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Avoiding the Anxiety Spiral: A Conversation With Therapist Eitan Zerykier

Aleph Beta Quarantined - NEWEST episode

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Rabbi David Fohrman

Rabbi David Fohrman

Founder and Lead Scholar

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If the current pandemic has left you feeling a little more anxious than usual, well... that's to be expected. It's normal to feel anxious when we're confronted with so much uncertainty and such little control. You're not alone; many of us are having these feelings. So is there any way to keep it in check? To regain a sense of control, calm, even peace? In this episode, Imu talks to trauma therapist (and Aleph Beta COO) Eitan Zerykier about practical tools for staying in the present and not letting your anxieties drive you.

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Transcript

Imu Shalev: Hi everybody, this is Imu Shalev, and welcome back to another episode of Aleph Beta Quarantined. I wanted to bring this conversation to you, I'm talking to Eitan Zerykier, my colleague. He is an LCSW and a trauma therapist, and I wanted to chat with him about a lot of things going on today, how it's impacting us psychologically, our anxieties, maybe how to talk to our kids. And don't worry  - Rabbi Fohrman will be joining us shortly in an upcoming episode.

Eitan Zerykier: Hi. How are you, Imu?

Imu: I am -- you know, that's a complicated question nowadays, right? Which is why you're a good guy to talk to. So Eitan, I wanted to talk to you about a lot of the thoughts and feelings swirling around in my brain, and I think in the minds and hearts of many others. There's a lot of anxiety as to what the next days are gonna bring. We're basically quarantined, extreme social distancing, no shul, no school. My kids are home, no playdates. I'm trying to figure out the next three days, and then my mind is spinning because I know it's not gonna be three days, it's not gonna be a week, it's not gonna be two weeks. This could be a month. And then I think, a month, oh, there's Pesach [Passover], I was supposed to go to a hotel, I was supposed to speak at a hotel. And I'm thinking, boy, the economy is really bad right now. There's a lot of anxieties. A lot of thoughts that are spiraling. Tell me how I and others can make sense of those thoughts and feelings.

Eitan: Yeah, it's a great question, Imu. There's so much uncertainty about the future that's really going on right now, and that's tough, for humans to have uncertainty for the future. You mentioned a whole bunch of things in those few sentences. You mentioned thoughts and feelings, you mentioned short-term worries, long-term worries, you used the word 'not,' like things that are not going to be a certain way, and then you changed it said they could be a certain way, and then you went back to saying they will not be a certain way. So there's a few things going on there, as I listened. 

So, to start, I think human brains are made to try to make sense of things. So for example, when you hear that someone has gotten into an accident, right, what is the first thing you ask? You ask, 'what happened?' We don't usually stop and ask, 'Are you okay? Is everyone alright?' The first thing we do is try to figure out what was the storyline. What is all the information you can gather, so I can make sense of this. And right now, what we have in front of us, is like that annoying puzzle that's missing one piece, but here it's missing a lot of pieces. So our brains are sitting there in this, you know, uncomfortable state, saying I want a full puzzle, I want data, but I don't have it. 

So what do we do? The brain is incredibly good at trying to write its own storyline about the future. We're good at traveling to the past when we worry about regrets. We're traveling to the future, when we worry about what's going to happen. I think everybody's doing it, it's completely normal. It's what makes us humans, it's what helped us establish the world instead of some other mammal or animal doing it, because of our ability to think about the future, plan for it, and then be ready for it. So your brain's doing its job. It's thinking about the future. 

Imu: Yes, but it feels very unpleasant.

Eitan: It does, yes. It's not comfortable, because of that uncertainty, yeah. 

Imu: So I appreciate the validation, and I get that it's normal, but how would you recommend us going forward with those feelings? You know, sometimes I can tell that there are thought spirals that might not be very productive, and sometimes very confusing. Tell me how one deals with those thoughts and emotions. 

Eitan: The interesting thing is that people want to be able to control their thoughts and do something about it, and the truth is, we can't control our thoughts. We can't get rid of our thoughts, I should say. What we can do is replace our thoughts with different thoughts. Our brain won't stop thinking, but we can sort of choose what we focus on. So Imu, do you have any food nearby, that's maybe on your desk near you, or something you can reach from where you're sitting?

Imu: I have coffee.

Eitan: You have a cup of coffee. Okay, great, that's perfect actually. Now if you can look at the cup from where you are right now, what would you notice about it? If you were to look at it objectively, as if you were seeing it for the first time.

Imu: Um… it has a pretty cool pattern on it that I didn't notice, it's sort of a paisley. Yeah, I think that if I give myself a moment with the cup, the pattern is more vibrant. I'm noticing its color, it's different shades of tan, the paisley is kind of curled in a very floral sort of way. 

Eitan: That's great. You noticed it, you really took a moment to pay attention to the pattern, you noticed something that's a little bit new, a little more vibrant, than if you just looked past it. How about if you pick up the cup now, and hold it in your hand? Hold it in two hands, maybe put one hand underneath, really feel how heavy it is, feel the bottom rim, what the texture's like. What is it like, holding this cup as if you've never seen it before, never felt it before?

Imu: It feels very cup-y.

Eitan: Is it smooth, is it rough? Is there something about it, the weight of it in your hand, that feels either comforting, or reminds you of something, or just -- do you have any reaction to holding that cup? 

Imu: The top is smooth, it's like a glazed pottery, it feels kinda nicer than, like, a metallic sort of cup or a plastic cup, it feels a bit more alive. On the bottom, it's a bit grainy, because it's pottery. It has heft, it has warmth.

Eitan: It's warm. You feel a little warmth in your hand, and it feels a little, you've got some weight there.

Imu: Yes.

Eitan: How about when you look inside the cup? What color is the coffee?

Imu: I drink black coffee.

Eitan: Black. It's black. Can you smell it from where it is right now, or would you pick it up and give it a real deep smell?

Imu: Oh yeah, that smells really good. 

Eitan: You like that.

Imu: Yeah, it's a great smell.

Eitan: And if you look at the ripples, as it moves around in the cup a little, sloshes around a bit?

Imu: I wouldn't say it's glorious, it actually looks more like nuclear waste when I look at it very closely. But it smells really good.

Eitan: It smells good, it smells good. Now, if you bring it to your lips really, really slowly and you take, let's say, the smallest sip that you could muster, and hold it in your mouth, really really taste it before you swallow it. Is that what you thought, when you look at the coffee and it looks like nuclear waste, could you imagine that it tastes like that?

Imu: Yeah, no, my brain definitely associates them together, but, no, it's kind of wild to think of -- it looked like black nuclear waste, but when you taste it, it has a real depth of flavors, and the tip of my tongue kind of felt a little bit more sweet, and as it traveled to the back of my tongue, it had all sorts of bitter flavors. It sort of felt like the depth of the flavor from sweet, to a little bit sour, and bitter, really unfolded across my palette. And it's interesting to think of it coming from a black nuclear waste coffee.

Eitan: There's this black liquid that somehow, the stuff in your mouth responds, and your brain responds a certain way to it. And it has a smell that comes off, and something that happens when you smell it, you taste it, you feel it, the warmth that it gives you. And now if you were to bring it back to your mouth and take a nice, like, an appropriate gup, or whatever you call it, to enjoy it thoroughly. You feel it go down, how does -- how does coffee feel for you? All the comfort and warmth and energy that you get from even each gulp. What's that like?

Imu: It's great. It's definitely comforting, it's energizing, it's familiar. Yeah, it feels kind of heightened, like a much more heightened version of the coffee that I drink normally.

Eitan: Ah, yeah. So Imu, I want to ask you a question: we've been working, we've been doing this coffee-tasting experiment, for, I don't know, maybe it's four minutes, maybe it's five. In those four or five minutes, how many times did you think about coronavirus --

Imu: Not once.

Eitan -- and about the future? Not once.

Imu: I mean, I felt a little silly at times, but I didn't think about coronavirus, or about my future Pesach plans.

Eitan: Yeah, yeah. There's this ability we have for our brains to jump to the future, jump to the past. And so when we decide that, yeah, I'm gonna sit in this moment and do something, to feel something, we can decide where our brains go. And that's an exercise that someone can do with almost any piece of food, or really anything, even the chair that they're sitting in. If the person listening to this right now just decides to stop for a moment right now, take a breath, and just feel whatever is supporting them in the world, whether they're standing on the floor or there's a seat below them, and feel where their body comes in contact with it. And you feel how you can settle in a little more, be a little more comfortable on your body. And then you can rely upon the things that are around you, holding you up. We can use our brains in many different ways. We don't always have to let it jump to the past, to the future. We can really be present. 

Imu: Yeah, I mean, that was wild, I don't know whether everybody followed along or if this was as calming to all of you as it was to me, but it certainly was calming. I certainly felt -- I'd say that these were the best four minutes of my day so far, least anxious four minutes of my day so far. 

My question to you, Eitan, would be -- I feel like what we did was mindfulness, is that right?

Eitan: Yeah.

Imu: Yeah. I don't want to say that it's effortful, or like it takes a terrible amount of willpower, but why is it -- I'm familiar with the techniques of mindfulness -- why is it that I don't whip it out, right? Why don't I turn on my mindfulness? The technique you just demonstrated felt very powerful. Can you help me figure out a way to make sure to do this?

Eitan: It's a great question. It's really true. A lot of people know what to do, and it's hard to really do it, right? We all know a lot of good things that are good for us but we don't always do them -- we don't go to the gym, we don't go to sleep on time, we don't eat right -- so I'd like to consider those moments that we just practiced as going to the gym, the mind gym, where we take a moment and we actually practice and we work out. 

It is not easy. It's effortful. It's basically concentration, which can tire us out. If we practice it often enough, then it becomes a little more frequent at the front of our minds and we become better at it, we become stronger at it. If you work out at the gym enough times, you won't huff and puff as much up the stairs. If you practice things like this frequently enough then you'll also notice that when it comes time to be worried or to have a quiet moment, we don't get swept away by our thoughts, our negative thoughts. You don't get as caught up in moments because you're aware that that moment, those thoughts that are bothering us are just thoughts. Right? The same way that the coffee was able to replace whatever worrisome thoughts I have, those worrisome thoughts come and go. And when I'm done drinking the coffee, other worrisome thoughts might come and the coffee's gonna go. So there's a bit of a mindset that also a person gets into, and realizes that what's worrying us are all fleeting thoughts, and then data from our bodies that's responding to those thoughts, making us feel uncomfortable. Like I mentioned before, it's not comfortable to have uncertainty. Our body doesn't like it. 

Imu: So let me push back, actually. Because, don't you have to worry? Like, isn't this a time to worry right now? Shouldn't that be frightening? Part of me sort of feels great when I freak out and say, you know, I bought five pounds of matzo, and you know, I stocked the fridge -- why should I turn that off?

Eitan: Yeah, absolutely, I agree with you. Worry is useful. Worry is really, really useful. We need to worry in order to plan for the future. One of the theories is that there are probably two types of thinking. One is rational, right? I need to make a checklist, and I use that rational part of my brain when I need to do math and I need to make, you know, certain decisions. And then there's the emotional part of my brain, which lets me know when I'm feeling things, and that's really important, because I need to know who I like, and when I'm safe, and when I want to feel joyful, and what moves me, and what I care about in that way. In times like these we end up thinking a lot more with the negative emotion part of the brain, and it makes it really hard to think with the rational part. 

What we try to do sometimes is balance the two, so that if we're freaking out, we can notice the thoughts that are making us nervous, notice the feelings that might be bothering us, and try to rein them both in and set to make better decisions. So we don't have to buy a month's worth just because I'm uncomfortable with uncertainty. I can still be somewhat rational and reasonable and buy even the right amount of food. I can respond in a reasonable way, in a measured way, to the things that are going on, so that I can prepare, not worry needlessly or uselessly, in excess.

Imu: So Eitan, how do I know when my worries and my feelings are valid and important for me to plan for the future, and how do I know when they've spun out of control or whether those worries are probably too much, and maybe I need to sip my coffee a little slower?

Eitan: So I like to use the analogy of a bus. We're the bus driver, we have different things that have happened to us in life, so that's like us stopping off at various bus depots. And different things get on and off. Some of them are good, some of them are bad. There are all these little voices that sit on the bus and they tell us things, you know, they tell us 'you're great,' or 'you're terrible,' or 'who do you think you are,' or 'you really better buy more food, or you'll be in trouble.' Now, sometimes that stuff can become a cacophony, and a person will just pull over the bus and say forget it, I'm not driving anymore. 

Imu: Netflix.

Eitan: Right. Some people will stop, they get off the bus, and they just say forget it, I'm gonna go watch Netflix and ignore everything in the back. But all those voices have something to tell you, and the question is gonna be whether you continue to drive the bus. So for example, if you say 'I'm not driving anymore,' and you let anxiety drive the bus, my panic is gonna drive the bus -- you're gonna end up with a freezer full of food and no space to keep any of the fresh food, or no money, or whatever. So you'll wind up making some bad decisions about your stockpiling methods. Or you may shut down and say 'I'm not driving at all, I'm staying home, I'm turning this thing off, I'm not doing anything because I don't know how to respond.' These are the not-so-useful versions. 

But if we decide that, yeah, those voices can keep going in the back of the bus, I'm still driving, I'm gonna make the decisions, and I'm gonna listen to the fears and the worries, I'm not gonna let them shut me down, or push me too hard in any direction, because I know where I want to go. There's a part of me that knows the right answers to these questions, and I want to listen to that part more than to any of these worries. I can listen to those voices and take them into account, but ultimately, if we stop long enough or we listen hard enough, there's an us that's driving the bus, that sort of knows where the right thing to do is, most often.

Imu: So you're saying that when our worries serve us and can be productive and we should let them drive the bus around for a little while, but it's time to fire them or kick them off the bus once we've done a fair bit of rational play?

Eitan: I think it's a bit more subtle than that. They're not gonna get off the bus, and you can't really let them drive the bus for long or it's gonna crash.

Imu: So be clear. I'm driving, and when my worries are in charge, then what? They're in the front of the bus?

Eitan: They're yelling, and you're responding. You're taking direction from them if you decide to let them yell in your ear and you listen, then you can end up in a bad spot, or, you know, making extreme decisions that you'll regret. And this is in all parts of life. It's not always clear what we should do, but we usually kinda know a little bit of where we want to get down the line. 

Imu: I think this kind of conversation and that analogy is very useful, because it reminds me how much of my life -- I go through life, actually not realizing that I'm the bus driver. To a large extent, I let whatever feeling, emotion, event, control which direction I actually take, and there is a part of me that realizes that I need to grab hold of the wheel just a little bit more, for a more stable, healthy, calm drive. And that, I think, is powerful for me to realize that yes, this is an anxious time, this is a time where I need to make the right moves to make sure my family is safe and secure, and that I have responsibility to the larger community to make sure the larger community is safe and secure, but I don't want to freak out, and I don't want to be this unpleasant zig-zag bus ride. There's a way to drive this bus calmly, even in the face of something uncomfortable and difficult. So I appreciate that analogy.

Eitan: Sure. I don't want to get too far afield, but there's an excellent song by a band called Incubus, and the lyrics really really speak to this. It goes 'Sometimes, I feel the fear of uncertainty stinging clear / And I can't help but ask myself how much I'll let the fear / Take the wheel and steer.' And then it goes and on explaining how he's been driven in the past, but lately he begins to find that 'I should be the one behind the wheel.' I mean, it's really a very solid song for this analogy in case anybody wants to check it out. It's solid, really solid.

Imu: That's beautiful. I love these analogies. You know, my son has a song that he loves, it goes, 'The wheels on the bus go round and round, round and round.' And I feel like that's a metaphor for life -- like we're gonna get through this. Speaking about kids' songs and kids, Eitan, I want to talk to you about children, how we might talk to our children about everything that's going on, right? So for many of us, we have young kids at home, those kids can be teenagers, they can be nine-year-olds, or they could be, in my case, four-year-olds -- how do we talk to our kids about what's going on? Should we talk to our kids about what's going on? Any advice you have there?

Eitan: Yeah, it's not easy, and it definitely deserves some time to think about before we just broach it with our children. So I hope this isn't too late for some people, but hopefully it'll be useful. 

Let me give you a window into a child's brain. For example, when 9/11 happened, it was playing on TV over and over and over again. And then they noticed that when children in schools were drawing their experience, they drew numerous, multiple, over and over again, as if there was a whole city of towers falling down. They didn't understand it was the same thing happening. They thought it was happening over and over and over again. And until people understood that that's what was going on for their children, it was hard to talk about. 

So one of the things we want to do at the beginning is ask our kids what they think. What do they know, what have they heard, what kind of information do they have, rolling around in their tiny, young, cute, undeveloped brains, and how can we help them sort it out? You'll be amazed what you hear when you ask them what they think. They may know a lot, they may know very little, they may believe some things that are way, way out of proportion. And our job is then to try to let them know that they are ultimately very safe. They really are. In this pandemic, of all things, they're okay, and most of us will be okay. Although there may be a time period where there's a lot of people who are sick. And that's important for them to know. We can prepare them by letting them know they may be home from school. The things that we know are going to happen, that are not incredibly scary, we can tell them are going to happen. 

And the most important thing for parents is to try to stay as calm as possible and look out for children acting very differently somehow. If they start having a real reaction, if you see them regressing, if you see them acting younger than they are, if they start acting much more violent than they used to, if you see incredible mood swings, then it's time to really speak to a professional. But at the very least, just talk to them, listen to them, see what they know. And make them feel safe, as they really, truly are, without our own anxieties getting in the way.

Imu: Would you say that that's like a key factor, maybe even more than how to talk to your kids is how to be with your kids? You know, if we're not acting like everything's okay and a child can sense that, is that gonna have an impact on our kids?

Eitan: Yeah, I mean absolutely, it's such a great point. They say that emotions are contagious, and kids especially, they see every little subtle thing on our face, they're looking out, they can sense what's going on with us, because they know us very, very well. So one of the things I might recommend is to be really present with our children. One of the incredible things about shabbos [sabbath] is the opportunity to create our own space with our family, to do the things that they might normally do with other people or be led by others. So for example, we can do kabbalat shabbat [prayers welcoming the sabbath] together in our own homes and sing together, even though it may not be something that we're always comfortable doing in front of a whole crowd, we can sing with our children in our house, even though it may not be intuitive that that should be done. We could leyn [chant] the Torah for our children if we know how, or let anyone of the age read to us, just to keep us together. Those are some small things.

Imu: I saw a friend of mine posted on Facebook how he set up his living room as a shul. A table with a tallis [prayer shawl] spread over us, he put a Chumash [Five Books of Moses] to actually read Torah. He had a little divider and set up groups, and had his eldest daughter be the group leader. So it's really interesting that you're saying that, it sounds like keeping some semblance of routine and structure and ritual is calming.

Eitan: Yeah. And stepping into a place where we may not always be -- look, I'm not always the guy who wants to daven in front of everybody, but maybe it's time to step out of our comfort zone and be that for our kids, so that they can have it. Even if somebody plays an instrument, do kabbalat shabbat early together. Play guitar. Sing together. 

Let's get back to presence with kids, though. Ultimately we do have a lot of worries, and let's say the time comes where the ritual is over, the meal is over, we're sitting on the couch with our kids, it's a quiet moment, let's say they're reading, or playing a board game, and suddenly your mind goes there. So, Imu, I'm going to ask you a question. You have a scrapbook at home of old photos, right?

Imu: I'm not the scrapbooker in our family, but my wife has plenty of pictures and lots of -- yes, there are scrapbooks.

Eitan: Do you ever pull them out and look at an old picture and the whole storyline comes to mind? Like 'I remember what was happening then?'

Imu: Sure, all the time. 

Eitan: Okay. So I want to suggest that if you could for me, take a moment and tell the story of what's going on right now for you in your house. What do you notice? What are the special things that are happening now, that, if you took a picture and looked at it in the future, those are the things you would look at?

Imu: Well, right now I can hear my son downstairs, my four-year-old who's home from school, walking around and singing Hanukah songs, he still hasn't gotten over the fact that it's not Hanukah.

Eitan: How old is he?

Imu: He's four.

Eitan: He's four. He's still into Hanukah, even though we're in March, it's, what year is it? 2020. How old are you?

Imu: I'm 33.

Eitan: You're 33 years old. You have a four-year-old kid downstairs in this moment. If you were to take a snapshot, right now, of the scene in your home, whether it's of you sitting where you are, the scene of your family downstairs, or when you're sitting later at the shabbos table with your family, a snapshot, or you shopping -- what's the story you would tell about that moment? Instead of waiting for later to look back on memories, we could be really present if we tell the story in the present. We can really experience it much more if we notice what's going on around us. So you just did that really, really well, like, look, there's my four-year-old kid. Remember when he used to be stuck on Hanukah? That's, like, I'm gonna miss that. That's really cute. He's never gonna be four and stuck on Hanukah again. 

Imu: I'm never gonna miss waking up at 5:30 in the morning and hearing him sing ma otzur.

Eitan: Exactly. And when he moves out, and you miss him, you're gonna want that. And all the things we live through so quickly without stopping to appreciate them, that's how we can be really present. Like 'ugh, I'm so bored, I have to play this board game with my kid that I hate.' But, dude, you're playing a board game with your kid. 

Imu: Yeah, that's very useful. A lot of the reframing, seeing the positive. Eitan, thank you so much for helping pluck me out of the endless stream of worries and concerns and fears. This was really great.

Eitan: Thank you. I'm really, I'm so happy that I could somehow provide any amount of relief. And thanks so much for even allowing me to try to share, to try to pitch in a little here on the really amazing efforts that you guys are putting out there to try to help the community.

Imu: Absolutely, and full disclosure, Eitan is actually our Chief Operating Officer at Aleph Beta. So he's no stranger to what we do, and we figured we have a trauma therapist on staff, and this was a really great opportunity to hear from you in this capacity. I'm not used to hearing from you. But thank you, Eitan.

Thank you all so much for listening. As a reminder to everyone, Aleph Beta is currently free to anyone in quarantine or practicing social distancing. If you want to help us up and ensure that we can continue to provide free resources if you're not already please consider becoming a member. You can sign up at alephbeta.org, it's the best way to make sure that we have the support we need in order to continue to create resources like this. We really appreciate all the support. And don't forget to be in touch with us -- we love hearing from you. Tell your story, send us a voice note at info@alephbeta.org, or just your general comments. Thanks everyone. 

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