Therapy For Gay Men

Jen talks to psychiatrist Ken Howard - founder of Gay Therapy LA about his thirty years in working with gay men and their mental health.

Ken talks about how to cope with "birthday anxiety", and he illuminates the different therapy approaches he uses with patients from working on trauma, or using a positive psychology coaching approach, or some good old fashioned cognitive behavioral therapy around anxiety in all stages of life.

To find out more about Ken's podcast, public speaking, and his life's work go here: https://gaytherapyla.com/biography-of-ken-howard-lcsw/

For more information on Jen Kirkman, the host of Anxiety Bites, please go here: https://jenkirkman.bio.link

and to get the takeaways for this episode please visit: http://www.jenkirkman.com/anxietybitespodcast

To send an email to the show write to anxietybitesweekly at gmail dot com.

Follow Jen on Twitter @jenkirkman or Instagram @jenkirkman

Anxiety Bites is distributed by the iHeartPodcast Network and co-produced by Dylan Fagan and JJ Posway.

See omnystudio.com/listener for privacy information.

Episode Transcript

Speaker 1 (00:08):
This is the Anxiety Bites podcast and I am your host,
Jen Kirkman. Welcome to another episode of Anxiety Bites. I
am your host, Jen Kirkman. My guest today is Ken Howard.
He is the founder and director of Gay Therapy l A.
He also has a podcast of the same name. And

(00:30):
I have a lot of listeners reaching out to me,
especially during the episodes that I did back in February,
there are more relationship based. There were people saying, you know,
is there a kind of therapy for gay men? And
I I had somehow come across Ken Howard on on
my Instagram because I follow a lot of therapy things
and then I get recommended this, and I get recommended that,

(00:51):
and you know, we're on opposite coasts. So we've been
trying to make this interview work for a while. But
I've also noticed a try end that therapists have on
their websites. Now you know, oh, they're trained in this
and that, and they see children and adults, and they're
also lgbt Q affirming, which means they may not be

(01:13):
gay themselves, but they will not um be completely oblivious
to what the gay experience. Maybe you know, they may
be anywhere from just hey, I'm not a bigot too. Oh,
I have some training in you know, the cultural things

(01:33):
that may cause depression or anxiety in addition to you
know what we just have inherently on our own because
they are lgbt Q in America or in a certain
state or in just the world during this time, or
their you know, their family doesn't accept them or whatnot.
But I wanted to wait until I could talk to
someone who is actually a specialist like kenn Is, so

(01:58):
that I could give the most of this topic on
an episode that I could since it's out of my depth.
But um, I figured you don't want like, you know,
me and in a straight therapist talking about you know,
the gay experience. And so Ken exclusively has worked with
gay men gay clients, whether as individuals or couples, for

(02:18):
over twenty nine years. He's based in Los Angeles and
West Hollywood, and he does provide coaching for gay men
and gay mail couples via phone or you know, a
zoom session to clients all over the US and in
many countries, especially places where people do not have access
to a gay therapist. Now, what is interesting about this

(02:41):
episode is although we don't really get into relationship anxieties.
We do just talk in general about anxieties that gay
men might face, but we really kind of just end
up talking about anxiety because there is obviously this universal

(03:01):
thing that that if you have anxiety, have anxiety, We're
all going to experience the same things. Of course, depending
on your circumstances in life. You know, if you're a
black woman, if you're a gay man, you might have
obviously different and more anxieties than someone in society who
doesn't have to put up with extra pressures from society,

(03:25):
bigotry from society. You know, there is more to quote
worry about. But um, what's interesting about this episode is
a lot of my episodes come from the place of
the person with anxiety, in the sense that we talk about,
you know, your normal, this is what it feels like,
this is what anxiety is. What I liked about my

(03:46):
conversation with Ken Howard has really got into what he
does in his practice, and he has so many different
modalities of helping people, whether it is he takes more
of a coaching attitude with some one in one moment
or more of a you know, direct psychotherapy moment, whether
it's positive psychology or cognitive behavioral therapy. There is all

(04:07):
of these different modalities that he is studied in and
can kind of weave all of them through in one session,
and you get to hear, you know, like a fly
on the wall, Oh, he had a client yesterday with
this issue, a client yesterday who at that issue. And
so I really think you'll get a lot out of
this episode from that perspective, and it's a great episode
if you've never been to therapy to kind of hear

(04:28):
what can go on in a therapy session, as well
as something Ken teld us at the end of the
episode spoiler that anyone can go to therapy. You don't
need to have a disorder of any kind. You don't
have to have a mental health diagnosis or be on
the lookout for one. You just can have a goal.
You don't even have to have a problem. You can
just have a goal and you want some help achieving

(04:50):
that goal. Okay, So before I get into my conversation
with Ken Howard, I'll just let you know a little
bit about him from his From his bio, he's devoted
his professional career as a therapist exclusively to working with
gay men or individuals um or gay mail couples. In
the nineteen eighties, um Can enlisted in the War against

(05:15):
AIDS as a training Can you hear the I live
next to a fire station. We've been so far, so
good on this podcast, where you don't always hear it.
I don't know if you could just hear that, but
I'm not starting over. Listen. Sometimes there's fire trucks, okay.
Um Ken began as a trainee in mental health, first

(05:36):
in psychology and then in clinical social work. He volunteered
at AIDS Project Los Angeles as a phone buddy, providing
phone counseling to people with eights. He noticed that the
guys who had more mental health support survived longer and
better than their peers with poor mental health. Later formal
research proved that observation. Ken's own diagnosis as HIV positive

(05:56):
in November lad him to abandon the pursuit of his
five year plus PhD psychology program because, as he says,
at that time he was literally afraid that he would
not live to see the completion of a doctoral program, and,
as he says, he was far too obsessive compulsive to
die with a half finished degree. He chose to pursue

(06:16):
the two year full time MSW Master of Social Work
program in the Mental Health Concentration at the University of
Southern California School of Social Work, where his internship training
right from the very beginning, emphasized the population that he
wanted to work with most, the LGBTQ community and to
do his part in the fight against AIDS. At the

(06:39):
LGBT Center, he co facilitated a group for gay and
bisexual male incest sexual abuse survivors. Later, he got very
interested in helping people with more severe psychiatric disorders or
chronic mental illness, and he completed a clinical internship at
Pacific Clinics, Pasadena, specializing in assisting persons with schizophrenia and
other severe persistent mental illness and developing a model of

(07:03):
care called psycho social Rehabilitation and assertive community Treatment. After
years of formal supervised training, he earned his California State
License to Practice Psychotherapy, which is the LCSW licensed clinical
social worker, with a special additional training as a psychiatric
social worker, which qualifies him to discuss medications and their

(07:25):
use more in depth, but not as precisely as an
empty psychiatrist. So Ken Howard knows his ship. Okay, people,
so enjoy my conversation with Ken Howard and maybe you'll
learn about something new, like I did something called birthday anxiety,
which I've got coming up the summer. But this isn't
about me right now, Okay, enjoying my conversation with Ken Howard,

(07:46):
and of course you can go to the links in
the show notes and read more about Ken and find
out about his podcast, in his book and all kinds
of things. So I'll see on the other side. You know,
I always kind of kind of joke, you know, we
gay men tend to pay the bills. You know. It's
it's it's an affluent market niche in general. I mean,

(08:09):
it's kind of a stereotype that all gay men, you know,
have design and clothes all the time. That's not true,
but um, you know, it's a desirable niche. It's just
that I think niche as you have to be careful
because you've got to have some kind of an entry
ticket in terms of credentials. You know. It's, uh, it's
like any other field where specialized knowledge or specialized expertise

(08:34):
really comes in handy. And you know, early in my
career I made the very important decision that I was
going to be a specialist. I was gonna put all
my eggs in one basket, you know. And at the
time building my practice and building my career in the
nonprofit world, people said to me, you know, if if
gay men are or you know, if if gay people

(08:55):
are approximately ten percent maybe a little less of the population,
you're excluding of the world from ever being able to
be your client if you really specialize in a exclusive practice.
And I said, yeah, I know that, but you know, um,
partially from a business standpoint, specialization and niche, you know,
tends to create business. You know, if you're dry cleaners

(09:20):
and you specialize in cleaning suede and you get a
spot on a swaye jacket where you're gonna go, you know,
or there's a specificity is just so important sometimes because
there isn't time to study everything equally, you know. I
always make the joke if I get a call from
a teenage girl with an eating disorder, I'm going to
refer to a colleague who sees teenage girls with eating

(09:41):
disorders all day long. But for gay men, it's kind
of like, well it's and you know, and I was
advised in grad school by this woman chev Romain names,
but she said, well, I told her I wanted to
specialize in gay men. You know, this is from day
one of grad school. And she said, well, and you're
going to be a very narrow perison. And I thought,

(10:03):
you know that that's one of those things I called
subtle homophobia. Because if you had somebody saying just about
any other specialization like ge that'd school counselor I want
to specialize in teenage girls who suffered with eating disorders
and support their recovery, they'd be like, oh, that's interest
good for what? Yeah, exactly, And and it's just and

(10:24):
it's one of my things, you know, politically about subtle homophobia,
because I think it's everywhere, and because I'm just old
and curmudgeonly at this point. But you know, but but
I'm very proud of that, and it was the reason
why I made that kind of it sounds a little sappy,
but I am a little sappy. It's uh, you know,

(10:44):
I I kind of came of age in my twenties
during the AIDS crisis, and I saw a lot of
beautiful souls, you know, gay men who died very prematurely.
And I said, I can't stand back and watch this
without giving to this community. Not on my watch. If
I can do something about the decimation of gay men

(11:06):
in America, I'm going to do something. It's like Superman.
If I have these powers, I'm going to try and
save people with them. And so that's the commitment I made.
First two people with HIV, especially gay living with HIV.
Later I did work with women and kids in youth
with HIV, so the whole HIV spectrum. But it's my

(11:27):
I think it's my gift back and I think it's
my existential I can't speak French. They for my for
my career, you know, kind of the the original kernel
of inspiration, and so it really, I mean it sounds happy,
but really what I'm doing every day and supporting gay

(11:49):
men's mental health and well being is ultimately I'm fighting
back against the AIDS crisis. You know, I did have
that trauma, and every day, politically and clinically and socially,
I fight back against what we lost in any way
I can. And that to me, that's a career. Fine,

(12:10):
that's that's fine. If that's my life, I'm happy with that.
My grandmother taught I'm sorry my grandmother taught first graders
how to read for thirty years and that was her career.
And it's like, okay that, you know, she didn't teach
oul gebras, she didn't teach college chemistry. You know, she
taught first graders how to read for thirty years. And
to me, that's a noble life, you know. And I

(12:33):
don't really believe necessarily in St. Peter. But when I
get to St. Peter and he says, who are you, dude,
I'm gonna say I helped gay men's mental health and
well being for over thirty years. Yeah, okay, come on in, welcome, Yeah,
wipe your feet before you come in the door. Yeah.
And uh. And that's kind of just the whole drive

(12:53):
that drives my career. So when I do career coaching,
we sometimes talked about that. I say, what is the
drive that will get you up in the morning, even
on a rainy, cold Monday morning when you don't nobody
wants to go to work, They want to stay in bed.
But what is important enough to you that you might
get up on a rainy Monday morning and go to
work anyway? Because your work is that important? And you know,

(13:15):
if people can answer that then I think they're on
their way to a good career. And I think what
you said is so important to the people saying well,
that's niche, that's narrow. You know, it's coming from this
how much progress we've made, and I know there's so
much more to go, but it comes from this really
ignorant place. It's like you experienced this decimating plague that

(13:38):
was being ignored by the government because most of the
victims were gay and left a generation of who knows
what kind of beauty we could have in the world.
This generation was left to die. The mental health impact
on that is insane. And it's not like, um, gay
people were able to get married or have protection at work.
I mean it was like and these people still have

(14:00):
to be closeted while they're dying at this place. I
mean I to me, that is broad in the sense
that if you can help this community with mental health
as they go out into the world and flourish, because
this might be one of the first generations that really
is allowed to um, you're taking your expertise and your
survival and your gift, you know. And to me, like

(14:23):
you said, your grandmother taught people to read well once
you learn to read, you can do anything, you know,
and once you get your mental health in order, you
can become anything. And then they will be inspired by you,
and they'll inspire others that just I'm so happy to
hear you say this and I and I'm just grossed
out by those people that said those things, because it's
it's you know, luckily you were not influenced by them.

(14:47):
That's one of the things about you know, the history
of HIV and AIDS is that, um, so much of
it is lost. And it taught me a lesson really
about history, about what people in general know about the
height of the AIDS crisis today. And I just think,
wait a minute, wait a minute, that that's the tip
of the iceberg. That's that's not even half of it.
You there's so much more than people know about. And

(15:09):
I want to, you know, if you apply that to
anything else, to World War two, or to the Civil
War or the Civil rights movement, or just anything in history,
and think, oh my god, anything in history we really
only know the tip of the iceberg about, you know,
if we could talk to people who live through some
of that. Some there's still a lot very very old people.

(15:32):
But the Holocaust for example, something like that. You know,
we realize it's humbling because it means that even what
thirty years later, you know, so much as lost to history.
And I think it's it's important because there were so
many things about the AIDS crisis that nobody talks about,
and yet you know they were there, just little everyday things,

(15:54):
you know, things in the news. The level of hysteria
was much worse, I think than people realize. You know,
there was a college director who wanted to put on
a production of The Normal Heart, a gay and aids
them to play, and somebody burned his house down for
directing a gay themed play. I mean that stuff was

(16:15):
lost to the news, but yet things like that happened.
Or Ryan White, a little boy with HIV trying to
go to school and you know, I had to change schools,
you know, just things like that, and people are like really, yeah, really,
And there was a lot of you know, speaking of anxiety,
you know, there's a there was a lot of the

(16:37):
theme of anxiety that came out of the AIDS crisis,
I think because there was anxiety about getting it, getting
HIV positive, and then there was anxiety about what course
it would take which was my situation. You know, I
always say I was diagnosed with HIV in n and
I worried about whether I would outlive my ninety two
year old grandfather. Yeah, and there was just all this.

(16:59):
You know, people who were diagnosed, you know, practically within
weeks of that. You know, we're dead in a year
and certainly in ten years. You know. Oh, you know
this is you know, if your HIV negati if you
take one pill once a day, you know, for prep
pre exposure provolaxes, and if you're HIV positive you take

(17:20):
one pill once a day for antivirus medications. So you know,
gay men across America, you know, are getting up out
of bed every morning and popping a pill. And and
that's the end of the HIV store. I mean not really.
I mean it's a lot of people would say, hey,
buddy boy, you know, it's not over, and there's still
a lot of suffering and challenges and and there are

(17:40):
I have my own challenges medically. I'm at the doctors
once or twice a week for some kind of HIV
related something or something. And you know, so I understand
that it's not over, but I think we also have
to be very grateful for things like progress and change
and the heroes of our society, like scientists. I will

(18:02):
never meet little little dweebs who were probably made fun
of for being a chemistry geek, you know, instead of
being a football player. But you know they're the ones
with their little test tubes that found a way to
keep me alive every day, you know, so just every day,
I'm kind of grateful that some little dweeb or you know,
white coat who studied chemistry while I studied theater, you know,

(18:26):
is found a way to say my life because they
invented you know, I centrists or or whatever. And you
know it's it's got bust the geeks, you know, because
they're the ones that create the medicines that keep us
in our loved ones alive, right, you know, they keep
the theater department alive. Well, you know this brings me

(18:48):
to this is what's so fun to talk to you
about because you have, um, you have this episode of
your podcast about birthday anxiety, which I never heard anyone
talk about, and you know we all have it. I mean,
you know, I'm gonna be fifth you soon and I'm
not not anxious, but you know, but I do like
the specificity of it in the gay community too, because
I don't know if you've seen this. I have a
friend named Sam Pancake is very funny comedic actor and

(19:11):
he lives in l a And there was a viral
video going around of him on stage because he was
talking to a younger gay man in his twenties and
Sam's in his fifties, and the younger gay man said
to him, Oh, I can't believe. I can't imagine being
in my fifties. I'm just gonna kill myself when I
get to be that old. And Sam went on a
rant on stage that was epic, and he was like

(19:33):
just everything we've been saying, like, um, well, I'm glad
you feel you have that luxury, but you know, I
would you know in my generation, like we're all scared
of AIDS and so many people I know would have
loved to have lived till fifty and you know, blah
blah blah. And it reminded me of that when I
listened to your episode about birthday anxiety, that you say
there are men gay and who come to you with

(19:53):
birthday anxiety and it's in and how would you I mean,
I guess it could relate to anyone really, But what
what is your advice for someone who is anxious about
getting older? Well, I think, you know, I worked a
lot in my in my therapy practice. Um. You know,
I mainly work in the school of therapy called cognitive
behavioral therapy, which is awfully useful for a lot of

(20:17):
things as opposed to the old school psychodynamic and psychoanalytic.
Although there's a saying the older therapist gets the more
here she uses psychodynamic and psychoanalytic elements because it gets
it more depth. I get that that's a developmental thing
for therapists, and when I've done clinical supervision of coaching

(20:37):
young therapists, we talk about different therapies and models of
therapy that can be used. I actually taught models of
therapy at USC. But I also draw a lot from
developmental psychology and existential psychology, you know, existential stuff about
what gives life meaning and purpose. So I was talking about,

(20:58):
you know, what do you get up out of bed
rainy Monday morning to do? You know, that's kind of
an existential motivation for what kind of mark do you
want to make in this life? But then develop memorly, Um,
I think there's a little bit of an underappreciation even
among therapists for developmental issues across the lifespan, especially with

(21:19):
what I call the zero birthdays. Birthdays that end into zero.
Thirty and forty are the big ones. You know, in
my practice, a guy turning thirty, there's a whole syndrome
of what happens. It's very predictable, and there's a whole
syndrome at forty. It's less so at fifty and sixty.
By fifty and sixty you kind of give your fuck.
But it isn't that funny because I think it's different

(21:41):
for women, because well, I mean everyone's different. But for me,
you know, I'm like having physical symptoms I'm going through
like menopause and is really the worst and uncomfortable, and
so fifty for me, forty was like nothing. I was like,
who cares? And thirty I think it's a gen X thing. Um.
I was a little anxious, but I feel old. But
in my growing up, my generation, we knew that from

(22:04):
twenty to thirty you were kind of supposed to be
a funk up. It was fine. I think these days
kids have more pressure than like want to have their
life together by twenty five and I was just like,
I don't need to do that. So at thirty I
felt a little bummed out, like it was time to
start growing up. But I didn't feel old. I didn't
feel old until I still don't feel old. But I
feel like fifty is the first birthday I'm gonna go,
oh ship. But it's what are people experiencing in your

(22:25):
practice at thirty and forty? Like? What is it? Just? Um?
Well again, if you're looking at the gate mail niche
you know, in in really a close up focus, you know,
I think, um, you know, it's how people what there
is called present you know, fancy word for the first
thing a guy says on this first therapy session, really
is you know, well, you know, I'm having some concerns

(22:48):
about this and that and you know the turning thirty transition. Um.
If we look at professional stuff, it's sometimes about coping
with their first managerial jobs, give or take. You know,
you can be a CEO like twenty two, or you
can be you know, the guy sweeps the floor at sixty.
It just depends on the field and your individual career park.
But you know, in general, speaking broadly, you know it's

(23:12):
coping with more responsibilities at work, you know, maybe less
opportunities to go out in a weeknight because you've got
a major presentation at work the next day, or because
you're in a position where you give me major presentations
at work then, or um, settling down. I think there's
a homing instinct around thirty where you're like, yeah, then

(23:34):
you know, just kind of horn around and um, you know,
at thirty you start to have a little bit of this. M.
I wonder what it would be like if I met
a guy and settled down and the issue maybe to
have kids or not, And um, I think there's a
whole financial responsibility. You know. One of the things I
ask guys who are new who are thirty, I kind

(23:54):
of saying, what's going on with you? Far one k?
You know, and some of them are like million dollars
in my four and because since I was twenty my
grandfather's loaded and fine, you know, others will be like
what's that, and like where do you work? Oh? You
know IBM, you know, someplace with full benefits where you
know they have afore own OK. And I'm like, Okay,
tomorrow you're going to your HR office and saying, Hi,

(24:16):
how do I enroll in the fore OUM okay, you know,
because it's you know, there's professional things, there's financial things,
there's certainly health things, um things about it's a it's
a little bit of a wake up call about when
you're not in your twenties anymore, you kind of transition.
It's like you've gotten a promotion in life. You know,

(24:39):
you're going from twentysomething to thirty something, and you know
that's a very characteristic change, you know, kind of a
little bit of a buckle down, a little bit of
a um, you know, completion thing. You know, it's like, well,
I've had one more course to go before I finished
my m b A and that's been going on for

(25:01):
four years. And it's like, okay, you're taking that course
this year so that you have an NBA by your
thirty one and then you're gonna be making twice as
much by forty one and whatever. And you know, that's
when I become kind of uncle ken about, you know,
the mentor and then turning forty. Unfortunately, I try not
to tell guys who are thirty of it. It gets

(25:22):
worse when you're turning forty because they're like, oh no,
and uh but you know, turning forty, there's just a
lot of neuroses that comes up about aging, body image.
Did I make the right choices in life? Do I
want to change my career? Did I choose the right
person because I've been in a relationship for eighteen years

(25:43):
since i was twenty two, and I'm not sure he's
the right one. You know, these are all things that
whether or not you want kids, you know, by forty
you've got to start really making that decision because I
do the math. You know, if you have a baby,
you're going to be fifty eight by the time it graduate.
It's high school, so you know, it's uh, you can do.

(26:04):
Plenty of people do that. It's not the end of
I've seen that it works out fine. But you know
in that in the the the blog article about gay
men and birthdays, there's also another part of it, you know,
like the guy at at sam Pancakes show that you
know a lot of aging anxiety. And Eric Erickson, who

(26:24):
was a great theorist psychologist author, kind of said every
phase of life and he outlined certain phases has a
challenge and a reward. It's not done any one age
is better than or worse than others. It's just that
you get some kind of an advantage of being whatever,
forty something, but you also have a challenge with it.

(26:46):
And he said, if you the trick, the trick to life.
Eric Erickson was basically saying, if you can emphasize the
joys of each phase and minimize the pitfalls with a
risk of each phase, it gives you a more confident,
less anxious that word, way of approaching your life. And

(27:06):
it's also an opportunity to the existential, you know, to
celebrate your existence, you know, to celebrate that you have
a life. You didn't you know that car did not
hit you when you crossed the street running for the
ice cream truck at age ten. It missed you. So
now you're fortyes, so be glad. You know, you could
have been on the pavement, you know, or um. You

(27:29):
know that infection that you had, you know, when you
were twenty two, Okay, they were antibiotics for that and
you survived. So welcome to forty. You know, all of
these existential things about your here and all the other
people who love you in this life are here, and
so your birthday is always a time to celebrate it
because think about the guy who wanted to have a

(27:50):
forty six birthday and he didn't because the junk driver
hit him, you know, when he was thirty one, and
that's it. No more forty six. So if we cognitively
reframe what a birthday means to emphasize the reward and
kind of the challenges, Yeah, they take care of themselves,

(28:10):
then then you got it and you get you get
to do that every year. You know, you kind of
get a new lace on life every year on your birthday,
and I'll take it. You know. It's better than tached
time every year. So it is a reframing because I
think a lot of people spend their birthday jumping into
the future, Oh my god, I'm closer to older, and
then looking back, Oh did I do everything I should
have done? But you're saying no, look back and celebrate

(28:32):
the fact that you're you're here, Like anything could have
happened that would have taken off this planet and it didn't,
so here you are. Yeah. I have a friend who's
ninety two who runs two miles a day, and it's like, okay,
I'll have what he's having. Yeah, exactly. God, I mean,
I'm sure he enjoys the running, but I'm like, like

(28:53):
running now. He also has a very strict raw foods diet,
and I'm not I'm not sure I could handle that
because I like I like my junk food. Well, plenty
of people have lived to a hundred on junk food.
That's true. We'll be right back. I know you've talked

(29:16):
about that. You I love this. In terms of dealing
with anxiety, you say that people are not really experiencing
like an anticipatory anxiety about anything in their life, because
there um there. It's because they're experiencing a fear of
a possible loss. I've never heard it framed that way.
I love that. If you can tell us about that, well,

(29:37):
I was. There were two guys yesterday in my practice.
They were almost backed back. And that happens sometimes where
you know, I'll see two clients in a day, or
maybe sometimes in a row, that are remarkably similar. It's
like some kind of alignment of the planets that's making
them think about anxiety. And sometimes something in the news.
I noticed that I've had days where guys will come

(30:02):
in and every one of them will be somewhat agitated,
and then I'll say I'll get a break and I'll say, Okay,
what's going on. I'll turn on my my phone with
the Apple something in the news, and there'll be something
like a mass shooting or something, and I'm like, something
is making everybody anxious today? What is it? And then
lo and behold there's there's always some kind of news
story that you know, just it's kind of like the

(30:26):
full moon. You know, a lot of people psych hospitals
sometimes say, you know, oh boy, full moon. You know,
people act up. But in cognitive therapy work, I frame
anxiety management in certain ways. You know, it's others probably
do it better. But what I've come to use over
a long time about we have a relationship to anxiety.

(30:50):
And I think anxiety draws on the human psychological defense mechanisms,
you know, because we're programmed as people to assess and
respond to threats, kind of like the animal Kingdom, you know,
the animal Kingdom, these these national geographic specials or something.
You know, how does a muskrat deal with threats? You know?

(31:12):
And I think sometimes anxiety means that are warning systems
are out of whack, you know. So sometimes I make
the analogy of anxiety like a smoke detector in your home.
You know. Sometimes it's three in the morning and your
building has bad wiring and a fire is starting in
your living room and you're gonna die if you don't
wake up and get out, you know, So the thing
goes off, Beppe, you know, get out now so that

(31:35):
you live. Other times, you know, the smoke along goes off.
It just because you burned the toast, you know, and
you can't wave the thing and open the windows and stuff,
and you have to say, smoke destector, stop, I'm fine, really,
you know, and the smoke detector says, yeah, but I
smell smoke. Are you sure you're okay? Yes, I just
it's burnt toast, don't worry about it. And you know,
our anxiety system is like that, you know, anxiety system

(31:57):
goes off and say, are you sure this isn't a
day injuriest thing? Because should should we not be running?
Should we not be hiding right now? And we have
to say no, it's okay. It's just I'm asking my
boss for a raise. I am a little unpins and needles.
It's not a problem, you know. We have to talk
back to our anxiety mechanism. I love this. I will

(32:20):
now put this in my tool kit of talking to
it that way, that like something's checking in on me
and I have the control to say thank you for
checking in. This isn't a fire. I love it anyway,
Sorry interrupt going. And I think also it's about a
fear of loss, you know, anxiety. I think it just
means that we value something. You know, I'm anxious to

(32:41):
drive my brand new car home from the dealership and
get it home because it's my new baby. And you know,
if you're anxious, you know, the first time driving at home, well,
it's because you like your new car, you know. Or
if you're anxious before you give a talk at work
of sales, presentation and on you know, the fourth quarter

(33:02):
of sales, of course you're anxious because you want to
do a good job and you want the company to
succeed and you want the audience to appreciate your efforts.
Or or an actor going on stage, gosh, and anxious
before going on stage, Well, of course you are because
you you want to do right by the play and
do right by the audience and the director. And um,

(33:22):
it's not a guarantee that you will, because maybe Seen
three is a little under rehearsed, you know, but you
do it anyway because you know, one of my favorite
self help books by Susan Jeffers, I think she's gone now,
but it's all in the title, feel the fear and
do it anyway. You know, just just because you're anxious
about something doesn't mean that you don't do it. It

(33:43):
means that you know, okay, too bad. You're gonna have
to just be uncomfortable. But that's not a reason not
to go on stage or give the sales presentation or
ask for a raise. You know, you have to work
through that, and you don't wait until you're comfortable to
do something, because you might wait forever and it's too important.

(34:03):
You know, you kind of have to say not today, satan,
you know, to your anxiety, which is a cognitive intervention.
You know, um, that's thoughts stopping in cognitive behavioral therapy,
or it's really it's reframing. Especially oh gosh, I have
to give a sales presentation, and I'm so nervous. It's
I get to make a sales presentation because I've got

(34:26):
this great job. You know. They ethel Merman, the Great
Broadway star. They asked her do you ever get anxious
before performance? And then I don't get anxious. I know
what I'm gonna do. The audience ought to be anxious.
They don't know what they're gonna get. Oh that's great,
you know, And I think that's what it's. I don't
know if she was always that confident, but yeah, it's

(34:48):
probably a thing she had to tell herself, you know,
before she and out there. You know, I like the
idea of the laws. So let's say someone is anxious
because they're about to make a presentation or they're going
to propose to someone, or they're gonna asked him on
on a date or whatever. Is like, okay, like you said,
of course you're angios. You want to do right by
the company and you want to do a good job.
But is underneath that the loss, like the deep anxiety

(35:11):
is and if I don't do a good job, like
it gets that's where it gets disproportionate. Where it's like,
if I don't do a good job, like the proportionate
thing might be like, oh my boss would be a
little disappointed, but they still value me. But the deep
like anxiety, that's not proportionate. That's the loss is like
and then they'll fire me and then I'll be homeless.
Or I asked this person on a date and they
say no, and I'm rejected and no one loves me.

(35:32):
Ever I'm alone, you know, is it? Is it that?
What you mean by that? There's another thing about kind
of the train or the ladder of you know, it's
it's filling in all these and therefores you know, it's like,
I'm anxious about my presentation and therefore I'm going to
do badly, and therefore my boss is gonna fire me,
and therefore I'm going to be homeless, and therefore I'm

(35:53):
going to be whatever from there. And you know, it's
it's kind of the fear fantasy or the the spiral,
you know, that whole downward spiral thing. And you know
I said, you know, be careful of the crystal ball.
You know, you just can't predict the few. The odds
are that you're going to do a good job, because
first of all, you want to, and then if you don't,

(36:16):
you know, um, then you have to kind of adapt
in the moment. You know, if you go to make
your sales presentation, your zip drive you know, got wet
and it doesn't work and you're without your power point
or something and you have to wing It's like, well
then you you wing it, you know, and you're just
gonna do the best you can. You know, I was

(36:37):
coached one time by a business coach that kind of
Most people professionals could probably stand up and give a
talk on what they do for an hour without any notes,
in any preparation, but if they've been doing it for
a while, you know, people freak out about speaking, but
most people have it, especially in the Q and A.

(37:01):
We'll continue the interview on the flip side of a
quick message from our sponsors. Worked yesterday with a guy
who has a particularly strong case that session after session
about anticipatory anxiety. You know, if you're an adult child

(37:22):
who has caretaking responsibility for elderly parents, you know there
might be an anticipatory anxiety about your parents getting worse
and passing away. Or if you've had a dog for
fifteen years, you might start to get real concerned that
she might not live much longer as your pet. And
you know, it's it's you can really kind of make

(37:43):
yourself crazy by living in the future where you're living
with that loss, but you're you're feeling it today, and
you know that's when kind of way I think we
have to kind of orient ourselves to the present. You know,
I think we're ring about the future is kind of
an anxiety that we're borrowing from the future. And then,

(38:04):
you know, feeling bad about a lot of stuff in
the past is a little bit living in the past
when you're right here today. And so you know, there's
a big argument for kind of living in the present.
You know, it's lots of horrible things could happen in
our future, because horrible things have happened in our past,
but there's also great things that have happened in our

(38:25):
past that we felt just great about, and probably things
in our future that will feel great about. And there's
a there's a Shakespeare line but kind of butchering it,
but it roughly says, our lives are as a fabric,
a weave of good and ill. And now that's kind
of what what that is. I mean, Okay, you have
to leve with the fact that, yeah, you if you're

(38:47):
anxious that there is going to be some real ship
that's gonna happen, it's gonna hurt, It's absolutely gonna hurt.
But there's also going to be some stuff. Hopefully the
majority that that's good stuff too. And you know, I
think cognitively a tool that you always have is what
social workers are taught with. What is the adaptive coping
for this? No matter what happens, even if it's something

(39:10):
really bad, like you lose your job and you totally
your car on the way home. Okay, that is one
fucking bad day. But if you say, okay, what's the
adaptive coping for this, It's like, well, I call the
insurance company and I'm gonna get a new car soon
and I'm gonna my insurance with the house and get
some new stuff. And you know, look at yourself, you know,

(39:33):
are you in little pieces? We'll know I'm I'm fine.
All right, Well let's start with that. Let's start with
the fact that you got shoes on your feet. You
can walk and see and here and I'll be in
poop and eat and drink and all that. So so
you've got something to work with. You know, you have
no house and no car, but you got shoes. Let's
start with that. You know. Or Louise Hayes little adage,

(39:56):
Um Louise Hey, was this inspiration? You know her? Yeah?
You know, and she uses the phrase, you know, how
can I take a positive approach to this? Yeah? You know,
you bank the presentation and it sucks because you had
bad numbers and the power point broke, and you know
your college is like dude, um, that's a great job
and that board, you know, and then you say, how

(40:18):
do I take a positive approach to this? You know,
you might email your boss and say, I don't think
today went well. I want to revise this. How about
the next staff meeting? I do an update with the
missing slides and should probably go yeah, that's probably a
good idea because that one sucked, you know, And then
the next week, you know, you do it over again,

(40:38):
say sorry, guys, that didn't work out so well last week. Anyway,
follow up fourth quarter is going to be there. You know.
That's adaptive coping. And I love that you say positive
approach and that Louise said that because you're not saying
positive thinking. You're not saying, oh, it's great that I
am only of my shoes, it's great. I sucked up.
You're saying, Okay, let me take a like like you said,

(40:59):
a coping, let me take, let me cope, let me
you know, be honest, get in touch, try to think
of something better for next time. I it's very realistic.
Is something people can do right, It's not just think
positively about it. I love it, And I think the
other thing it's really important to talk about, which we're
not getting to it we should, is which a lot

(41:20):
of people I think would say, is say, you know,
that's easy for you to say, buddy boy. You know
you didn't get fired from a six figure job because
you gave a shitty sales presentation. Now you have to
do another one and your asses on the line. You know.
It's that idea that sometimes anxiety comes from trauma. You know,
it's like, oh, I'm going to walk down the street
at through in the morning because you know, I forgot

(41:42):
something and I'm going to go look for it and
in the dark alley. You know, that's a lot easier
to do if you weren't beaten and mugged in a
dark alley three years ago or thirty three years ago,
you know. And so some of that is validating the
trauma and the loss that we've been through, because when
we've been through a very painful loss, you know, there's

(42:03):
a part of our psyche that's kind of say, okay,
note to self. There are dangers out there. There are
muggers out there, there are drunk drivers out there, there
are bad critical bosses out there. But again, that's where
you have to bring it to the present and say,
I realized, you know, I was really upset by being
mugged in the dark alley. However, that was another city.

(42:24):
It was years ago. I'm with somebody, you know, I'm
with my boyfriend, and my boyfriend's a cop. You know,
I'm now accompanied by a cop on a dark alley,
and you know, I'm going to look and see where
I've dropped my wallet or something. And it's well lit,
and you know, the chances of being mugged they're there,
but they're not so great that I can't go look

(42:45):
for my wallet in the dark alley and kind of
revisit the same circumstances that you know, I worked with
somebody who had a phobia about driving because he had
two bad car accidents. And you know, to rehabilitate from
the anxiety of driving when you've had two accidents, that

(43:05):
that's a real process. You know, you have to kind
of validate that it was painful to go through that.
But at the same time, that does not mean we
don't say and therefore never drive again. We say, and
therefore you've been through a lot that was hard to
get through. Let's rehabilitate so that you can live your

(43:25):
life as a driver again. Yeah. So, I you know,
when I have a client in therapy for anxiety, I
look for trauma, and you know, sometimes we have to
validate and have them process the trauma before we can
get to day to day anxiety management. You know, it's
like a prerequisite course for the anxiety management is trauma recovery.

(43:46):
And what would you say could be categorized as trauma?
I mean, are you looking for like big T trauma
or can you say maybe trauma for them was losing
a pet or you know whatever. Does it matter? Well,
I think you know, it's it's very subjective because it's
also cultural. You know, UM, the definition and the the

(44:06):
d s M, you know, the Diagnostic and Statistical Manual
NONM disort is by the American Psychiatric Association, you know,
has altered the definition of post traumatic stress disorder over
the years because they took out something that was in
a previous edition of you know, Outside Normal Functioning or
outside normal circumstances, and it's like, well, but if you

(44:28):
live in a war zone, you know, in Syria or something,
you know, bombs are in everyday occurrence. So it's not like,
you know, if if you were living in l A
and there were bombs going off everywhere, that would be unusual,
but not in the war zone. So it's so it's
it's somewhat culture bound because I think a trauma can
be anything that's a trauma to that person that kind

(44:50):
of rips the fabric of their adaptive coping skills, that
overwhelms their ability to cope. And you know, sometimes we say, well,
that's not a bad stress, get over it. But who's
to say what's a bad stressor or not. You know,
it's like that line in Antimame with the Society Girls.
As I stepped on the ping pong ball, it was

(45:10):
gashly and in the ping pong tournament, you know, and
it's like okay to her, it was Josh gosh like,
but you know, to us, it's like, honey, get over yourself.
And you know, it's we don't we don't want to
minimize other people's trauma because it has the most meaning
to them. Yeah, you know it's I've dealt with guys

(45:33):
who have had breakups after you know, five weeks of dating,
and I kind of feel like something, dude, it was
five weeks. Come on, But you know, if it was
a five weeks that meant a lot of things to them.
You have to work with it as if it were
five years or whatever, because we're kind of the definers
of what our trauma is, of what it what it

(45:54):
means to us and why and if you if you
deal with it that way, you're giving them to tools,
whereas if it's like, hey, just learn how to be like, hey,
it was just five weeks. I don't know what how
much of a tool that is. If you do treat
it like it was five years, now they're going to learn,
you know, grief skills, survival skills, whatever right that they
need for the next time, because they might the next

(46:15):
time they fall in love and through that type of person,
it might have another five week relationship that devastates them.
Now they have that life experience under their belt that
you've helped them through, especially when we understand trauma is
a social experience, it's a cultural experience, it's a neurobiological experience.
That's the other thing I think if if those neurobiological

(46:36):
defenses get activated, that gets activated regardless of whether we
think the stimulus warrants that or not. You know, it's
if we get goose bumps watching a horror movie, you know,
because we're scared. The person next to us might be like,
this is boring, Why do you have goose bumps? You know,
but the other persons like, yeah, this is really scared. Whatever.

(46:58):
You know, It's it's a little bit subjective. But but
once that system gets activated, all the stuff around trauma
is right there, reporting for duty and and that's part
of that's kind of as a psychological process, but it's
also a neurobiological process. Yeah, that's why trauma recovery involves

(47:19):
so much neurobiology. I used to teach about that. It's
about how the left brain is talking to the right
brain and you know, things like that. You know, but
trauma has to be processed like we're digesting a meal
in our g I system, anxiety bites will be right back.
After a quick little message from one of our sponsors, Well,

(47:49):
I like what you said to about like back in
the anticipatory anxiety of you know, my parents are getting older,
they could die my pet. It's like you can't say,
unlike someone who's saying the sky is falling, you can't say,
that'sn't gonna happen, right, it's like going to validate that
is going to happen. But I love what you said
about don't borrow, you know, borrowing from the future. And
I love that example because literally, if you think about it, um,

(48:12):
if you keep borrowing, if we're talking about money, if
you kept borrowing from your savings to buy a car,
buy something fun by the time you really need it,
and maybe you're too tired to really work a full
time job and you need your retirement savings and you
get there and it's empty. You know you're on empty
when you get there. So if you're borrowing like from
your future and trying to grieve now, I don't know

(48:33):
how because you're not really doing it right now. By
you're not like actually grieving now, you're doing some weird
anxiety things. So like by the time it's time to
grieve right, I imagine they have no practice in doing
so correctly. And so same with trauma, Like if you
don't validate it, they're not going to get better, like
you have to validate yes, this happened, and you have

(48:54):
to validate yes, these things will happen. Now what you know,
here's our room. Yeah, and it's existentially you know, accepting that.
You know, I call it the ocean moment. It's like,
you know, it's um when you realize what's going on
with you where you have these symptoms and it's like,
I don't know why I'm doing this, what's going on
with me? And then you talk to a therapist and

(49:16):
it's like, I think you have PTSD and there's that,
or I think you have generalized anxiety. Just sort of
there's this moment of oh shit, really I'm one of
those I've got a diagnosis now. But you know, you
can transcend it and say, because the next question should
be okay, how do I adaptively cope with that? And

(49:37):
you say, well, you know, let's do this, this and this.
And it's not only I think we're preventing against you know,
calamity in the future, but I think it's also about building.
You know, you might be oh, I'm already even gonna
get old and I'm gonna be penaltist and I'm gonna
be like that old homeless guy saw in the street
last week, and it's like, well, you know, there are

(49:59):
ways to do your very best to avoid that. And
you know, I don't want to blame the poor homeless guy,
but something went wrong along the way that he ended
up like that. You know, um, bad fortune, which is
part of it, and possibly bad choices which are a
part of it. You know, it's some kind of a
combination of what happens to us and what we do.

(50:20):
And so a lot of what I do, from a
very positive psychology standpoint and even a coaching standpoint, is
to say, at every phase in life, I think every
day in life, you say, how do I put my
best foot forward? You know, it's like if I don't
want to end up home? Was like the guy I
saw last week, really, what's in your retirement fund? Well?

(50:41):
Two cents? Okay? Uh? Could you you know, do you
have twenty bucks? And well, sure, I got three dollars
in savings. Okay, take thirty of that or that and
go on Amazon and buy a used copy of a
Susie Ormon book on money management. You got six san
bucks with chipping to get Yeah, all right, you get

(51:02):
that copy and maybe it's a Little Dog here because
it's used. But you you read every word of that book,
can do everything Susie Orman says, and you just reduce
your chances. It didn't eliminate them, but it reduces your
chances of being old and homeless. You know, if you
do everything that Susie Orman says in her books, or
Jane Bryant Quinn says in her books, you just reduce

(51:23):
the probability of calamity financially quite a bit. And you
could say that about anything if you, um, you know,
I had a kidney stone last year, so of course
I was like, what is the adaptive coping for kidney stone?
And I found a YouTube channel, um Jill Harris, and
you know she said, how do you eat better to
reduce your chances of recurring kidney stone? It's just whatever

(51:45):
it is, I think you research it and say how
can I put my best foot for my mom survived
cancer three times. You're in colon and breast and she's
eighty seven now, and you know, well, how do you
do that? It's like all you you know what early
symptoms are. If you have them, you get checked. If
you have that, you get good treatment. You follow a

(52:08):
treatment plan. Thousands of more and more hundreds of thousands,
millions die of cancer. But you reduce the odds that
that something bad is going to happen by saying, what
is the absolute best set of choices that I can
make that gets me ahead in some way? Health, dating, sex,

(52:28):
I certified sex there because you know, there are all
these things that we can do about. I think sometimes
when we were dealing with anxiety and focusing on laws
with the threat of loss, what's the other side to that?
How are we focusing on gain and growth? Yeah? Is
this what? Because I was going to ask you about
positive psychology, the positive psychology method, because I saw that

(52:50):
on your website and I actually had never heard of
it before, and so it sounds like that's what part
of it is. It almost has that like coaching element
to it in a way. It's not positive like like um,
hippie dippy, like just manifest the money, but you're just
saying like you're taking a positive step, like we'll start saving.
I mean, you know, there's the things we can control,

(53:10):
things we can't. One thing you can control, start saving,
you know, Yeah, you can't control the stock market crashes
after that, but just start saving and it does step
to the brain about a positive mindset, you know, the
acting about to go on stage, that I can't go
out there and look like an amateur. Okay, that's that's great.
But see that's very different from I'm gonna go out

(53:32):
there and I'm going to give a good performance because
I'm going to do justice to the script and the directing,
and I'm going to tell this story the best I can.
To see the difference there, it's it's there's a real
difference between I don't want to lose and I will win.
I also hear in that example of the actor a
little bit like with all the things they want from

(53:54):
it and that they plan to do, none of them
really are about the actor. Like I hear a little
bit like getting out of self, you know. With that,
it's like I want to honor the work. I want
to do a good job. You know, I'm just the vessel.
Like there's something about that that I feel like must
be part of it too. Like if you're sitting there
anxious about your future, someone's offering you some practical steps.

(54:16):
If you're like, no, I think I'll just sit here
and worry. It's like they want to cling to their
self and their ideas and if you just say we'll
start saving. It's kind of like, I don't know if
there's like a lack of not narcissism, but there's like
a lack of thinking about all the time a little bit. Yeah,
A good way to you know, help a lot of

(54:38):
things is to kind of get out of yourself, you know.
And yeah, there's that cliche, best way to help yourself
is to help others. I think there's a lot to
that because it takes the you know, the belly button
gazing and the ruminating. You know, ruminating is really an
anxiety symptom or perseverating on something, so you know, it's
you also have to look at the secondary game we

(55:00):
call it. You know, some people have a secondary gain
to being sick because they never have to take responsibility
for anything. Or what secondary gain and anxiety might be,
you know, kind of unconsciously wanting people to take care
of you because they never really have. Ye that that

(55:21):
can be something about that you know about um, is
there a downside to being relaxed and confident? Well, maybe
there's a responsibility there. If you're relaxed and confident, you're
expected to do great things. Whereas you an, I don't
know about this. I don't know about this. I'm just
gonna I'm just gonna stay inside and hide. It's like, well,

(55:42):
how convenient you know that doesn't take much effort, that
that can be confused with introversion and social anxiety, which
is its own Well, you know, I was going to
bring that up, but I love you are the only
person to say secondary gain. And I think I've heard
that somewhere in my life. But I love it because
you know, again, I'm just a pot I'm not a
THERAPISTMS podcast or about anxiety. And the people will write

(56:03):
to me and you know, like I'll do an episode
where the guest clearly lays out this is how you
da da um, you know, get over your fear of
drawing driving okay, And someone will write me, I just
heard your episode about fear of driving. Nothing was left
on the table in that episode, like you will if
you do these things and work with people, get over

(56:24):
your fearture. And they go, um, it didn't help me, um,
because I have the worst fear of driving more than anybody.
And they'll say that and I can just like intuitively
feel that they didn't listen to they didn't put anything
to practice, but they need to be the most anxious
driver who ever lived. Because if that's true and no

(56:46):
solutions work, then they're just they can't drive. There's no solutions,
and so that's simple, you know. And then once people here,
you're not a lot of people don't want to hear
you're not alone. This is normal, there's a solution. They're like,
oh no, it's like you've just given them homework, not hope.
You know, it just depends on the personality, I assume, right,
and you have to be willing to change. Louise Hey

(57:08):
was real big on that, you know, she said it
was someone's down there and they're reaching up. I will
reach down my hand and pull them up. But I
will not take their hand and have them pull me down,
you know, because you know that that's you got to
be careful with that stuff, because you know it's about
identity shift. You know, if you're you know, big, were

(57:30):
big ap on your shirt, anxious person. You know, if
you weren't the anxious person, and what would you be, Well,
maybe you would be the neighborhood's greatest dog trainer, or
the city's greatest architect, or the city's greatest attorney. You know,
there has to be that identity shift from what's familiar
and even comfortable, comfortable in the uncomfortable, you know, like

(57:53):
the hypochondriac um and have an identity? Shall I do
a lot in substance vieuse recovery When I worked with
so many gay men who have gotten in over their
head with Crystal Matthews, A big part of it is identity.
I say, what are you? Who would you be if
you were not a Crystal methodict, because that's their primary identity.

(58:14):
You know. It's like, well, you know, to start, you know,
I used to be this great architect. It's like, what
have you done lately? Well? Nothing, I've been too messed up.
It's like, well, how about being the great architect again?
What would that take? No, I'll going to a a
every morning before work. Okay, go to every every morning
before work, and then focus on you know, the new

(58:36):
building on Third Street, the big blue and you like it.
Will know because it did did it's not environmental and
they should have fixed it. All right, Well, then you
do you do it, you know, go build a building
that is environmentally friendly and you know, long story short,
you know, that's that's what he did. You know, he
got back into work. He he not everybody needs twelve star.

(58:56):
I've worked with guys who've had success with and without
twelve stuff. I would, but you know, he recovered and
got married, and you know, he posted it on Facebook.
I'm normally not Facebook friends with clients, but somehow we
ended up, and you know, and he posted a picture
from his wedding and I commented, you know, congratulations, and

(59:20):
he wrote back, well, a lot of that's due to you.
And that's you know, that's the greatest compliment because he
went from you know, shooting up a needle in his
arm three times a day or whatever it was, to
not doing that at all, and you know, and that's
a success. You know, It's a shift and identity. And

(59:42):
I think a lot of people could say if they're
dealing with an identity that's that doesn't feel right to them.
You know, I'm the unemployed person or I'm the person
who's underemployed, Say to yourself, what is the identity I'm
trying to cultivate. Do that with actors all the time.
You know, I'm a and server, but what I want
to be is a sitcom star. It's like, well, okay,

(01:00:05):
that's one of the hardest things you can ever ever
do in Hollywood. But you know it's it's possible. You know,
they right checks every day to sitcom stars on umpteen
different shows. You know, work for somebody entertainment payroll. It's like,
you know, there's a lot of checks that go out. Yeah,
and you know, but but it is kind of a
shift in identity and and processing. The therapists use something

(01:00:28):
go motivational interviewing about change about and we say what
are the pros and cons of that? You know, if
you said to somebody, what are the pros and cons
of your anxiety being resolved? They what do you mean cons?
It's great, It's like, no, look closer. There would be
some cons to you changing the life that you've known
for years now. Yeah, and you know you get out

(01:00:51):
of the sick role. It's interesting, like some people in
your life might want you to stay that small some
some don't you know, who knows. You might have to
give up the friends you have that are uh, you know,
as they say in twelve Supercovery lower companions, you know,
you might have to meet people that um give you
a run for your money. You might have to meet
other successful architects, and that's kind of scary and I

(01:01:12):
almost wish there was an intervention process for people with anxiety,
not to bully them, but in the sense that your
family and friends sit around and they tell you, like
who you could be if you didn't wear the identity
of anxious person, like if you got help, Like I
see you differently, the news of yourself. You know, you
used to be whatever, you know, whatever, Because I think

(01:01:33):
a lot of people don't know how to deal with
the anxious person in their life, and they kind of
just ignore it. Everyone pretends everything's okay. And I don't
know how anyone would move out of that identity if
they didn't feel um, I don't they weren't encouraged or
um if they didn't know that others saw them as
having that potential, you know. I think it's it's both
the support and the challenge, which of course therapists do

(01:01:53):
all the time. If you only challenge people, they'd be like,
fuck you, buddy, I can get beat up somewhere else.
If you only part them, then they never change. It's like,
oh yeah, he was very nice as a therapist. He'd
be a very pleasant guy. Why did you leave him? Well,
I didn't make any progress, you know, And so I
joke with clients. Sorry too, I'm gonna beat up on

(01:02:13):
you today because I think you're making a wrong choice
or something like that, you know. And it's both. It's
it's the dichotomy of I hear you because I think
anxious people need to be heard. I have this fear.
Why well, because of this? Why because of this? You know,
you want to hear them out. But at the same time,
there's just a little bit of Okay, I hear you,

(01:02:34):
But suck it up, you know, feel the fear and
do it anyway, because at some point you have to
think what you're trying to do with your life is
too important for your anxiety to hold you back. That's
too much power. Oh I love that. Yeah, And you
focus on what you want to do or what what
do I want to do that my anxiety is keeping

(01:02:55):
me from And you've got to walk through it like
you're walking for a burning building, in order to get
the other side and say, Okay, now I can drive,
Now I can fly. I'm gonna fly. I'm gonna go
to my niece's wedding in Poughkeepsie. I'm gonna fly tomorrow,
you know. And it's because you want to be there
at the wedding and say congratulations, honey, this is your
dream wedding. Congratulations, you know, and you want to be there.

(01:03:15):
You focus on what's on the other side of the challenge.
Is there anything any words of wisdom that like, just
someone is listening, they want to take the first step
to going to therapy. They're like, I do and know
if I have this bad note and whatever, you want
to say to anyone out there that is thinking about
taking that step and starting therapy, starting therapy, just well,

(01:03:39):
I think people say, you know, they think that there's
some kind of a high threshold for therapy. It's like, oh, well,
you know, I mean, I'm a mess every day, but
I don't need therapy. I'm not I'm not crazy. I
just you know, drink myself into oblivion every day or whatever.
And it's they think it's some high bar to you know,
you that you need therapy. You know, the bar for

(01:04:01):
going into therapy is just having any kind of goal. Well,
I don't really have a goal except well, you know,
I want to raise because I've been in my job
for four years and I wanted to tell my cheap
boss to give me a raise. Okay, that's a goal,
because you could go into therapy and say, I need
to build my skills in a sort of communication because
I want to ask my boss for a raise, you know,

(01:04:21):
or or anything. There's really nothing too mild to bring
to therapy if it's important to you. You know, you
you don't have to be have you know, associate identity
disorder in order to therapy, and you know, and you're
because it usually means that it's part of a broader growth,
you know. So anytime you go to therapy, it's like

(01:04:41):
putting a little seedling and sticking it on the window
sill in bright sunlight, because you know it's going to
grow in the light of that support. Hey, hope you
enjoyed my conversation with Ken Howard. So here are someon
takeaways from this episode. Again, everything you need to know
about Ken is in the show notes. If you want

(01:05:03):
to follow me on social media, I'm at Jen Kirkman
on Twitter and on Instagram as well. Send an email
to the show Anxiety Bites Weekly at gmail dot com.
We might read it on the air. And don always
say we it's me. Do you hear any other people hosting?
Here we Go? Here are some takeaways from this episode
and you Get You can also find them on Jen
Kirkman dot com click Anxiety Bites. Links are in the

(01:05:26):
show notes. Okay Can saw during the AIDS crisis that
there was also an epidemic of anxiety, anxiety about getting
HIV and anxiety about having it and not knowing what
course it would take. Developmental psychology and existential psychology look
at things like what gives life meaning and purpose For

(01:05:46):
anyone with birthday anxiety, Instead of worrying about the future
or regretting the past, try to stay in the present
moment and celebrate that you're alive, here and now. If
you can emphasize the joys of each phase of life
and minimize the risks of each phase of life, that
can help with confidence, which can alleviate anxiety. You can
think of anxiety like a smoke detector that's going off

(01:06:07):
in your home, which is great when there's a fire,
but the anxiety smoke detector only goes off when there
is no fire. You're just cooking some toast and the
toaster and you don't have to respond to the anxiety
as if there is a real fire. Sometimes the underlying
reason that someone feels anxious in a situation is that
they're worried about experiencing a loss. And anything that we

(01:06:30):
care about deeply can cause us anxiety for that very reason,
we are afraid of losing it. When we feel anticipatory anxiety,
we are borrowing from the future, and we need to
orient ourselves to the present instead of trying to feel
a future loss today. There is always an adaptive coping
mechanism for any bad thing that can happen to us,

(01:06:52):
which involves taking the next best step to solve a problem.
Sometimes a client in therapy for anxiety is really actually
experiencing trauma, and they have to be helped to work
on and process that before getting to work cognitively on
the anxiety. In that case, the prerequisite course for anxiety
management is trauma recovery. Trauma is a social experience, a

(01:07:17):
cultural experience, and a neurobiological experience. Trauma recovery involves a
lot of neurobiology. It has to be processed like digesting
food in the GI system has to be processed. When
people are working through addiction, recovery or anxiety recovery. They
are going to have a new life on the other side,
which means in a way, they're shedding their previous identity

(01:07:41):
as that always anxious or addicted person. A therapist job
is to support but also challenge a patient. Anyone can
go to therapy. You do not need to have any
kind of mental health disorder. You could see a therapist
just to get some tools in order to achieve a
life goal. There you go, Thanks for joining me on

(01:08:02):
another episode, and just remember anxiety bites, but you're in control.
For more podcasts for my heart Radio, visit the I
Heart Radio app, Apple podcast, or wherever you listen to
your favorite shows.