety.

And so I started doing the unhelpful things. I lost faith that they actually had the strength and resilience to work through this difficult emotion and and build skills. And I'd forgotten myself, even though I should know this stuff, right? I'm supposed to, but every parent struggles. I forgot that kids are not fragile.

They're antifragile. They are this concept that they will grow stronger through challenge and, yes, some adversity as long as they have the support around them, as long as they have community, as long as they have love, as long as they have purpose, and all of those basics that our grandmothers and grandfathers could have told us are important. We can help them through that. They are not fragile. We can let go a little bit, a lot bit of our anxiety about our kids' anxiety.

Well, I love the way you're targeting in a sense a little bit the mental health profession because in the same way the parents have to help the kids not catastrophize, the health profession has to do the same thing. So that when you come to them and you say, oh, the world's coming to an end. I've got all this anxiety. If the therapist or the coach is able to say, look, we're gonna get through this. This is fine.

This is part of life. And they create that safe place for you to tolerate that anxiety. I think just like the children and the parents kinda work it through, I would think the adult that's getting some counseling would have an easier time working it through as well. I agree with you a 100%, and this is where I feel such a profound sense of failure as a mental health professional. I feel that I've been part of the problem because inadvertently, we have become a predatory industry where we have made people feel weak instead of strong, vulnerable instead of resilient.

And I really think it's mostly unintentional. And there are of course bad actors in every field, but I think that this story, this really this disease story of mental health has now ceased to be helpful and has started to turn against us. Now remember, we have pushed for many decades for a sort of medical model of mental illness in part because we just wanted parity in terms of mental health coverage, you know, so that insurance would actually cover therapy and that mental health is health. And so the medical model, this idea that it is a valid health condition and struggle and should be supported, that's an important one. And as a researcher, I think the medical model is important because it allows us to use the tools of science, which are powerful, and to break down what might be going wrong if someone is struggling with mental illness or just a psychological emotional struggle and to figure out better solutions, more targeted solutions.

I believe in all that. But what I don't believe in is the disease model of mental illness and psychological struggle where we say, if you have anxiety, you're broken. We have to eradicate every signs of uncomfortable every sign we see of uncomfortable emotions because it means something's wrong. That is where the medical model has let us down. And even Thomas Insel, who was the director of the NIMH for ten, twelve years, so this is the major mental health research funding agency in The US, he wrote a book recently about healing and he himself said in an Aspen Ideas interview about three or four weeks ago, the disease model of mental illness doesn't work.

Full stop. And what he meant by that is that we can't treat mental health problems, ninety percent of them, like an infectious disease where you find the virus, you find the dysfunction, and you eradicate it or fix it. That doesn't work. We're not gonna make all anxiety go away or depressed feelings. We have to have better models.

We have to have better delivery systems, and we have to rethink what we're doing. It's fascinating. I'm not an expert on this at all, but I know there's some controversy around, for instance, temperature. When you have a high temperature, we take aspirin. But I know there's some people that say, look, the the high temperature is what kills the virus.

And so, by treating and by bringing the temperature down, you're not necessarily helping get rid of the virus. It's almost like you're saying that people that went into the field, right, they had the mindset of if you're feeling bad, right, you're depressed, you're anxious, you're uncomfortable, it's our job to make you feel better. And the challenge is, what I'm hearing you say is, that because anxiety is a tool that we use to alert ourselves to how we should plan and deal with the future in a proactive, responsible way, that by trying to get rid of the anxiety, we're taking away a very valuable tool. Yeah. I love how you put that.

And it is an opportunity cost in that sense because we do have the opportunity to use it. Now, that's not to say you should never break a fever. Right? That's on the spectrum. And that's not to say that you should never manage anxiety because that's also on the spectrum.

Sure. We get into these very black and white ways of thinking. Right? But I don't really give tips in this book per se, although I think there are quite a few in there. Right.

But one thing I do give at the very end of the book is a framework for shifting our mindset, and that framework has three parts that I think speaks to what you're saying. One is that when we think of anxiety as this advantage we've evolved to have as a tool to use, the first step in using it to our advantage is to, as we've already talked about, is to listen to it and to know that there's information there so we can build skills around that. But then the second principle I highlight is that it's not always going to be useful to us. Sometimes it's free floating. Sometimes it's too overwhelming.

And that's when we have to find balance and, you know, in a way we have to be alchemists. Right? We have to work with all these aspects of ourselves and we have to figure out a way to turn lead into gold. And for me with anxiety, what that is is we have to know when to let go of that future tense. You know, anxiety makes us into these mental time travelers into the future.

Sometimes we have to let go of the future tense and use tools that we have at our disposal to bring ourselves back to the present. And I think this speaks very strongly to the kinds of mindfulness tools you were mentioning, some of the spiritual tools. Some people aren't into that, they love to exercise or they talk with a they have a great conversation with a friend or they go to their spiritual advisor, whatever it is. I love to write poetry. It's bad poetry, but it expands my way of thinking and it immerses me in my present experience.

But what that allows us to do is it allows us to take a break from that future tense from anxiety, strengthen ourselves, nourish ourselves, figure out if it's helpful or unhelpful information, and not just white knuckle it through all the time. So that's the second step. And then the third step is once we know where we're at, is it information? Is it helpful? What do I do with that information?

It's like energy. It has to go somewhere. Where do I direct that energy that comes from anxiety? It's like a wave. Right?

It's moving us into the future. How do I swim? How do I surf it? How do I let it carry me in a helpful way? The best way to do that is to hitch it to a sense of purpose, of meaning in our life, something we truly care about, even if it's small, but something that makes us more fully our human selves, that makes us feel that flow, that that great sense of, you know, what we can accomplish and do in the world that's making a contribution.

And anxiety can really be a helpmate in us pursuing our purpose. So when you look at, again, where the puck is going and where the world is struggling with things like polarization right now and people are self isolating and they're sticking with their tribes and they're not mixing as much. How would you see anxiety as an issue to deal with relating to polarization? I think anxiety is the linchpin in that polarization because talking outside our tribe, our perceived tribe, it's driving anxiety. It makes us uncomfortable, and we just wanna be in our comfort zones.

But one thing to remember is that nothing great ever happens in the comfort zone. Nothing productive or truly excellent. So when we think about this polarization, yes, it's comfortable. It's like a warm bath a lot of the time, but it's going to limit and disrupt us. And I think one way in each of our own lives to start teasing that apart is to say, okay, when I'm rejecting ideas that are different from mine or that make me uncomfortable, let me actually take a moment and look at the anxiety that I'm experiencing there.

And let me start to explore, what am I anxious about? Am I anxious about my worldview being blown out of the water? Am I anxious about, you know, do I feel like the world's going to fall apart if this person has this viewpoint? You know? And you need to be a scientist about it almost.

You need to be a little curious. You need to explore. And once you start exploring where that anxiety is coming from, it often abates that anxiety. And then you can start to say, okay, if I'm trying to be in my bubble and that's not really helping the world right now, where can I build the bridges? And you can't really build a bridge until you know where your weak points are, where that anxiety is actually telling you you're scared or you're uncomfortable or you just don't know what way to go.

So I feel like anxiety is part of that exploration and our own personal questioning of why we're getting into these tribal polarizations. Yeah. It's interesting. I wonder if unconsciously, when people befriend people or cancel people, that part of it is because we've been taught that anxiety is something to be eradicated. I think that's a 100% right.

And it makes me think of sort of you know, we we talk, you know, kind of everyone screams about cancel culture on one side or the other of that discussion and safe spaces. And, you know, I have some thoughts on that. I think cancel culture probably harms more than it helps. I think safe spaces should not be what they are today. They, you know, it's important to protect people from hate and prejudice, but we can't be emotionally comfortable in all our conversations.

I think it's instructive to go back to the history of safe spaces to understand though the pros and the cons. Kurt Lewin, who was one of the fathers of social psychology and one of the first industrial organizational psychologists, created safe spaces after World War II. He was contacted by an organization that was fighting for racial justice and also ending religious, particularly antisemitic, injustice as well. And they said to him, listen, all of this is playing out in the workplace. What can you do?

And so he developed this idea of safe spaces and what he called sensitivity training. But what did this look like? A safe space was actually a place where someone came to fess up about their biases, their own personal biases. So if I was a woman in a leadership position, I would come and say, hey, listen. I'm realizing about myself that I think all the men working under me are just not smart enough.

I know that's not true. It's sexist and it's biased and I want to work on this to actually make it better. And so a safe space was safe because that person could acknowledge their limitations without fear of being canceled. It wasn't a word back then but canceled, judged, that they would actually, and through sensitivity training, the community would be trained to help them come to face with those biases and do better and work towards them. And they were painful, like really content like they were very emotionally raw spaces, the safe spaces of Kurt Lewin.

But what these safe spaces achieved is great organizational transformation. People did better. They made better rules in the workplace about how to deal with these the kinds of biases that arose and and advances were made. You don't make advances when you protect yourself from all differing ideas. And that's, I think, a problem that we have right now that we need to find the right balance in.

That makes sense. So over the last couple years, culturally, we've had kind of a strange relationship between science and fact. Has that had any impact on you? I mean, I'm such a dyed in the wool scientist. And on some level, it stuns me what people will believe in this notion of this kind of anti science sentiment because I mean, just look around you.

Science has has saved us again and again. I mean, I think science is the new rock and roll. I mean, honestly, I won't continue on that. But what's interesting to me as a scientist with this anti science sentiment out there or sort of to say what I believe or want to believe is true is that as an emotion scientist, I understand that entirely. Because really all this anti science sentiment, this sort of what are some of the phrases for these sort of selective facts or, you know, I'm forgetting all the catchphrases.

It was so hot about four or five years ago we talked about that. But really, those facts that we often believe counter to evidence are just the ones that make us comfortable, that make us have a more secure sense of our world view, which makes us comfortable and not anxious. I think all of this anti science sentiment is fundamentally anxiety management. It's interesting. I agree with what you're saying, but I wonder, like you said, for instance, that science is kind of the rock star and in which I agree with.

But pushing back a little, science is trying to eradicate anxiety in a black and white way, and isn't part of the balance here, the left brain and the right brain. Science is really good at understanding the rational linear part of life. But living in that kind of right brain, a femoral place where faith and letting go and mindfulness fit in is complimentary to science, but it's science doesn't take us all the way to the promised land. I love that you're heading in this direction with this. Well, not this scientist, but I I very much hear what you're saying about the discipline of science and how it tends to work, that science is people and science is society.

It's also, I think, most fundamentally, a set of tools. Before I was a scientist, I was a classical musician. And science, like classical music, these are classical traditions because there are rigorous methods that one learns, and there's a right way to play Bach and there's a wrong way to play Bach. I mean, you know, strictly speaking. I was an oboist of all things, one of the most obtuse instruments out there.

Many people may not even know what that is. I even went to conservatory. I was almost launching that career. Anyway, there are tools and techniques you master, and, of course, same with the scientific method. But then what do you do once you've mastered them?

The great artists, the great scientists, they transcend them. So that I see science as being a set of tools just as I saw the oboe as an instrument to play. So where does that leave us though in really opening ourselves up to other ways of knowing? You are probably aware and might be interested in the fact that there is actually a very rich science of mindfulness. Yes, it does deconstruct it and try to understand kind of the pieces of how it works, but it also really honors the fact that the whole is greater than the sum of its parts as well.

There are people who study human consciousness and who are really interested in using all sorts of tools, whether it's neuroimaging or psychedelics or whatever it is, to really understand how some human experiences are epiphenomena. Again, that's more it's that the whole this this experience, yes, we can break it down but it's often just more than that, some of its parts. So I think that if we and I know you're really interested, Jim, in breaking the polarization and the binaries, if we stop thinking of, you know, science is right brain and spirituality is left or whatever that, you know, and of course that's not even really right from a neuroscience perspective, but if we stop thinking in that way and we think, and it's the same way that we should think about anxiety is what do these tools, what does this experience, like of anxiety, provide us? Right. How do we work through it?

How do we leverage it? How do we find individual differences in what this means to each person in their life? I think that's the way forward and science can be an incredible for me, it's the tool that I've chosen, but it can be an incredible tool in that journey and it doesn't have to be incompatible with having a spiritual practice. I'm also a very, you know, meditation and actually I when before I became a scientist, I became a Hindu. And I believe it was the practice of Hinduism and the discipline of the technique that allowed me to do something as hard as shifting from being a musician all my life to deciding to be a scientist.

So I don't think the two are mutually exclusive. Yeah. I think they're complimentary. I don't think they're mutually exclusive as well, but we live in a world where there's a beginning and there's an end. And we're looking for answers to things, but there also is a place I think you're trying to get to with anxiety where you sometimes just have to not know what the future is.

Right? There isn't an answer, and you can prepare for it, and you can think about it, and you can ultimately come up with the greatest strategy in the world. But we do not control the outcome. And at some point, the letting go to me is something that as a scientist, you don't wanna do. Right?

Scientist wants to take you all the way, and yet, it's like three stages of creation. You know, you have the inspiration, you write the book, you let it out there, and then it ultimately takes on its own life where you can't control it anymore. You're giving it up. I think the more we understand that science can take us part of the way, but I hear what you're saying is that we ultimately have to sit alone and do that work with that anxiety to transform it in a way that's positive. I think that's a beautiful point, Jim.

I think also what was coming to mind as you were speaking is that some of the most spiritual, adventurous, kind of out of the box thinkers that I've ever known have been scientists. And it's when they can acknowledge that there are other ways of knowing, And they're valid, that science is one way of knowing, but it's like you're looking at a picture or one of those holograms and you look at it from one angle and you see one image and you shift your angle just a little bit and you see another image. So I agree wholeheartedly. I also think, and this is what makes me really excited to have written a book rather than just do my academic work and just, you know, with the 20 people who do the same work as I do, is I'm really interested in flipping the script on anxiety as not just being, Oh, it's protective and it's not so bad, to being, Wait a second, no. It's actually, well, to quote Kierkegaard, I hate to quote Kierkegaard on you, but Whosoever learns to be anxious in the right way has learned the ultimate.

It actually will make our lives better, not just we'll manage the anxiety. It will make us better and I love talking with creatives, for example, artists, musicians. I love talking with creatives because they understand the transformational effect that anxiety can have in our lives because anxiety and creativity inhabit that same space, that space of uncertainty where something that's never existed before, it hasn't happened yet. Right? Whatever you're creating or whatever you're feeling around anxiety, you're in that space in between where you are now and where you want to be.

And so I feel that in having these conversations with people who don't do science is really the way that we're going to push our ideas forward and figure out human solutions that are going to work for humans in addition to some of the great tools that science have given us. As we come to the end, Yara, I I love the way you put that. And as a musician, I will throw back at you that between the notes, that space between the notes is what makes the music. Beautiful. It's such an important topic for people to hear.

And, you know, I know when people are anxious, they just wanna feel better. You know, when you're tired, you just wanna go to sleep. You know, when you're depressed, you just wanna pull the covers over your head. And I so understand this desire just to get out of the anxiety and make it go away. Me too.

But I think you're encouraging us to recognize that that is a shortcut that's not gonna get us there. That we really do have to examine that anxiety and use it as a tool to to help us solve these issues. Yeah. It's like selling people broccoli sometimes though. You know what I mean?

I'm like that person who talks about all the feelings you don't wanna have. Right. When you wake up at 5AM with those worries going through because to be honest, I experience this all the time. Sure. You know, you wake up at 5AM or 4AM or 3AM and your worried thoughts are just galloping through your head and your heart's racing.

Right. And someone might ask me, how can you just tell people to stop trying to make anxiety go away? And really the answer to that is, well, it's not going to go away if you just try to push it down. It's gonna pop right back up. Like, if I tell you don't think of a white bear, your mind's gonna immediately think of a white bear.

So we have to actually build skills to work through it. So one thing we can do in this one small example, I think can apply to all sorts of things in our life. So the very first thing when we have those worried thoughts that are waking us up, your first impulse is going to be, you know, push it away, but counter that impulse and as a first step, just relax for a minute and just breathe and be in the moment that will allow you to tune into what those anxieties and worries are. So, you know, we've learned so much about breathing and just take one to two minutes, take a deep calm breath, feel your heart rate start to slow, tune into that your body and feel your tense muscles, you're probably tense, release them, let them go. So just breathe, notice your heart rate, let go just a minute or two.

And then once you do that and you're you know, the worries are still there, then you remind yourself anxiety is information. What can I learn from anxiety in this moment? So be curious. Okay. I'm listening to what's going through my head.

Two days ago, I woke up just like this worrying about my daughter. And so I just listened for it. What are these jumble of thoughts? What is my concern? What do I care about?

And she and I had had a fight the morning before. I'd said some things I regretted. I also found that I was really frustrated about some things. And so I just treated myself like I was a friend. I was lending myself an ear in the moment and just really listening to what those concerns were and what really is rising to the top of your mind right now.

And then the third step after that is once I've understood what the information is, I've had this fight with my daughter, it doesn't feel good, I need to repair it, you just decide on an action, just one actionable, a goal you can set for yourself. So I set for, in that example, worrying about my daughter, I made a plan to have a conversation with her over breakfast. I just planned one or two things I knew I needed to say that kinda got to the heart of what was bothering me. I made that plan and I stopped with that. And what you know what happened?

My anxiety went down. My heart rate slowed and I knew that I had this actionable thing that I could pick up again when I woke up in the morning. So that simple breaking it down of slowing down, being present, then listening to what anxiety tells you and then making a plan, 75% of the time that's gonna get us to something helpful and productive. That's a beautiful, beautiful example, and thank you for sharing, Tracy. This has been wonderful.

Oh, thank you so much. I really appreciate it. The Puck Venture Capital Beyond is produced podcast.