You're listening to Voices of Your Village, this is episode 233. I got to hang out with Dr. Ellen Vora. Oh gosh, I love hanging out with Ellen. She is incredible. She wrote a beautiful book about adult anxiety. And let me tell you y'all like we know anxiety is on the rise and we need concrete tools for what to do with it. And when I first started reading her book, The Anatomy of Anxiety, it was one of those things where immediately I was like, yes, yes. Yep, so much yes to this. As a human who once lived with a lot of anxiety and has learned a lot of tools that I get to employ in the day to day to live with less anxiety, I felt like I just felt so seen in this book and it felt really validating. And Ellen and I get to really get into the down and dirty of what is anxiety and what she refers to as these two different components of anxiety, this false anxiety and true anxiety. And what do we do about both of them? How do we manage them? What does it look like to navigate them and how do we create systems that support our lifestyle? Ellen is one of those humans. I feel like I could hang out with forever and we just got to scratch the surface. So please snag her book, The Anatomy of Anxiety to dive deeper into this work. You wont regret it, I promise. All right, folks, let's dive in.
Hey there. I'm Alyssa Blask Campbell. I'm a mom with a Master's degree in Early Childhood Education and co-creator of the Collaborative Emotion Processing method. I'm here to walk alongside you through the messy, vulnerable parts of being humans, raising other humans with deep thoughts and actionable tips. Let's dive in together.
Hello everyone, and welcome back to Voices of Your Village. Today I get to hang out with someone that I just adore. I get to hang out with Dr. Ellen Vora. Ellen wrote the best selling book The Anatomy of Anxiety. And this was one of those things that, like, came across my feed in some capacity, and I immediately was like, oh, my gosh, yes. Snagged it. I'm an audiobook person. So immediately started and just kept finding myself being like, Yep, yes. 1000% agree. Holy cow. This is what we talk about in the tiny humans, too. It's just so in alignment with our work, and I feel like there's so much discussion around anxiety, and this book was like, next level what's happening. I'm not a Band Aid on a bullet hole person, right? I kind of don't care what's happening on the surface. What I want to know is what's going on beneath the surface? And that is what this book dives into in such a beautiful way. And Ellen, I'm so jazzed I get to hang out with you and chat about it.
00:03:19 Dr. Vora
Alyssa, the pleasure is mine.
I also, like, super cool to have a psychiatrist that wrote this book, that fires me up, because in my head, my association with psychiatry is medication. And you dive into so much more than medication in this book. And I think that you paint a really beautiful picture of how medication isn't the enemy, but also maybe not the answer.
00:03:54 Dr. Vora
Yeah, that's really well said. It's interesting because anytime I bring up any kind of like, let's think about alternatives to medications, or let's think about times when it isn't indicated, it always lands as, wait, what are you saying? Are you anti meds? I was like, no, I'm a psychiatrist. I prescribe medication. I put patients on it. But to me, it's not the first reflexive choice. It's always part of a greater holistic understanding of what's going on here. What are the root causes of this person's depression or anxiety or ADHD? Can we address it at that level first, is medication necessary as a bridge out? But I never think of medication as the ultimate root cause resolution.
I love that. I am curious. Like, I know why I was really jazzed that there was a book about anxiety, but what was it for you? Why were you like, I'm going to write a book about anxiety?
00:04:47 Dr. Vora
I wanted to fix a problem that I was seeing, and I saw the writing on the wall. My patients were all struggling with anxiety on social media. Everyone that was in my DMs was coming to me with questions about anxiety. It felt like it was the PH of our age, like, the way we get out of balance. We subjectively experience that as anxiety right now, in this moment. And so that felt like, okay, this is a problem that needs solving. But I also felt like I had a lot of original ideas around anxiety. And so I felt a little bit like in that Elizabeth Gilbert big magic sense, like, do you accept this mission? I was like, let's do this.
Love the Liz Gilbert shout out. The first thing, which I'm sure is what I think probably draws a lot of people in your book that I glommed onto, was the concept of true versus false anxiety. Can you break down for us? What is the difference between the two? When you say true anxiety, what does that mean? When you say false anxiety, what does that mean? Because I want to dive into both.
00:05:51 Dr. Vora
Yes. False anxiety, which has such a triggering sound to it. Very importantly, not to invalidate the very real suffering. It's really just avoidable anxiety. It's anxiety that's based in the physical body, and it occurs when something tips our physiology out of balance, and it trips us into a stress response. And then we subjectively experience that stress response as anxiety. And the kinds of things that can trip us into this stress response. They're usually seemingly innocuous aspects of modern life. So it can be a bad night of sleep, an extra cold brew coffee, a hangover, a blood sugar crash, something off in our gut. And these are happening all the time. They're pinballing our physiology around and creating a lot of unnecessary suffering. So the idea with false anxiety is that you identify that underlying root cause, address it at that level, and eliminate unnecessary suffering.
Yeah. So, like, for our Seed community, this for us, we break down as sensory regulation, really looking at the nervous system from a sensory perspective, and then we move into emotional regulation next, which is really what I think you categorize as true anxiety. And yeah, we always start with sensory reg, what we call the triangle of growth, with sensory reg being at the base because it's exactly it like sometimes you have a snack and you're like, oh, actually, everything feels fine now, right? Or like you have a nap or you sleep or yeah. And all of a sudden, you're like, oh, the world feels clearer now.
00:07:23 Dr. Vora
That's exactly right. And it doesn't invalidate that. We have problems. We have stressors. And when we're in a moment of false anxiety, our brain, the consummate meaning maker that it is, will always swoop in and tell us a story about why we're anxious in that moment. And we'll say, oh, I'm anxious because of this thing going on at work and this interpersonal dynamic from the 7th grade that still irks me. And it will tell us a story, but that's actually just the mind attempting to make sense of what is first and foremost a physical sensation. And so I remember when I first had my daughter and she was a baby, and it was like, Why is she fussy? And we put a list on the fridge. It's like, does she need a diaper change? Is she overtired? Is she hungry? Is she teething? Does she need to be burped? And it's like, I realized we as adults are just oversized toddlers in so many ways. And we also have that kind of list. It's a little longer. It's slightly more complicated. We get ourselves into more physiologic traps than babies. And so I think that it's the same ideas in those moments of peak anxiety. Have a list you can reference, let it remind you and jog your memory. And I sometimes have my patients say to themselves, my problems are real and I need a snack right now. So that we're not invalidating that story our brain is telling us, that's still true, but it doesn't feel quite so overwhelming or quite so doom and gloom once we've regulated our physiology.
Sure. I love that so much as you were sharing it and you shared about your daughter as a baby, I was recalling. So when I had Sage, I encapsulated my placenta, which I always feel like, I have to throw a disclaimer of like, I also don't make my own soap, on the level of crunchy. I'm like, not super crunchy, bad Vermonter.
00:09:06 Dr. Vora
I'm proudly crunchy in all the ways I wish I made my own soap. I don't have the skill.
Yeah, I don't, and I have no plans to, but I for myself from like, a hormone perspective. I was really nervous about losing a whole slew of hormones kind of all at once within the birth, so encapsulated my placenta and consumed the capsules, whatever. And then it was at the six week appointment and my midwives were like, hey, if you're still taking it, you don't have to, you can stop. And I just stopped. And about a week later, I was sobbing. I was sobbing all the time. And I had had the opposite experience postpartum, where I was just like, this is the best thing I've ever experienced. I love it so much. Like, I'm leaking fluids from all holes and everything hurts, but I love this and kind of like a high postpartum. And then I stopped taking the placenta and within a week, I was depressed and sad and cried and didn't want to leave the house and nothing else had changed. And I didn't clock this. My husband was like, just very validating. Totally. All that's true. Did you stop taking the placenta last week? And I was like, oh, my gosh, yes. And so I started and then I ended up weaning off of it and didn't have that experience again. And the sadness went away. And for me, it was like that. When you were just sharing about your daughter postpartum and having a newborn, I was like, oh, right. Like, that happened for me, where it was total hormonal, physiological, all the hard things of having a newborn were still true before and after said pill consumption, but my experience of it was vastly different based off of my hormones.
00:10:57 Dr. Vora
Completely. And I mean, I had a similar one of these last summer where I literally wrote a book about false anxiety and we had gone to Europe. And in Europe, I'll consume things I don't consume in the United States, like wine and coffee and gluten and it's fun. And then I got back and I was like, I'm still a coffee drinker. And I was drinking coffee a little bit every day. And I was at this we were in a country house with friends and I was really irritable and I was just like, why is everyone so terrible? And I want to kill everybody? And at one point, my friend sweetly pointed out to me, like, is it that everyone's terrible or could it be the coffee? And it feels so insulting in the moment because you feel a little bit foolish and you're very invested in your ideas that no, everyone is terrible, but we have to be able to laugh at ourselves and bring humility to it. That like, okay, there's some truth to the stories our mind tells us, and our physiology is out of balance. And like, in that moment, I had to be like, shoot, I literally wrote a book on this. And here I am in a false mood, blind to it, completely unaware that it's going on. And indeed, I tapered off the coffee and suddenly I liked my friends again and there you go.
00:12:08 Dr. Vora
But the hormone thing is its own special case because hormones are so powerful and have such an outsized impact on our mood, on our perception of the world. And I think that we haven't even gotten into that primer on what is true anxiety yet. But I'll say now that the premenstrual time, the late luteal phase. And in the menstrual cycle...
The time where I feel like the world is ending.
00:12:31 Dr. Vora
The world is ending. Our partners are particularly irritating.
No problem is solvable.
00:12:36 Dr. Vora
Yes. It's an interesting confluence of true and false anxiety, I feel. And there is a false component to it in that a lot of us have an exaggerated PMS state. And this has to do with the ways that modern life has given us a lot of exposure to exogenous estrogens. So in the form of endocrine disruptors and personal care products and perfumes and cleaning products and plastics, pesticides. So we're a little bit excessively estrogenized, but then we're also a little bit lower in progesterone because we're chronically stressed and many of us are deficient in a lot of the nutritional building blocks that we form progesterone from. And so we have this sort of physiologic out of balance shift into the late luteal phase that blows the whole thing up. And we have worse PMS than we otherwise would. And so with my patients, as I've gotten them more into physiologic balance, they don't have as pronounced of a PMS state. That said, it is truth serum. And I don't think we need to be throwing the baby out with the bathwater. Like we culturally will call a woman bitchy or irrational, but in many ways, it's the one time in the month when you're like, wait a second, this situation is not okay. And in our Follicular phase, we're like, oh, that no big deal. But in our late luteal phase, we won't stand for it anymore. And I think that there's something to be honored in that. But we also need to carve out a lot of space for rest and baths.
Okay. Love this. Also feel like I could chat with you on the side about this more, but I did the Dutch test recently and my estrogen is crazy high. So as you were describing, I was like, oh, were you just reading my hormone results? Reading my hormone panel? Because just got that back. Yes, spot on. It's so interesting. I love data. I love learning about that jazz, but that's fun to think about that maybe I'm just more like badass Alyssa will assert boundaries yeah. Versus when I'm like, no, I can take that on. Sure, it's fine. I like that shift.
00:14:44 Dr. Vora
The truth is probably somewhere in between how we feel in our Follicular phase and how we feel just before our period. They both are distorted in some way.
Yeah. That's such a cool way to look at it. Okay, so now true anxiety.
00:14:56 Dr. Vora
Yeah. So true anxiety, by contrast to false anxiety, this is purposeful anxiety. It's not something that we get to decaf coffee our way out of, not something it's actually interestingly enough. It's not what's wrong with us. It's really what's right with us when we are able to viscerally connect to what's wrong in the world. And so this is our inner compass. It's nudging us, asking us to slow down, get still and pay attention. And usually there's a call to action baked into it. It's telling us, you know, that this situation in your personal life, in your community, in the world at large is not okay, and you have a role in this. There are a lot of not okay situations in the world, and we can't have full fledged true anxiety about all of them. We wouldn't accomplish anything, but we have to know the ones that really resonate, that really light us up and mobilize us. And that's where when we let that true anxiety fuel purposeful action and we show up and carry out some really just to show up in any way, then we're not mired in our anxiety anymore. We're fueled with purpose. And so true anxiety, it's not something to suppress or certainly not something to pathologize. It's really something to listen to and honor.
Okay, let's get, I want to dance with you here. So when I think of anxiety in the true anxiety sense, I think of it as getting stuck in fear. Right. Really, when I break down from the emotion perspective, what is anxiety versus what is fear? For me, anxiety is when it's almost like quicksand for fear, where we're trying to get out of it or something feels really scary and we can kind of get stuck there. For me and this for our podcast listeners, isn't new. I was raped at 14, and so I had really anxious teen years afterward, which makes total sense, right? Like, looking back, totally. My body and brain were trying to survive, right? And so I could get into the quicksand of it all and spiral into something from I'm going down into a basement or I'm wearing buttonfly jeans, and there goes the spiral. And when I am looking at true anxiety, what I'm really curious about is when you're working with folks in your approach to being with fear, without being consumed by fear. Right. How do we allow it without it overtaking us?
00:17:40 Dr. Vora
Yeah. So let me kind of separate this out into two.
00:17:44 Dr. Vora
There's, like, granularity to this answer. So on the one hand, trauma is its own category and its own interface between true and false anxiety. But I think with trauma, it really is that if you are lucky enough to be in a situation now where you're no longer in danger, then what's needed there is to help the limbic system understand that that was then and this is now. And I think that we have a cultural problem here, which is that we think the path to that is talk therapy. And I don't have anything against talk therapy. I do it all day long. It's my day job. I think it's great, and I think it's lousy for trauma, and it's not only ineffective, but can even be retraumatizing. And so I always refer out to some trauma focused therapy like EMDR. Somatic experiencing therapy, some of my patients do something like DNRS or primal trust, but something that's really less verbal and operating on the level of the limbic system, and it's just helping retrain reprogram the limbic system to understand the threat has passed. It is once again safe to be in my body. And I think that that's needed so often with trauma. I think, on the other hand, true anxiety, there's all of these kind of entry level true anxieties of like, I think I might be in the wrong job. I might be in the wrong relationship. I feel like I should be an activist in this cause. And then there's the inherent fragility of walking this earth in a human body like, we're going to die and we're going to lose the people that we love. And I think that's the big kahuna of true anxiety. And I think there it's different for all of us. But I encourage my patients to at least give themselves permission to seek because I don't think we're ever going to find some logical, rational, comforting answer to the biggest of the true anxieties, which is our mortality. And at least in my own experience, I find comfort in any experience that helps me access a feeling of maybe there is something vastly beyond my comprehension occurring here. And if that's the case, it makes loss feel a little bit less absolute. It makes these themes of control and everything being up to me. Having anticipated every potential negative consequence that's just anxiety, catnip, it's all up to you, centering on themes of control and certainty. And I think that every once in a while when I feel like, okay, something vastly beyond human comprehension is occurring here, I can let go of it. I can access a feeling of trust and surrender.
So helpful. I have a few things. IFS has been, Internal Family Systems, I feel like I didn't make great headway from a trauma perspective until I worked with an IFS trained therapist that was very good for me. And, okay, now in this, like, I think for me, my greatest anxiety triggers are all parenthood related of like, am I doing the right thing, right? Did I choose the right childcare? Is there the right amount of time that he's there? Or I just went on my first trip away with Zach where my little guy was alone with Nana, who he knows and loves so well. Did we do the right thing? Did we prepare him enough? Did we communicate the right amount, or was it too much or not enough? Just like that freaking spiral of making decisions about another human's life, right? Like, anxiety felt easier for me to manage when it was just my life, and now it feels just exponentially harder and so much easier for me to get into that spiral of, is this the right thing? And that trust for me can feel harder to access when I'm like, I don't know, I'm not sure that this was the is the right choice, was the right choice and find myself getting to this place of, like, okay, if it's not the right choice, what are the possible outcomes? And having to kind of work back from there? What if we get home and, yeah, he never wants to separate from me for the rest of his life. Like, is that a potential outcome of this? Maybe just bedtime sucks for the next two weeks when we separate or whatever, what are potential outcomes? And that problem solver part of me gosh, she's so good, and she's so overworked and exhausted, but coming up with, like, what are all the potential problems to solve so that then when I go back home from this work trip, I am ready for whatever's coming my way in terms of whatever I just dismantled or disrupted. Does that make sense?
00:22:39 Dr. Vora
Oh, yeah. I'm just going to riff on a variety of aspects of this. I think one thing is that, well, there's safety, like, really in the life or death sense of safety, and I want to come to that one in a minute. But in terms of thriving, all members of the family thriving. There's a lot to this, and I think one is to have a healthy level of frustration and rebellion against modern life that has overwhelmed us. We're in a paradox of choice. There's too many considerations. Like, when I think about what it was like for our parents to parent us, it was equally impossible, but they didn't have the car seat racket in quite the same way that we do. There's just more layers. There's more emails from the schools. There's more camp sign ups happening early. There's just a lot. And I think we protect ourselves a bit when we are annoyed with that. And rather than just thinking, like, I should be better, a little bit of like, the world is kind of crazy right now, and if I mess this up, shrug. You know what? I did my best in a crazy system because it's too much. It's too much. I think we do need to trust ourselves, and we have a world that's like barreling toward more and more externalizing, our trust to external instruments. Right? Like I think about wearables, and I'm all for wearables. A lot of my patients benefit from them.
Break down what a wearable is?
00:24:02 Dr. Vora
Thank you. Like an aura ring or using the Apple Watch or the original was the fitbit, but basically like tracking, how are we doing? And I think about how it's like you used to wake up and be like, how'd I sleep? I think pretty good. I feel okay. And now it's like all the data says I actually got an 84 and it says I didn't have a lot of deep sleep. And I think that we keep handing over our power and saying, I don't know how I feel. This external instrument tells me how I feel. But we're getting even more and more atrophied at our ability to just tune in and know. And I think that actually has big ramifications because we need to strengthen our connection to our internal knowing. And I think that once you have a baby, a child, we are preternaturally aware of what needs to happen in a situation. And so can we trust that about ourselves and not give over our power all the time? Safety....
Also can you just come deliver that message to me regularly? Can I have it as an audio file? I can just play that clip.
00:25:05 Dr. Vora
We just need to be on mutual speed dial for each other.
00:25:09 Dr. Vora
I mean, I think I do live by this is just like all I can do is do my best, my reasonable best. And when you say do your best, the recovering perfectionists among us here. Oh, I know what that is. 150,000% effort. Bend myself into a pretzel, eliminate all possibility of failure. That's my best. I mean, you do your reasonable best, it's 85% effort. You can feel proud of it, but you don't get it bent out of shape. And I think with the dizzying array of like, how do we show up best for our children? You strive for the 85% effort, like good enough. And then ironically at aiming for 85% effort, we're able to stay intact and present and attuned and it ends up being the maximal best situation for the overall family unit in the end. So just taking some of that pressure off of ourselves to nail every decision. Safety is a bigger one. And that's where I think about this, where when I lost my mom, which is different than losing a child, but still it was too early and it was still quite tragic, these unimaginable tragic losses. There's of course nothing that we can say that makes that okay. I'm not interested in any spiritual bypass around that. But what I've learned in my own experience with that was that I had to make meaning of the experience to be able to resiliently get through it. And so with the big sort of capital S safety losses. I think it is actually helpful to somehow see this as part of some greater order and that's not going to be everyone's truth and that's absolutely okay. And I just offer that up as just to give yourself permission to explore what feels true to you. And sometimes when we can make meaning of the unfoldings of the events in our lives, this helps us find our through line to resilience.
Yes, I'm really glad that you separated those two. I don't have a lot of anxiety around safety or health stuff. Not a whole lot. For me, it's more the everyday life decisions that start to feel like they add up to me. But my husband grew up with parents who both have more anxiety than my parents do around health and safety. And so I see that play out with him and I feel like I'm always like, he's going to be fine. Sure, he's whatever, climbing on that thing. What's the worst that happens? He breaks an arm. I very much err less on the side...but I do find that I will not consume and just close out the things that, for me, from a health and safety perspective, feel so out of my control and so big and scary, like death. And if there is a show where a kid's going to die, I won't watch it. That's not for me, because then I have to like my brain will go to like, what if that was my reality? And I just frankly don't want to go there. I don't know if that's healthy or not, but I'm like, I'd rather avoid it.
00:28:25 Dr. Vora
I think it's like, shockingly healthy. And I'm worried these days because I call this the banality of fear in my book, where we used to know, like, advertising knows that sex sells, but I think they've also gotten hip to the fact that fear sells. And I think there's a lot of adrenaline junkies. We're kind of addicted to some sort of hypertonic cortisol state of life. And when you look at the TV shows that are resonating with people that are the talk of the town and I feel like, oh, maybe I should watch that show so I can be part of the conversation and hear what people are talking about. And I find myself, like, in a cold sweat watching these shows. I don't necessarily think that's healthy for us. I think that we want to be really conscious about what kind of state we put our nervous systems into. And I noticed that even with advertising, when an advertisement is trying to fear me into buying something I don't need.
00:29:21 Dr. Vora
Peace. And just like no, stop. We're all anxious enough. We don't need to be bathed in excessive fear for some really trivial reason.
Yeah, well, you know what? Thanks. Brene Brown, in her most recent book, Atlas of the Heart, shared at one point in there something related to, like, whatever emotion you're feeling internally, then if you add shock or surprise to it, it heightens, right? So if you were feeling really excited about something and then there's a surprise party and you were already feeling excited, your surprise heightens. If you were feeling a little scared, like you're watching a show and you don't know what's coming next and that's not something that excites you, you're feeling scared and then there is something jumpy or a surprise like your fear heightens. And I was like, that was so validating for me to hear. So I was like, yeah, I don't want to do that to myself. That's not fun for me. I don't love that. And so I just avoid it. And my dad will joke that I'm one of the most annoying people to watch a movie with that has any suspense because I'll just keep saying, what's going to happen next? What do
you think is going to happen? I want to know what's coming so that I can prepare for it.
Have you been scrolling the Internet? And there's all these tools for calming your child and how to regulate and whatever, and you try them and your child just gets amped up or that doesn't work. Or you find yourself in these cycles where it's like epic meltdown. Try to come back from it and you just feel like you're putting out fires all day long. If this is you, you aren't alone. And we collaborated with an Occupational Therapist to create our Sensory Profile quiz. This is going to help you learn about what helps your child regulate what's happening in their unique nervous system. We are all different and figuring out what you're sensitive to or what helps you regulate is the key for actually doing this work, for getting to a regulated state, for having tools, for calming down, for having tools for regulation. Head on over to www.seedquiz.com to take the quiz for free. You can take it as many times as you like for as many humans as you'd like, and we will deliver results right to your inbox to get you kick started on this journey. Seedquiz.com.
00:31:11 Dr. Vora
But just to kind of go back to the millions of little decisions, I mean, I applaud your ability to be cool with the big safety things. Like my daughter on a play structure on a playground. I'm like free range kids if she falls totally good in the end, but when she's like in a car with another parent driving, I'm like, oh God, life is too fragile, it's too vulnerable for this. But I think that those millions of decisions, part of the reason they paralyze us and overwhelm us has to do with the fact that we're being given this message of you kind of need to thread the needle and your kid needs to nail it to be okay in life.
00:31:13 Dr. Vora
And this is actually at the heart of one of the many ways that kids have a lot of true and false anxiety these days is that in setting them up for winning at the game of what Brene Brown calls the road to nowhere, but basically, like, making sure that they're achieving academically and spiky and have some special skill. And then they're getting into good college, and then they're getting a remunerative job, and then they can send their kids to a fancy school and have put their kids on the road to nowhere and so on and so forth in helping them succeed and thrive. Sometimes we've actually missed the plot. And then what they actually needed from us was for us to not be so stressed with maximizing every decision and they just needed some unstructured time to be in nature, interacting with other children so that they could be the best versions of themselves with a strong connection to their integrity. And I think that we are sometimes throwing the baby out with the bathwater. Maybe that's not even the right term here, but we're missing what we really want to cultivate. It's not necessarily SAT scores and how this all looks on paper and how it adds up in an achievement focused world. But is this a child that is a good person that has a sense of themselves that's able to resiliently move through life and to do that with integrity and kindness. And I think that that sometimes is not what we're accomplishing the opposite when we're really trying to accomplish the fancy college application.
Totally. I appreciate that so much. And I think for me, what I have to continue to come back to, because my goal I don't care if he ever goes to college, whatever. I want him to feel safe. And it's such a projection of parts of me that just haven't always felt safe. And I have to be really mindful of that, that it's okay for him to also not feel safe. And I'm not failing if he's in an unsafe situation, if he doesn't feel safe, whatever. And emotionally safe for me, physically safe is separate, but emotionally safe is really the one that gets me and have to continuously be like, yeah, he's going to be around kids and he's going to feel embarrassed. He's not going to feel like he can be vulnerable with everybody. Not everyone's going to love every part of him. And I hate that that's all true and have to really, my anxiety can come in there of like, okay, well, what if he stays over at my parents house and he is asking for help in some way or he needs something or his feelings are dismissed or whatever. I'm like, yeah, that's okay, it's okay if he is in a classroom and his teacher isn't the most emotionally supportive human right that's my work is allowing not necessarily the like, I want this down the road success for him. It's that I want his experience of life to be as safe as it can be and allowing for that not always to be true is hard.
00:34:36 Dr. Vora
Yeah. I mean, I have to tell myself constantly with parenting that my job is to create a sufficiently strong foundation of everything I want for my daughter in the home setting. That when she's out in the world and it's not that, she's okay, she's sturdy, and also that she can recognize this doesn't feel right, and so that can help her navigate. And so I think we get to impact the foundation to some reasonable degree. And this has applications with safety, emotional safety, physical safety. It's certainly how I think about false anxiety with kids. Just to bring it back to that for a moment. I think that kids these days, these days they're inflamed. They are eating a lot of processed foods, a lot of sugar, a lot of additives and food coloring. They're sleep deprived. They're seeing blue spectrum light and screens on into the evening. They're looking at video games and social media and there's a lot that's pinballing their physiology all over the place. And so they're really out of balance. And if I tried to make sure that she never ate, like, a food coloring ice cream cake at a birthday party, well, that would backfire. I would not have a net healthier child. So I need to be okay with the fact that that's life right now. I would love to change that on, like, a government wide policy, but I think that for now, there will be pizza and birthday cake. And so it's at home where I want to make sure she's nourished, where I want to make sure she has some relationship to real food and has, like, a really consistent bedtime and there's darkness in the home after sunset so that she has healthy melatonin release and everything that comes with that. So I think we get some say in how we are impacting their false anxieties in the home setting, at least when they're young. And I think it gets harder and harder as they get older, because teenagers, I'm not sure how much say we have at all with influencing them. But I think that we also have to be okay with the fact that it's about 80% of an impact and then 20% of the time it's all hell breaks loose. But that when we are making a foundation, that's the best we can do. And it's actually quite good.
Yeah. And I think within that, Shefali has been really helpful for me. And they're like, yeah, let's see. You're not in control of anything. The releasing of that as she now has a 20 year old kid and has gone through those teenage years of experiencing the lack of control that we once had when they were little and she and I were having discussions. She said something about, like yeah, and like you can build these things now where I can say to Sage, sure, you don't have to, like you can eat whatever you want here that's on the plate or whatever is going to be provided, and here's what different things do in our bodies, and here's how it might feel. Like, sometimes I feel really frustrated when I haven't had food that nourishes my body or gives me energy or whatever. And helping him understand that these foods play a role or sleep, oh man and being able to relate it back to myself, last night I didn't sleep really well. I was having coffee until 3:00pm yesterday in the afternoon before I picked you up, and then I couldn't sleep. And today I feel a little grumpy. Today feels harder to do. Just for them to hear like, oh, these things affect us and it affects, and Mom's not perfect at it, and I don't have to be perfect at it. And they play a role in how we feel and how we experience life and how we experience the world and that we do have the control over that, over what do they hear us talking about and modeling so that they can learn when they're a teenager. Yeah, you might go and have hamburgers and fries and milkshakes and like, cheers. That's awesome. And if you then have a sugar crash and you're now in a fight with a friend, maybe these are connected yeah.
00:38:39 Dr. Vora
So much yes to that. And I think just like modeling for them, the thought process of this and this physiologic impact and now I'm in a false mood, just helps strengthen they have muscle memory now to take with them to be like, the world is ending. Wait a second, I'm sleep deprived. And you've trained them to be able to identify that. And I think it's also just a moment of parent accountability, which is like, such a revelatory concept, and it's so beautiful. It's so beautiful. Every opportunity for rupture and repair with our kids is so fantastic. I certainly noticed this with my daughter. When I mess up my modeling, my conditioning would tell me, like, oh no, I failed here, and oh, no, I better not let on, I better not admit this. And then in the court of law, she'll be able to hold that against me or something. But instead, what I've learned to do is say, like, oh, you know, what just happened here is like, I made a mistake, and here's why, and here's what happened there. And I can imagine how that must have felt for you. And anyway, I just caught it and recognized it, and here I am admitting it and apologizing. And I think that it's so powerful because it does validate their reality. I think we were gaslit so much as kids when a parent was just fully wrong, and then there was never any admission of that. And then I think that it also not only validates their reality, but I think it also strengthens the bond, but I think it also shows them a model of accountability and that it's okay to make mistakes and that it's not the end of the world. And I think all of that helps them go through life with the ability to do those things and have better relationships.
Yeah. Since we were just talking about food, this is a part of your book, I'm sure that you've heard a lot of feedback about or I'd imagine you'd hear a lot of feedback about. It's a hard topic to talk about. There is a lot of triggers around it. I think a lot of us grew up with unhealthy relationships to our bodies with food about these things. And we live in a culture that doesn't make it easy to make choices, food choices that nourish our bodies. And what's fast and easy for me to do as a working parent isn't necessarily what's going to nourish me and what my brain is craving when I'm overwhelmed, when I'm stressed, when I'm whatever isn't something that's going to nourish me. Give me grilled cheese and tomato soup every day of the week. If I'm stressed that's what I want. That's what I'm craving. And so for me personally, as I've done so much work and continue to do around my relationship to food, my relationship to my body, it can be this swing of like, am I falling too much into diet culture stuff? Am I now in a space where I'm not making healthy choices for my body that help me feel better? And it almost feels like this back and forth inside of me sometimes. And so to consciously bring food into this discussion and say, like, yeah, it affects how we feel, I think is important and really hard to do. And you did it. I think you did a good job in your book. Can you speak to it a little bit?
00:42:01 Dr. Vora
Yeah, I think you're exactly right. It's such a fraught topic. I have gotten feedback on it. I certainly did my best to bring nuance and to not be sort of like an eating disorder trigger. I don't think everyone, it didn't land that way for everyone. But that's certainly my goal. And I think that here's the tricky thing, is that you're exactly right. What we eat impacts how we feel. That's why this matters. And we're coming off of a couple of decades of truly toxic diet culture that told us what you eat impacts how you look. And that was really the emphasis. And it was telling us, like, restrict and cut calories and don't eat fat. And the goal there was, like, to be thin or to look like this. And it had so many issues in it, it had so much sexism in it, it had so much white supremacy in it. There was so much that was toxic about that. And it really just kept women consumed with thinking about these things and hating ourselves and changing the way we eat from a place of deprivation and self punishment and badness. And so I'm all for walking out of that and leaving it goodbye, smell ya later. Toxic diet culture. And yet I do talk about eliminating certain foods and restrictions on certain things. And that reads like toxic diet culture. And for me, the goal is always, how do you feel? And my friend and colleague Britt Frank has a great way of saying this. She's like, choose your heart. And it's hard to eat real food, and it's hard to feel lousy and have, in my case, polycystic ovary syndrome and autoimmune disease from eating bad food. And that was harder for me. It's actually easier to put a lot of effort into eating well. And I think when we've walked out of toxic diet culture, it turns out what we walked into unwittingly were sort of the arms of big food, and they are the big winners, not us so much.
Help me understand what that means.
00:43:51 Dr. Vora
Yeah, so big food, as in, like, the processed food industry, has engineered our food to be hyper palatable, which is a nice euphemism for addictive. Basically, what's happened here is that we've said, I'm done with toxic diet culture and with restricting what I eat. And so then we say, I'm just going to eat whatever I feel like. And now we start to eat like teenagers, and we're like, you know, what I feel like is a bunch of...
Burger, fries and milkshake.
00:44:20 Dr. Vora
Yeah. And then we have a culture telling us, treat yourself. And so now we're being told, yeah, eat whatever you want. But the tricky thing is, in our current food landscape, whatever we want, you're not going to choose the nourishing balanced meal over the crack cocaine. And so we are choosing that, and we feel worse in a different way. And so I think we have to be really careful about sort of like as we're discarding this patriarchy, let's not run right into the arms of another one. And what we actually have to do is nourish our bodies from a place of radical self love and oriented around, like, with an attitude of ease and pleasure. It has to be affordable and convenient, and it can't come from a place of self negation or feeling like we're fragile or becoming obsessive or letting meal prep become a part time job. And this is a difficult balance to strike, so we have to name that, and we have to understand the onus is on us, unfortunately, to navigate the food landscape and figure out, how do I eat in the way that my great great great grandmother knew was nourishing to a body.
Sure. Or that Europe knows is nourishing to a body.
00:45:28 Dr. Vora
I think what sucks is that our systems right now in the States aren't set up for this. Right. That so much of the onus does fall on us. And that feels hard when it's, like, not making so many decisions all the time. And frankly, that in my dream world, I would be able to navigate some sort of blood test or something that would let me know, like, here are foods that don't do well in your body. Right. And that it could be personalized, because I don't think that my diet and what works best in my body is necessarily going to be the same as my husband's or as my brothers or as whomever else is around me. And what feels hard for me is committing to something and not knowing if it's going to help. Right. I recently started doing cold showers. I only did it because of my hormone test that came back with low dopamine, and I would not have done it without the low dopamine result. My hormone test. No, I'm not choosing that hard. And then I started doing it and I was like, I wish this wasn't working. And it is, and I'm feeling better. And I hate that fact, and I don't want that to be true, but it's true. And now it's like, okay, it's two and a half, three minutes every shower is worth it for me because there are noticeable results for me in how I get to live my day to day then. And so it's worth it. But it's hard for me to say, like, I'm going to cut out gluten when I friggin love it, to not know, to be like, is this going to make me feel better? Does my body care? That feels hard for me. And I wish systemically there was data. I want the data on myself to then make these decisions.
00:47:22 Dr. Vora
Some of these things have blood tests. Some of the blood tests are imperfect. There's plenty of people that are like, we'll sell you that blood test and it's not actually giving us meaningful information and it costs sometimes upwards of $1,000. And it's like, not. I think that this comes back to the wearable conversation where it's like to me, there are all kinds of ways to test for these things, but I will still always think that the gold standard is you eliminate it, you see how you feel. You reintroduce it, you see how you feel. End of story. And then within that elimination, it's important to do it well because you want clear data and it's really hard to do that experiment properly. Like with gluten, I've had so many patients over the years be like, okay, so I went mostly gluten free for the month.
I call my diet right now gluten minimal.
00:48:09 Dr. Vora
So yes, actually a lot of sacrifice. And if it's just to sort of be a little bit healthier, that's great to be gluten minimal. If it's to get the data of does your body not like gluten, then it's actually just a lot of sacrifice for very little information because there's a lag in terms of how our immune is reacting to gluten. And so if you're consuming any, you're kind of still effectively eating gluten. And also I've had patients sort of go 100% gluten free but not realize it's in certain oats and it's in soy sauce. And so they're inadvertently getting gluten and then we get murky data again. So it's tough out there. I think that it's also the American food landscape is interesting in that I'm one of those people that we're a large demographic, actually, where I'm not technically celiac. I'm extremely gluten sensitive in the United States of America, and I can go to France and be win an award at who ate the most gluten today and feel great.
00:49:06 Dr. Vora
So this has to do with our agricultural practices. It's our roundup that we spray on our crops. It's our hybridization of the wheat. There's so many factors to this. It's not what people always tell me they're like. It's that you're on vacation and you're relaxed. And for what it's worth, I've actually run all the experiments. I've been working in Europe and tolerating it fine. I've been relaxed on vacation in Hawaii and not tolerated gluten. I've run every angle of this. I'm committed because I really like gluten, and it's not just a matter of relaxation that's a factor. I don't deny that. But there are real differences in our agricultural practices, and it's hard to escape that here. It's even in our tap water. So I think that it's really tough. The onus being on the individual is so, so tough. I think that to that Britt Frank sense of choose your hard, it is sometimes worth getting into new rhythm with how we nourish ourselves. And for some of us that are inclined to rebel against restriction, maybe it's less focused on what you eliminate and more focused on adding in nutrient dense foods. So we're really juicing up our brain and giving it all the raw materials that it needs to function well. And even that looks different than what we've been taught to think of as healthy. We think healthy as, like, arugula and chia seed pudding. And what I mean when I say that it's like egg yolks and chicken liver pate, organ meats, eating bone marrow, fatty cuts of meat. That's really where we find real nutrient density in a way that helps give our brain what it's missing.
Yeah, that's helpful. For me, I'm definitely more of an add in than takeaway. When somebody tells me I can't do something, I just double down. Like, in life, I'm like, I can't wait to do that 7000 times, and that is my immediate reaction. And so restricting is harder for me. Adding in feels more achievable and yeah, I think it sucks that the systems aren't supportive for us here because of the fact that you pointed out, like, what we eat affects how we feel and not just how you physically feel, but how we emotionally feel. And I think it's a tricky landscape to navigate in the emotions discussion when we don't have equity for food access and all that jazz across the board and a problem I think we got to continue to work to solve.
00:51:26 Dr. Vora
Yeah, that's right. It's an enormous problem, and there's steps for us to take on the individual level, but there's also a lot we need to fight for on the government policy level, equity level. It's a big problem, but I will continue to say the unpopular and triggering thing, which is that what we eat matters, so we can't ignore that.
Yeah. And so we got to fight like hell to make it accessible and achievable, especially for our tiny humans. Oh, Ellen, I could do this forever with you. I have 7 billion more questions I want to ask you, but for the sake of time, I'm going to hold back. The last thing that I want to touch on before we wrap up here is when we have that true anxiety surface, are there, like, hot tips that you're like? Here's what you can do. Say you're like, all right. I'm prioritizing sleep. I'm monitoring my caffeine intake, really working on the false anxiety or avoidable anxiety parts. And now I have these true anxiety spirals happening. What are some hot tips for in the moment?
00:52:36 Dr. Vora
Yeah, I mean, for me, hot tips are all about the false anxiety. And true anxiety is, like, so unhot. And even the spiral almost suggests it has more of that false anxiety or panic quality. I love Barry McDonagh's approach to panic disorders where he talks about basically not resisting that when we try to strong arm anxiety and say like, no, I don't want to feel this, it doubles down. It's like the rebellious Alyssa.
It's the quicksand.
00:53:10 Dr. Vora
It is, exactly. And so to sort of run towards it and basically say, like, anxiety, show me what you got, give me your best. And that that can sometimes just take the wind out of its sails a bit. I also find that it's really helpful to just recognize this is not me going crazy, losing my mind, having a heart attack. This is me. This is my body working. Something mobilized, a stress response. And here's the physical manifestations of that. My heart is pounding. My breath is shallow and rapid. My tunnel vision is occurring. I'm feeling tingling in my hands and feet. I feel lightheaded. Like, this is the body in a stress response. It's working, it's doing its thing. And to be almost like this investigative scientist, watching that, observing it, and always knowing sorry, and always remembering that it occurs, it peaks, and it resolves on its own. And to sort of know this is exquisitely uncomfortable in the moment, and this is discreet. It has a finite it has an endpoint. And I think that hot tip, so throat management basically, I always think about it as we start with false anxiety, that's the low hanging fruit. It's the quick wins. I meet somebody and I think, let's identify the possible causes of false anxiety for them, address that, and then we clear the air a bit, and it makes it possible to really drop in and tune into the true anxiety. And true anxiety remains. It has a thematic quality, and that's where you want whatever feels right to you for exploring that content. So one person might meditate. Someone else might do the shamanic drum music shaking practice that I have in my book, and someone else might journal, and somebody else might talk to a therapist. Someone else might take a quiet walk in the woods. And you basically just need to create the stillness, the silence, to access that little whisper of your unconscious that perks up and says, here's what we know is not right, and we need to take some steps around it. And so it doesn't lend itself to hot tips, really. In many ways, it's actually a slow process. But I do think tears are an important like, if there was a hot tip, I think maybe it's crying more because we are so blocked and we're so shut off. And I think we need to give ourselves permission to let things flow. And tears are a perfect example of this, where we have a lot of cultural conditioning that says crying is weakness. It's a burden on other people. We apologize when we cry and that's a really good keystone shift to make for ourselves is to give ourselves permission to cry fully. Not make it smaller, but actually let it be full and complete. And then we see that the energy starts to move, our energy shifts, our thoughts move with that. And that that's a really good sort of way of accessing our true anxiety and way of moving through and finding the key call to action baked into it.
I love that so much. Allowing, allowing expression and allowing emotion. Dang it's so hard to do. I was recently giving I did a presentation on an emotionally intelligent work culture at a conference and one of the questions that came up right after was about, I have this employee and they're quick to tears. When there's something that's hard or having a hard conversation, they start to cry. And I was like, oh, great. I love that. And she was like, well, what do I do? And I was like, do you have to do anything? Can you just cry? And there was like this awkward and I was like, we've made up this rule that there's a certain age or stage that you're going to hit where you're supposed to stop crying when you have a hard emotion. And I think we need to call bullshit on it. In actuality, I'm so jazzed that that human is releasing an emotion, that crying is a really healthy response to emotion and it makes sense to do. And I'm so glad you threw that in there. It literally just came up in my recent past and I wish we did more of it.
I love how you handled that. And it's interesting, right? We know that ACTH is a component in our stress response. It actually comes out in our tears. So in certain ways when we cry, we've actually completed the stress cycle. We've decompressed the stress in our body. And when we block that, we miss that opportunity. So that employee, it's like, yeah, what should we do? We should encourage that and have more employees try that technique.
Yeah, give it a whirl. I love it. I love it so much. Ellen, thank you so much for joining me, folks. Go snag The Anatomy Of Anxiety It is just full of goodness. Highly recommend the audiobook, by the way. Love it. And not all audiobooks are created equally. It was well done. I like the person who reads here. It's just good job. And Ellen, where can folks connect with you?
00:58:23 Dr. Vora
For the most part on Instagram, where I'm @ellenvoramd and over on my website, www.ellenvora.com, I think most of my life's work is consolidated into those 250 pages of The Anatomy of Anxiety, so I hope it's helpful.
Yeah. Thank you so much.
00:58:43 Dr. Vora
Thank you, Alyssa.
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