Breaking the Shame Around Anxiety with Susan Kay

In this episode, we’re talking with Susan Kay, a psychiatric nurse practitioner with over 40 years of experience treating anxiety, panic, and mood disorders.

Susan opens up about her own lifelong journey with anxiety—from childhood panic attacks to the hard-won wisdom that comes from facing fear head-on. Together, we explore:

• Why anxiety often begins early and hides behind shame
• The connection between fear, the nervous system, and avoidance
• How to stop letting anxiety drive your decisions
• The power of small, brave steps and saying “bring it on”
• When medication, therapy, and community can all play a role
• The deep relief that comes from being seen, heard, and loved

It’s an honest, compassionate conversation that reminds us we’re never alone in our struggles—and that healing often begins the moment we start talking about it.

About Susan:

Susan Kay is a pediatric and adult psychiatric Clinical Nurse Specialist with many years of experience treating both inpatients, residential and outpatient populations. She provides psychotherapy both short term and intermittent as well as psychiatric evaluation and medication management. Her designation as a Psychiatric Clinical Nurse Specialist has now changed to Psychiatric Nurse Practitioner by the American Nursing Credentialing Center.

Susan is seeing pediatric and adult populations in an outpatient setting. She offers primarily psychiatric evaluation and medication management is her specialty. She has extensive experience treating affective disorders, ADHD through the life cycle, Autism Spectrum Disorder, OCD and psychotic disorders.

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*Information shared on this podcast is not medical advice. If you have a concern about your physical or mental health, please seek support from a proessional.

Transcript

Jan: Welcome to things my mother forgot to mention, the podcast 

Patti: where we say everything our mothers didn't. 

Jan: I'm Jan, a trauma therapist and author, turned rogue storyteller here to talk openly about the body aging and all the. Wait, what 

Patti: moments 

Jan: of womanhood 

Patti: and I'm Patty, an online business and tech nerd whose purpose is to elevate the voices of women in our world and who doesn't believe in taboo topics.

Things my mother forgot to mention is the podcast for every woman who's ever said, wait, why didn't anyone mention this to me? 

Jan: Join Jan and Patty. Two, outspoken, curious, outrageous women as they dive headfirst into a messy, magical, and often WTF realities of aging health, and quite simply being a woman from rogue chin hairs and vaginal thinning to mental health, perimenopause and scalp cancer.

Yes, really 

Patti: nothing is off limits. It's funny, it's raw, it's real talk. Your mother definitely skipped. 

Jan: Let's get into it. Hey, Patty, how you doing today? I'm good, Jan. How are you? I'm actually busy, but uh, I'm having a good day. It's a beautiful day out, so. 

Patti: Awesome. 

Jan: And I'm excited to be talking about, uh, anxiety today because it's big for probably everybody.

Patti: Mm-hmm. 

Jan: Yeah. And, and we have a guest here. 

Patti: Yeah, we do. I'm super excited because last time we talked about my experience with anxiety and we dove into that, but today I'm really excited to have somebody else come in and talk about anxiety. Mm-hmm. That also had experience in all sorts of ways with it.

Jan: Mm-hmm. Well, this is a good friend and colleague of mine, and her name is Susan Kay. And she's a pediatric and adult psychiatric clinical nurse specialist with many years of experience treating both inpatient, residential and outpatient populations. She provides psychotherapy, both short term and intermittent, as well as psychiatric evaluations and medication management.

Her designation as a psychiatric clinical nurse specialist has now changed to a psychiatric nurse practitioner by the American Nursing Credentialing Center. Wow. 

Patti: Wow. Yeah. That's a lot. Yeah. Welcome Susan. 

Jan: Welcome 

Susan: Susan. Um, thank you. We had to cut some initials out of my, uh, credential. So they made it NP instead of all that other stuff.

Jan: Oh, I see. An np. Got it. 

Patti: So as a psychiatric np, I imagine then you are able to prescribe medications as needed for mental health and things like that to patients. 

Susan: Do like comprehensive evaluations and medication management primarily. Um, although I see many patients that combine medication management with short term or intermittent psychotherapy.

Mm-hmm. 

Jan: Right. That's great. Yeah. Well, as long as long as I've known, uh, Susan, she has, uh, been excellent at what she does. That's one thing I do know. If anyone is really struggling with their medications and there's a lot of, uh, challenging other medications they're taking, she's always been able to target it and get it right for many people.

I've referred to you, so that's amazing. Thank you. And now you're in private practice, right? Yourself? Yes. That's awesome. So today we're gonna talk about things our mother never mentioned when, when it comes to anxiety. Uh, so Patty and I are really curious about, uh, your journey with that. 

Susan: Yeah, well, um, I started, um, having anxiety, I think the day I was born, um, because they tell me I refused, uh, to eat.

Um, so, uh, they used to give my brother a dollar, uh, if he could get me to drink my bottle. And you can imagine he was, uh, nine years old. So he probably, um, got me to drink my bottle one way or the other. Um, but I wasn't really aware of my anxiety, um, until. I was, uh, like in elementary school and I was going to overnight camp and I was all packed and I loved overnight camp, but when I was getting ready for bed, I had a panic attack.

Mm. Wow. I had no clue what was happening to me. Um, I didn't know about panic attacks. My mom forgot to tell me that. Did 

Jan: she have any of those? I mean, maybe she was having 'em, 

Susan: she had panic attacks when she was younger. And then when I was born and I was around, um, she was phobic of certain things, mostly travel.

And I guess she was anxious about everything, including the pillows being out of place Wow. On the sofa. Mm-hmm. So, but I didn't recognize that either. I only recognized that she had difficulty with traveling and driving long distances by herself. Wow. Um, so she needed a companion. Um, and luckily my father provided that for most of her life.

Yeah. So when 

Jan: you had your panic started having your panic attacks, did she not talk to you or tell you what was going on or like help you understand what was happening? No. Um, 

Susan: she was glad to give me the panic and the anxiety, but she wasn't so good about identifying it and. Um, also, um, I think this is a big part of anxiety.

I felt ashamed so I didn't share it with my friends or my, even my mom. I didn't tell her like that first night when I was in my room. I never told her that that had happened and I didn't know what it was. And then for the rest of my camp years, which went on till I was 16 years old, um, I had a best friend that also went to the camp and I knew everybody.

'cause I went back every summer for like eight weeks. So it was like a wonderful community for me. But. They called our names as we got onto the camp bus and the camp was about six hours away. And so we, um, would get onto the camp bus one by one as they did a roll call. And my friends, uh, name started with T but mine was starting with K.

So I would get on the bus first and then I would get very anxious escalating to panic until they called the T's and my friend got on the bus. So despite wanting to go and despite um, loving, you know, the whole community at camp, um, I was anxious about leaving and my friend being on the bus with me. Yeah.

Which is crazy 'cause she was standing in the parking lot ready to get. 

Patti: Right. Right. It's not like she was not gonna get on the bus. No. Yeah. No. Yeah. But I think that's the interesting thing about anxiety, especially when you, you don't yet have experience with it and it's new to you, is that you don't realize that a lot of the fears that you experience aren't rational always.

And you, and they don't always make sense. They're not always something that you can easily say, oh, I understand why I would have that fear and, and that sort of thing. And so I think that's part of it that also makes it, I think, embarrassing is because you're like, why would I be anxious about something that feels so silly?

But it wasn't to you and it was this, this big thing that was happening. 

Susan: Well, and it's not only emotional, it's not only what goes through your mind. Yeah. Um, but it's also physical 'cause there's physiological correlates mm-hmm. To what is going on. So you're dealing with it in a somatic way. As well as, uh, an emotional way.

And the shame for me that came with it, like, why can't I do this? Everybody else is doing it. Yeah. Um, when I got older, that just took over and I felt, uh, it ruined my self-esteem, um, because I felt dependent on having a companion. Yeah. And who understands that you're in college. How, how do you tell somebody, I'm going to get my hair cut down town, can you come with me?

Um, you know, so I was always plotting ways, you know, like somebody would say, oh, I'm going to get my haircut, and I'd say when maybe I should go with you. Right, right. And so people didn't really know, um, and, um. So going to college, when I left for college, it really escalated. Um, and then I began to be fearful of traveling, driving, taking a bus, taking the t.

Uh, I couldn't do any of that. I mean, I could drive locally where I grew up. Um, but I was in Boston and I wasn't able to drive. And as my education, um, progressed, I had to get to different hospitals and do my clinical rotations. So my parents stepped up, they bought me a car because I was most comfortable with that.

Mm-hmm. And, um, so I learned to drive locally to the places that I had to go. Um, and um, I think that brings up another really key point, um, for me. Um, and that's like the force of moving forward. Many, many people with panic attacks and phobias and agoraphobia, they avoid pain, they avoid the challenge. It's overwhelming.

Mm-hmm. In the moment you feel like you're gonna die. Um, and so it's very, very easy to just avoid and not do the things you wanna do, which leads to escalating regret, um, and feeling stuck. So I figured that out Jan, just about the time I met you. 

Jan: And I was wondering about when that happened. We met, what, 83 84.

Was it 86? I think. 86? Mm-hmm. 

Susan: And I don't know when we traveled to California, but that was my first trip. Um, and it was 10 days. Um, and, uh, I don't know if you remember this, I, I think I've mentioned it recently, but, um. On that trip you were producing the workshop that I had gone to. So they picked you up and they left me as a participant at the airport and I had to spend, you know, three or four hours at some airport on the tarmac waiting for the bus to come pick me up.

Oh my God. Now if you think back to what happened when I went to camp, just my friend standing in the parking lot and not get on the bus, and now you've disappeared and I'm in some airport, many miles, um, from home, obviously 

Jan: this is in California, right? Yes. This is when you did the heart, the heart conference, right?

You did that? Yes. Was that with Carol? Yeah. Okay. Right. Oh my gosh. I didn't realize, Sue, I didn't really know. I was gonna say, I didn't know you had such big fears, like this anxiety that was, that led you to not getting on planes and all kinds of things. I, I didn't know that when I first met you. You know, 

Susan: that was clearly in my late twenties, early thirties.

Mm-hmm. And see even then, like close, close friends didn't know because I didn't tell them. Right. However, you know, if you think about it, and I'm gonna say this was my first real challenge, um, where I had the courage to do it anyway. Mm-hmm. And I sort of said to myself, if you die, you die. Yeah. But you can't live your life like this.

Mm-hmm. And so, uh, I was really, really afraid of silence and fasting. I remember that. Three days of not talking to anyone. If I panicked, what was I gonna do? Make somebody else, um, start talking to me. And then you left and went, you know, partying with the other, producing right? Leaving all the participants in the house, uh, drinking juice.

And uh, um, so right before we went into, we, we listened to music, we had a meditation, and then silence and fasting started. And you were next to me and you said, Sue, I love you. And that is so, so important. I do remember that someone, 'cause I don't know, you intuitively knew to say that and then you left.

But for me. Knowing someone, even in my fear, loved and accepted me. Mm-hmm. The fear went away. Hmm. You know, I did great. Never once did I panic during that three day period ever. Um, and I think it was that Jan, who was my friend, wants me by saying, I love you. Yeah. Um, so, you know, my advice for people is the only way to make anxiety go away.

The only way to loosen its grip is to say, bring it on. And when you say bring it on, you mean it. You bring on the pain, I'm just gonna do it anyway. And. You know, the dragon gets smaller. Yeah. You take the need out of its sales. But it took me until I was in my late twenties to thirties to really get that my strategy of avoidance was making things worse.

Yeah, interesting. Yeah, 

Patti: that was something I talked about. Um, when Jan and I had our conversation as well, was that for me. The avoidance, right. A lot of the anxiety started to become anticipatory anxiety, and I was always afraid of the next panic attack. And I didn't wanna do anything that would trigger that.

And that's what happens with all the fear and not wanting to do things, is you're trying to avoid having that uncomfortable feeling of anxiety and of having a panic attack. And that's ultimately what I did was when I started to feel, I would say, I'm feeling anxiety. That's okay. And, and that's how I was able to just sort of like, instead of becoming afraid of it, I'm anxious.

Oh, oh no, I'm gonna have a panic. It was, mm. Okay. That's a feeling I'm having. And that's okay. I'm, it's okay to feel anxious. I'm not going to die. And maybe I will. And that's the other part of it too, is that I learned in cognitive behavioral therapy and things like that is, well, follow it. Follow the fear.

What is the worst that will happen? I'm gonna die. Okay. Well, it's been a great 

Susan: run. You know, I did the same thing. It's like, okay. If I die, it will be better than living my whole life like this. Yeah. Yeah. And so I was willing to die, but you have to take little steps. Mm-hmm. It doesn't all happen one day.

Um, little steps, little steps until you're ready to say, I'm gonna do the thing I'm most afraid of. And my mom, she had a whole different approach to this. Mm-hmm. Her approach was to nurture security. So you anticipate and you build in, uh, safeguards. Um, you protect against the unexpected. Um, and you avoid fear.

Well, that's what I did for a long time. Mm-hmm. But then it started to destroy me. Yeah. And what my mom did. Is not what I did. And you know, whatever's happened to you, whatever traumas you've been through it, life doesn't exempt you from pain. Yeah. So you can't say, well, I've been through enough, I'm not gonna do that.

You have to just say, do it anyway. And then my mantra was, you got this. Yeah. 

Jan: So did any of your brothers, uh, siblings, uh, have anxiety or is it just you and your mom? Well, I think they had anxiety, 

Susan: uh, but it didn't get in the way of their life being successful. Yeah. Um, they traveled, they married, um, they had very, very successful businesses.

Um, and, uh, you know. One of my brothers did have panic attacks whenever he didn't have enough sales, but he had everything that I did not have. I was trying just to get through the day. 

Jan: Yeah. 

Susan: And their lives move forward when mine didn't. But I really wanna say, I think this is really important is, um, by the time I was 40, um, I knew that I wanted to be a parent.

And again, I couldn't make peace with the regret I would feel. So the bravest thing I ever did was leaping empty handed into the void of adopting an infant at birth. Um, and I was a single parent with no support. I had no partner. I had no custodial partner and I didn't have any family that lived in the area, and my mom was almost 80.

So though she wanted to help me, it was limited what she could provide. Yeah. Yeah. 

Jan: So did you have a lot of panic attacks then when you were raising Sophie? 

Susan: It was all anticipatory. Hmm. Um, uh, it was the, from the time the birth mother said yes, until the time my daughter was born was probably the most difficult, um, time of my life.

Luckily it was only eight weeks. Um, um, but um, once I had her in my arms, I never looked back and I had no anxiety. Um. Until she was about, uh, two and I began, um, she started moving. So she required, I couldn't bring her everywhere I went 'cause she was like beginning to walk and maybe one and a half. And so I had to stay home and I had to disconnect from my support systems.

Um, so at that time I kind of checked out, probably remember that, um, I did and, uh, you babysat a little bit for me. Um, but um, I got over. Pretty quickly. Um, and uh, yeah, that was it. And slowly, slowly over the years, I've done more and more and more traveling. And I know I told you recently, I flew solo both ways, um, there and back to Colorado.

And I had to change planes in a giant airport in Denver. Um, and one of the flights was massively turbulent and everyone was in a panic, like the guy across the aisle had his head on the seat in front of him and was kind of crouched down. And I felt very little anxiety. I just kept saying in my mind, over and over again, just because you think this plane is gonna crash.

It doesn't mean it's gonna happen. Yeah. And so that's what I said over and over. The next thing I knew we were in Denver. Yeah. 

Patti: You know, my sister-in-law, she has struggled with some anxiety too, specifically with traveling and, and I never had until I had one of my anxiety spikes and then all the, and I had traveled everywhere and was fine and loved it.

And turbulence to me was like driving over bumps in a car. I lo like nothing phased me. And then all of a sudden, you know, I started having all this and then I couldn't anymore and it was horrific 'cause I had a terrible panic attack on a plane and that was the end of that for me. But, so my sister-in-law started sharing.

She is like, you know what I do is I think if I really need to get off of this plane, I could open that door. They're gonna pull me down. I might get sucked out and die, but I could. Open that door if I really need to. And I think what, what, like talking about this is a reminder for is how powerful that yes, there are these physiological symptoms that happen with it, but also how powerful our minds are in the middle of that.

Um, for us to be able to find whatever strategy, whatever thing we need to say, that's the right thing to make us go, okay, I can make it through this next little bit. Um, and another thing that helped me a lot when it, when I was sort of spiking was I had this professor who was talking about grief and she was saying that for me, it's no longer I'm gonna try to make it through today.

It's, I'm gonna make it through this next minute and then when I am finished with this minute, I'll make it through that next minute. But it's, it's every minute at a time. And that was another thing that helped me as well, because instead of saying it's gonna be this long flight or this long driving, for me, long distance alone can be challenging as well.

And like, so instead of whatever these things, it's just. Every minute and, we'll, I'm gonna let future Patty deal with the next minute, but right now, this is the minute I'm dealing with, and I can make it through a minute. Anybody can make it through a minute. And like, I think the, the power of our minds is, is pretty amazing when we look at it from that perspective.

Susan: Yeah. Yeah. I do, I do think that's really been an anchor for me is having these little mantras. Um, but also, you know, my mother taught me to build in security. Now she nurtured security and didn't do the things she was afraid of, um, until very later, after my father died. Um, she began to, but, um, she nurtured the pain, the fear, and like finding security.

What I did was just knowing it was there. So saying to a friend, you know, if I get really. You know, fearful. Can I call you? Can I text you? Mm-hmm. Um, are you gonna be around that day? So I don't think I ever do that. I don't think I ever text or, you know, a friend said to me this last time, you said that you were gonna text me, so I was texting you and you never answer it.

And, you know, uh, but knowing, well, if it gets that bad, I can reach out. If I'm at 30,000 feet, I can still reach out. Um, and, um, you know, someone. Patty, like, just like what you said, someone said to me once when I was like, well, if I'm in a plane, I, I'm trapped. I can't get out. And they said, well, at 30,000 feet would you wanna get out?

Yeah, 

Patti: I right. Yeah, yeah, yeah. I'm similar with the security thing as well where I always, and, and I play with that sometimes to help myself with a little bit of exposure. So like, I like making sure I, the last time I've taken Xanax, I can't even remember, but I wanna make sure I have my Xanax just in case.

And you know, or the same thing. I ha I will if I'm, I am going somewhere, I make sure I have certain people and ready to go in case they need to answer the phone, but I never usually do. And so it is that anticipatory, once you start building your internal toolkits or you have whatever other things, for me, I have medication for my anxiety that helps me on a regular basis, but.

All of these things are, are really helpful. So it is, I think it's not, not doing things, but it's doing things. And if you need to have those securities that make you feel a little bit better, do it. If that's what's gonna help you get to the next place and live your life, you know, that's I be ashamed of.

Jan: Right. I was gonna ask you, Sue, the, so with your clients obviously being in practice for how many years is it in 40, what is it? 

Susan: 40 years? 

Jan: 40 years with, 

Susan: with children and 

Jan: adults. And so here you are at, at, you know, do you talk to them and about anxiety and you do the intermittent kind of therapy or a brief therapy, and you also do medication management.

So do you tell your clients, okay, this is what you have to do, you just have to face it and go through it? I mean, what do you do? I 

Susan: absolutely say that, but not at the beginning. Right? If someone comes in and says, I'm having panic attacks, and I say, well, you have to face it. Good luck that the world has been telling that.

Do it anyway, man. Anyway. And they're like, I can, I can't. That's the last visit I'll get from that. Oops. So, you know, I say to them because having them experience hope in the moment is really important. Hmm. So, you know, maybe I say to them, we can fix this. Um, and even though you may not see that right now, I know we can do it.

Um, and we might not make it perfect, but you won't have to live this way. I promise you. You won't. Um, and it may be that you take small steps. It may be that you work with me, um, and we'll add medication. Oh no, I don't want medication. Well, then you'll have to make friends with the anxiety independently.

Oh, maybe I will have medication. Um, so, you know, I say, you know, medication is like a step up. You know, it's like, you know, someone giving you a step up, it gives you traction. Mm-hmm. But you are gonna fix the problem, but you might need some traction to do it. Yeah, I was saying they begin to think, is she serious?

Well, this really happened, but I'm very confident about it and I think I pass on that. Mm-hmm. That sense of effectiveness. But you know, you have to get with the program, um, to do it. And it doesn't mean you have to do it, you know, this week or this year even. Um, and, um, you know, the one thing about anxiety is so much of it is anticipatory in terms of panic attacks, and then other people just live with constant anxiety, which is a little different.

Um, a little different approach. Mm-hmm. Um, and you, with those people you, like Patty was saying, you have to, uh, let them embrace it. Mm-hmm. It's part of you, you know, instead of pushing it away and feeling bad about it, you know, you embrace this part of yourself and, um, uh, with panic and fears of, you know, phobias, you have to be a little bit more courageous in the moment.

Um, but it's baby steps. Um, and once you realize, oh, once I get on the plane. I'm gonna be okay. 

Patti: Yeah. 

Susan: The month before I travel is gonna be as bad as it gets, right? 

Patti: Yeah. Yeah. That's always how it is for me too, is it's always the worry between like all the things and all the gymnastics my brain goes through leading up to the whatever it is, and then I'm in it and I'm like, oh wait, I was supposed to be nervous about this part.

Right? And you're doing it and you're there and you're totally forgotten to be anxious because you've put so much energy in the pre and you've done whatever you needed to do to prepare. But I agree. I think there's sort of these levels of like, I'm at the point where I've had periods in my life where I'm panicky and I have panic attacks, and it's very acute.

I will always have anxiety that I've just made peace with. I've had it my entire life. I will always have it to some extent. Whether or not it's disruptive in my life is a different story and I just live with it. And there's certain baseline of that's just a part of my life and I'm like, okay. I just don't think about it much.

And it's just, don't 

Jan: you think that certain people, I, I mean, this is my, my, uh, I would say my belief. Which is that people who have very early trauma, uh, depending on what the trauma is, uh, does really create their nervous system, kind of high tone, high sympathetic charge. So they're gonna be more dominant in the sympathetic charge, like the spinning the, the anxiety.

It's not gonna be toned down. It's gonna be toned up. And I think that certain people who go through early tra trauma, I mean, it could be up until like age eight to 10, their brain isn't all that well developed. And so everything's coming in and they get overwhelmed. And I think that sets the stage for having more anxiety or panic, uh, attacks.

So I don't know, Sue, I'd love to hear what you think about it since that's your, your area. 

Susan: You how I was saying it's not only physical, but it's emotional too. Yeah. We've talked a lot about the emotional part, but there's a somatic part Yes. That's based in biology. And you're absolutely right. You nailed it.

It's the sympathetic nervous system that takes over. The parasympathetic nervous system is like clueless. Right. Um, and that's where meditation and, uh, therapy, it engages the parasympathetic nervous system in the moment. Um, you know that it's there, you have to engage it because the sympathetic nervous system, like your heart rate, your blood pressure, your fight or or flight response is primed and it's primed early.

It's primed into the cells of your body. Mm-hmm. There is nothing you can do about it. To make it go away other than No, it's anticipatory. Do it anyway. Um, and you learn ways of engaging, being able to slow your heart rate and slow the panic response. Um, and then, you know, there's a parasympathetic nervous system, um, as part of your brain.

Um, and it needs to be engaged. You can't let the sympathetic nervous system, as they say, drive the bus. Yeah. It doesn't know how, 

Jan: unfortunately it does sometimes. 

Susan: Yeah, it does. It does. And then you need to, uh, take the keys and have it sit in the backseat. Yeah. Um, because the adult And you need Yeah. 

Patti: You're drunk.

Go to the back. 

Susan: Yeah. Yeah. And you know, Patty, what what's amazing to me is that you and I have never talked. Um, and yet do you see how much similarity mm-hmm. In what saying we have gone through and how to deal with it? It's like even amazing to me because I have felt so much shame throughout my life. I don't, I don't always share it.

And hearing you, it just is like, yeah, this is a thing, and other people have this too. 

Patti: Yeah, absolutely. And it really is, I mean, go ahead Jen. 

Jan: You're not alone is I'm saying. Yeah. It's almost like, it's almost like aa, you know, you start thinking something's wrong with you and you go to an AA meeting, just any of those meetings where everybody's kind of in the same as position and they're talking about how screwed up their life is or whatever they've done, or how they've let people down and nobody judges them and they just feel like it's a safe place.

And that's. Kind of like talking about this is that more people, I, I think, have this, but no one talks about it 'cause of the 

Patti: shame so many people have this. The, when I, what is it? Like 12 years ago now, when I had kind of my biggest spike when I really started having panic attacks and all of that, I had a really great, I was in, uh, the theater community in San Francisco and had such an amazing community.

And I went to Facebook. And when Facebook, I'm still on Facebook. I don't care. We're we're older people on Facebook, but I went to Facebook and I, I've always been somebody, I've always been like this, I've always been like, I just talk about stuff because I think it's important. And so I post on Facebook and I said, y'all, I don't know what's happening.

I am debilitating anxiety. I can't do anything anymore. I used to take public transit everywhere. I can't get on a bus anymore. All these things. And I'm like. Does anybody have anything? And the number of people that I never would've imagined had anxiety respond, like the comments on that post were massive.

And people who also privately messaged me because they didn't wanna share it publicly, but also people that I had, like these big performers that I had worked with that are like, you know, uh, blown away the number of people who struggled with anxiety, who had panic attacks, who, who lived the same way. It, it was really comforting in that way, though it doesn't fix it in your body, but it was that of, I, I'm not alone.

And that was kind of the first moment for me where I was like, well, I'm gonna start talking about this. Then as I find these tools, I'm gonna share them as I go through this experience. Because look at all these people who, who struggle and it's, it's so much, I mean, there's so much shame. Yeah. 

Susan: For me it was like.

Wow. Like how did she know exactly what I was thinking or feeling like this is a thing. Yeah. This is an illness. This isn't just me being inadequate. Right. Um, so, and you know, talking to you today, Patty, it's like both of us are saying the same thing. Yeah. Like, Nike just do it. 

Patti: Yeah, yeah, yeah. Um, yeah, 

Susan: I became a therapist because I had a lot of sensitivity and tolerance for people and what they were struggling with.

It didn't matter to me What, trying to understand it and embrace it with them and take the journey with them. Yeah. And you know, I wanted to get over it. Some people don't. Yeah. Okay. I'll hold your hand. Mm-hmm. I'll help you be with this. Um, and it's not like I go into a therapy session saying, you have to get better for me.

So I know that I'm an effective therapist. Mm-hmm. I go in and say, this is your journey and all I wanna get out of it is that you feel better. That's nice. So whatever it is that's gonna make you feel better, I'm good with it. Um, yeah. Yeah. And I think so you're normalizing it. You're normalizing it for me.

Burden off my patients likehmm. You know, this may not work, uh, this may not work right away, but I'm in it with you. Yeah. Um, and, you know, whatever your goal is, it's okay with me. I'm not setting a goal. Yeah, you are. Yeah. 

Patti: I love that. And I love too how earlier you sort of mentioned that, you know, if somebody comes in and they're like, well, I'm not ready for medication.

Okay, great, well that might mean we have to do it this way. And it took me three years to say, maybe I need some medication because I can't man. Like I still three years of all the things. And then like you said, it was a step and it was like. Oh my gosh. Like I have a baseline of not waking. The moment my eyes open, I'm anxious.

Before I've had a freaking thought, like, how is this humanly possible? But like I get to start having a baseline and now I can really build my toolbox and I can really feel and pay attention to what's happening in my mind and, and get some control over it. So it's not just like, I think people are, think that taking medication for something is like giving up or well, it's forever, or, well, it's just that and nothing else.

And for 

Susan: me, I just wanna do it myself. Right. You know? Yeah. No, it's just traction we're giving you. Yeah. 

Patti: Yeah. I love looking at it from that way. 

Susan: Mm-hmm. It's not gonna do the trick alone, but it will give you some traction so that you can engage your strengths, um, to, to meet these challenges. Um, and the payoff is you can let go of regret and shame because you'll feel like a hero or a heroine, um, uh, in your life instead of, why can't I do these things?

So for me, I never get up and feel like I don't want to go to work because, uh, I feel like I am befriending people. Mm-hmm. Um, and helping them. Um, I don't share my experience very often. So even doing this publicly, um, is a first for me. But I do share what I know. Like I will share, the only way to make the dragon get smaller is to face it.

Yeah. Um, and all of a sudden the wind is out of its sails. Just trust me on that. Um, and, um, so I speak for my experience. I just don't share the personal, uh, part of my life usually. 

Patti: Yeah. Well, I appreciate you sharing it here. Yeah. It's so, it is, it's so nice to hear somebody else share some of the things and, and you said some things too that I've not heard too many people say before.

Just, you know, like I've, you're the first person I've heard say, well, I like to make sure there are people that are ready in case I need to call them. And that was something that like, yeah, sometimes I just think I'm neurotic, but sometimes I'm like, it's what I need. So it's good. You know, like it is, it's nice to feel seen and nice to think, all right, it's not just me and I'm doing okay.

You know, I'm functioning. It's good. I 

Susan: have built in security in my relationships. It was like Jan, she's taking off, but all she said intuitively is, Sue, I love you. It wasn't romantic. It was like a friend. Yeah. And that was enough to feel like, oh, I'm loved. Why would you feel afraid when someone says. You know, you're loved.

Mm-hmm. Um, and so, uh, it's that, that built in security. Um, and that's when I started to understand, uh, that love is really important and it's really, it's really what keeps us going. 

Patti: Mm. Yeah. 

Jan: I love that. This is great. So what would you say for people who, you know, I mean, do you give 'em any specific things to do, like go to therapy or do a workshop on this or do you know, CBT or do you have any?

Susan: I mean, as it comes up, if I think someone needs extensive weekly trauma work, um, you know, I'll refer them to someone who can do that. I will still see them like monthly. Um, and help them along the way. Um, and I'll see them for 40, 50 minutes when I see them. Mm-hmm. Um, so I am doing meds, but I am keeping my finger on the pulse of the progress they're making and kind of trying to juice it.

Yeah. And so, uh, that's how, and you know, sometimes people just say, well, you know, I get more out of, uh, being with you, uh, than I do out of my therapy. And I'm like, well then if you really feel like that, talk to your therapist about it and you know, it's up to you who you work with. Mm-hmm. Right. My most recent experience with that is.

The patient was talking to me and I said, well, I know you're not gonna agree with this, but you have to see this clip. And I pa played him the Bob Newhart. 

Jan: Oh. Oh my gosh. That's the best. Have you ever seen that, Patty? I don't, I don't. I'm not sure what you were talking about, so. No, I don't think so. Bob Newhart.

So this is way back when we were, you know, it's an old TV show that was in, I don't know, I know who Bob Newhart is. Yeah. Sixties or seventies or something. Yeah, yeah. Seventies. He was a psychologist and he, uh, you should look it up on YouTube. There's many renditions of it, but it's basically called Stop It.

Patti: Okay, 

Susan: so if you look up Bob Newhart slash stop it, you will see this clip. It's about four or five minutes. Well, when I showed the patient that clip, he was like, he was a little bit arguing with me and I, I didn't engage with that. I just said, well, you know, consider this. Well, the next time I saw him, he was like, I fired my therapist.

I got more outta that one clip with you. I have been a year of therapy and I was laughing and you know, I've worked with him for probably another six months. I'm still doing his meds, but he's found another therapist now he can work with weekly. 

Jan: But you know, you bring up a really good point, Sue, is that, uh, is finding the right therapist.

Yes. And not to be afraid to say, this isn't working for me and I'm gonna look around. I mean, because, you know, if you're not getting what you need, you need to find somebody else. And you have every right to do that. I like that. Yeah. Yeah. 

Patti: And not every therapist is gonna be right for you. And, and it may have, have nothing to do with that person and just how you are.

I was super picky. It took me like a year and a half to two years to find the current therapist I'm in. I went through several and I was just not embarrassed to say, oh, thank you so much for your time. This is not a fit for me. And move on after a number of sessions and until I found somebody who is just the.

Amazing. And so I think it's really important to advocate for yourself when it comes to your therapist. I, I think therapy is super helpful. I think everybody should be doing it at least once in their life. And, um, but yeah, take the time to find it and you might not know what that means. And so just go and see how you feel and, and see if you grow and if you learn from that therapist.

And I've had some that talk about themselves a lot. I had somebody who talked about themselves all the time and I was like, this just feels a little inappropriate, so I don't think you're a fit for me. I have one that hugged me when I specifically said I was struggling with physical touch, and then she hugged me and I was like, thanks so much.

I won't be returning. You know, so like, you just have to, you have to go through it sometimes and find the right person, but they are out there and there are some amazing therapists of which I sit with two. But yeah, I think it's, you know, it's really good. 

Susan: The other thing is for that particular patient, he, it was a, well, a young guy, um, like showing him that clip.

Um, it's like, uh, in the session he was able to see like consciousness loves contrast. So when he saw that clip, he realized I'm not getting this in my therapy. Because in that moment he saw the contrast between what happened when I showed him the clip and challenged him, um, compared to how he responds to support.

Um, and so that kind of consciousness, because he actually had the experience in the moment. Um, helped him to see, wait, I need more challenge than I'm getting. Mm-hmm. Yeah. More pushback. Mm-hmm. Yeah. Like he, the contrast between, uh, the two approaches became very obvious to him. 

Jan: Mm-hmm. Yeah. Yeah. Great. You know, uh, I am, as far as, I never really realized this until I became a therapist, but that, uh, OCD, which is what I was diagnosed with when I was very young, uh, is an anxiety disorder, which I didn't know.

And then Uhhuh, I was like, oh, now it all makes sense, you know? And, uh, you know, so I used to think I didn't have any anxiety. I thought, oh, no, I'm fearless. Uh, now it, it's, as I've, you know, done some work on myself, it's now I realize how much anxiety I do have. So it, it's been a journey. And I, I think that I don't have as much problem about like, going places and doing things.

You know, I usually just leap and then see, talk about it later, you know, like, whoop, I shouldn't have done that. But, uh, that's, that's been my life. But now as I've gotten older, it seems like the tables have switched. And now it's like about, I'm, I'm much more conservative, which is very interesting. And I feel some of those feelings you guys are talking about, I think it's 'cause I've done more trauma work and mostly somatic work is the kind of somatic work I've been doing.

Mm-hmm. And now I, you know, getting on planes, I look out and I think, gosh, I am feeling anxiety. I never realized that. And, and of course you used to be a flight attendant, you know, and I never even thought about that. So I don't know what that means. But later in my life, I've, I, I think it's because I've done more work somatically, that I'm just much more aware of what's going on in my body.

Before I think I was more shut down. So, 

Susan: yeah. I, I really agree. Like, I have not gotten to the place where I can do much with the somatic part. Like once I start feeling it. It will precipitate not only a panic attack, but almost like a violent seizure. I mean, it's not a real seizure, but my body just starts trembling and I don't understand it, like, why is this happening?

But the hands-on and the tuning into my body, it, it's, it's still very much a challenge. It's overwhelming and, yeah, time. I've done somatic work. I've had to stop because Yeah. Really I don't, I don't see the value in it because I don't know why my body responds that way, like what is going on. Mm-hmm. And I feel like, uh, I'm possessed like an alien's there.

Mm-hmm. And I've never had a therapist, like a somatic therapist, that would help me understand this. 

Patti: Mm-hmm. 

Susan: Um, or ways to deal with it. 

Patti: Mm-hmm. So somatic therapy, is it both? Because I did the somatic therapy for a period, but they didn't have hands on me. It was movements myself. So like she would have me, like, we would say, like learning how to set boundaries and I'd go, stop and I'd have to do this full motion.

Mm-hmm. And things like that. And that actually was. The first time I started having full, huge panic attacks was when I started doing that somatic therapy, and I was okay. And it, that was the 12 years ago as I was in the middle of doing this work, and I think I mentioned this in, in, when it was just you and I, Jan, and that was like what I considered a baby therapist.

She still had a supervisor, so maybe she wasn't quite, you know, able to handle some of my complex trauma, but I had never experienced the level of, of panic that I had until I started doing that, that w that kind of somatic work. And I was, that was, yeah, I've never done it theory 

Jan: behind somatic work because I've been doing, I told you, bionic biodynamic, cranial sacral work.

I've been doing that plus somatic work. With a woman who is an SE practitioner as well as an ISP, which is a different form of expanding the emotion in your body and having your body discharge it. So, uh, but the whole idea is that the nervous system, when it goes into the sympathetic charge and it spins out.

If it can't fight to get out of there. 'cause you know, so if someone's coming after you and a kid and you can't fight it and you can't, uh, flee because if you do, they're gonna come running after you, you're stuck in that, that sympathetic charge right there. You. And so somatic work is all about completing what never got to be completed, which is either to fight it or to get outta there.

And that's what you're doing somatically in someone's body and, and looking for what they call a release or discharge of energy that comes out and it calms you down so you move into the parasympathetic. So, so I've been, but I'm telling you, it's, it's a little, it's uh. Slow is good when you're, it comes to somatic work because for people who have had trauma, if you do too much too fast, it's too much for people, really is, well, they disassociate 

Susan: and then well, then they go 

Jan: into like a dorsal vagal shutdown, which is a dissociation, which I think that's where most people live.

I lived there most of my life, so anyway, but that's, that's the whole idea behind somatic work is moving the stuck energy of the fight and flight response and getting it to move and complete what it was never able to complete, which is pretty amazing 

Susan: that, and see my brain got good muscles, you know, I took the atrophy of avoidance and brought courage to it to move forward.

But you know how I said the anxiety is in your cells? Mm-hmm. I have not yet. Been able to work with that. And I think that causes like physical illnesses and I totally agree, Sue. Um, you know, it's still at this age, um, I'd have to have someone who is really good, um, at grounding to be willing experience that.

Yeah. Yeah. But I think if I could do that. Oh my God. It wouldn't be so much of the guarded, you know? Yes, yes. 

Jan: Uh, the darle response, the guarding, the bracing is what you're talking about. Bracing. Yeah. And that's what most people do is they go to bracing, you know? 

Patti: Yeah. The white knuckling it. Yeah. 

Jan: Yep. Yeah, 

Patti: yeah, 

Jan: yeah.

Well, that's a whole nother area of anxiety that we're probably not gonna get, uh, resolved right now. Yeah. We, I think 

Patti: this is officially the longest episode, uh, that, that we've, that we've done so far be, I could talk about this all day. I mean, it's so, there's so, it's so nuanced and it's so deep and there's so much about it.

Um, and it's fascinating. I find us as people incredibly fascinating and therefore. I find anxiety as scary as it can be when you're in the moment. Sometimes it's also very fascinating to see what we go through and how, like I said, our brains do these things that are physical and emotional and mental and all of these things.

And sometimes with thoughts we can stop it and change it and yeah, it's pretty, we're pretty incredible beings 

Susan: and sometimes I see it in animals. Yeah. They don't have that thought process. My dog braces constantly, I'm walking along. All of a sudden he puts the brakes on and you know, I don't know. Is he picking that up for me?

Probably not. But he doesn't have resource of what to do and like sometimes dogs will get aggressive. Mm-hmm. It's a fear response. Mm-hmm. It's not an anger response. No. It's a fear response. Yep. And you wanna back off. Mm-hmm. Um, and you wanna show leadership, um, and then the dog settles. Yeah. Um, so mm-hmm.

Watch your animals 

Jan: because they have a lot to teach you. 

Susan: Yeah. 

Jan: Right. And, and the somatic training, they did film clips of animals that when they're, you know, like bears, polar bears, there's another animal that fakes being, um, dead. So animals will actually leave them alone if they're, you know, a predator.

And talking about the threat response as human beings or animals. Um, I think it might be mammals. All mammals is that there's a certain, their nervous system is working too, and they, and where they go to is to a dissociation or like a shutdown because they're afraid they're gonna be eaten or whatever.

It's a fear response. So, yeah. But yeah. Anyway. Well, I, I don't know if we've gone that long. I've really enjoyed talking about this. And sue, me too. Thank you so much for coming on. I hope that, uh, you enjoyed some of this. 

Susan: I loved it, Jan. It's always fun to, uh, have a visit and, and to be real, to be authentic.

Yeah. It's just rejuvenating when you can be with someone and be authentic. So I'm just gonna make this one last comment, um, which is pretty comedic jam. It's like when you needed to have your hip replaced. And your OCD kicked in, you know, the weekend before the surgery you were up on ladders, replacing cabinets and painting and cleaning.

And I am cracking up thinking, okay, Jan, do your thing. Get like it all cleaned and handled. Yep. With the hips that you can barely walk. Um, what are you doing on this ladder? And, you know, the OCD needed the ladder. Yes. 

Jan: It got the best to me, so, yep. That's, that's what happens. And I feel so much better after I've done that.

Patti: But you know what, if you hadn't have done that right, you might not have been able to heal as well and rest during that because you would have whatever thoughts that you're worrying mm-hmm. About. Yep, that's true. But it was done and you were able to just focus on healing. That's, yeah. Nice. Yeah. Thank you Susan, for coming on and chatting with us and being open with us about it too.

Jan: Yeah, and you're a professional and you still have, you know, it's like that's what the, you know, I always said that as a professional, the reason I got into this business is because I have my own trauma, so, you know, we do what we need to heal. So I'm a big fan of that one. Yeah. Yeah. So, well, thank you.

Thanks for listening to the podcast. If you like what you've heard, please share it with friends, subscribe and leave 

Patti: a review. And remember, information shared on this podcast is not medical advice. If you have a concern about your physical or mental health, please seek support from a professional. 

Jan: If you have a story you'd like to share about things your mother forgot to mention, you can apply to be a guest.

Patti: We'd also love to hear a quick 92nd thing you've learned in your life. You can find links to both of those over at our website at things my mother forgot to mention.com or in the show notes. Thank you.