Ellen Vora, M.D.: What Our Anxiety Tells Us
“I think we're due for a cultural rebranding around crying. I think that crying, you know, if we start to cry, we inevitably apologize or invariably apologize. We sort of suck it back in and make it as small as it can be. Like the way someone would pinch back a sneeze, we’re like holding the tears back, making it smaller, collecting ourselves. And you know, if you know, somebody who's crying frequently or you're like, they're in a bad place. And I think that we really need to see crying as this deep wisdom from our body saying, you need a release right now, let's have of one. And when you get an opportunity to cry, dive into it and let it be big, let it be complete rather than smaller. Like let it be bigger.” So says Dr. Ellen Vora, a Columbia University-trained psychiatrist who takes a functional and holistic approach to mental health—namely, she treats the whole system, looking for where states like anxiety and depression might be rooted in the body, whether it’s less-than-ideal nutrition and an out-of-whack gut, or poor sleep and breathing.
In her just-launched book—The Anatomy of Anxiety—she tackles this state that is ever-present for many of us. In fact, it’s easy to argue that if you aren’t feeling anxious, you aren’t really alive in this complex, difficult rollercoaster of time. But in Ellen’s model, she differentiates between true and false anxiety—both are very real and valid concerns. For false anxiety, typically there’s an imminently treatable physical root that can be addressed until the body comes back into balance and the mind calms. True anxiety, on the other hand, is an alarm clock that something is not right—that you’re out of alignment, or integrity, in some way. In this episode we talk about both, including the overwhelming load that we’re all carrying and how important it is to cry. We also explore psychedelics and what it means to really heal.
EPISODE HIGHLIGHTS:
It’s not ‘all in your head’, it’s in your body…
Building your sleep toolkit…
Honoring real food cravings…
The importance of finding release…
MORE FROM ELLEN VORA, M.D.:
The Anatomy Of Anxiety: Understanding and Overcoming the Body's Fear Response
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TRANSCRIPT:
(Edited slightly for clarity.)
ELISE LOEHNEN:
Obviously, I I find you expert in many things and I've known you for an awfully long time. But why anxiety?
ELLEN VORA, M.D.:
Why anxiety…it’s completely born out of the problems that are showing up in my office. So I'm up for writing a book on a number of different topics, I could have written about bipolar, or depression, or just about psychedelics. But right now it's like, it hits me over the head every day that where people are suffering and where they need support fast is around anxiety.
ELISE:
Yeah, no, it makes a ton of sense and I have an anxiety disorder, and it's one of those things that's intergenerational. I, I ha my mom has it, my aunt has it. I think my son has it. AndI loved your book because I love you. I thought it was, it felt very conversational, sort of like engaging with you on a long walk, which is one of my favorite things to do. But I love this sort of dichotomy that you set up at the beginning around true anxiety and false anxiety. And starting to tease out one, I like that you honor all of it. I just wanna say that. It's all very real, but it can have different causes and maybe it's a spiritual awakening, and maybe it's a caffeine addiction, right?
ELLEN:
Yeah, that dichotomy, it feels really important to, to me that we have a slightly different conversation about anxiety, because right now, you know, we've inherited the way of thinking about anxiety that comes from the DSM, the Bible of mental health field and it has its merits, but it's basically telling us, well, your anxiety is either generalized anxiety disorder or maybe it's panic disorder, whether with or without agoraphobia, or one of the various other classifications. And the intention with these different classifications is, is really always to steer management and in the conventional approach to anxiety that does steer management, it says like, oh, if you've met these criteria for generalized anxiety disorder, then perhaps medication is indicated, or if it's panic, maybe you should pursue in behavioral therapy. And that's kind of useful, but it's, it has no bearing on how I approach care with anxiety.
And for me, what steers management much more usefully is to divide anxiety to two categories: false anxiety, true anxiety. And false anxiety: That term false is by no means to invalidate the very real suffering of anxiety. But it speaks to the straightforward path out. False anxiety is avoidable anxiety. It doesn't need to be happening. And it's usually the result of a pretty mundane physical state of balance, usually precipitated by something like a blood sugar crash, or being sleep-deprived, or maybe you ate something your body doesn't tolerate, you're inflamed, maybe a food poisoning. Maybe you're a little deficient in micronutrients like vitamin B12. And that could be a number of other sources of false anxiety. And the idea here is, do the investigation figure out what is the culprit in your case, address it, and then walk away from that anxiety from your life. You don't need that anxiety.
It's not serving any ultimate purpose, but then true anxiety very much on the other hand is not something to pathologize. It's not something we really can medicate away. It's certainly not something that we can caffeine-free and gluten-free are way out of. It ishere as purposeful anxiety, it speaks to our relationship to this life with all of its vulnerabilities. And I think it also has a lot to do with what we are uniquely here, our unique perspective, where we can make a contribution. And I don't mean that to be such a weighty, heavy, like putting this big responsibility on everybody. It's really just to say that that thing that really matters to you, it matters and you're uniquely positioned to make some difference around it. So slow down, pay attention to it, take some steps, in the name of like see that true anxiety as a call to action.
ELISE:
And to me, my anxiety exists on somewhere on the spectrum. So there are certain things that are theoretically within my control that will inspire it or set me off. I hyperventilate, so I over breathe, which I think is actually very undiagnosed, underdiagnosed. People don't really know what it is and they associate hyperventilation with panicking and breathing into a bag. But for me, it's that, I mean, you know this better than I do, but I can't take a deep breath because I'm already too much oxygen in my system, but it sends a suffocation message to my brain that I'm gonna fucking die. So it's really terrifying, and I'm used to it at this point, but I can do it. I can get into a hyperventilation cycle for, uh, months, weeks, where by the afternoon I'm too sort of almost panting, and it's really debilitating. But it is usually a factor of sleep disruption.
Um, like I'm a little bit of a baby about my sleep, and then too much caffeine, which you brought to my attention years ago. And then it sort of gets me going. And then the existential part of it is this longstanding fight with my body where my body's the last thing I listen to. And, the last sort of thing that I honor where it's this perpetual—going back to Yale. So for people who are listening Ellen and I went to college together, and in college I found that if I took six credits, we needed four, I think. I took six credits. I just, generally I did better. I needed that sort of like extra drive in order to excel. And then if I don't have enough to do, I don't get anything done. So it's that like productivity whip. So this is a terrible pattern and that's what has provoked my anxiety cycle is this internal despair there that I have an anger at myself around driving, taking on too much spreading too myself way too thin. And I just can't stop doing it.
ELLEN:
Interesting. I hadn't really thought about it in, in its relationship to the idea of taking six course credits when you could be in, should be taking four. It's almost like with your breathing and with lifestyle the block here is that you can't slow down. Even when the sort of sped up life, sped up breathing, rapid shallow breaths, are really creating a snowball effective suffering and discomfort. It's like your body really doesn't have the right carbon dioxide oxygen ratio to be able to slow down. It's an interesting one. I remember the last time we talked about your breathing. I think breathing is such an underappreciated factor in anxiety. I wish I had said more about it in the book. There is a section on it, but at this point I could write a whole chapter about it. And so often people struggling with anxiety and this is a form, a false anxiety, it's improper breathing.
And what I see most commonly is it relates to structural issues with the nose and the hard palette. And that itself is created by aspects of modern life like multi-generations of a soft diet and micronutrient deficiencies. So when you look at like remaining hunter gatherer societies on the planet, they have these diets, these traditional diets that really prize the most nutrient dense foods, like organ meats. And, you know, the ghee made from the cows that ate the first spring grass and these kinds of concepts, Cod liver oil. And so they get vitamins, A D E K all these things that are low little bit in short supply and like a modern Western diet. And it helps people develop broad, strong jaws and wide dental arches. And so the whole mouth kind of develops wide. It allows the large, the hard palette to be a broad shape. And all of this creates really good airflow through the nasal passages. Modern life, soft diets, underdeveloped jaws, narrow hard pallets, crowded teeth and improper airflow through the nose. And that has so many impacts on our mental health. And it affects how we can sleep, which in turn impacts every aspect of our mental health and certainly impacts how well we can focus during the day. But there's no stronger stress signal to the body than I can't breathe. And it's even more than blood sugar crashes, right? Like it's a faster way of the body thinking I'm gonna die. And when you can't get a good breath, it's gonna trip you into, it sounds almost like you get into a cycle that then reinforces itself.
ELISE:
Yeah, no, absolutely. And I'm sure you read Breath by James Nestor. And, when I interviewed him that obviously is a topic close to my heart. And then I spoke, I interviewed when I was at Rafael Pelayo when I was at goop, who was the head of the Stanford Sleep Institute or a physician there, and we were talking about breathing. And so I only, as an adult realized that I'm tongue tied. I now have sort of an ALF appliance to expand my pal. And when my dentist, my orthodontist, adjusts my appliance, which I wear at night, like he drops me into parasympathetic. He can like put pressure on my palette and it will drop me. It's the most profound relief. And I think that, you know, I'm a sensitive person. My son has the exact same pattern. So he also goes to the same dentist and has an Alf appliance that they that's in his mouth permanently to expand his palette.
And I'm trying to help him, like he has exhibits the exact same tendency. So it is it's structural I think one of my ribs is pinned. My who knows. I mean, we just contort ourselves over time, but as you say, you know, when I was younger, when I was in my twenties, before I had a better understanding of—my dad's a ironically, a pulmonologist and I have subtle asthma as well—but the common, um, the common reaction, well, it's just in your head, like you're just anxious and you need to deal with your anxiety, which is true and false. So as the book I think is, is wonderful in the sense that it actually has. There's nothing more annoying than being told, you're just creating your own distortion field.
ELLEN:
I’m here to kind of like flip that on its head. And like we've had this whole, you know, very misogynistic, really like, you know, dismissive of the hysterical to be saying at this point, it's all in your head, often to women, often to women who seem to be like making an audacious attempt to advocate for their health needs in the doctor's office, how dare they. And I think that, rather than it's all in your head, the first half of my book is actually really saying it's all in your body. That your anxiety is a downstream consequence of a state of physical imbalance in your body. And, you know, Will Cole, who we both know has a wonderful way of saying this is like mental health is physical health. And I think that's the paradigm shift we need to begin with, is to recognize like all these things that we're even starting to blame ourselves for.
Like, ah, I just need to reign in my anxiety. It's all in my head. Look first to the body, get that into a state of balance. Then we'll see where we're at. And often people are considerably less anxious, considerably less depressed, ADHD improves, when we get the physical body imbalance, which isn't necessarily an easy path, but it's a doable path. And that's what I outlined in a very actionable way, the first half of the book. But then what remains behind that is not something for us to be shaming or pathologizing. That's really, we maybe just need to rebrand how we experience it that urgency, rather than feeling it as a nuisance or something to try to eradicate. Can we see that as purposeful? Can it sort of transmute into a feeling of this is what drives me like the libidinous drive towards making a contribution. And I think that that's how I wanna shake out that conversation in a different direction. Like it's not all in your head, but the part that is in your head is really in your heart. And that is what you're here to do, who you're here to be.
ELISE
I love that. I want to put a pin on that and talk about that in a minute. I'm glad you mentioned ADHD, because I think you, you point out and it feels like this is starting to get a lot more awareness and it's essential. It's one of the things that Rafael at Stanford was talking about ADHD for children is potentially a sleep disorder and or that that’s a massive, that sleep apnea children is underdiagnosed, because they don't fit this model that we have, that you're an overweight man who snores. Um, you know that goes back to that mouth breathing and narrow palette issues that sleep should be assessed as part of any treatment plan for someone diagnosed with ADHD, or an adult. So let's talk about some of the practical sleep. Obviously you talk about sleep a lot and sort of its all of its essential upsides like the glymphatic system. Can you talk us through sort of the toolkit where you would want people to start? Yeah. Just in general, like the first things that you rule out when someone presents with anxiety.
ELLEN:
Sleep is definitely a place that I start when I'm trying to address anxiety from the physical angle. And I like to say that sleep is eminently treatable. Like it's an issue that plagues so many of us in modern life, but for the most part, the body knows how to sleep, wants to sleep. There's some aspect of how we're leading our modern lives that's getting in the way of us being able to fall asleep and sleep deeply. I will caveat by saying, I think perimenopause and menopause is a tricky situation. Shift labor, jet lag, certain really organic sleep disorders can be trickier to manage. But for the most part we can improve our sleep. And even in those cases, there are things we can do to improve sleep. So I start this sleep approach by really thinking about light, because it really comes down to our circadian rhythm and our whole circadian rhythm.
It's a good design. It's basically saying that light makes us release cortisol. So we feel awake and alert and darkness allows us to release melatonin so we can feel sleepy. And that whole thing was foolproof on the proverbial savannah of evolution where if it was nighttime, it was by definition, dark out, and you could only really see fire and the moon. But in modern life, after the sun sets, we're surrounded by a psychedelic light show. We have our laptop open to a spreadsheet on the couch. The overhead lights are on. We bring our phones into bed with us. And so even just getting strategic about light and making sure our eyeballs see some actual sunlight first thing in the morning, and that after sunset, we're somehow preventing our eyes from getting exposed to blue spectrum light. And there's two main ways to achieve that. And one is a simple strategy of selling your house, quitting your job, moving off the grid, homesteading, throwing your phone into the ocean, and you know, just living that lifestyle, which is great.
And then if you don't want to go all in on that, just yet, then you could just get blue block and glasses, which I also give my blessing to. That's what I do. And I put them on at sunset. I wear them until bedtime and it at least blocks my eyes from seeing blue spectrum light. So it's not going to super press my melatonin and disrupt circadian rhythm. So that's where I start. There are a lot of other strategies that are helpful. I think we can all at least reflect on bedtime. That's an interesting one. The remaining hunter gatherer societies on earth seem to have arrived at a somewhat consistent bedtime. It's around three hours after sunset. So that's the time to look for your tired signs. It’s that when you're yawning and falling asleep on the couch, that might be the right time to sweep yourself into your bed.
Then you fall asleep easily, cuz it's this sweet spot when you're perfectly tired. Whereas what most of us do is we push past that because modern life, and we still have to clean the kitchen, and we still have to do more logistics, and open our laptop up one more time to finish a little bit of work at night. So, so then we're pushing past the point when we're perfectly tired and we get into a state of being overtired, which anybody who's a parent is like, ah, yes, overtired didn't know that was a concept that existed until it had a newborn. And then we all learned the hard way. What happens when a kid gets overtired and they're tired one minute. And then once they're overtired, they're like crying uncontrollably, and arching their back, and then emanating heat. And we're adults. We are just oversized toddlers in so many ways and we also get over tired. So if you know that you get that second wind feeling and you're sort of tired, but wired and then you're tossing and turning when you're trying to fall asleep. It might be worth pushing your bedtime a little earlier, looking for your tired signs somewhere around three hours after sunset.
ELISE:
I liked that subtle shift because what, in my mind I had thought, oh, when it gets dark, you're supposed to go to bed, which is obviously deeply impractical, but three hours is doable. It's very, it lands you right on my personal sweet spot. And I think we are, it does feel like culturally we're starting to shift from this like all sleep when I'm dead mentality to prioritizing rest. Like that sort of old idea seems to be dying. It's just, as you said, often feels impractical particularly for parents or people who are doing their second and third shift and then that, and I love that it has a name sort of this idea of, um, that me time that like insistence on like I'm just gonna screw it and be on my phone because I, this is the only mean time I get.
ELLEN:
The sort of like rebellion, bedtime procrastination that we do where it's like F my life, I'm gonna be on my phone at 11:45 PM because you know, everyone needed so much from me all day. It's my time. And then it's actually just, you know, we're shooting ourselves in our own foot because we are not getting to bed and time to get enough sleep. It's a tricky puzzle. I think that we're in this great rethink right now. Where can we create lives that we don't need to escape from quite so much at night and have no easy answers there, but it's at least worth reflecting on.
ELISE:
I liked your discussion of food too. I thought it was nuanced, and fair in the sense of sort of like this, the way that all of these strictures on how we're supposed to eat, feel very patriarchal. And then also like how Big Ag, et cetera is a patriarchal system too, but that we often will fight one. I have certainly felt that way like that rebellious teenager in the, the last like year or two where I'm like, I'm not gonna be restrictive and screw this. And, and then I, in a way I'm like, but I really should probably not be standing in the middle of my kitchen, inhaling chicken fingers and fries, like dusted with, um, whatever.
ELLEN:
It's interesting, right? Because there's absolutely sort of patriarchal ideals and toxic diet culture. And at this point, even toxic wellness culture telling us like eat a perfect diet and you know, eat entirely clean, which has this weird, like moral panic component to it, like yeah, dirty food. And, and I think that, of course, you know, these ideas of like to be small and to be perfectly thin, whether or not that's anywhere near what your body wants to be. And so understandably with the right intention, we've pushed back against that. And we've kind of been like F it all. And that's where body positivity comes in, and there's so much good to that to sort of speak truth to that power and those pressures that we put people on to understand that weight is not necessarily an indication of health. And so, you know, that's not the right metric to be using to understand whether or not somebody is healthy.
And even to have bigger conversations around like is physical health everybody's goal, you know, and to have an acknowledgement of the systemic factors that are making it harder for certain populations to have that state of physical health. And all that being said, I think we swing not just too far, but like too in one direction with body positivity, which is like, well, then I'm just going to have no restrictions and eat whatever I want. And in a weird way, there's this other patriarchy standing in that corner over there, like the big food company, just being like, ha ha ha. Thank you for championing our cause. And so then what we do is we reach for the drug-like foods, and it's sort of no longer an act of radical self-love. It just becomes like an addiction to a service that another patriarchy is selling us.
And I think, can we find that balance where we are feeding ourselves well, nourishing ourselves from a place of radical self love, but not from a place of restriction or sort of a moral superiority around eating clean. It's what makes our bodies feel good. And can we do that in this world that makes it really hard to eat well? And so can we do it without feeling fragile and afraid of food? Can we do it without too much strain and driving ourselves crazy? I think it's really challenging. I try to live this balance. But I see many of my patients falter, it's not easy to find the right rhythm with it.
ELISE:
Yeah. And even sort of the name body positivity inherently is implying how we should be feeling, which I think is difficult. We have very complex relationships with our bodies. And so this, like the stricture of feel positive is also, its own kind of box where really, you know, I think with the call of anxiety as well, it's like, well actually, what is your body trying to say? And can you decode its appetites, and what it wants, and what it needs? Like so much of life is trying to figure out how to understand the language. And I think it's so hard as women because we are, I tend to disassociate from my body, our bodies don't always feel safe. They don't always feel loved. We often feel betrayed by them. I don't know if it's as complex for men, but I feel like for a lot of the women I know, just like actually getting into your body and loving your body is a challenge.
ELLEN:
I had this patient brilliantly put it one day. She was like, she was like, I feel like my therapy with you, Dr. Vora is actually couples therapy between me and my body. And it was interesting how, like that was, you know, I didn't even realize that's what we were doing, but the focus really was on how can we slow down and have a conversation with our body, have mutual respect, not be so entrenched in our positions of, I feel betrayed by you, or I don't like you, or you're the enemy, and how can we see ourselves as on the same team as our bodies. Can we extend love? Can we understand like an open line of inquiry of like, help me understand what you need, help me understand what you're trying to tell me. And, you know, it can feel goofy, anybody who doesn't like to like lie on their bed with their hands on their tummy talking to their body. But I encourage people to kind of go into that goofy space and try to open up those lines of communication in a really sweet way. Like bringing a lot of like the same gentleness and compassion you would bring to really trying to heal any kind of troubled relationship that you're fighting to rehabilitate.
ELISE:
Yeah. What do you advise? I mean, I will say, a really important point for me in my relationship with my body. I know we just were talking about this as a potentially toxic, but was what, the first time I actually did. I did the Clean Program. I did Dr. Junger’s program. It's the first time I'd ever done anything like this. This was many, many, many years ago after I had my first baby and I felt really terrible and, um, had been dismissed by my OBGYN who I loved, but was like, he was very, you know, I was one of my second baby was like the last baby he delivered. He was, you know, at the end, end of his career, of a different era. And I remember going to him and I was like, I don't feel good. And he was like, you're fine.
You're a new mom. And I was like, pleased test my iron. And I was wildly anemic, like to the point where he was startled, the second time they wanted to give me a transfusion. So I get so anemic during pregnancy. Anyway, I did Clean Program and Junger put me on some other things like B-12, et cetera. And, oh my God, I just felt dramatically better. Like it just reset something for me. And as he said, he's like, well, you're just like cleaning the walls because as I started to reintroduce things, I could understand actually, I could read the signals from my body of what it liked. And didn't like. No problem with gluten, for example, don't tolerate dairy. Even though I insist on eating it. So all of that said, I don't do that all I haven't done it in years, but do you recommend for people who are just sort of like have no sense of what's happening? How do you get them to that place of truth where they can actually sense like, oh my body does not like broccoli.
ELLEN:
Yeah. I think, yeah, you raise such a good point. There is that sort of toxic orthorexic adjacent quality of like a cleanse and often when it's calorie restrictive, it just lays the foundation almost like is kindling for developing any kind of obsession with food, or a binge later. So that's, that's really tricky territory. And thin ice to be on. I think that the trouble is, is that our modern processed food industry. It's pretty smart about how it engineers food. And often in times they've figured out how to make these, what I would call franken-foods, somewhat addictive. They can behave like drugs in a variety of different ways. And so I do think it's sometimes necessary to control-alt-delete our taste buds and our brains sort of dopaminegic anticipation of the drug hit we're about to get from food. There are different ways to do that.
I'll usually point someone of the Whole 30 diet, um, to basically have a, it's a really nice way of outlining. Like here's what you can eat and focus on nutrient density. And this isn't a diet. This is balance. This is nourishing, and substantial. But it takes out what might be tricking your brain into not just yearning for nourishment, but yearning for a drug hit. And I think that that's how I'll go about it. And I think I always want people to have in mind, the compass for eating is generally err, on the side of eating real food, generally err, on the side of avoiding fake food and you wanna listen for your cravings, they will guide you towards what nutrients your body needs, but you need to discern is, is that a craving for a nutrient, or is it a craving for a drug?
And if your body's like, hi, yes. My deep internal wisdom is telling me right now that what I really need is pizza. That's probably a craving for a drug, but if it's telling you, you need a dripping rare steak and you need a pile of mashed potatoes, that's probably a genuine need for some form of macronutrient or micronutrient. And so to just kind of ask yourself is what it's craving a real food, in which case I'm gonna honor that. And I think this loops into, well we can go there or not, but when you were feeling so lousy and iron and vitamin B12 helped you feel better. I think this is a really underappreciated aspect of postpartum anxiety. And there's a lot that goes into why someone might be anxious in the postpartum period. And you know, you can sort of point to the obvious of like, oh shit, you just had a baby and now your life is transformed, but you're not getting good sleep.
And the role transition, the expectations on women, the absolute, you know, just bankrupt level of child, parental support we have in this country, so on and so forth. But we're also so nutritionally depleted, we grew a baby, we birthed a baby. Sometimes we bled profusely during that. And then we might be nursing a baby. And in Chinese medicine, I think they say one drop of breast milk is like 10 drops of chi or blood. It's basically understanding that this is your best stuff that you're giving over to the baby. So new moms are deeply nutritionally depleted and our brains, it's just a piece of flesh in our body. Like anything else, like any other organ and it needs the raw materials in order to function properly, for us to feel good and function well. And so a big part of supporting postpartum anxiety in my practice is repleting mom nutritionally.
ELISE:
Hmm. Yeah, no, obviously so under and, and, but it feels like, at least now there are a lot of antidotes, or people trying to create antidotes and, and raise awareness around postnatal depletion and its very real effects. And then obviously what happens is we then go on still depleted back to work. Often we go and get pregnant again within sort of a reasonable time span, but you're starting again from a place not only of depletion, but also getting older. And we just don't focus on that. It's not something tested, it's not studied,, it's not understood or talked about by a majority of OBGYNs like that just it's not nutritional part of it is not, alas. But I do think awareness seems to be raising. In terms of women. I mean, I'm, I just read this book, um, which I loved it might be out of print, but it's called The Natural Superiority of Women.
It's by Ashley Monague who is, he's a late anthropologist, visionary anthropologist trained by Fran Boaz who was, you know, Ashley and other addressed sort of UNESCO in 1950 to stipulate like to assert there's no such thing. There's no such biological thing as race. This is not a real thing. So he's deeply ahead of his time. But The Natural Superiority of Women is about how women are biologically suited for survival. That's his definition of superiority. And he also talks about psychologically and, and within stress responses, how studies around, he first wrote this book in like 1950 and then has updated it before he died. But I think it was during air raids, um, and other incredible stressful cultural moments, women just endur,e were able to like carry on in a much more durable way than men, which is contrary to what we would believe.
I don't know what other studies there are. I can post it on social, but I wonder, too, in the context to something like COVID, and the existential anxiety of this moment in time, and all that women are carrying. The women I know in my life are killing it, killing themselves also in terms of pulling everything forward, socially, at work, at home, not that the men are lousy, but the women seem to have an incredible capacity. So do you feel like in our ability to sort of be the donkeys really of like stress and…how does that show up for us? I certainly feel that way. There are times when I look back and I'm like, I don't know how I got through that and I know it's in my body. But what happens?
ELLEN:
Yeah. I mean, I think that you're bringing up such a great point. The fact that we have such a deep reservoir of reserves that we can draw upon, I think does make it hard to catch that initial communication from our body of, you know, you can make this withdrawal on your energy, but you will need to pay me back at some point. I think we can miss that signal. And if you think about you, with your six classes, you think about the character Luisa in Encanto. If you've seen that movie, the new Disney movie, like we can feel like we're carrying the weight of the world and we're managing, but there's an inertia to it. And if we just keep going, keep going, and never slow down and pause to ask the question like, am I okay? Can I handle this? We'll just keep going. It's momentum.
But I do think that we missed some signs from our body that we are barreling towards burnout. And I do think that even though we have these reserves, and we are in this superior sex that's better designed for survival. I do think we get ourselves into trouble with burnout. And what I think of as more of like a psychological state of resentment. I think we're more likely to take on all of these burdens from a place of obligation to do it, do it, do it, and then ultimately to resent that other people aren't helping to meet our needs, even though we're meeting their needs. And I actually think that's on us. I think that's on us to recognize our needs and ask for them to be met and give people the opportunity to meet our needs if they want to not obligate them into it.
But I also think that, you know, to go one step further, that's on our culture for making women never feel like we have a right to speak up that somehow these feminine ideals are overlapping with selflessness. And so I think that I'm looking forward to what I think we're seeing the beginnings of is a cultural shift of, I just, I can acknowledging I have needs. There's no shame in that. And to speak up for it. And, and perhaps most importantly, to hear it from within our bodies, when even though we can carry the weight of the world, can we save that capacity for when it's really necessary, but in a regular, on a regular Tuesday, do we need to be Luisa carrying every burden of our households and our communities? Can we actually balance showing up with rest and in that moment to moment listening to our body and knowing here's when I can help, joyfully, and here's when I need to take my rest.
ELISE:
Yeah, no, I think that's so important that not only an assertion of needs, but I think that so many of us have been trained to not even assess our own and, or identify them so that we can express them. You know, we've been taught that we don't really have needs and in this other-centric way in which we're raised. And it's funny too, I was speaking to a friend whose dog died, and it was tragic and, and awful, and she's been having a huge reaction to it. And, you know, I'm like, it's totally understandable. And I think she was a little bit like me. I was watching a Marvel movie with my kids, my husband this weekend. And at the end I was crying quite profusely. And my husband was like, you really need a release. Like you really need a cry. And that that's, I think what I was saying to my friend, I was like, I think that you've just been also carying a lot. This is about more than the dog. The dog, yes. But this is it's your body is like, I haven't cried despite everything else in years.
ELLEN:
Oh, I'm so glad you brought this up. I mean, we have kids, young kids, right? So when you see a kid they're heading into a meltdown, like, I don't know about you, my husband and I will look at each other and be like, sort of start to do the post-mortem. Like, how did this meltdown come about? And what did we do wrong? What was the misstep? But like often it's actually just that the child's body in its infinite wisdom understands it needs a release in that moment. Had a long day at school, learning a lot, learning to read, like learning how to be a person in the world. We're taking on a lot, carrying a lot. And kids are still in touch with the fact that they need a release and they don't put up a barrier. They act actually allow themselves that release. Adults, adult women, I think very much don't hear our need for a release and have so many barriers to giving ourselves that release.
I think we're due for a cultural rebranding around crying. I think that crying, you know, if we start to cry, we inevitably apologize or invariably apologize. We sort of suck it back in and make it as small as it can be. Like the way someone would pinch back a sneeze, we’re like holding the tears back, making it smaller, collecting ourselves. And you know, if you know, somebody who's crying frequently or you're like, they're in a bad place. And I think that we really need to see crying as this deep wisdom from our body saying, you need a release right now, let's have of one. And when you get an opportunity to cry, dive into it and let it be big, let it be complete rather than smaller. Like let it be bigger.
And to really see it as good for that person, they're having a good cry. And often, to see someone else crying and let it be an opportunity for us to cry as well, to use the sort of mirror neurons and busy to just jump in and everyone is splashing around in salty tears. And I think that that is something that we just need to recognize as a positive thing. There's a component of our stress response called ACTH adrenal cortico tropic hormone that actually comes out in our tears. So we, in certain ways cut our stress response off at the roots when we allow ourselves to cry.
ELISE:
And there's nothing sort of more painful. I mean, there are things that are more painful, but that burning sort of that feeling, that moment when you're suppressing and you can feel it burning. I often feel like I'm just carrying around a very overfull bucket and I don't always know how to get it to the point where it can spill over. I think that that instinct to repress, or suppress our emotions is so strong and so many of us, because we don't have time to lose our shit. And so I agree with you. I think the cultural conditioning are figuring out for me, it's like, what are the triggers? Like, how can we get this going? So we're letting the bucket deplete. Will Siu always says, you know, when he's seen me cry, he's like, don't bring your eyes to your face. Like, don't that we have so many automatic like wiping, or trying to stop, and he's like, just keep your hands away from your face. No Kleenex, like, let it go, keep it going. And I think, and maybe it's not always tears. I like that you bring up like shaking, dancing, like that sort of physical release, too.
ELLEN:
So like, I think that there's so many beautiful ways to build in a release. And you, if it's physical exercise for you, great. It could be dancing. It could be journaling. It could be cuddling, could be playing with a puppy. I love shaking. I love putting on Shamanic drum music and shaking for a couple minutes in between patients. For me that really clears the slate. That's the control-alt-delete on my nervous system. I will say about crying two things. One is we could segue into psychedelics if we want to talk about that, because I feel like psychedelics taught me how to cry better. I thought I had grieved, and then when I started working with psychedelics, I was like, wait, I had so much grief pent up. And it taught me how to open that portal so much more like a deep opening of the grief portal. And I think that if you do need help getting started with crying, Pixar movies, like they're basically like tear porn, you know, like they'll get you going and, and then get into the rhythm on your own of just whenever you need the release, give yourself that release.
ELISE:
Let's talk about psychedelics. And that grief portal that's been, you are far more studied in psychedelics than I am. But that's certainly, every time that I've done them historically, that has been one of the primary lessons, which is just because you stuff it, doesn't mean it goes away. It's in these suitcases and your body and it, it can be like a great attic, cobweb release, sort of like really letting things out. Do you think, and maybe even in terms of anxiety, although maybe anxiety is its own thing, I don't know about psychedelics and anxiety, certainly psychedelics and depression, but what do you think that they're great when done appropriately, in a therapeutic setting, with the integration… I think people too, like the, the experience in of itself is very powerful, but the integration around it, the therapy around it is often more powerful. What do you think the great promise is?
ELISE:
Yeah. And I agree, I think it's like 10% the peak experience and the medicine, and then it's 90% the integration of what came through. So the great promise. I like it as a paradigm shift for how we're addressing mental health, because, you know, it's still a little familiar, like it's active at the 5HTA-2, a serotonergic receptor. So it's still, you know, it echoes what we're already doing with our antidepressants. Um, so that's part of why it might create an enduring antidepressant effect and anti-anxiety effect. Um, anti-inflammatory, it promotes BDNF. So we have neuroplasticity and neurogenesis, you know, we can grow and change and adapt and get unstuck. But part of the reason I find it most exciting is that it's acknowledging that a big component of why we struggle with our mental health is psycho-spiritual. And it's been something that we've really neglected.
I love Will Siu’s quote on this. He's like said something to the effect of psychedelics are not just tools for healing trauma. How does he put it? They make spirituality palatable for a starving Western world. And I think that part of what I love is this mystical experience, hypothesis of psychedelics that, you know, under the right set setting and all the caveats of this needs to be safe and appropriate and indicated, that it can somewhat reliably create a peak spiritual experience. And it's not like we need to convince everyone to believe in God. It's just that we need to invite everyone to at least be asking the questions, to just pull the curtain back enough that we're like, wait, could there be something somewhat incomprehensible happening here? And I think it takes the pressure off of what's really at the heart of the truest of true anxieties, which is the vulnerability of being alive, of loving other people, of not wanting to die and not wanting to lose the people that we love.
And when we think that this material existence is really finite, and this is all there is, of course we're gonna be hypervigilant, and anxious, and thinking that all we should ever do is go to the doctor and get a scan for cancer. But I think that, and like never leave our house, but I think that that's of course gonna keep us maybe alive at the expense of living. And that's not actually a salve for anxiety. So what we wanna do instead is have an experience like a psychedelic ceremony, where we're overcome with awe, where we might feel even just for a few hours an experience of being guided by a living force that helps us learn in a very felt experience kind of way. This is what it could mean to surrender and trust.
ELISE:
Okay, now I'm gonna cry. That was beautiful. That was our mic drop moment. I think. Uh, no, I agree. I think there is something so just anxiety obviating in that feeling of belonging to something bigger. And it doesn't eradicate that hypervigilance, but I think that there is something profoundly healthy about feeling like it's not all on me. Like there is some intelligence to this universe. It's not, everything happens for a reason. Certainly. Um, it's will probably always be beyond our comprehension and as we learn and understand more about consciousness and the universe, but it is I think, any faith that, for example, that your mother is still present in your life and guiding you and helping you, like, that's a beautiful idea. And if that makes life more meaningful and less scary and more connected, we need more of that.
ELLEN:
Yeah, for me, it, you know, at least at first, when it felt like more of a conscious choice, when I was faced with this idea, my mom died too young and it was like, do I believe what my atheist, scientism, skeptical upbringing has taught me to believe? Which is the end is the end. It's senseless. There's nothing else that felt like an unbearably cold version of the world. So I sort of made a proactive choice. Like I'm gonna choose a different way of making sense of this, that not to say everything happens for a reason. I don't think it was fair. I don't think it was right. I just want to have some sense that she continues to exist in spirit form, and that I can continue to connect with her. And I've found the kind of positive reinforcement of that worldview. And it's sad to me to think about missing out on that. Cause it does bring me an immense amount of comfort and meaning and um, yeah, and I think I'm, if I'm wrong, like if it turns out I'm totally diluted, then it brought me comfort and it kept me feeling connected to my mom. And so I don't feel like you really lose out if you can, you know, there's no forcing this, you can't just force a worldview. If it doesn't feel true for somebody that's okay, and there's no better or worse with this, but I, for me personally, it has been comforting.