0:10

Welcome to the Anxiety Society

0:12

podcast. We're your hosts,

0:14

Dr. Elizabeth MacKinbell and Callie Werner,

0:17

both therapists and individuals that have

0:19

navigated our own anxiety journeys. Have

0:21

you ever wondered how we became a society

0:23

that is so defined by anxiety? Tune

0:26

in as we discuss, learn, and

0:28

dive into what anxiety is how

0:30

we perpetuate it, and how we can

0:32

stop it. This podcast will be

0:34

real, raw, and unfiltered, just like the

0:36

anxiety that plagues so many of

0:38

us. We're here to push boundaries,

0:41

challenge the status quo, and deep dive into

0:43

topics that are sure to make you

0:45

uncomfortable. If you're ready to step

0:47

outside of your comfort zone and

0:49

explore the unfiltered truth that will help

0:51

you change your entire relationship with anxiety

0:53

and get back to living your

0:55

life, you're in the right place. This

0:57

is the Anxiety Society podcast. We

0:59

live it, we contribute to it, and together

1:01

we can change it. This

1:10

episode is brought to you by OCD

1:12

Institute of Texas. Listen up, parents.

1:14

This summer, from June 9th to the

1:16

13th, 2 to 6 PM, we'll

1:18

be having an adolescent OCD camp, where

1:20

adolescents will learn tools to help

1:22

cope with their OCD, using peer -to -peer

1:25

support, one -on -one clinician support, and

1:27

group therapy approaches. If this

1:29

is something that's interesting to your

1:31

teen, please give us a call

1:33

back at our admission line, 832

1:35

-900 -8687, and we'll guide you through

1:37

the process. Welcome back to

1:39

the anxiety society podcast. Today we are

1:41

joined by Dr. Eric Storch, who is

1:43

a mentor, colleague and friend of mine

1:45

that I am so excited to have

1:47

on because I feel like our listeners

1:49

are going to be so excited to

1:51

hear from you for so many different

1:53

reasons. Like we'll definitely break down different

1:55

diagnoses, but also your ability to talk

1:57

about how to help their kids.

2:00

If they have anxious kids is a hot

2:02

topic that everybody wants to know the answers to.

2:04

So thanks for joining. We're so, so excited

2:06

to have you. I

2:08

forgot to also mention I want

2:10

to throw in one extra part of

2:12

your bio, Eric, that you are

2:14

an incredible karaoke enthusiast. Oh, yes. We've

2:18

sang many duets together. You

2:20

and Eric? Yes. I have not up

2:22

that courage yet for that exposure. But

2:24

I'm so proud of y 'all. Yeah.

2:27

So this will be a really good topic.

2:29

And I think it's going to always have to

2:32

start off with what we like to call

2:34

our anxious moment. So Eric, I was telling you

2:36

a little bit about that earlier, um, but

2:38

we jump in and we've at this point in

2:40

time just gotten out of the holidays. And

2:42

so we've probably got a lot of those brewing

2:44

that we could share, but. We'll just pick

2:46

one and Liz said she's going to start us

2:48

off. Oh, I did. Okay. No, I did

2:50

not, but here I am. Um, okay.

2:52

So I actually have a crazy anxious moment

2:55

today that I'm going to share. Um,

2:57

so I, Matt and I traveled

3:00

for like our last trip before

3:02

the twins come. And often

3:04

when I travel, I get an IV when

3:06

we get back being this pregnant, just to like

3:08

have some hydration and whatever. And

3:10

we have this anyway, it's like a mobile place.

3:12

This is a lot of people do this.

3:14

I know. Everyone's going to tell me I

3:16

shouldn't do it. I won't again. And

3:18

so I get this IV. I'm fine. Like no

3:20

problem. Matt's like, I'm going to get one too. Okay.

3:22

I'll get some extra hydration. Great. So it gets

3:24

vitamin drips, whatever. He helps me with bedtime.

3:26

We put the kids to bed. It's like, nope. Everything's

3:29

normal. Like no issues going on.

3:32

Matt tells me he's going to go,

3:34

um, move the car and run an

3:36

errand, comes back upstairs. 20 minutes later,

3:38

I was unpacking and he's like, Liz,

3:41

something's really wrong. And he was in. I'm

3:43

not, I shouldn't laugh. This is terrible. It was

3:45

crazy. But full shock, like

3:47

literally his body was convulsing. He like,

3:49

his whole body was tensing up.

3:51

He, his blood pressure dropped. He spiked

3:53

a huge fever. Anyways, four

3:56

days later, however long he's still in

3:58

the hospital, he was in full sepsis shock.

4:01

And it. My gosh, talk about anxiety. Like

4:03

I still have anxiety over it, but it

4:05

is so hard to navigate when someone you

4:07

love is struggling and you're not like, you're

4:09

not a medical professional. You know, this isn't

4:11

normal, but you also don't know what to

4:13

do. And he's being a male, being

4:16

like, I don't need to go to the hospital. No, I'm

4:18

okay. And I'm like, you have to go to the hospital.

4:20

This is not okay. Like we have to figure this out.

4:22

Thank God he's okay. He's going to be fine. But,

4:24

um, oh, I just, I hate

4:26

medical stuff. But what I will

4:28

say is that. For me,

4:31

those sort of incidences, despite the

4:33

fact that they're horrible and you hate

4:35

them, they kind of like put

4:37

life and anxiety in check a little

4:39

bit, right? It kind of makes you be

4:41

like... these other things I get anxious

4:43

about or like I worry about like don't

4:45

really matter when someone's life is what

4:47

matters. You know, so I love that because

4:49

I think it's so true. I always

4:51

tell people if you're actually like preparing for

4:53

all of these what ifs, all you're

4:55

doing is deterring your life more. And when

4:57

some of those scary what ifs do

4:59

happen, you actually have this different kind of

5:01

response due to your adrenals and all

5:03

of these other things and you work through

5:05

it. And so were you the strong

5:07

person for Matt? Um,

5:10

I think that I,

5:13

yes and no, it like complicated everything because

5:15

the doctors wouldn't let me go up there

5:17

until they knew it wasn't viral or contagious

5:19

and it was bacterial. So they didn't have

5:21

to worry about it, but it's just been,

5:23

it's been tough. But I think, I think

5:25

it's just harder in general when you have

5:27

kids because you can't meet Eric, you know,

5:29

but like. you have to split responsibilities. So

5:31

I can't like be at the hospital supporting

5:33

him. So you feel like you're like neglecting

5:36

him, but you have to be home with

5:38

your kids and what do you do? So

5:40

I don't know if I've been strong, but

5:42

I'm here. You, you haven't navigated

5:44

this. You're still doing the podcast today.

5:46

I would say that means you handled it.

5:48

So yeah, point of anxiety though is

5:50

that sometimes these really scary things that of

5:52

course no one wants when they do

5:54

happen, they like put other things in total

5:56

perspective. Yeah, for sure. Okay,

5:58

I'll go next. Mine is

6:01

I don't really want to follow that. I don't know.

6:03

That would be more anxiety -provoking. You don't need to. Yeah,

6:06

I think, so mine is, this happened

6:08

yesterday. We had my parents come over

6:10

for a very delayed Christmas gathering and

6:12

my husband has been painting our cabinets

6:14

this beautiful color and it's taking a

6:16

while and I understand why. There's a

6:18

lot of corners and just... that you

6:20

have to crawl into to get to

6:23

all the the cabinets and it he's

6:25

very good at any project that he

6:27

does but it does take a while

6:29

and my family has Including myself made

6:31

some comments about how long these things

6:33

are taking like some just like jabs

6:35

here and there and I we had

6:37

a heart -to -heart about communication styles and

6:39

how that wasn't super helpful for him

6:41

to make some of these jabs about

6:43

how long it was taking. And I

6:45

was super worried that my parents were

6:48

going to say it again after we

6:50

had. this like heart to heart that,

6:52

okay, this isn't helpful. We're going to

6:54

move forward. And so I was just

6:56

like kind of on edge for half

6:58

the time, like, oh, I hope my

7:00

parents don't make a comment about, cause

7:02

we laugh about it sometimes, um, but

7:04

wouldn't have been the time. So yeah.

7:06

You're just like, you're anxious about what

7:08

someone else might say. I hate that.

7:10

Yeah. And, um, the way I, I

7:13

worked through it was, you know, just

7:15

having some acceptance leaning and leaning into

7:17

it. And we actually had a great

7:19

time. Nobody said anything about the cabinets

7:21

and everybody was happy. Even if they

7:23

did, it would have been fine. It

7:25

would have been fine. uncomfortable for little

7:27

bit. Yeah. Yeah. So that's mine. And

7:30

well, I saw throughout

7:32

and I am. So

7:35

I tried out for an over

7:37

50 soccer league. Yes. How'd it

7:39

go? Well, they first of

7:41

all, they are making exceptions for

7:43

people that only qualify for the under

7:45

30. Right. So they

7:47

were letting you. Yeah, I know they were letting

7:49

you out on a 20 years or so.

7:52

So I've been played in three and a half

7:54

years and this comes from a guy that,

7:56

you know, Kelly as a former athlete, like, you

7:58

know, I played my whole life. So

8:00

I get out there and I'm nervous.

8:02

I've never met these guys before. I'm

8:05

sort of wondering how am I thinking

8:07

in the over 50 league right now? Because

8:09

again, you know, I'm at least not

8:11

50. And, and, and

8:13

I was so rusty that arguably

8:16

I was better than a cone

8:18

in the goal, which is my

8:20

position. Better than nothing. Better than

8:22

me. Better than nothing. You know,

8:24

it was there. But

8:26

the way I dealt with

8:28

it was just put myself out

8:30

there and appreciate that every

8:33

day I cannot get any worse

8:35

than that. And that

8:37

when I come home, people that

8:39

love me will continue to love

8:41

me and won't care how many

8:43

goals I gave up or how

8:45

Awfully in pain I was because

8:47

no one really cares about how

8:49

uncomfortable that is And and so

8:51

on so that's it been fun

8:53

It's you know what it's been

8:55

fun and quite quite revealing one

8:57

of the things I learned most

8:59

is is that I can't see

9:02

so You want me to play

9:04

you know in the evening you're

9:06

gonna get a completely different goalkeeper

9:08

than someone in the day An

9:10

eye doctor appointment I think there

9:12

just hits this time where you

9:14

go from being able to read

9:16

a menu right in front of

9:18

you, and having to hold it

9:20

out at a distance. That

9:22

no eye doctor can fix. Yeah, and

9:24

I just think it's just out of

9:27

it. I always laughed though, Eric, for

9:29

those who want to know this fun

9:31

fact. Eric and my husband Matt co

9:33

-led or co -coached Eric's son's soccer team.

9:35

I knew this. And Matt is like

9:37

Eric, like super competitive and shows up.

9:40

And I think I can't remember how

9:42

old. The age range was then

9:44

was it like six to seven year olds? Yeah, it

9:46

was it wasn't very old So like Matt shows

9:48

up with like a clipboard and a whistle and cones

9:50

and Eric's like mess for like six to seven

9:52

year olds He's like yeah, I know but like we're

9:54

gonna be really good right? Anyway,

9:56

they were not very good But they had

9:58

a lot of fun and it was very

10:00

humbling because Eric Matt then taught our Olivia's

10:03

soccer, which was three and four year

10:05

olds this year. And I think that it

10:07

helped prep him, although he is still

10:09

so mad after every game. I understand why

10:11

they can't figure this out. Why are

10:13

they picking flowers over there? Oh,

10:15

yeah. Well, one kid kept eating his drawstrings and

10:17

Matt was like, if he does this again, I

10:19

can't. I was like, what are you going to

10:22

do? Like he's three years old. It's fine. So,

10:25

okay. Well. Thank you

10:27

for joining today. As you guys

10:29

know, Dr. Storch is an incredible psychologist

10:31

who works at Baylor College of Medicine and

10:34

has spent his entire career dedicated to

10:36

understanding both research and the treatment side of

10:38

obsessive compulsive disorder, anxiety disorders, and so

10:40

many related disorders. And I have so many

10:42

questions and so many things to talk

10:44

about. So I'll kind of give like an

10:46

overview of what I would love and

10:48

then we'll just dive right in. But, you

10:51

know, we talked a lot, we've talked

10:53

about OCD, we've talked about anxiety before, but

10:55

I would love for you to spend

10:57

a second, Eric, talking about

10:59

how, especially like with kids,

11:02

how do you differentiate if it's just

11:04

anxiety versus if it's OCD? I

11:06

think, I mean, there are a whole

11:08

bunch of different aspects to help sort

11:10

of distinguish. I mean, first and foremost

11:12

is just the nature of OCD relative

11:14

to these other anxiety problems. Now,

11:17

here's the good, I think.

11:20

is that whenever I do a

11:22

training trying to teach clinicians how

11:24

to treat kids with OCD, I

11:26

come off and I'm like, look, you

11:28

guys are going to get

11:31

like five for one. I'm going

11:33

to teach you how to

11:35

treat OCD and you can use

11:37

this to treat kids with

11:39

GAD, social phobia,

11:41

separation anxiety, food phobia,

11:43

specific phobias, whatever it is. I don't

11:45

know if that's five, but But

11:48

the point is that, really,

11:50

it's sort of the original

11:52

trans -diagnostic from a treatment

11:54

and conceptual standpoint. So

11:56

of course, OCD have all the same symptoms

11:58

that you see in adults, you doing

12:00

kids. I'll be maybe with

12:02

a kid flavor, like I saw

12:04

a seven -year -old recently who had

12:06

intrusive thoughts about sexual topics. And

12:09

she just imagined, you know, penises

12:11

and vaginas, where a 17 -year -old

12:13

might think of something very different.

12:16

And so there are all sorts

12:18

of examples like that. Parents

12:20

are much more involved

12:22

in kids' symptoms with reassurance,

12:24

accommodation, confessing, and the

12:26

like, perhaps relative to

12:29

adults. But in general,

12:31

that symptom profile looks really similar. And

12:34

the conceptual piece, the functional

12:36

piece, operates exactly the same. and

12:38

kids as an adults, as

12:41

well as for other types of

12:43

anxiety -based conditions. Or as a

12:45

trigger, misinterpret that trigger, you want

12:47

to stay safe so you do something like

12:50

a ritual or avoid it, you feel better,

12:52

but you don't ever learn that the feared

12:54

outcome isn't going to happen or you can

12:56

deal with it. So that's

12:58

sort of the broad kind of

13:00

rubric that I think about

13:02

these things. And again, that differentiation

13:04

to your point about question

13:06

and I'm sorry about OCD and

13:08

other stuff. It's really that symptom topology that's

13:11

coming up. Yeah. So with the OCD, it

13:13

tends to be more specific around like these

13:15

bizarre intrusive thoughts, right? And these repetitive behaviors.

13:17

But at the same time, one of the

13:19

things I talk about all the time as

13:21

you do is that anxiety is still at

13:23

the core of all of it and the

13:25

treatment is very similar. But of course, there's

13:27

a little bit of nuance here and there.

13:30

Um, what about autism? You know, autism, I know

13:32

you've done a lot of work in the field

13:34

and autism is something that we I've

13:37

talked a little bit on the podcast

13:39

about how we feel like we're seeing

13:41

more autism than previously. Yeah, definitely. At

13:43

least in our experience, we are seeing

13:46

a lot more comorbid autism with anxiety

13:48

disorders. And I know you do incredible

13:50

research in that field. And so I

13:52

would love to just dive in and

13:54

learn more. Yeah, like about

13:56

both statistics, like all of it, but

13:58

then also how do you differentiate?

14:00

Because I know for me, Doing

14:03

advocacy work, I'll get a lot of people that'll say,

14:05

hey, I think my kid has OCD. Can we hop on

14:07

a quick call? And I'll say, sure. And a lot

14:09

of times it actually is more autism than OCD. So I

14:11

would love the audience to get to hear how you

14:13

differentiate the two. Yeah. And

14:15

it gets tricky because so

14:17

much what we do

14:19

is like a clinical diagnosis.

14:21

And so you don't get

14:23

the precision that you would

14:26

through like a surgical procedure

14:28

or a blood test. Yeah,

14:30

exactly. Let's start stats. About

14:34

50 or 60 % of

14:36

kids with relatively high functioning

14:38

autism, so we define that

14:40

as an IQ of about

14:42

70, and that's an arbitrary

14:44

piece, but again, some sort

14:46

of starting point. About

14:48

50 or 60 % will have clinically significant

14:50

anxiety. Of those, about

14:52

35 % will have a true diagnosis

14:54

of autism, I'm sorry, of OCD.

14:57

Now, when I say true diagnosis,

14:59

I'm not talking about a

15:01

kid's really excited about, you know,

15:03

Pokemon or always wants to

15:05

kind of talk about dinosaurs. It's

15:07

not OCD. We're talking

15:10

about OCD that looks very

15:12

similar, if not identical to

15:14

someone with autism who has

15:16

OCD. So you'll see a

15:18

lot of kind of repetition. Things

15:20

need to be done in a rule governed fashion.

15:23

We're talking about in supervision today,

15:25

a kid with perfectionism. And

15:27

they weren't consistent, just like a

15:29

Get it without autism that this

15:31

makes them better at what they

15:33

do So they need to do

15:35

it this way even though it's

15:37

taking them three times as long

15:40

as as their peers to do

15:42

a task and And so so

15:44

that piece is a it's frequent,

15:46

but the symptom profile is very

15:48

very similar I think what sometimes

15:50

sort of powers the the high

15:52

rates of autism of OCD and

15:54

autism is that the cognitive pattern

15:56

where there's a It's much more

15:58

black and white. So it's sort

16:00

of like, if I'm thinking it,

16:02

then I'm doing it. If I'm

16:04

thinking of an intrusive thought or

16:06

having an intrusive thought that I

16:08

could kill someone on impulse, then

16:10

it's not abstract. It's now that

16:12

I'm about to do it. There's

16:14

height and risk of this I

16:16

apply. Right. And I, well, I

16:18

understand why so many parents get

16:21

it. misconstrued because a lot

16:23

of those repetitive behaviors look like they would

16:25

be compulsions. And it's

16:27

confusing because to the parents, I, yeah, it

16:29

is getting in the way of their

16:31

everyday performance or things that they want to

16:33

do. But when I've worked with autism,

16:35

it's more of this individual almost likes doing

16:37

these behaviors. It brings them comfort. And

16:40

that's a great, that's brilliant.

16:42

And it's a great way of

16:44

really distinguishing in many cases

16:46

what's core to the autism. as

16:49

opposed to what's really OCD

16:51

co -occurring with autism. And

16:53

we've all used those terms, egocentonic,

16:55

like people like it. They're not

16:57

distressed by it. They seek it

16:59

out. They enjoy it. Those

17:02

are some clear variables that align

17:04

with something being more consistent with

17:06

an autism diagnosis. Whereas

17:08

in OCD, it's much more

17:10

upsetting. The person doesn't like

17:12

to have these you

17:15

know, have these thoughts or engage in

17:17

these behaviors or if they're disrupted, then

17:19

they get upset by it. Now,

17:21

there is a little bit of an overlap,

17:23

that gray area. And so

17:25

you see this perhaps a

17:27

bit more in autism than

17:29

you do in non -autistic

17:31

kiddos, where there may become

17:33

variable insight, but things

17:36

are done in a very

17:38

kind of methodical or

17:40

intentional way. in that

17:42

way is apparent. But for the child,

17:44

they're not distressed by this. But the

17:46

world around them is sort struggling with

17:48

it. It's not working for school or

17:50

with peers or the family. And

17:52

so that's where really talking

17:55

to a professional can help you

17:57

differentiate is this is really

17:59

sort of more kind of anxiety

18:01

compulsive versus, you know, aligned

18:03

a bit more with autism. And

18:06

then that flexibility is key. Yeah, I'd

18:08

love to give a case example for

18:10

us to just kind of talk through

18:12

to make sense of when I was

18:14

working with a kid in the past.

18:16

They had to eat the same thing

18:19

for lunch and dinner every single day,

18:21

no matter what. the schedule was, it

18:23

was hard for them to be flexible

18:25

outside of that. So you can imagine

18:27

that would get in the way of

18:29

their ability to go out and hang

18:32

out with friends or participate in sporting

18:34

events, doing all these other activities. But

18:36

they also had OCD. They had harm,

18:38

intrusive thoughts. They had need for symmetry

18:40

or exactness tied to OCD. And the

18:42

parents really wanted them to work on

18:44

this aspect of the... lunch and dinner

18:47

because didn't fit into their routine, right?

18:49

They weren't able to do a lot.

18:51

They were limited. Um, but

18:53

I was pretty positive that piece was

18:55

the autism, um, because they didn't see

18:57

it as a problem. The individual didn't,

18:59

uh, and they liked it. They, they

19:01

had some joy in it. Am I

19:03

hitting on that correctly? That's

19:05

exactly. That's a perfect example. Um,

19:07

and, and one could, could argue, you

19:09

know, I mean, on the one

19:12

hand, the, the food preference may be

19:14

driven by their preference, whether that's

19:16

autism or just a preference. On

19:18

the other hand, it was sort of

19:20

impairing. It was going to get in the

19:22

way. And so that level of insight,

19:24

whether it's in a kiddo with autism or

19:26

not, can really sort

19:28

of take something that is

19:30

impairing and obscures. Is

19:32

this just preference or is

19:34

it something else? I

19:36

tend to let that impairment drive treatment

19:39

targets. I have a question, too. So

19:41

I think that one of the things

19:43

we get asked a lot is, Okay,

19:45

so what is how does treatment

19:47

look different, right? And I'm often

19:49

recommending like ABA treatment for autism

19:52

Obviously, I'm recommending ERP with an

19:54

OCD specialist who knows how to

19:56

work with kids for OCD with

19:58

kids and and or anxiety disorders

20:00

CBT work But curious if you're

20:02

giving the same recommendations and if

20:04

there are any providers that do

20:06

some comorbid ABA slash CBT interventions

20:08

So I don't know about the

20:10

ABA slash CBT piece per se

20:12

what What I do love about

20:14

ABA, though, which aligns very much

20:17

with the treatments we all do,

20:19

is it's very much based on

20:21

the functionality. And what does

20:23

ABA stand for? Oh, applied

20:25

behavioral analysis. And

20:27

so it's really thinking about

20:29

what are the functional determinants

20:31

of a particular set of

20:33

behavioral patterns. And so

20:35

maybe it's reduction of distress,

20:37

which of course is core

20:39

OCD or anxiety. Right. Maybe

20:42

it's reinforcement, whether it's social,

20:44

whether it's access to things you

20:46

want. But it starts

20:48

targeting the functionality in

20:50

teaching the parents how

20:52

to also sort of

20:54

be partners in the

20:56

therapeutic process. And

20:58

so I think to that point I

21:00

raised earlier about, how does it look

21:02

different? That's one of the biggest points.

21:05

So of course, when we treat kids,

21:07

it's a family affair, whether it's an

21:09

autistic kid or not. But

21:11

when we're working with someone with

21:13

autism, we're really always engaging people around

21:16

them to help support them. And

21:18

sometimes that helps address that there's a

21:21

little bit of a variation in the reports

21:23

that you get from a kiddo, from

21:25

a parent, or so on, and smooths that

21:27

out. One of the

21:29

things we've seen empirically is that

21:31

gains that you see in therapy

21:33

when we've worked with autistic kids

21:35

with OCD or anxiety have been

21:38

a little more slippery. Yeah. So

21:40

like a kid who's doing well,

21:42

six months later, they might,

21:44

that might be, excuse me, back at square one.

21:46

And so a little bit more supportive family

21:48

engagement can be really helpful. And

21:50

one thing that I found too,

21:52

as a clinician, as I've consulted and,

21:54

you know, have worked with a

21:56

lot of comorbid autism and OCD is

21:58

that for me, I think it's

22:00

having a good understanding too that with

22:02

autism, it's going to be much

22:04

more concrete behavioral interventions. less

22:07

ambiguity, less abstract, but

22:09

also the outcomes or the goals

22:11

might be very different, right? For someone

22:13

with OCD, my goal is that

22:15

you leave ritual free, that you leave

22:17

like without any OCD symptoms where

22:19

some of my patients with comorbid autism,

22:21

they actually may really want or

22:23

need to hold on to some of

22:26

the rituals, but can they become

22:28

functional versus dysfunctional? So I think so.

22:31

I think so, I think, you know, meaning

22:33

when someone like I'll give an example,

22:35

but if I've had a patient before with

22:38

autism and OCD and they had contamination

22:40

OCD and so for them, they still wanted

22:42

a very clear shower routine. Yes, we

22:44

needed to remove like OCD rituals from the

22:46

routine, but it still was rigid in

22:48

the sense that they wanted to know, okay.

22:50

What do I do first? What do

22:52

I do second? And that they were fine

22:55

with that where with someone with OCD,

22:57

I might want them to get rid of

22:59

all the rules and sometimes skip a

23:01

routine or like do it differently or purposely

23:03

do your shampoo last versus first, that

23:05

sort of thing. Yeah, more willing to settle

23:07

with functioning over freedom for someone with

23:09

or just like still wanting to keep more

23:11

strict structure. Yeah. What

23:13

do you think? I think

23:16

absolutely that that's a really

23:18

important. potential difference

23:20

here. And, you know, when

23:22

we were talking about your anxiety

23:24

moment, Liz, and you

23:26

mentioned putting, you know, kids to

23:28

sleep, you know, at night

23:30

time, there's a very helpful routine.

23:33

Coming off a spring break today was a

23:35

disaster to get my kids back to

23:37

school. And it's because

23:39

we are out of routine. So everyone's

23:41

tired, you know, cranky, you know, whatever. And

23:44

so there is that part where

23:46

routine is really helpful, especially with

23:48

young people. And we see it

23:50

more relevant when we work with

23:52

kids with autism or adults with

23:54

autism, too, is, hey, this

23:56

is cool, especially if it's not

23:58

causing problems. And that impairment is

24:00

sort of that driver. Yeah. Yeah. We've had

24:02

patients even here with autism and OCD, where we

24:04

will help them create a shower plan of

24:06

like what to do for a second in it.

24:08

Like we laminate it and put it in

24:10

the shower where they can see it. And they're

24:13

not doing OCD rituals, but they just, they

24:15

want to know because they need a routine, right?

24:17

Like that's very important to them. And maybe

24:19

part of that could be IQ as well, right?

24:21

Like it just helps them function a little

24:23

bit better if in front of them. But with

24:25

someone with OCD, if they were like, okay,

24:27

I want a list to follow and they didn't

24:29

have autism, I would be very strict of

24:31

like, no. we're not doing that, that'll turn into

24:33

another ritual and could become unhelpful. Yeah. Is

24:35

it appropriate to educate someone with

24:37

autism? And if so, how do

24:39

you do it on how, okay,

24:42

some of these behaviors might be

24:44

negatively impacting you? Like, is

24:46

that a good approach to even take? Yeah,

24:48

I think so. And in terms of

24:51

really reflecting on how they want their

24:53

life to look like, what are the

24:55

values that they have? And

24:57

how, how are these rituals just

24:59

like any, other person, whether

25:01

without autism, is interfering with that.

25:04

And so that's sort of a driving

25:06

piece of all of our interventions

25:08

is, okay, well, here's where you want

25:10

to be, whatever that is, here's

25:12

these things that are keeping you from

25:15

there. How can we pull apart some of

25:17

this stuff to get you to this

25:19

point? And, you

25:21

know, sometimes you have to be

25:23

thoughtful about what those goals are.

25:26

And and flexible just as

25:28

we would with anyone who presents tarot

25:30

clinics. So I want to pivot to anxiety

25:33

because I think this will take up

25:35

so much time and it'll be so important.

25:37

But there are no parents who can

25:39

say they don't know what anxiety is, right?

25:41

Like you, you deal with it either

25:43

yourself or with your kids. And

25:45

you've been working with kids with anxiety

25:47

for decades. And I know that you've

25:49

really looked into a ton of research

25:51

and background between different interventions, whether it's

25:54

interventions that involve the parents without the

25:56

kids, the parents with the kids, the

25:58

whole family system. But I would love

26:00

to hear just a little bit about about

26:02

your research, your background, like where you

26:05

are today as far as if somebody presents

26:07

with an anxious kid, what are some

26:09

of the first things you tell them that

26:11

are critical when they start to think

26:13

about or consider engaging in some sort of

26:15

treatment for what's going on? I

26:17

love that question, Liz. So

26:19

the first thing I

26:21

try to do is objectively,

26:24

I'm optimistic, I'm hopeful. Tara

26:27

Parris and I, another

26:29

close colleague wrote a

26:32

commentary on a study

26:34

of Norway and Sweden.

26:37

And they followed, they treated 269

26:39

kids with OCD, but actually

26:41

like sort of like late therapists

26:43

with supervision. So not, you

26:45

know, Cali Warners. I mean, these

26:47

were people that went to

26:50

a training and then got supervision.

26:52

And then they followed him over

26:55

time. And three years later, 90 %

26:57

We're doing great. 75 %

26:59

were in remission. About

27:02

15 % were still had mild

27:04

OCD. And then

27:06

about 10 % were not doing

27:08

well. So 90 % were killing

27:10

it on a CBT -based intervention.

27:12

And if that didn't work, you

27:14

did a little more CBT,

27:16

or maybe you added some sertraline.

27:18

But this is naturalistic stuff.

27:20

So no medication. Some

27:23

of them did have meds, but

27:25

a very small number would have

27:27

meds. But this intervention

27:29

alone was behavioral. Say

27:31

that again, sorry. This study was like,

27:34

was looking at the behavioral intervention outcomes,

27:36

not medication. Yes. So it

27:38

started with behavioral intervention. And then

27:40

after 14 sessions, if they didn't do

27:42

well, they either got more CBT

27:44

or they had Zolop added. Got it.

27:46

And then from there, it sort

27:48

of became a really open naturalistic stuff.

27:51

But most had CBT as their

27:53

only thing, or together

27:55

with an antidepressant. And

27:58

so I start with stuff like

28:00

that. We now

28:02

know it works. Now,

28:04

here's the thing as a parent. This

28:06

is all about you applying

28:08

it. So the more

28:11

that you commit to this, the better it goes.

28:14

I also contrast to other things. So

28:17

think about, wow. Having

28:19

kids, we were talking about kids today. So

28:22

when you decide to have kids, it's not a,

28:24

yeah, we're going to have it. And then it's

28:26

just going to raise itself and so on. So

28:29

we have a lot of work that goes in

28:31

it. And there's a lot, you put in that

28:33

work because you're ready. You want it. You're

28:35

investing in it. And so here,

28:37

we're sort of saying it's a lot

28:39

less work than having a kid. It's

28:42

a lot less work than getting in shape. All

28:45

we're talking about is doing this

28:47

series of. things so that you can

28:49

do all these other things you

28:51

really want to do. And so

28:53

I set up the expectations, but I

28:55

also set it up in a way

28:57

that really sort of contrast it with

28:59

what happens if you don't do it.

29:02

And let's think about it in the

29:04

overall context at play. And

29:07

then we start going as a family

29:09

on this, working collaboratively

29:11

and developing a new

29:13

skill set for how to

29:15

interface with anxiety triggers

29:17

in a different but adaptive

29:19

manner. So what

29:22

I see more often than not

29:24

is that anxious kids often come

29:26

from anxious parents, or at least

29:28

there's some anxiety going on in

29:30

the family system. How critical

29:32

is it to you feel that the

29:34

parents are also, if they are really

29:36

struggling to not enable anxiety, right, or

29:38

to not give in, how often are

29:40

you also encouraging them to seek their

29:42

own treatment? Yeah, it varies

29:44

I'm trying to make an assessment

29:46

of is it adaptive ie for

29:48

the therapy or not I love

29:50

the story from grad school where

29:52

I'm oblivious if someone had a

29:54

crush on me I would never

29:56

know which probably is because no

29:58

one ever has accurately like detecting

30:00

the world But I picked it

30:02

up this this one mom of

30:04

a kid I was reading totally

30:06

had a like I could pick

30:09

it up as I go to

30:11

my supervisor I'll supervise her

30:13

up like I'm so anxious about

30:15

this. It's obvious. It's responsible as Eric.

30:17

This is great. What do

30:19

you mean? She'll do whatever

30:21

you want to do to support

30:23

her, you know, her kid. And

30:26

I was like, oh, okay. So kid

30:28

got better, you know, exposure, all this

30:30

good stuff. And here's

30:32

to the point, you know,

30:34

is that she You

30:36

know, she also had some anxiety too. But

30:39

that anxiety was adaptive in her

30:41

engaging in the treatment process for

30:43

a kid, because she didn't want

30:45

her child struggling this way. And

30:47

there's a little bit of that

30:49

adaptive element of anxiety that was

30:51

coming in fueling that. On

30:54

the other hand, you do see

30:56

plenty of times where parental anxiety

30:58

is problematic. And those

31:00

are the instances where you

31:02

have to you

31:04

know, have them engage in their own treatment. And

31:07

even throughout, sometimes it's other stuff.

31:09

You know, sometimes it's

31:11

a parent who has problems

31:14

with organization or attentional

31:16

capacities. And I would make

31:18

the argument that that doesn't get

31:20

the same attention as like a

31:22

parent with anxiety or OCD gets.

31:24

But these are other constructs that

31:26

we need to be thoughtful about

31:28

it in terms of applying to

31:30

treatment. Like you have a parent

31:32

who has ADHD that's untreated. and

31:34

they can't get their kid to

31:36

session on time, and so you're

31:38

missing out on session content, or

31:40

they can't help apply some of

31:42

the therapeutic concepts. And

31:44

so it's, again, it goes back to that function

31:46

of what's the presentation, how is

31:48

it supporting or not the treatment,

31:50

and then how do we intervene

31:53

accordingly to level it out? 100%.

31:55

So a question I have, I'm

31:57

going to go off. the

31:59

deep end for a second, but

32:01

it'll all be related is, because I

32:03

get this question all the time,

32:05

but like, how much do you think

32:07

foods or sugar or, we'll

32:09

talk about sleep later, because we know

32:11

the impact of sleep probably a little

32:13

bit better. So we'll start with just

32:15

like foods and sugar play a role

32:17

in kids' behavior or kids' anxiety. I

32:20

did a little experiment last night. So

32:23

my, this was, This

32:25

was not a well -received experiment

32:27

by my significant other. I

32:31

was

32:33

interested. Two

32:35

weeks ago, my eldest

32:38

had a back procedure. I

32:40

spoiled her to death. One of the

32:42

things I particularly spoiled her on was

32:44

she loved sour patch kids. Do

32:47

you have a favorite color?

32:49

Red. Okay. Oh, this

32:52

will work great. Red dye

32:54

40. Here I am. I love

32:56

blue. So I picked out

32:58

all the blue ones and these

33:00

like men's brown bags. But

33:03

now we have every other kind, which

33:05

of course she's too good for. Right.

33:08

But someone needs to eat them. Yeah. If

33:10

I have being red left, I'll bring some. But

33:13

with my nine year old, I was

33:15

like, I wonder how many I can

33:17

give her until she starts getting jazzed

33:19

up. which was probably not a good

33:21

idea on Sunday night. Sunday

33:23

night, by the way, after holiday break before

33:26

they need to go to school the next

33:28

day. It wasn't the best parenting moment. I

33:30

didn't let her play with knives or

33:32

weapons. That's good, yeah. So

33:35

long story short, she

33:37

was pretty hyped up and

33:39

that didn't go well

33:41

for bedtime. Now, the

33:44

joking aside, I mean,

33:46

I think eating well is

33:49

relevant. Do

33:52

I think eating

33:54

well is a cause

33:57

or significant in

33:59

the equation of OCD

34:01

exacerbation, onset or

34:03

exacerbation? No, I don't

34:06

personally, nor am

34:08

I a dietary expert

34:10

either. I

34:12

do think, however, that

34:14

things like having an

34:16

adequate diet and then

34:18

sleep, which you referenced,

34:21

can really exacerbate problems.

34:24

And so sometimes that can be

34:26

as short -term as, you know,

34:28

someone gets angry and they

34:30

just can't control themselves or responses.

34:33

And so that exacerbates the

34:35

profile, you know, or it has

34:37

a more compounded effect over

34:39

time. So again, relevant

34:41

part of the equation for sure. I

34:43

agree, by the way. Yeah, we talk

34:45

about this all the time that I

34:47

think, you know, Cali's much

34:49

more healthy than I am. But like, you

34:51

know, I think all these things are important

34:54

and they're good and they can make you

34:56

feel better, but they're not treatment. And they're

34:58

also not probably the cause of anxiety or

35:00

OCD. Yeah, I wouldn't thousand percent agree. I

35:02

also kind of just think back to this

35:04

example when I had taken some time off

35:06

from running and this is when I was

35:08

like in the midst of really heavy training

35:10

and I had taken a couple weeks and

35:12

because I wasn't used to it, I started

35:14

getting restless leg syndrome, like really bad at

35:16

night before I would go to bed. restlessness

35:20

feeling led to stress, which in turn started

35:23

to feed my OCD because that ERP piece wasn't

35:25

fully in place. And so I think that's

35:27

such a good indicator of how, like, yeah, of

35:29

course, if you eat a huge meal and

35:31

you're bloated and you're going to have a hard

35:33

time going to sleep at night, you're going

35:35

to be sleep deprived the next day, which leads

35:37

to stress, which then leads to, yeah, if

35:40

you're struggling with OCD, it's not going to be

35:42

a great day for your OCD. Yeah,

35:44

and I think sleep is something that

35:46

is even different, right? Like we can

35:48

all agree that if you are sleep

35:50

deprived, your capacity is

35:53

just that much lower, right?

35:55

I mean, I think about this always like

35:57

being a mom, but like postpartum, I can't

35:59

tolerate as much as I can, you know,

36:01

when I'm getting eight hours of sleep or

36:03

whatever it might be. And that's just, that's

36:05

to be expected. One thing I

36:07

always talk about though is that, so...

36:09

I do a lot of presentations and

36:11

I just did one recently at my

36:13

kid's school and I was talking a

36:15

lot about how behavioral interventions start when

36:17

your kids are actually really little, right?

36:19

Whether you're teaching them that they can

36:22

climb up something at the playground that

36:24

they're really scared of and they think

36:26

they can't and you're trying to encourage

36:28

them and you're trying to validate them

36:30

or you're sleep training your kids or

36:32

whatever it might be, right? But we

36:34

do these behavioral interventions really at young

36:36

ages. And it's interesting because I always

36:38

say like, I can often

36:40

tell the parents that don't do any

36:42

behavioral interventions early on and it's not

36:44

in a bad way, right? But it's

36:46

these, it's parents that are not, you're

36:48

not letting your kids feel distress. You're not

36:50

letting your kids feel anxious. You don't

36:52

have a lot of tolerance for it.

36:54

And so I would love to hear

36:56

your thoughts because we talk about this

36:58

so much on the podcast, Eric, just about

37:00

how important it is to allow kids

37:02

to feel anxious, to feel upset, to

37:05

validate that, but to also let them

37:07

feel that versus rescuing and fixing it for

37:09

them. I'm with you right there. You

37:11

know, I think in difficult times

37:13

and in good times, kids and adults

37:15

learn how to deal with things. And

37:18

if we never give anyone any

37:20

sort of variability and experience, then it's

37:22

really hard for them to learn

37:24

how to cope with adversity, which is

37:26

inevitable. Adversity isn't

37:29

bad. I mean, think about when, you

37:31

know, you went to a camp or

37:33

I tried out for the over 50

37:35

team first time. I don't know anyone.

37:38

But I knew enough from past

37:40

experiences that I could be sufficiently

37:42

social, that it doesn't, world's not

37:44

gonna end if I stink, which

37:46

I did. And

37:48

so again, it's those experiences

37:50

that really help empower you.

37:52

And I think if we

37:54

keep kids from that, yeah,

37:57

they're gonna fail to develop

37:59

that. And you said it

38:01

as well, Liz. It's

38:03

being supportive, being

38:06

encouraging, acknowledging

38:08

the difficulty of a situation, but

38:10

also acknowledging your confidence and their

38:12

ability to deal with it. And

38:14

I think these are all things that

38:16

parents can really do effectively empower their

38:18

kids and hopefully get them out of

38:20

the nest so they can have that

38:22

second honeymoon, which I know you're a

38:25

couple of years away from. Yeah, just

38:27

a few. No big deal. If

38:29

it ever happens with my sisters, like, my

38:31

sister, you guys, like, cannot believe that I'm

38:34

gonna have four kids under four, but she

38:36

loves to just give me reminders. So, like,

38:38

we'll be at dinner and she's like... so

38:40

you know, like pretty soon if we ever

38:42

want to go to dinner together, we now

38:44

have to have a private room because you

38:46

have nine people that you're traveling with. Oh,

38:51

if you ever fly again, you need a whole row

38:53

because now you have four kids and two adults. I'm

38:55

like, thank you. Thanks for their. Yeah,

38:59

so I mean, Cali will let you

39:01

hop in, but I would love to

39:03

hear Eric from you just like. What

39:05

are your biggest takeaways? So if a

39:07

parent is listening and they have a

39:09

kid who has anxiety or who struggles

39:11

with feeling anxious at different times, whether

39:13

it's bedtime or school or whatever it

39:15

might be, what are some of the

39:18

biggest themes that you feel you're constantly

39:20

educating parents and families on? I

39:22

think the first is

39:24

that anxiety is a

39:26

normal piece to development.

39:29

A second is that as a parent,

39:32

You didn't do anything wrong and

39:34

and you can also change the

39:36

way that you're doing things to

39:38

help support your child as well

39:41

Third since you brought up the

39:43

bedtime would be a book my

39:45

parents read to me and me

39:47

to my kids Love this book

39:49

going on a bear hunt and

39:51

it's all about you know people

39:54

a family who comes across different

39:56

obstacles on their quest to find

39:58

a bear, which is an awful

40:00

idea. I love

40:02

bears, though, by the way. Yeah, they

40:05

are very nice. Pandas are very

40:07

cute, I will say, as one particular

40:09

type. But

40:12

what I love about that book

40:14

is whatever the obstacle was, they

40:16

sort of identified it, and they recognized they can't

40:18

escape from it. They have to go through it

40:20

if they want to achieve their goal. And

40:23

so really kind of that

40:25

message of, hey, Let's think

40:27

about what these goals are. Even

40:29

if your child's goal is different because

40:31

they're a little one, and really their goal

40:33

is, can I sleep with mom and

40:35

dad? It may not be the

40:37

goal of mom and dad, but you can set

40:39

the goal because you're the parents and you

40:41

know what's best for them in that moment. Hey,

40:46

this small steps towards a more adaptive,

40:48

flexible approach can be really a

40:50

nice strategy for trying to deal with

40:52

some of these things. I love

40:54

it. Yeah, me too. I have to

40:56

share a funny story about sleeping

40:58

with mom and dad. When I was

41:00

really young, probably not as young

41:02

as I should have been, but young,

41:06

my parents had a bed where they had

41:08

the footboard at the end and the headboard

41:10

on the other end. And they had told

41:12

me, you cannot sleep in our bed tonight.

41:14

And I was so scared because I would

41:16

like... movies and stuff that I shouldn't have

41:18

at that age, I think. And I remember

41:20

before they got in bed, like they were

41:22

showering, brushing their teeth, doing all those things.

41:24

I got in between the footboard and the

41:26

mattress and I laid there for like an

41:29

hour. And I just waited until they got

41:31

the lights off and went to sleep and

41:33

wiggled my way in and I slept in

41:35

the bed that night. Oh my gosh, that's

41:37

so wild. And I feel like it's so

41:39

different because now I'm like, okay, like I

41:41

would definitely know because I'm like constantly checking

41:43

the camera to make sure my kids. They're

41:45

fine and in their bed, but oh my

41:47

God. Yeah. I don't sleep with

41:49

my parents bed anymore. Just so that's good.

41:51

Yeah. No,

41:55

but it is true. It's this, I

41:57

think that I talk about this a lot

41:59

on the but like Olivia,

42:01

who's three versus three and a half versus

42:03

grace, who's two and a half has

42:05

way more anxiety than grace. Like just in

42:07

general, they're just made up different. You

42:09

can tell Olivia's cautious. She's anxious. She thinks

42:12

things through where grace is. Complete opposite. Um,

42:14

enough said there. And it, but it

42:16

is, it's the tactics you do have to

42:19

take are different. Like I can tell

42:21

Grace, like you're going to bed good night

42:23

where with Olivia, like I need to

42:25

prep her on things a little bit sooner,

42:27

but like we can still have the

42:29

same outcome. But like Olivia, I do think

42:31

one thing I'll say is that. Even

42:33

like don't underestimate the power of your kids,

42:35

you know of how smart they are But also

42:38

how proud they can be of themselves because

42:40

last night she was like mom I've slept in

42:42

my own bed every day for like so

42:44

many days has it been five days and I

42:46

was like it has because she has this

42:48

habit of her and Grace share a room that

42:50

she'll crawl in Grace's bed and Grace hates

42:52

it. Grace will be like I want my space

42:54

I don't want anyone in my bed and

42:57

so but This morning, you could tell it was

42:59

the first time she's so proud of herself,

43:01

but she's not even asking anymore, right? And you

43:03

can build that confidence that they can do

43:05

hard things and that they can be proud of

43:07

themselves at such a young age. And it's

43:09

just so critical to do for development. Yeah. I

43:11

don't mean to ask a loaded question as

43:13

we're wrapping up, but. really good question for two

43:15

parents. Do you feel that it's

43:17

harder as a parent to parent in today's

43:20

day than it was before? And I think

43:22

I'm asking that because I think about how

43:24

there are so many ways to track your

43:26

kids now to know what they're doing at

43:28

all times. And I think all of that

43:30

leads to more anxiety, but. I'll

43:32

go first. I mean, I have no idea because

43:34

I didn't raise him in the old days. So I

43:36

think that when we baptized our kids, I remember

43:38

my pastor asked me that question. He was like, are

43:40

you afraid to raise your kids in this world?

43:42

And I was like, yeah. And he was like, well,

43:44

don't worry. Every parent of every generation has always

43:46

felt that way. And so I loved that he was

43:48

like, that's normal. Like stick to your values, your

43:50

morals, you know, bring him to church, those sort of

43:52

things. But his point was that like people have

43:54

always been scared no matter what generation. I

43:57

think the hardest thing for me as technology

43:59

is that we don't let our kids have a

44:01

lot of screen, have screen time or certain

44:03

things. And it is very hard. Like when you

44:05

travel in certain things, if other people are

44:07

getting it to not expose them to that. And

44:09

I find that to be difficult of like,

44:11

oh, how do I not fall into some of

44:13

those social norms? But I want

44:15

to stay strict, but I also don't want to be

44:17

this like strict parent that doesn't let my kids

44:19

have access to anything. So I don't know what are

44:21

your thoughts, Eric? But I feel like we're also

44:24

behavioralists. So we. We are, I have

44:26

so many friends that are like super into

44:28

gentle parenting and certain things that just doesn't

44:30

have a lot of research behind it. And

44:32

I'm much more into like, what is evidence

44:34

-based? What are healthy behavioral interventions? What's a

44:36

healthy divide? And so I think that we're

44:38

probably also feeling that a little bit less. What

44:41

do you think? Yeah. Yeah. No, I

44:43

use, you said my number one concern.

44:46

And it, you know, it just

44:48

gets trickier as they get a

44:50

little bit older too. So

44:53

the stuff becomes more and

44:55

more addicting. And

44:57

then the access just becomes

44:59

ubiquitous. And it's a never ending

45:01

battle. And so

45:04

I think that's probably

45:06

my biggest concern. On

45:08

the other hand, I

45:11

think we are... So

45:13

there have been some

45:15

positives in this era

45:17

versus... I'm

45:19

the old guy when I

45:22

was raised so bullying back

45:24

when I was a kid

45:26

was rampant I mean all

45:28

the time everyone got it

45:30

and I think we see

45:32

that exists some ways different

45:34

but it's less than it

45:36

was. It's not as readily

45:39

allowed. This is one example.

45:42

I think we're seeing things like

45:44

teenage pregnancy actually down relative to

45:46

when I was in high school. And

45:49

so there are some positives

45:51

where kids have their heads

45:53

on perhaps a little bit

45:55

more adaptively than they did

45:57

when I was a kid.

46:01

Well, education is better around things like that

46:03

too and more accessible, right? Like you think

46:05

about teen pregnancies, you think about bullying, like

46:07

I feel like that's something that we even

46:10

get pushed on social media. Like you're getting

46:12

fed that education around what to do and

46:14

how to prevent it and how to help

46:16

your kids notice it so early now. Yeah,

46:19

absolutely, absolutely. So it's

46:21

hard. I think whether

46:23

it's now or 30 years

46:25

ago, you know, I think

46:27

your pastor gave brilliant advice on Every

46:30

parent's been worried. And the good

46:32

thing is you do the best you

46:34

can. And if you

46:36

feel like something's out of your skill

46:38

set, whether it's having an anxious

46:40

kid or a kid who's sad or

46:42

whatever it is, you

46:44

seek out counsel from whether

46:46

it's mental health professionals,

46:48

religious leaders, close friends and

46:51

confidants to try to figure out

46:53

what the best strategies are. 100%.

46:55

Well, thank you for everything. I love.

46:58

The insight, the knowledge, the quick tips. As we

47:00

wrap up, I would love for you to leave

47:02

just kind of a final piece of advice for

47:04

parents if they're listening, thinking, I'm curious

47:06

if I need to seek mental health

47:08

treatment. Like, should I bring my kid

47:10

in? Is their anxiety bad enough that they

47:12

need a provider? What do you

47:14

tell people? Like, how do you help people gauge when

47:16

they should seek out treatment? And should it be them

47:18

with their kids? Should it be the parents alone? Like,

47:21

what should that look like? I'll quote

47:23

my father -in -law little kids little

47:25

problems big kids big problems So so

47:27

right away what I mean is

47:29

you know when the problem small it

47:31

may not be massive But if

47:34

you can catch that then that's gonna

47:36

be a good thing So second

47:38

is when it's impairing seek out help

47:40

before it becomes even more impairing

47:42

That's the nature of anxiety which we

47:44

all of course know is comes

47:46

a snowball getting bigger and bigger as

47:49

it goes down the hill. So

47:51

we want to stop it as early

47:53

as we can on top of

47:55

that. And

47:57

then trying to find folks

47:59

that know how to

48:02

treat anxiety, like everyone in

48:04

our group right here,

48:06

people who dedicate their careers

48:08

to it because they

48:10

will know it inside and

48:12

out. That's

48:15

I think the benefit of a specialty

48:17

model where you get people who they're

48:19

really kind of cutting their teeth on

48:21

this. Um, and, um, and our experts

48:23

in it as opposed to more of

48:25

a generalist. Any tips or

48:27

tricks or whatever we want to call

48:29

it for people, fats, et cetera, for

48:32

people to look out for. So like

48:34

that's kind of the right path, but

48:36

anything that you would say be cautious

48:38

of. And just so I'm

48:40

understanding the cautious of in terms

48:42

of. You know, I always tell

48:44

people be cautious of going down

48:46

all these rabbit holes around what

48:48

your kids should eat, giving them

48:50

celery juice, changing, you know, putting

48:52

this red light in their room

48:54

versus like evidence -based interventions. Yeah,

48:56

celery juice, oh boy. Yeah,

48:59

so here's sort of the good thing. You

49:02

know, whether it's 50 years

49:04

ago or today, these behavioral principles

49:06

for understanding anxiety really, really

49:09

work and they can be integrated

49:11

in a very compassionate yet

49:13

massively effective approach for dealing with

49:15

anxiety. So while

49:17

these things, whether it's

49:19

diet or so on, may be

49:21

aligned with your interests and values and

49:24

that's terrific, really trying to

49:26

invest in that the stuff that's been

49:28

shown to have the biggest effects, I think

49:30

is going to get you the best

49:32

bang for your and your child's luck. 100%.

49:34

Excellent. Well, that's all I had. This

49:36

was amazing. Thank you. Thank you. Yeah. So

49:39

great to have you. Hopefully we'll have you

49:41

on again. I love getting to learn, getting

49:43

to hear from you and us being together

49:45

to chat about all the things we care

49:47

about, which is helping families and individuals

49:49

know that there is help available. And I

49:51

love when you said the first thing you

49:53

start with is that message of hope because

49:55

so many parents listening have started to lose

49:57

that. And it's critical that they remember that

50:00

these interventions really do work and can

50:02

get people totally functional. Thanks. The

50:04

Society, We it, we

50:06

contribute to it. Together, we can change

50:08

it. Thank you for joining

50:10

us today on the Anxiety Society

50:12

podcast, where we hope you gained insights

50:14

into the world of anxiety that

50:16

you didn't know you needed. To stay

50:18

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50:20

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50:44

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50:49

Can you come through?