Today we are joined by Dr. Russell Morfitt, co-founder of LearntoLive.com. Dr. Morfitt explains the differences between stress, worry, anxiety, social anxiety, and panic, and tell us how using the techniques of Cognitive Behavioral Therapy (CBT) can be life changing. The Learn to Live program is designed to teach CBT skills online to anxiety sufferers, those who suffer from depression, and even insomniacs! Listen in to learn how you can begin to free yourself from the burdens of anxiety.
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Guest information for ‘Anxiety, Stress, and Worry’ Podcast Episode
Dr. Russell Morfitt, Chief Psychology Officer, Learn to Live. Dr. Russ is a co-founder and clinical leader of Learn to Live. He has been helping people live better lives for more than 20 years and uses that experience to infuse each program with his natural compassion and Cognitive Behavioral Therapy research. He leads the clinical and data teams that design Learn to Live’s services and measure outcomes. For Russ, Learn to Live means bringing the life-changing benefits of CBT to everyone who needs it.
Computer Generated Transcript for ‘Anxiety, Stress, and Worry’ Episode
Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.
Announcer: Welcome to the Psych Central Podcast, where each episode features guest experts discussing psychology and mental health in every day plain language. Here’s your host, Gabe Howard.
Gabe Howard: Hello everyone and welcome to this week’s episode of The Psych Central Show Podcast. My name is Gabe Howard and I’ll be your host for the rest of the show. And we have a great guest with us today. We have Dr. Russell Morfitt with us who started a really cool program for people who suffer from anxiety called Learn to Live and I’m going to let him explain it better because I have probably already botched it, but, Dr. Morfitt, welcome to the show.
Dr. Russell Morfitt : Great to be here Gabe.
Gabe Howard: Well we’re glad to have you here so first if you can explain what Learn to Live is and just give us a little background on that. Who it helps? What it’s for? And you know, kind of take us through it.
Dr. Russell Morfitt : Glad to do that. You know we’ve learned that three out of four people who suffer from problems like anxiety or depression related difficulties will never come to see a psychologist like me in the office for whatever reason, either because of accessibility or cost or that they really just don’t know where to start. So anyway, we created Learn to Live which offers programs to help people apply the solutions that research is shown to be most helpful. We actually have four programs. We have one program for stress, anxiety, and worry. We have another one for depression. We have one for social anxiety and one for insomnia. So these are four CBT based that is Cognitive Behavioral Therapy based programs. It’s not like Skyping with a therapist, it’s not tele-psychology. It’s actually going to the to our website and accessing programs that have been prepared. They’re all self-contained. The research has shown that going through a program like this can be just as effective as seeing me in the office face to face so people can access our programs because their employer provides it to them or their health plan provides it to them or their university and then they can go complete our assessment learn about themselves and if they are finding that, wow I guess I am socially anxious then they can use one of our programs.
Gabe Howard: You sort of piqued my interest there when you said insomnia. Is insomnia something that responds to therapy?
Dr. Russell Morfitt : It really does and that’s one of the best kept secrets out there regarding therapy can touch on issues that have been historically viewed as being primarily medical issues. But absolutely there’s a solid batch of research that shows that when cognitive behavioral therapy is applied to insomnia it’s actually the most powerful treatment that’s been identified in research you know most of the medications that are out there can be fantastic for people in the short term but they really aren’t designed for long term application for treatment of insomnia. But when a very specific batch of CBT tools is applied to insomnia can make a huge difference in people’s quality of sleep and the amount that they’re able to sleep and they can fall asleep faster.
Gabe Howard: Let’s sort of merge into a conversation about anxiety for a little bit because I think that our listeners understand anxiety most of all it’s kind of this one thing that sort of binds us because it seems like in this day and age, everything makes us anxious. Is that reasonable?
Dr. Russell Morfitt : Anxiety really does seem to be on the increase and especially it seems to be on the increase in cultures and in countries that actually have higher higher levels of income. The countries where there are there’s lower levels of income. You’d think well those people would really be struggling more. They must be more highly anxious but now we see it more in western and more affluent countries. And we have a number of influences that are happening in our culture it’s wonderful that we have access to more information. And you know we have our 24 hour news cycle that always keeps news that is interesting in front of us. And as it turns out danger is particularly interesting news and danger is more interesting than say safety or or predictability and truth is that having this kind of access can keep us keep us worried and keep us concerned about what might be coming next for us.
Gabe Howard: Along that same vein, you know you mentioned the 24 hour news cycle, and I think people can absolutely relate to that. But how is the technology footprint in our lives you know mobiles, phones, computers, social media, Facebook, Instagram, wearables, apps. I mean all of these things that keep things in front of our face as well. Is this impacting our anxiety? Is this increasing our anxiety?
Dr. Russell Morfitt : Probably a mixed bag game. We know that we get really compelling inputs from each of those media that you mentioned. And that’s interesting to us. And we all like we have to turn back our calendars about one hundred years to the days when people went to bed when it got dark or they got the news when they read the paper right. But.
Gabe Howard: All right.
Dr. Russell Morfitt : But now we have this opportunity to experience perpetual and ongoing input and that does tend to perpetuate anxiety for some people. So for some people all that news brings fear the technology makes it sometimes easier to avoid. So if I have a proclivity to avoid things any way because I tend to be anxious I’m more likely to do it if it’s made easy for me. And so if I’m able to have conversations without seeing people face to face then I just might do that if I’m if I’m given to anxiety. You know you mentioned social media and certainly the social comparison plays a big role in the anxiety for many people especially social anxiety. So if I’m seeing everyone happy on Instagram or Facebook which can be wonderful for our social lives but can be very difficult for our social lives and I start doing that social comparison and I started thinking well oh well happiness must be the natural set point for living and always being happy is how I should be I’m not. So now I’m questioning how I’m experiencing life. I maybe I’m engaging in some kind of social precautions and as a result and I’m posting the really positive things about myself. I’m less authentic and then I maybe remain or afraid of disclosing who I really am. My social anxiety is perpetuated so it can affect us negatively in some ways even though it also gives us really good opportunities to connect if if we want to.
Gabe Howard: So whether you’re seeking out for lack of a better word negative information or positive information the way that you internalize that information can decide sort of how you are viewing that? Are we really just sort of programmed or are some of us programmed to just be anxious? And that’s what we have to learn not to do?
Dr. Russell Morfitt : We get programmed by our social learning and then we also have our own genetic predispositions and the answer your question is yes we do tend to be pre-programmed to experience data in a certain way. And for those of us who are starting off with an orientation where we tend to have a cognitive set where we’re assuming that others are likely to be critical of us that we are defective in some ways we don’t measure up. If we take only a superficial look at what’s available out there on social media what we’re going to see is, “Oh yeah. Look at YouTube comments. People are really critical.” And I might stop there and then I look at social media and look others are happy and happier than me and more well-adjusted than me and have more friends than me. Oh yeah. I’m really defective and those beliefs can be perpetuated unless we deliberately choose to start questioning them and start looking around and you know some of the CBT tools are really useful for that like data collection it’s a kind of behavioral experimentation where we simply force ourselves to start looking around. And even though we might have for example the assumption that yeah everybody is super judgmental and they’re going to criticize me given the chance when we pause and start looking around at the people around us we often find that wait a second not everybody is that way. And when we start looking at our own lives and start questioning whether really those standards of being perfect and always happy really have to apply to us and really do apply to everyone else we often find that wait a second that isn’t really true. That’s not how the world works.
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Gabe Howard: And we’re back talking anxiety with Dr. Morfitt. In all of your research and everything that you’ve done and what are some misconceptions that you found from people who are coping with anxiety? What is it that society sort of gets wrong?
Dr. Russell Morfitt: There are a few things that come to mind, Gabe. One is that anxiety itself is problematic and often that’s the starting point for people who suffer with anxiety. You know obviously I don’t like it. And so the assumption is often so anxiety is therefore bad and yet we know that anxiety really serves a useful purpose when it’s at a modest level. For you, Gabe, to prep for this discussion took a little bit of anxiety to nudge you for an athlete who’s going to prepare for an event, who’s doing training. A little bit of anxiety can nudge them toward trying harder and that’s something that was learned over the years and good psychological research. So that’s one misconception that anxiety is problematic. You know the flip side would be that anxiety itself has to be chronic and merely coped with you know instead many people become skilled at recognizing it and normalizing it. They learn tools and so in truth they can apply their favorite tool like I’m most familiar with CBT tools so that they might find that you know if I apply exposure, we call it fear facing at Learn to Live, or I apply acceptance do catastrophes. And that’s a cognitive tool if I apply those tools that way the second anxiety just isn’t such a powerful force in my life anymore. And I’ve tried to stop controlling it. I let it come I let it go and I just respond to things differently. So it turns out that, wait a second, anxiety doesn’t have to be just the set point for me that I have to necessarily be stuck with it. I think another misconception is regarding the treatment for anxiety and many people assume that CBT you know which is has the strongest evidence basis in treatment of anxiety problems. They assume that that CBT is about changing your thoughts, which that’s part of it. That’s the “C” of it, but the behavioral part “B” is so often omitted and that involves really leaning into the anxiety if I do exposures like we call it you’re facing it, at Learn to Live we call it “flaw facing,” I’m deliberately being imperfect because I’m struggling with perfectionism that drives anxiety and or I can do a marginal exposure where I’m imagining stories. So I worry about things well what if I would imagine those stories come true on purpose? I’m leaning into the anxiety and then along the way I’m relinquishing precautions and letting go of those things that I’m tempted to do to try to play it safe. So I’m no longer going to just keep looking at my phone to avoid an interpersonal interaction or no longer going to like keep so busy that I don’t experience this troubling thoughts that would bother me other work wise. So those are some misconceptions that come to mind, Gabe.
Gabe Howard: I really liked what you said having some anxiety about doing something important you use like me preparing for this podcast or athletes preparing for the big game because I agree with this. I’m often backstage with other speakers before we all go on you know they kind of keep us in the green room and there’s always usually a younger speaker there. It’s like, “Oh I’m so nervous, and I bet you don’t get nervous.” That is what they say to me and I’m like, “No. Are you kidding? This is the most anxiety producing thing that I ever do.” I am more anxious standing behind the stage than I am when I walk on it. But I would say that that’s great. I hope that never goes away because that makes me take it seriously that that makes me practice that makes me be prepared. That makes me know where all of the files are. That makes me learn to pronounce your name correctly, Dr. Morfitt, because I don’t want to be embarrassed or ashamed or on and on and on. So it is interesting that you have also said that the research kind of shows that having some anxiety is fantastic. So when does it cross over? I mean obviously if the anxiety was so bad I couldn’t connect for this podcast that would prevent me from doing my job and making a living. But a little bit of anxiety, being prepared is good. Are there any markers? I mean how does a person know?
Dr. Russell Morfitt : It is a little bit subjective but you know a couple of markers involve how distressing is it to me? How upsetting is this anxiety to me? How much am I really suffering? And if my suffering is really subjectively quite high then probably going to be something I want to look at addressing or if it’s impairing me because I’m not able to live the life that I want. You know, I’ve found, in the past before Learn to Live became so busy and was and has been growing, in the past, I spent a lot of time you know as a psychologist in the office and I would say there are really three different reasons why people came to see me for anxiety in the office and one was yeah. Because they were feeling so anxious and the anxiety was really distressing to them. The feeling was so strong that it was very difficult to manage it. And so the discomfort was one reason another reason was because they found that they were avoiding so many things because of the anxiety. They wanted to avoid the anxiety and as a result their world got smaller and smaller and they were sick and tired of having to avoid so many things in order to be comfortable.
Dr. Russell Morfitt : Third reason would be because of all the precautions that they felt like they had to engage in but either they didn’t like continuing to do those things or others in their lives were bothered by them so others in their lives might have said you know these kind of compulsive things that you do and maybe the person actually had obsessive compulsive disorder. So these compulsions are really problematic for us or for the person but it could be that the precautions that they engaged in outside of OCD were problematic that you know it’s just hard that we always have to do all these certain things in order for you to not feel so anxious and so because of the anxiety because of the precautions because of the avoidance they wanted to do something about it. So I would say if any of those three things are causing difficulty in someone’s life then they might want to take a step to do something about the anxiety.
Gabe Howard: From a medical perspective, what’s the difference between everyday stress, worry, anxiety, and then clinical level anxiety? And I know you talked about it a little bit, but are there different definitions for those four things?
Dr. Russell Morfitt : I’ll try to keep track of the four that you just asked about, Gabe, but if I might add another one which would be panic to the list because panic is another one that’s often confused at times or experienced alongside the other the others that you mentioned. In general we think of we think of stress as being that experience of discomfort where I’m facing a specific thing. So there’s a real trigger out there that’s obvious that I can identify. So maybe it’s a deadline, or maybe I’m anticipating talking to someone, or maybe there’s a bill that needs to get paid. And so there’s a specific thing that I can point at and I can say that thing is a threat that I can identify at least perceive it as a threat and as a result I’m experiencing a lot of discomfort. And so my muscles are often tense because I’m in a state of readiness and it might be that my heart is pounding or that I’m having some chest pain it could be that I’m feeling hot. So I often have physical markers that go with the stress. We know that anxiety in general tends to be kind of similar to that except often anxiety. There isn’t an obvious stressor out there necessarily. Sometimes I can’t point to anything so the anxiety is more of a free floating experience that I have this thing is bothering me. Not sure exactly why but I’m feeling anxious. Sometimes people would say well I can I can feel anxious sometimes. I can identify triggers sometimes I can’t.
Dr. Russell Morfitt : But that tends to be one of the distinctions between anxiety and stress that stress more often. There’s this identifiable trigger and then we would say that anxiety is more at a clinical level if some of those other criteria that I just mentioned a moment ago are met. And it’s really affecting my life and I’m really uncomfortable are unable to do these things that I care about or it’s distracting me from from doing what I care about. I mentioned panic as well. So if we flip to looking at panic some people will report that they’re experiencing anxiety when what they’re really experiencing is panic and panic is more a short lived less prolonged event so a panic attack usually lasts from like one minute to 20 minutes. So it’s not experienced over an extended time and it’s much more brief and intense. And during that intense panic experience, a person’s heart might be racing they have other physical markers as well they might feel dizzy lightheaded wave a wave of hot wave of cold might feel nauseated or tingling or prickles in the fingers. And so those physical markers are really strong during panic attacks alongside this urge to escape or to get to safety. And so sometimes people experience panic but call it anxiety. And within CBT treatment for example we address the two very differently especially the ultimate fear is of the panic attack rather than having panic because I’m afraid of something else.
Gabe Howard: And where does worry fit in and all of that? That gets us our fourth and or fifth?
Dr. Russell Morfitt : Ok.
Gabe Howard: Of the grouping.
Dr. Russell Morfitt : Ack, I didn’t get all of them. Yeah. So worry is mostly the thoughts that relate to anxiety and stress. So think of worry as unproductive ruminating kind of churning thinking it’s not producing a product that is resolving a problem. It’s not about effective problem solving. It’s about me thinking over and over about something in a way that’s not helpful. It doesn’t produce a solution. It keeps me anxious.
Gabe Howard: Well I appreciate your answer. That’s where we’re getting near the end of the show so that the I have two more questions for you. The first one is, where can folks find this online program? The Learn to Live Program?
Dr. Russell Morfitt : Our programs are made available to people in various ways. So our programs are available to people who their employer provides them with. Our learn to live Web site and a special code they can use for accessing our services or maybe their health plan or their university has provided that to them. Other people can simply go to our Web site LearntoLive.com. And for some people they want to simply take the assessment. I’m so glad we’ve been able to make an assessment available to people so that all those people out there who say I don’t know if anxiety is a thing for me. I don’t know if I’m depressed? Is my insomnia bad enough that I should be worried about it? Well they can complete this assessment and there’s five different domains that are being assessed in this quick assessment takes five six minutes to complete and people are able to to learn about themselves and then they can find out whether you know that anxiety level is really problematic for them whether their stress is at a really high level and then what runs behind that. Then there’s an algorithm that might recommend one of our programs if it would be a good fit for them and then they can either choose to do nothing.
Dr. Russell Morfitt : Okay, I learned about myself from the assessment. They can choose to enroll in one of our programs. The one that was recommended or a different one if they do enroll. What they’ll find is that there’s a welcoming video for each of the eight lessons so if they’re going through say the social anxiety program they’ll be a different lessons they experience each one last 30 to forty five minutes. They can start and stop as much as they want whenever they want and they’ll find that there’s a welcoming video and then there’s animations that they can learn the tools through that are really quite disarming and then they can apply the skills right on the site and through the the tools that we provide. We decided early on we could have made it highly text based where it’s like read and quiz read and quiz, you know learn like you do in school read and quiz. We chose not to do that and so instead we’ve made it much more multimedia. That’s what people would experience when they when they do any of our four programs.
Gabe Howard: Thank you so much for being here with us today and thank you for all of that information. My final question before we go ahead and close out is, how do you you personally deal with your anxiety and stress? Inquiring minds want to know.
Dr. Russell Morfitt : How do I apply this stuff to myself? That’s a good question Gabe. I, you know in truth, I do a lot of in vivo exposure that is facing my own fears. So social anxiety comes naturally to me. So I find that social situations I have the opportunity to deliberately make myself uncomfortable at times and I benefit from doing that even sometimes doing things imperfectly at times. I do a lot of cognitive work with myself as well, decatastrophizing. I think so. Talking through Wait a second even if this does go wrong is it the end of the world. That kind of thing. How could I cope if this person really does judge me or how terrible would it be if this car wreck does happen or if I end up being late sometimes I do progressive muscle relaxation where I’m relaxing my body or I do breathing exercises sometimes I apply a lot of acceptance where I’m sort of riding the wave of anxiety or whatever modes I might have frustration in the heat of the moment. I’m actually pretty absent minded. So I make some mistakes and then when I make mistakes it would be easy to beat myself up. So I apply alternatives to dwelling as a tool. That’s what we call the exercise of saying OK I am going to move on from this thought. It’s not helpful to me to dwell on this mistake that I just made. I’ve really learned already everything I can from that. And it wants to stick and I’m moving on and sometimes that involves doing some little mental games to help me move on you know and generally I don’t handle stress or things like anxiety perfectly, but I keep working on it and I find that I am making progress every day.
Gabe Howard: I think that is a great message and I really appreciate you saying that because I think sometimes people believe like you said earlier in the show that people haven’t figured out that other people don’t get anxious because they’re a doctor and they’ve done a bunch of research on anxiety or on and on and on. So I really appreciate your candor and being honest that hey you get a little better every day and anxiety affects you just like it affects everybody else. Excellent. Well, thank you so much for being here we really really appreciate it. And thank you everyone for tuning in. And remember you can get one week of free, convenient, affordable, private online counselling anytime anywhere simply by visiting BetterHelp.com/PsychCentral. We will see everybody next week.
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About The Psych Central Podcast Host
Gabe Howard is an award-winning writer and speaker who lives with bipolar and anxiety disorders. He is also one of the co-hosts of the popular show, A Bipolar, a Schizophrenic, and a Podcast. As a speaker, he travels nationally and is available to make your event stand out. To work with Gabe, please visit his website, gabehoward.com.