When it comes to living our daily lives, it’s really easy to feel anxiety; living through a global pandemic will do that to a person, especially with the extra load parents have taken on. Anxiety can present itself in many forms, sometimes minimal, other times it can feel like this overwhelming presence in our lives and in ourselves. We’re diving into all this with Mary – who you may recognize from our previous episode, Setting Boundaries With Toxic Family Members. Mary Tate is a licensed clinical social worker who is very experienced in helping people manage their anxiety and was incredibly informative!

In this episode, we’re looking at how anxiety affects us physiologically, how it impacts us and our daily lives, and what we can do to help manage it. We delved into the different kinds of anxieties, clinical and personal treatment – even how a giant weighted butterfly can help to calm us down. 

Managing anxiety can seem like a big task, but we learned some really amazing tips that I’m sure you’ll find really helpful. Like Mary Tate said, “the experience of feeling anxiety is a human condition… And help is there. And relief can happen.” 

Want to learn more about the episodes we do and all the topics we cover? Join the UM Club! We have a new guest speaker and episode every week full of great information. Don’t forget to check out our first workshop on Hormone Health on April 24, we can’t wait to see you there!

Related Content

Setting Boundaries with Toxic Family members with Mary Tate from Tate Psychotherapy

Reclaiming Your Hormone Health with Laura Martire

Managing the Anger and Overwhelm That Can Come With Motherhood with Bryce Reddy from Mom Brain Therapist 

Setting Approachable and Practical Health Focused Goals with Kylie Senft from Mini and Me Fitness

Guest Expert

Mary is the founder of Tate Psychotherapy, a boutique group practice located in New York City that specializes in the mental health treatment of women, children and families.

In This Episode We Talk About

00:56 – Who is Mary Tate?
02:50 – What is anxiety and how does it affect us physiologically?
24:46 – Treating anxiety long-term.
33:43 – Treating anxiety in the moment and quick tips.
38:08 – What advice do you have for people struggling with anxiety?
42:13 – Where to find Mary!

Watch the Video

Listen to the Audio

Resource Links

Join the UM Club!
UM Club Facebook page
Healthy Hormone Workshop
Tate Psychotherapy
Find Mary Tate on Instagram!
Mary Tate’s book recommendations:
The Dialectical Behavior Therapy Skills Workbook for Anxiety
Overcoming Unwanted Intrusive Thoughts
BURNOUT: The Secrets To Unlocking The Mom Stress Cycle

Read the Full Conversation

Hello and welcome to another episode inside the Unapologetic Moms Club. I am very delighted to be bringing back Mary Tate from Tate Psychotherapy again. You may recognize her from our previous episode all about setting boundaries with family and friends. So make sure to check that one out too. But today, we are digging into all things anxiety. So welcome back, Mary.

Thank you. So happy to be back. And kind of similar to the previous discussion we had, anxiety is often an offset of boundaries and family dynamics, but also anxiety being just its own simple thing. And it being affected with ourselves and with other people that we love, including our kids. So we’ll dive into a little bit of that too.

Absolutely. As I’ve been exploring more about my anxiety with my therapist, and kind of doing different things, I’ve definitely noticed kind of the differences of when I’m able to manage my anxiety better and how I’m able to show up for my family and be a little bit more patient and things like that. So for those that haven’t heard our previous episode yet, can you tell us a little bit about who you are, what you do, why you’re so passionate about it?

Absolutely. And so as you know, my name is Mary Tate, I’m a licensed clinical social worker. I’m located in New York City, and I have a small group psychotherapy practice. We’re a female only team. And we primarily work with women, children and families, for a variety of things. Anxiety is a big one that women come in with, relationship issues, couples counseling, life transitions, depression, postpartum depression, all kinds of things. 

And my background in social work – prior to opening my practice, I worked in health care, working really heavily in trauma work, worked as an HIV social worker for several years. I opened up my practice right before COVID. So it’s been a very interesting viewpoint on the mental health world, and an exciting benefit of the pandemic is that more people are much more open to talking about their mental health and just kind of the effects that, you know, we all went through this collective trauma together. So this is a wonderful time to kind of be deep diving into these things that we’re all experiencing.

Absolutely, you have so much experience, and you’re such a wealth of knowledge. So I’m really looking forward to hearing what you have to say on this topic. 

So let’s get into it. What exactly is anxiety? And I’d like to learn a little bit more about  how it physiologically affects us, like what’s actually going on within our bodies?

Sure. Well, anxiety is used all the time, right? We use this phrase like, “oh, you’re just anxious,” or, “I have anxiety,” but to each person, that’s gonna be something totally different. So there is this cognitive element to anxiety. But then there’s also this physiological part, which usually is what brings people in. 

So the physiological things are very uncomfy, right? So, classic ones that we’re going to think about are heart racing, or sweating, or feeling really jittery, even lightheaded. And most people have experienced some sort of physical symptoms of anxiety, right? It’s not just in your head. There is a piece that is the cognitive thinking part of anxiety, which we’ll get to, but anxiety that manifests physically is going to typically be what we would classify as an anxiety disorder. Once it gets to that point where it’s affecting us physiologically, and it’s really kind of intense, that is where we’re like, okay, we need to have some tools in place so that this isn’t disrupting our lives.

So some of the symptoms that we think about, you know, when we think about anxiety as an umbrella term, are going to be a range of fear, worry, stress. And, you know, sometimes people are able to just kind of float along and be like, “oh, I have a presentation. I’m a little nervous, a little shaky,” but then they get over it, right? Or they, you know, have like a trip coming up and they’re maybe – especially with COVID – maybe a little nervous, like“what if I get COVID” and all these things. But they go, “you know what, I’m just gonna truck through it.” 

Those are great coping mechanisms, and maybe we all know people like that, that are able to kind of float by. But sometimes it’s really easy to get stuck, and anxiety is incredibly common. And when kind of these feelings of getting really stuck are more persistent – under the umbrella, there’s generalized anxiety disorder, which is going to be this like immense disproportionate fear towards circumstances or events that we don’t have control over. There’s social anxiety disorder, which people talk about a lot with public speaking. But also think about returning back to work, or going into social settings, and all of a sudden, all these new people, social interactions.

There’s panic disorder, where we’re going to think about having repeated panic attacks. So panic attacks are going to be things where we’re hyperventilating, this impending sense of doom, and just like, you can feel like really uncontrollable fear, with like really, really bad racing thoughts. And when we’re kind of at the point where panic attacks are interfering with our lives, and we can’t identify the triggers, or they’re happening for no reason. That’s a huge piece with the physiological piece that we want to worry about. 

And one that people don’t really think about as an anxiety disorder, but is also very common, is obsessive compulsive disorder, which always has its own TV shows. I think anytime TLC network puts like a TV show about a psychological condition, it gets very stigmatized. But, you know, people that experience OCD and that type of anxiety are going to have intrusive thoughts. So a common one with moms that we’re going to think about is like, “oh, my gosh, is my baby breathing,” and you aren’t able to get that out of your head, and “I’m just really anxious about my baby.” Which is great, because we love our baby. But also, that’s an intrusive thought, you’re looking at its heart rate, you’re watching its belly breathe on the video, but you still don’t you don’t believe it. 

And then usually, there’s a compulsion, so behavior to make you feel better. So almost, you know, uncommonly, a lot of people think “oh it’s just anxiety.” There’s a lot of that intrusive thought compulsion, what do I, what am I worried about? Is it real? Is it rational? What do I do to make myself feel better? 

There’s so many different facets to it. 

So many, and I haven’t even gotten to answering your question yet. And another one that people kind of will also put under the umbrella of anxieties is post-traumatic stress disorder, which also has a lot of anxiety symptoms. 

So with what causes the physical symptoms of anxiety and that connection, is how it kind of manifests, and this is going to be different for everyone. One fact that surprises a lot of people and my clients is – we talk about serotonin, right? So when people are prescribed, oftentimes, like maybe a Zoloft, or let’s say a Prozac or Lexapro, they’re these medications that affect how serotonin is regulated within your body, to help control anxious symptoms. So what’s interesting is serotonin likes to live in two places in your body, lives in your brain, of course, but also lives in your gut, your stomach. So think about like a five-year-old, maybe they have like their big soccer game coming up. What do kids that appear anxious usually complain about?

Butterflies in the tummy.

“Oh, my stomach hurts,” right? And so what’s really interesting is these medications, they’re called SSRIs, is kind of regulating how serotonin is used within your body to kind of treat those anxious symptoms. So that’s a big component of the medication piece and how it’s treated within the body. But I think that when a lot of people talk about anxiety, GI stuff comes up all the time. Right? It’s always talked about, “my stomach hurts.” That’s usually the number one thing that women that I work with will complain about, “oh, I have all these gut issues, of going to the GI doctor a lot, don’t know what it is.” And their doctors will say “well, before we do a colonoscopy, before we do all this invasive stuff, why don’t you go see a therapist, like just for a little bit?” 

And I think that’s incredibly helpful because sometimes they show and they’re like, “oh, I’m not stressed, but I’m not sleeping, barely drink enough water. I’m like, jittery, I drink so much coffee.” And I’m like “I don’t think-” I mean, IBS and everything are very real, but let’s not give ourselves a whole other thing by letting our anxiety trick us or tricking our bodies into it being something else. 

But at its evolutionary core, anxiety is a reaction to your body’s fight or flight response. So, you know, your fight or flight response is supposed to help you survive when there’s an immediate threat by either escaping it or fighting it. But with anxiety, right, your fear and your worry, the trigger of thethat fight or flight response – which leads to your sympathetic nervous system, which is a whole biology class. That controls your involuntary breathing and heart rate. 

So when we think about it, our body, biologically, is being tricked. So a first meeting with someone, or a new presentation I’m doing at work – my body thinks that there’s a bear foaming at the mouth coming our way. That is how your body’s reacting. And think about how distressing that is, to be living through that everyday, and your body is like, oh, we have to be ready. But it’s getting stuck. It’s not choosing fight or flight, we’re in the middle, and it’s not frozen. It’s just like, let’s just sit in this middle piece. 

There’s a really good book I’ll have to send you that’s based on Burnout. But she talks about how so many people – and for this talk, thinking about women – there are so many things that we feel kind of like threatened by, one, and two, there are so many things that happen in our lives that we just feel like we have no control over, right? And if we constantly have these things, where we think there’s a bear foaming at the mouth, like ready to attack us, likely, we’re gonna run from it, right? Most of the people I work with, when I asked them that question, they don’t go for like, “I’m going to go fight the bear.” Usually, it’s “I’m going to run from the bear.” However, in that scenario, if that was really happening, we would complete that stress response by running. Our body would go “oh, we run, we got our heart rate up, are sweating.” You know, we’re good. Like your body is told, “calm down.” 

Oh, that’s how it like processes it, is kind of that big exertion, normally physical.

Totally. And you know, our bodies do all kinds of crazy things when we’re like faced with the bear foaming at the mouth, right? Like, even weirdly, all of your blood will also leave the surface of your skin. That’s why people can feel cold when they’re anxious too sometimes, because biologically, your body’s learned, “oh, if this bear attacks me and it cuts me, if I don’t have all this blood at the surface of my skin, I won’t bleed as much.” Like our body does all of these crazy things to help protect us. But when it’s just like a work presentation, or a preschool interview, or something. Your body’s going “oh, we’re gonna get ready, we’re getting ready for that really scary bear foaming at the mouth.” And then it’s nothing. How do we train our bodies to be like “no, it’s okay.” 

So anxiety is very common. It’s very stuck there. And when we get to the part about talking about how to manage anxiety symptoms, one of the best ones in a biological sense is like getting your heart rate up. That’s why I know it’s annoying to be like, “oh, just you know, exercise every day.” I get it, but it is incredibly effective to take control of your body and say “no, you don’t get my heart rate up, I get my heart rate up.” And it doesn’t have to be big things. 

But heart racing, short of breath, you know, when stress response happens, we’re sending blood all around our body to breath, and when blood is moving so fast our body goes, we need more oxygen, hyperventilation, we think about panic attacks. Think about muscle aches. So you know a lot of times I’ll see people on Zoom rolling their shoulders or neck, or like going to the dentist and they go “oh wow, you grind your teeth” or “you need to wear a night guard at night.” That tense piece is like that prolonged period of stress, almost that frozen sense, can cause chronic pain. 

And I tell women all the time, you know, if you go and get a facial to notice just how it feels like if someone’s like massaging your face, and when you go to bed at night, how easy it is to notice that like, oh my gosh, like you’re clenching. Or like, how does it actually feel for like your face to become completely relaxed? It’s a very weird feeling. And anxiety also correlated with headaches a lot, people be like, “oh, I constantly have a headache.” And it’s not necessarily from serotonin, but probably from clenching, clenching our jaw so much, or constantly doing that. 

And then, of course, we kind of went over the GI stuff, your stomach hurts. And also, with anxiety, we sometimes will do a lot of avoidance behaviors. So maybe we’re not in our highest levels of anxiety, not doing the best at taking care of ourselves, right, not having the best nutrition, not having the best physical activity, which then, of course, only exacerbates all of those symptoms. Feeling exhausted, right, that’s one. Fatigue, or “what’s wrong with me.” 

Because their bodies on this like, fight or flight tense, all these things are happening inside. So it’s physically exhausting to be in that state.

Totally. And it keeps you on high alert, right? So, you’re exhausted, but also you’re waiting for that bear to attack you when you’re like laying on the couch watching TV. And so even thinking about like, maybe you’re laying down watching TV, and your toddler drops something. No crisis, you know, they just dropped a toy on the hardwood floor. But catching yourself like “oh, my God, like, what?” You’re like “why did I just get so freaked out by it?” It’s your body going like “you were not paying attention. You were watching TV and you forgot we’re in danger.” 

And talking about anxiety and sleep, huge complaint of like racing thoughts before I go to sleep, and our stress hormones, and women in hormones, a whole whole thing. But you know, when our cortisol levels are affected by stress, racing thoughts can make it harder to fall asleep, because our body can just not do that. And also not getting enough sleep creates some more anxiety, we can almost just give ourselves insomnia, because then we develop fears around sleep, or “what if I can’t fall asleep? Or what if this happens? And if I’m tired tomorrow, what happens with that?”

And then lastly, just constantly being someone that’s always sick. We all know these people in our life that just do not feel good, like they always have a cold or they’re always not feeling well, or they cancel plans a lot because they’re just like, “oh, I’m just so gross feeling.” You know, that fight or flight response, right? But after it’s in that for so long, our immune systems not going to function as well. So, you know, thinking about all of these things, and if you’re feeling all of these every day, anxiety can be incredibly debilitating. So I hope that was a really long winded answer to your question. 

It was and I love it. Like I love how you broke down all of that. One quick question before I go into it, in terms of the serotonin for anxiety, is it the lowering of the serotonin or is it too much? Or how does that work? Or is it erratic?

It’s a very complicated answer. Essentially, like dopamine and serotonin travel through neurotransmitters. And so the goal of using the SSRI, the medication, is to make sure that the neurotransmitter is processing your serotonin in a way that is allowing kind of, you know, the less anxious symptoms you’re wanting to have almost balance, right? You talk about chemical imbalance, all of that – which psychiatry is very complicated, right? 

We don’t have – I would love to be like, “hey Jannine, you came in, you said you’re anxious. I’m gonna send you for lab work to see how much serotonin you have, how much dopamine you have, how much of all these things so that I can know exactly.” Psychiatry is 100% based off of observation and reported behavior, right? That’s why when people get prescribed medication for anxiety, you’re started on the tiniest little baby of a dose, and they go, “okay, how does this feel after a few weeks?” And, “oh, I’m feeling better.” Okay, great, we can just stay right there. And it’s all about how that individual person’s feeling. 

So that is – it’s very complicated, right? Because it is this like, kind of woowoo, grey area. But I always tell clients, I’ve been on anxiety medication since I was a teenager. And it changed my life. And there have been periods of life where I’m like, “oh, that anxiety is visiting me again, in ways I did not realize.” And my brain needs more help. So I kind of talk about it in that way, too. But it’s also that, you know, there’s tons of things that I do that I know have nothing to do with my medication that have been very helpful as well.

Absolutely. Yeah. So it almost sounds like it might not necessarily be too much, not enough, but it’s the actual processing of how your body does it in that particular state, because it’s going to change all the time.

Exactly. Yeah. Think about COVID, for example, there’s tons of people that were like, “oh, like, all my stress was work stress, I don’t need this anymore.” And they were fine through COVID. And now we’re returning back to the office, and they’re going, “whoa, I’m having panic attacks every morning before I go to work,” right? Knowing your triggers, knowing the things that kind of get your body in that fight or flight.

Yeah, and I love how you just broke down all that physiological part, because I think a lot of us will experience different symptoms that can stem from anxiety, but we’re noticing, like you said, with the GI, something’s going on with my digestion, and we look to treat these particular symptoms. But when we can really take a step back, learn how this all works together, there’s other things you can do to treat the underlying that’s going to help all those other symptoms.

Absolutely. And medical, before I treat anyone really, if they’re coming to me with a lot of physical symptoms, like you have to go get a physical. Because we’re low in certain things, if we’re low in vitamin D, or low in B12. There are some things that have nothing to do with  therapy or mental health, that if you’re low in those levels, you’re going to feel exhausted, and then that’s going to lead you to feeling anxious or depressed. So all of those things, your annual physicals are very important. And your thyroid levels for women are incredibly important. If your thyroid levels are off the charts, then I’m not going to send you to a psychiatrist, I’m going to send you to someone else, I’m gonna send you to an endocrinologist or your GYN for that care. And then we work together on that end.

Absolutely. Yeah, we had a reclaiming your hormones episode back in December. And she’s actually coming back to do a workshop with us for April. But it’s very eye opening to hear about all of the different ways our hormones works together, and our thyroid and cortisol, and how making changes to your diet and exercise makes such a massive impact. I know we’ve talked a little bit personally about my ADHD diagnosis and anxiety. And so I’ve been really working on the nutrition side of things. And over the last three, four months, it’s been a huge change. And that’s mostly from nutrition.

Yeah, it is. Think about, you know, in the world, medications are incredibly helpful, but also like nutrition as medicine too. And I think that’s incredibly important that, at least for myself as a therapist, if you’re telling me like, “oh, I’m just not feeling good,” but you’re eating Doritos for every meal. That’s gonna stop me, right? All of these things, there’s balance in all of it.

They all play together. 

Yeah, realistic balance. If you don’t want to eat certain foods that are better for you, then, okay, maybe taking a pill is gonna be better. Right? So it’s what’s gonna work for you.

Yeah, and sometimes we need that quick relief with whatever’s going on in our lives. And that makes us more able to work on other options for long term and make those things kind of marry together for a treatment that works for that individual. 

Totally. Absolutely. 

So with that in mind, what are different ways we can treat anxiety? And so I’m assuming this will be kind of split between like preventative on going things, like we touched on nutrition, and then also when we’re in the moment experiencing perhaps panic attacks or more mild, just very, very anxious feelings.

So on more like the umbrella, you know, the number one, recommended, evidence based treatment for anxiety is called Cognitive Behavioral Therapy, which is used a lot in a good way, it’s becoming more popular,and is known as CBT. So the concept of CBT is like a triangle. So CBT therapists work at – and I do a lot of CBT with folks – how our thoughts affect our actions, which then affect our behaviors, in that triangle. So thoughts, behaviors, actions, or actions, behavior, thoughts. 

And really thinking about your brain, you know, I tell women all the time, “it’s okay, your brain is tricking you, your brain is lying to you.” We have to take our brain to the gym, and we have to retrain it, because you’ve spent your whole life doing this, doing this type of thinking pattern or thinking in these, I call them, thinking errors. And we have to train your brain to not do that anymore. Because it is stressing you out. 

And the good thing about cognitive behavioral therapy is that the goal is short term, not this 30 year psychoanalytical, you know, we’re gonna sit and talk about your past, and it’s very concrete. So a lot of people really like it. And in New York City, people love it, because we can put all your thoughts on a spreadsheet, we can say, “those are the triggers, this is the feeling attached to it. Why is our brain doing that? What can we do?” It’s very like, “alright, we’re gonna do this, and we’re going to practice it.” And you can hold onto it, it’s very concrete.

In a lot of ways, anxiety can be very well treated with this concrete thing. And when I work with children, I even have them name their anxiety, so like, “okay, that anxiety is not Susie, you know, you’re Susie. But your anxiety comes to visit you when that happens. So we’ll call it Annie, Annie the anxiety, what happens when Annie comes to visit? What do you do? Does your stomach start to hurt?” And what works for children works for adults, too. It’s like when she comes to visit, what happens? How do we get her to leave the room? 

And so it’s really thinking about this management piece. Anxiety is going to be experienced as a human being, we all have a fight or flight response, we’re all biologically going to be induced to do those things. So it’s more about when it happens, our ability to be able to kind of have control over it and it not controlling you. 

So with therapy, cognitive behavioral therapy is wonderful for that. You know, secondly, people find medication is a second component, a lot of times people do both, depending on the severity of your anxiety. If this is really debilitating, keeping you from being at work, having to leave school or not leave your house, you know, the spectrum of it. Kind of like I mentioned before, checkups, ensuring that the symptoms you’re experiencing are actually anxiety. Because if you’ve ever had low blood sugar, that feels a lot like anxiety. There’s some heart conditions, like heart disease can resemble a lot of things that feel like anxiety. So it’s incredibly important to make sure that the symptoms that you’re experiencing are not anything medical. 

And I tell people, that should relieve your anxiety immediately, that it’s not that, right? And then you don’t even need me. But then we’re able to kind of think about like, let’s not rule that out. And support groups. So sometimes, it’s really good to realize that like, “oh, I’m not the only one that does not like, I’m not the only one that does that weird thing.” 

And especially with obsessive compulsive disorder, which because it has like a TV show, people think like, “oh, that’s not it.” So many people that come in saying “I’m anxious” are actually symptomatic of OCD. Because it’s intrusive, it’s so much more common than we think. And it could be like co-occurring, like maybe there’s some of this generalized anxiety. But when we’re thinking about, like, lots of racing thoughts, or these thoughts visiting us. Like, why am I thinking that? That’s so weird. That’s not generalized anxiety, that’s OCD. And so it’s easy to get stigmatized on those things. But it’s all anxiety. It’s just how it shows up. And it’s totally different. 

And then of course, thinking about completing that stress response, right? Self-care – which self-care is like a whole whole thing. But truly, moving your body. It doesn’t have to be going to a cycling class or going to a gym, it can be all right, in between meetings, getting up and just like dancing in place. It’s just being able to have some movement, telling your body like, “oh, we can manage some of these things.” Of course, deep breathing, mindfulness, being able to turn off technology, figuring out what your triggers are through CBT maybe, trying to find ways to not do those. 

And sleep, good sleep, thinking about yourself like a baby. When our babies are anxious, what do we do? We swaddle them. We feed them, we bathe them, we do all these things. So if we’re doing that to ease kind of the anxieties in a baby, we need to be doing the same exact things for ourselves. And I’m a huge advocate for weighted blankets. Those are amazing and can be incredibly helpful, especially in moments where we’re feeling very overstimulated with anxiety, putting one of those on you, listen to some music. It’s a favourite medicine.

Yeah, when you mentioned the swaddling, I kind of had a lightbulb. Moreso lately, I’ve been like requesting hugs from my husband, when I’m just like feeling like anxious or stressed out, and like actually thinking about it a lot more. And it physiologically does something with your body, I think it’s like oxytocin or something like that. It instantly just grounds me and so I can see how the weighted blanket is a fantastic option.

Oh, it’s great. And for kids, they even create – a lot of children with autism, and other sensory disorders do really well with it. But if you have a kid that is just like a little anxious, or they’re, about to do something that they’re worried about, you can buy these stuffed animals that they can like put on, or like a little weighted blanket, but they don’t look like “oh, here, I’m gonna throw this weighted blanket on my child.”

Yeah, it’s much more fun. 

Yeah, it’s a little more fun. But it can give like the same effect. So kids love them, I have one in my office, she’s a butterfly. And sometimes when kids will sit in my office, they’ll just like put it on their lap to help them or they’ll hug it. And it kind of weighs them down into my couch, and they are obsessed with it.

I am getting one of these for my son, because I’ve been watching him over the last few months learn to process his own emotions and overwhelm, and he’s turning into someone who really likes to curl up in his bed. Like when he is upset, he wants his dragon, which has a bit of weight to it, you can heat up the beanbag inside it, and he’ll often like curl in a ball. He wants blankets and pillows on top of them. So I can see how like having something like that butterfly pillow could be really helpful for people that like to process that way.

It’s so funny when we think, you know, we did a whole talk on like attachment, right? That’s all of these things that we found to be comforting as babies, that we still, as people and grownups, we’re like, we want that still. We want to be swaddled. 

So yeah, those are kind of the more umbrella things. On more of the in the moment, maybe we’re at a friend’s house and we get a sudden burst of anxiety. My biggest tip is really to kind of address anxiety with these kind of sensory components when we’re in like emergency situations. So one that’s incredibly helpful if we’re trying to regulate emotion is to use temperature. 

So if we’re at dinner, and we’re really anxious, right, maybe this is like, “okay, I have a cup of water. And I’m going to just like, kind of internally, just be like okay, this water is really, really cold. I’m going to take a sip of it, and like hold it in my mouth. And notice that it goes from cold to warm. Really kind of telling your body like I have control over this physiological thing that’s happening. I can feel the coldness, or I ordered a hot tea and I’m going to get it really, really hot and hold it and pay attention to like these things in your body that you physiologically can control. 

Another really easy one to do is the 54321 method. So the 54321 method is you think – I might mess this up on the top of my head. You pick like five things you can see, four things you can hear, three things you can touch… Use your senses. And the last one is the one that you can taste. Use your senses, it’s a grounding exercise. Because when we’re in this fight or flight response, right, we’re thinking about the bear attacking us. And so we’re kind of like thinking, and we need to be able to be like, we’re here in this moment. 

So when someone comes to me in New York City, if they have a fear of the trains, I’ll say, okay, look, I’m gonna get on the train. And when you start to feel maybe the train stops in between stations, and we’re really nervous. Okay, like this is tied by things you can feel, you can feel the pole, you can feel your shirt, you can feel your hair, like noticing four things you can hear. I can hear the conductor, I can hear the music in my ear. So it’s really these things that we’re not being like, “hey, everyone, I’m practicing my coping skills.” But it’s these things you can do internally. 

It’s not going to stop the anxiety, right? Because normally, the most distressing part of anxiety is the physical sensations that we are feeling. The thoughts, while they can also be incredibly distressing, those in the moment are not, you know, it’s hard to process those when we have all these other physical things happening.

And it kind of perpetuates each other, you keep thinking these things, and you keep experiencing the physical response, and it keeps cycling. And doing these different things can really help shift from that chaotic headspace to focus down and then your body can start to follow.

Totally, totally, yep. I think calming the body down is great. In another type of therapy modality called Dialectical Behavioral Therapy, DBT, just an offset of CBT – therapists love three letter things. But DBT they do a lot of emotion regulation for distress, and they call it distress tolerance. Which is very helpful with anxiety and any other emotion that doesn’t feel good. But they do a lot of really good things about like acronyms, like the 54321 method, there’s one called the STOP method, where we kind of like, “alright, we’re gonna see, look what’s happening.” 

You follow protocols, which often come up in CBT too. This happens, this is what you do, this is what you try, and we’re gonna rate it 0 to 10. And then the way that we track it as therapists is go, “okay, well, when you did that thing five weeks ago, you said that was an 8 out of 10 anxiety. You just did it again, you said it was a 4 out of 10. So awesome. That’s what we’re wanting.” So the concrete piece with anxiety, incredibly helpful.

Yeah, it’s nice to have like the systems and something more concrete and not so like, kind of out there in a way, you can see the processes and kind of track your progress.

Totally, totally.

So if someone is listening, who is really, really struggling with anxiety right now, but might be a little bit nervous to actually reach out and ask for help. What would you recommend to them? What would you say to them?

Yeah, there are so many great workbooks on Amazon. Learning about anxiety can be very empowering. And sometimes a lot of people come to me because they didn’t even realize maybe what they were experiencing was anxiety, or they pick up a book – and I’ll send over some that I like – they read and they’re like, “oh, maybe this isn’t anxiety. Maybe this is trauma. Or maybe like, I’m feeling these anxious symptoms, because I’m having a lot of depression.” And sometimes people come to me, they’re like, “okay, I just did all this research on myself, and I don’t understand it, can you help me?” So with therapy, even getting to the point being like “is there something wrong with me?” Educating yourself is a really, really great place to start. 

Knowledge is power. 

Absolutely. And, you know, reading something that, you know, don’t buy the really dry, boring therapy book, but they have lots of great workbooks or like types of journals that deal with symptoms, and even helping you identify them yourself. If you do go to therapy, you come and you’re like your therapists dreams, they’re like, “oh, I’ve already done all this work.” And you’re like, “yeah, this is gonna be so easy. We don’t have to dig for all of this.” So I think that’s a really good place to start. 

And if you have a loved one that maybe you notice that that’s happening. You know, it’s really just, you know, coming like with comfort. And I think there’s a lot of benefit being like “that happens to me too.” Totally normalizing, like if you notice that they’re at a dinner table – and a lot of my examples have to do with food, maybe I’m hungry – if they’re at a dinner table, and they’re like shaking or something, just being able to go (even if it’s a little white lie) just being like “sometimes that happens to me too. And this is what’s helpful for me, I hold my cold glass,” and kind of giving them a tip just letting them know that’s normal, you know, this happens. And gently giving some recommendations, like, “you know what really helped me?” And of course not doing it in front of everyone, but letting them know, “I see you. I noticed, I don’t want you to be embarrassed. This is what helps me, I hope this helps you.”

Yeah, absolutely. Those are some great tips. So you’ve already shared or mentioned resources. So I don’t know if there’s any specific ones you can think of, but you’ll send those over to me, and we’ll make sure they’re included in the show notes.

Yeah, yeah, I’ll make sure I get that. That’ll be way easier than me murdering all the credentials and names of the books.

Yes. Yeah, no need to go into that, you can send those over, we’ll include them. Are there any last thoughts that you would like to share?

I think, overall, even with the pandemic and life in general, that the experience of feeling anxiety is a human condition. We’re all going to experience anxiety in some ways. But when it does become something that is debilitating, it’s keeping us from living our lives the way that we want to be living it, that we don’t have to do it alone. And help is there. And relief can happen. 

Yes. It doesn’t have to stay that way.

Exactly. There is relief in multiple ways. And so that’s very helpful. And one of the many things in mental health, anxiety is one that we can feel really confident that we can help people in. And so that’s always promising.

I love that, ending on such a hopeful note. So where can everyone find you if they would like to connect with you and check you out more?

Yeah. So we’re working on our social media presence. So @TatePsychotherapy is our Instagram handle. Our website is TatePsychotherapy.com. And through there, you’re able to contact me directly. And I’m always open for people if, even if they just have questions about therapy in general, or they want to know what type of therapy, or really anything related to mental health. I love being able to just connect with people, it’s why I became a therapist. So even if you’re not reaching out for therapy with us, if you just have some general questions or want to learn more about something or need a book recommendation, please feel free to reach out. And yeah, that’ll be great.

That’s fantastic. Thank you. Well, thank you so much for being here and for sharing all of that with us here. Like I said, you’re such a wealth of knowledge. I love having you on.

Yeah! I’d love to be back, there’s 1000 things we can go over. So I will look forward to the next time, and yeah, look forward to seeing you again soon.

Absolutely. Sounds great. And thank you for everyone listening in today. You can head over to the Facebook group or group chat, and we can dive into this a little bit more. Until next time, take care.


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