Summary
Highlights
Anxiety's primary goal is protection, motivating us and serving us well. However, anxiety can sometimes misfire or fire too intensely, leading individuals to avoid situations or the anxiety itself, which can become problematic. This avoidance, while understandable as humans are wired to avoid pain, actually prolongs and exacerbates anxiety, creating a cycle where individuals only know how to cope through avoidance.
The Mindform podcast welcomes Dr. Alissa Jerud, a psychologist specializing in anxiety disorders, OCD, PTSD, and emotional regulation. Dr. Jerud utilizes the ART (Accept, Regulate, Tolerate) framework for navigating emotions. Her new book, 'Emotions Savvy Parenting,' is also highlighted. She shares that through meditation, she sometimes feels less anxious before interviews, aligning with her approach to emotions.
Dr. Jerud explains her perspective that moments of anxiety are 'gifts from the universe,' referring to the core idea in anxiety disorder treatment: humans are wired for a full range of emotions, including uncomfortable ones. The urge to avoid anxiety, while natural, paradoxically makes it worse. Instead, viewing anxiety as an opportunity to practice relating to it differently is key.
Anxiety is seen as adaptive and functional, existing to protect us from danger and motivate us. However, it can misfire or become overly intense, leading to avoidance behaviors that ultimately become problematic. These avoidance attempts prevent individuals from learning to tolerate the discomfort, perpetuating the cycle of anxiety. Anxiety is not concerned with facts, logic, or probabilities, often appearing when something valued is perceived to be at risk.
Dr. Jerud initially focused on PTSD treatment, learning about prolonged exposure therapy, which highlights how avoiding trauma reminders maintains symptoms. Her postdoctoral work at the University of Pennsylvania's Center for the Treatment and Study of Anxiety expanded her focus to other anxiety disorders. She found the core rationale for treating all anxiety disorders to be similar: breaking the habit of anxiety reduction through avoidance. These short-term, impactful treatments, often involving real-world exposures, are immensely rewarding.
Dr. Jerud outlines the structured approach of exposure therapy. It begins with an evaluation and psychoeducation to understand the anxiety disorder and its maintenance. A 'road map' or 'in-vivo hierarchy' is then created, listing situations the person will gradually approach without avoidance behaviors. Subsequent sessions involve confronting these situations, processing the learning, and assigning homework. The focus is intense and direct, aiming for significant world-changing shifts in a brief period.
Dr. Jerud emphasizes that the goal is not to eliminate anxiety, but to relate to it more skillfully. She uses the analogy of a fly at a picnic: trying to swat it away only distracts from the picnic, but allowing it to be there as background noise makes the experience more tolerable. This approach makes anxiety less consuming and allows for a more enjoyable and present life. A bonus side effect of welcoming anxiety is its natural dissipation over time.
Dr. Jerud rejects popular advice that promotes soothing, fixing, or avoiding anxiety, such as deep breathing to calm down or making specific seating choices on a plane to reduce anxiety. These strategies reinforce the false notion that anxiety is dangerous and intolerable, which is counterproductive to her approach.
When someone stops fighting anxiety, the external change might not always be immediately apparent, though avoidance behaviors (like avoiding eye contact if socially anxious) can make feared outcomes more likely. The internal shift, however, is significant: less exhaustion from constantly appeasing anxiety, leading to a more rewarding life. Individuals learn to not give in to urges and to allow physical symptoms and thoughts to be present. Dr. Jerud advocates for approaching rather than avoiding, even if in small steps, and suggests professional support if these steps are challenging. The common advice to avoid anxiety, though seemingly kind, often prolongs suffering.
Dr. Jerud details the ART framework: * **Accept:** Acknowledging emotions, thoughts, and physical sensations without fighting them. It also involves recognizing what is beyond our control. * **Regulate:** Understanding emotions and taking steps to become less vulnerable to painful feelings, or to shift emotions when they arise unhelpfully. This can include addressing basic needs like hunger or sleep. * **Tolerate:** Allowing painful emotions to be present without leading to regrettable actions or making the situation worse. This involves acting in alignment with values despite discomfort, similar to psychological flexibility in Acceptance and Commitment Therapy.
Dr. Jerud's move into parenting work stemmed from her own struggles as a parent, realizing she was trying to control her children's behaviors, much like people try to fight their own anxiety. She learned to focus on her own reactions and found more enjoyment in parenting. She recognizes that parenting amplified the strong urges to fix or avoid uncomfortable emotions, helping her better relate to her patients' experiences. She wishes she had understood earlier that her job wasn't to ensure her children's happiness at all times, nor were her own painful emotions (like anger) abnormal as a parent. The goal is to let feelings be there while still acting consistent with desired parenting values.
When a child is upset, Dr. Jerud emphasizes acting consistently with desired parenting values (loving, supportive, caring), regardless of the child's distress or her own internal discomfort. This means conveying a message of 'I'm here with you. I support you. I love you, and I know you can get through this moment,' rather than 'This is too much for you; I need to fix it.' This approach prevents reinforcing the belief that painful emotions must be eliminated. She acknowledges that parents will sometimes fail, and in those moments, self-compassion and modeling repair through apology are important, teaching children about imperfection and reconciliation.
Dr. Alissa Jerud's book, "Emotions Savvy Parenting: A Shamefree Guide to Navigating Emotional Storms and Deepening Connection," is available on Amazon, Barnes & Noble, Walmart, and smaller bookstores. More information about her and her practice can be found on her website, allyajared.com.